Monkeypox continues to spread in the U.S., with more than 1,000 new cases reported this week in the nation. As people work to prevent infection, should they be concerned about catching the virus from touching surfaces?
According to experts and research, the answer is complicated.
Monkeypox, a relative of the variola virus that causes smallpox, is a disease that causes lesions and flu-like symptoms. It is typically found only in West Africa but a global outbreak of the virus began this May.
Close, personal contact, including direct contact with monkeypox rashes or scabs are common modes of transmission for the virus. Pregnant people can also spread the virus to their fetus through placenta and contact with animals sometimes causes infection.
Additionally, the U.S. Centers for Disease Control and Prevention said that touching bodily fluids and respiratory secretions from an infected person, as well as clothing, bedding, towels and surfaces that have been used by someone with monkeypox can result in infection.
However, some medical experts have said that the latter modes of transmission carry a low risk of infection.
“I don’t think I would worry too much about these very casual encounters with inanimate objects,” said UNC Health Infectious Disease Expert Dr. David Wohl, according to WTVD. “You’re not going to catch this at a restaurant. You’re not going to catch this off of a park bench. Trying on clothes I would say that’s pretty unlikely. You would have to have somebody, who right before you tried on clothes, who had lesions with monkeypox virus.”
“The risk of getting infected through a surface is quite low – it’s not zero, but it is low,” Scott Roberts, M.D., assistant professor of infectious diseases at the Yale School of Medicine, told WTHR. “And so, that risk of a fleeting contact or somebody briefly touching something probably does not lead to enough virus on that surface to infect you if you get exposed.”
A science brief released last year by the CDC regarding COVID-19 explained that “fomite transmission is difficult to prove definitively, in part because respiratory transmission from asymptomatic people cannot be ruled out.” Fomites are objects that are likely to carry infection.
Even so, frequent hand washing is a key public health recommendation for both COVID-19 and monkeypox prevention.
As for the likelihood of catching monkeypox from fomites, a study published in the Eurosurveillance journal in June explored the presence of monkeypox DNA on surfaces used by or located near two patients.
“Environmental sampling was carried out by carefully swabbing entire surfaces in the patients’ rooms and anterooms,” said the study. These surfaces included larger smooth and flat surfaces, as well as fabrics and complex structures such as door handles.
“All surfaces directly touched by the patients’ hands showed viral contamination with the highest loads detected in both bathrooms,” researchers found. Monkeypox virus DNA was also found on surfaces in the patients’ rooms, including some on wall cabinet door handles and fabrics.
“Immediately after handling the fabrics, the palmar side of the investigator’s right gloved hand was swabbed and confirmed to be contaminated in investigations related to both patient’s rooms,” according to the study.
Researchers said dried pox-family vaccinia virus is stable and infectious up to 35 weeks at around 39 degrees. Furthermore, they said that monkeypox-contaminated surfaces with at least 106 virus copies “could potentially be infectious and it cannot be ruled out that their contact with especially damaged skin or mucous membranes, could result in transmission.”
U.S. Secretary of Health and Human Services Xavier Becerra last week announced a public health emergency to address monkeypox cases in the U.S. This Tuesday he also announced efforts focused on providing vaccines and TPOXX treatment and said that there were 8,900 reported cases in the country at that time.
By 2 p.m. Wednesday, there 10,392 cases in the U.S., according to the CDC. New York, California and Florida each have more than 1,000 cases each.
For those who already have the virus, the CDC recommends isolating at home for the duration of their illness.
“A person with monkeypox can spread it to others from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed,” said the centers. “The illness typically lasts [two to four] weeks.”
According to the CDC, more research is needed to determine if monkeypox can be spread when someone has no symptoms; how often monkeypox is spread through respiratory secretions, or when a person with monkeypox symptoms might be more likely to spread the virus through respiratory secretions and whether monkeypox can be spread through semen, vaginal fluids, urine, or feces.
While many of the initial cases of this year’s outbreak were diagnosed in men who have sex with men, “it’s not going to stay in the lane it is right now and so we should be prepared,” said Wohl of UNC Health.
“I think the No. 1 concern I have is, like staph infections or like MRSA infections, where we start to see this in daycares, where we start to see this in athletes, in wrestlers, where the body would have skin-to-skin contact,” he added.
The CDC has instructions for monkeypox prevention as well as cleaning of contaminated surfaces and the Environmental Protection Agency has put out a list of approved disinfectants for emerging viral pathogens such as monkeypox.
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