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CDC confirms monkeypox in Hawaiʻi. Third probable case identified

Above: a monkeypox lesion. The lesions in cases that are part of the 2022 outbreak are often first seen on genitalia or the anus. Spread to other parts of the body is possible but doesn't always occur.
U.K. Health Security Agency
Above: a monkeypox lesion.

Sample testing from the U.S. Centers for Disease Control and Prevention has confirmed the state’s first case of monkeypox, identifying a South African strain of the disease.

This first case was reported June 3 in a stable patient in isolation at Tripler Army Medical Center who had a history of travel to a mainland state where there were confirmed outbreaks.

The Hawaiʻi Department of Health has since identified two more probable cases. Both of these probable cases are not hospitalized, and samples have been sent to the CDC.

All cases have been adult Oʻahu residents.

The third case has no travel history, and is potentially linked to a social gathering, DOH officials said Thursday. DOH Director Dr. Elizabeth Char called this “significant.”

“If we can't link it to any of the existing cases, i.e. the first or second person, then that would mean that they got it somewhere else from in the community,” Char said.

Contact tracing is ongoing to identify those who may be at risk of developing the rare disease that causes small, round lesions, rashes, and flu-like symptoms.

DOH officials said Thursday that contact tracing has been slow-moving, with one individual awaiting monkeypox confirmation from the CDC before sharing some information.

"Some individuals were waiting for confirmation of monkeypox from CDC before they really opened up," Epidemiological Specialist Joe Elm said of the contact tracing process. "And that was just you know, moments ago that we talked to one of the persons and they had been withholding information until they got the confirmation on monkeypox from CDC."

DOH is working with federal partners to get the vaccines and therapeutics from the strategic national stockpile, Char said. Vaccines were set to arrive by air Thursday.

While vaccination is not recommended for the general public, it can reduce the severity of infection if administered after exposure, Char said.

“We're doing contact tracing to identify those that are at high risk and likely would benefit the most from being vaccinated,” she said.

Monkeypox is typically contagious for 21 days, and transmission is relatively low, coming from prolonged contact with an infected individual.

Risk is relatively low in the state, but anyone can get monkeypox, and men who have sex with men are at higher risk, as reported by the CDC.

“Individuals at increased risk should avoid anonymous sexual contact or events where individuals may have close bodily contact with others,” Deputy State Epidemiologist Dr. Nathan Tan said in a release.

The DOH requests that any suspected cases be reported.

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