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Douglas County reports first presumed case of monkeypox

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The Douglas County Health Department reported the first case of monkeypox in the county Monday.

The Douglas County Health Department on Monday confirmed a case of orthopox in the county, which after further testing is expected to be the state’s first case of monkeypox.

Monkeypox is a virus in the orthopox family, which also includes smallpox. Monkeypox is milder than smallpox.

The person who is infected is a man in his 30s with a history of international travel, Health Department officials said. He is doing well and isolating at home. The department is tracing his contacts to identify any people who may have been exposed.

Just over 200 cases of monkeypox had been confirmed in the U.S. as of late last week, but more than 4,000 have been reported in more than 50 countries during the current outbreak. World Health Organization officials over the weekend called the cases “unusual” but did not declare a global health emergency.

Lindsay Huse, the Health Department’s director, stressed that the virus is not easily transmitted, unlike COVID-19.

“It’s very important to remember that the risk to the public is very low,” she said.

Justin Frederick, the department’s supervisor of communicable disease epidemiology, said transmission usually involves prolonged contact with someone who is infected. Transmission usually occurs through contact with infectious sores or bodily fluids, or contaminated items such as clothing or bedding. The virus also can be transmitted through respiratory droplets after close face-to-face contact.

Huse stressed that health officials were aware that the virus could be found locally at some point and had plans in place to address it.

Under the current system, the Washington Post reported, clinicians must report suspected monkeypox infections to health department officials, who decide whether the cases meet criteria to undergo testing at public health labs. Critics have said the process could slow or dissuade doctors from seeking tests. The Biden administration announced last week that it was authorizing five commercial laboratories to perform the tests, which were to begin shipping last week.

Frederick said an “astute clinician” diagnosed the case on Saturday and contacted her team, which connected with the Health Department. Specimens were collected Saturday and ready for analysis Monday.

Such samples are sent on to the federal Centers for Disease Control and Prevention for confirmatory testing. However, a positive result is presumed to be monkeypox because no other orthopox viruses are known to be circulating in the United States.

Dr. Kelly Cawcutt, an infectious diseases physician with Nebraska Medicine, was the infection control medical director on call over the weekend and helped field the call.

She said health officials do not think there was “any significant risk” to anyone in the clinic at the time or to health care workers who cared for the patient.

“It really was as smooth as it possibly could have been in a first-case scenario for us,” she said.

Dr. Angela Hewlett, another Nebraska Medicine infectious diseases physician, said the illness usually begins with a fever, headache, muscle aches, swollen lymph nodes and fatigue. That typically is followed by a rash that looks like pimples or blisters. The incubation period for monkeypox is usually seven to 14 days but can range from five days to three weeks.

Hewlett said it’s important for anyone with a new rash, particularly if they have had contact with someone with a rash, to contact their health care providers. However, she advised that those who have such a rash and suspect they may have monkeypox call the clinic first so that staff can have proper infection prevention in place.

With COVID still circulating, she cautioned that not everyone who develops fever and chills will have monkeypox.

Frederick said the Health Department has identified a few people it will be notifying about possible exposure. They will be monitored for 21 days after their last exposure.

There is no specific treatment for monkeypox, but some antiviral drugs have been used effectively, Hewlett said. Some people who have had close contact with an infected person may be candidates for a preventative dose of smallpox vaccine.

Staff at the Health Department’s information line at 402-444-3400 also can answer questions.

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