Q&A: Dr. William Schaffner on monkeypox | Health Care | nashvillepost.com - Nashville Post

Dr. William Schaffner

Vanderbilt University Medical Center epidemiologist Dr. William Schaffner does not see monkeypox becoming a threat to the general population. 

The Metro Public Health Department announced Nashville's first potential monkeypox case Thursday. The infectious disease, characterized by rashes and blisters, was more common in west and central Africa but has seen a global outbreak in 2022.

The epidemiologist who became a go-to expert on the COVID-19 pandemic detailed to the Post the difference between COVID-19 and monkeypox. 

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Is monkeypox as big of a threat as COVID was?

Oh gosh, no. Not even close. I mean, the two viruses are spread in very, very different ways.  As you know, COVID is spread very rapidly by the respiratory route. This [monkeypox] is a virus that by and large requires close personal skin to skin contact or very close prolonged respiratory contact for transmission. The current monkeypox outbreak in the United States and in Europe and other places is really being driven by close intimate contact, sexual contact, and largely among gay and bisexual men, although not exclusively, because it's gotten off into a few women also, but they continue to be the distinct minority, but it requires usually very close and almost always skin-to-skin contact.

Is there any concern around threat of death from this?

There haven't been any deaths in Europe or the United States in monkeypox cases. This is in part because the monkeypox variant that is causing this illness comes from West Africa, which is milder than the Central African variety, and also that the patients in Europe and the United States are generally healthy people younger and of good nutritional status and the like.

What does treatment look like for this disease?

These are illnesses that, not all but almost all, resolve by themselves without treatment. It can take two or three, sometimes even four, weeks for all of these lesions to dry up and eventually go away. But most of the patients don't require treatment. Treatment is being reserved, and we do have some treatments that are being reserved for people who are for one reason or other more seriously ill, or the threat of serious illness. If they're [immunocompromised] for example, they would receive treatment. Some patients have had lesions in and around their mouth or painfully in their rectum and that can be very very distressing so those patients are more seriously ill and are receiving treatment. 

Are there precautions that a person should take to prevent transmission?

The suggestions are: Be very careful. Know your sexual partner or the person who's going to be perhaps your sexual partner. Take the time to have them examine you and you examine them to make sure that there aren't any lesions that might be in question. Those kinds of very simple recommendations I think can reduce the risk of any new sexual encounter. And this goes for men and women as well as men who have sex with men.

Should Nashvillians be looking to get the vaccine for this virus at this time?

That is dependent a lot on the intensity of infection in any given area. For example, this is the first case in Tennessee, once it becomes confirmed, but there have been many more cases in New York City. The limited supply of the vaccine that's preferred, this [JYNNEOS] vaccine is being used in New York City, in populations at risk, but it's not recommended that we use it generally throughout the United States

Anything you want to add?

I think it's important to note that this doesn't spread widely the way COVID does. This is spread in a very restricted fashion, person to person through intimate contact. This is not a virus that's going to be a risk to the general population.