Sonoma County sees decline in monkeypox cases, mirroring wider outbreak trends

When examined by week, the number of Sonoma County monkeypox infections has been declining since late July.|
MARTIN ESPINOZA
THE PRESS DEMOCRAT

Key things to know about monkeypox

The monkeypox virus is part of the same family of viruses as the variola virus (which causes smallpox) and cowpox virus. Monkeypox is not related to chickenpox, but symptoms are similar with those of monkeypox being milder; monkeypox is rarely fatal.

Monkeypox often appears as a rash that can look like pimples or blisters that appear on the face, inside the mouth and on other parts of the body, like the hands, feet, chest, genitals or anus. Symptoms can be similar to the flu, including fever and low energy. Other symptoms include swollen lymph nodes and muscle and back aches.

Rashes go through different stages before healing completely. Sometimes, people get a rash first, followed by other symptoms, while others only experience the rash.

The virus can spread from person-to-person through: direct contact with the infectious rash, scabs, or body fluids; respiratory secretions during prolonged, face-to-face contact, or during intimate physical contact, such as kissing, cuddling, or sex.

It can also be contracted by touching items such as clothing or bedding that were previously exposed to an infectious rash or body fluids. Pregnant people can spread the virus to their fetus through the placenta.

County officials said it’s also possible to get monkeypox from infected animals, either by being scratched or bitten by the animal or by preparing or eating an infected animal’s meat or other products.

Monkeypox can be spread from the time symptoms begin until the rash has fully healed. The illness typically lasts two to four weeks. Officials said those who do not have monkeypox symptoms cannot spread the virus to others.

Monkeypox infections appear to be stalling or slowing in Sonoma County, according to weekly case rates and wastewater surveillance.

Local health officials said this week the data, though still preliminary, mirrors that of other locations, including San Francisco, New York, Chicago, Europe and other parts of the world.

Detecting a trend at the county or city level is difficult, because the number of infections tend to be much smaller with smaller populations, said Dr. Sundari Mase, the county’s health officer.

“It looks like things are kind of decreasing but it’s harder when you only have under 40 cases to reach any great conclusion,” Mase said. “But certainly the numbers seem to be slowing down.”

When examined by week, the number of local monkeypox infections has been declining.

During the first three weeks of July, the county logged three cases of suspected or confirmed monkeypox a week. Then, in the week ending July 31, a total of 11 suspected or confirmed cases were detected.

Since then, weekly cases have been eight, five, zero and two for the weeks ending Aug. 7, 14, 21 and 28, respectively. Data for the most recent weeks is still preliminary, health officials said.

Meanwhile, the concentration of monkeypox DNA in wastewater from Santa Rosa’s regional plant has also declined since the week of Aug. 11, when 1,396 copies of monkeypox DNA per gram of solid waste were detected. Concentrations fell in subsequent weeks, to 698 on Aug. 15 and 465 on Aug. 16, Aug. 18 and Aug. 22.

Monkeypox DNA has been undetectable since then, though there may still be very low amounts present that are below testing detection limits, said Kathryn Pack, health program manager for the county’s epidemiology team.

“Similar to trends seen elsewhere, (monkeypox) cases detected through laboratory and wastewater surveillance in Sonoma County appear to be slowing after a July peak,” Pack said. “However, case counts for the most recent weeks should be considered tentative as data is still being received and processed.”

In Sonoma County, a total of 36 monkeypox cases have been detected, including 21 confirmed and 15 probable or suspected cases, Pack said. Wastewater surveillance is currently active in Santa Rosa and Petaluma and will soon be established in Cloverdale, she said.

Mase said it’s difficult to say precisely what’s leading to the apparent decline in cases. The monkeypox virus is much more difficult to transmit than COVID-19, which can be easily spread via airborne transmission. The vast majority of cases have resulted from close, intimate contact.

Public health education targeting those who are currently most at risk — men who have sex with men — has likely also played a role in keeping case numbers down, she said. One example, she said, was the monkeypox vaccine clinics in July at the Lazy Bear Week in Guerneville.

The decline, Mase said, is “probably just a combination of different things, and possibly even just the natural course of things.”

You can reach Staff Writer Martin Espinoza at 707-521-5213 or martin.espinoza@pressdemocrat.com. On Twitter @pressreno.

Key things to know about monkeypox

The monkeypox virus is part of the same family of viruses as the variola virus (which causes smallpox) and cowpox virus. Monkeypox is not related to chickenpox, but symptoms are similar with those of monkeypox being milder; monkeypox is rarely fatal.

Monkeypox often appears as a rash that can look like pimples or blisters that appear on the face, inside the mouth and on other parts of the body, like the hands, feet, chest, genitals or anus. Symptoms can be similar to the flu, including fever and low energy. Other symptoms include swollen lymph nodes and muscle and back aches.

Rashes go through different stages before healing completely. Sometimes, people get a rash first, followed by other symptoms, while others only experience the rash.

The virus can spread from person-to-person through: direct contact with the infectious rash, scabs, or body fluids; respiratory secretions during prolonged, face-to-face contact, or during intimate physical contact, such as kissing, cuddling, or sex.

It can also be contracted by touching items such as clothing or bedding that were previously exposed to an infectious rash or body fluids. Pregnant people can spread the virus to their fetus through the placenta.

County officials said it’s also possible to get monkeypox from infected animals, either by being scratched or bitten by the animal or by preparing or eating an infected animal’s meat or other products.

Monkeypox can be spread from the time symptoms begin until the rash has fully healed. The illness typically lasts two to four weeks. Officials said those who do not have monkeypox symptoms cannot spread the virus to others.

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