Few mpox cases in Colorado so far this summer

So far, Colorado has only reported a handful of mpox cases this year, but health officials are urging at-risk people to get vaccinated and consider other precautions this summer.

Mpox, formerly known as monkeypox, took off in Colorado and nationwide in spring and summer 2022. The virus is native to parts of Africa and typically jumps into humans sporadically when people hunt or live close to animals that carry it. Last year, however, it was spreading between people in countries where it normally isn’t found, mostly through sexual networks.

The mpox rash can resemble other sexually transmitted infections or even pimples, but often causes severe pain. Some people also experience flu-like symptoms. While it’s rare, some patients have developed organ damage from mpox infections.

Last year, there were at least 404 cases in Colorado, and likely more that went unreported due to a lack of testing and awareness in the first month of the outbreak. At least 30,000 people got mpox nationwide, and 42 died.

So far this year, there have been five reported mpox cases in Colorado: one in January, one in May, and three in June.

Unlike last summer, vaccines and testing are widely available now, state epidemiologist Dr. Rachel Herlihy said. Statewide, 15,062 individuals have gotten at least one dose of the vaccine, which is given in two doses four weeks apart.

Still, it’s difficult to say how many people might get infected, since it’s not clear how many of those at the highest risk haven’t gotten vaccinated or whether people will take other precautions, like limiting their sexual partners, Herlihy said. It’s also unclear exactly how effective the vaccine is in preventing mild infections.

“It’s really difficult to say,” she said. “Obviously we’re in a very different place than we were last year.”

On May 19, the CDC warned there was a risk mpox cases would increase this spring or summer, though likely not to anywhere close to levels seen last year. It did note that some communities could see larger outbreaks, however, particularly if vaccination rates remain low.

During last year’s outbreak, 95% of Colorado’s cases were in cisgender men, and 75% of those who answered questions about their orientation reported they were gay, with another 11% identifying as bisexual.

There’s nothing inherently riskier about sex between men, but the virus happened to jump into that population. Since there are far fewer men who have sex with men than heterosexual people — and therefore fewer potential partners for any given individual — the same number of infections translates to greater risk.

Unlike COVID-19, mpox typically requires close contact to spread, and the most common route of transmission in the 2022 outbreak was sexual contact. The virus can also spread through contaminated items like bed linens.

The vaccine is free, and people who want it don’t need to show identification. While it’s only recommended for people with certain risk factors, providers have been instructed not to ask probing questions.

The state health department recommends people get vaccinated if they were in close contact with someone who has mpox, or if they:

• Have multiple or anonymous sex partners
• Patronize venues where people have anonymous or group sex
• Have HIV, or are eligible for medication to prevent HIV infection
• Were diagnosed with gonorrhea or syphilis in the last six months
• Are immunocompromised and think they may be exposed to mpox at some point
• Exchange sex for money, shelter, or other goods
• Have a sexual partner who would be eligible based on the above criteria

The Colorado Department of Public Health and Environment is hosting vaccination events on Friday at Denver bars Trade and VYBE. Hospitals, clinics and public health departments are offering testing and vaccines, with a full list available on the state’s website.

Questions about the vaccine have emerged recently after a cluster of cases in Chicago, where the majority of the 13 infected people were fully vaccinated. No vaccine is perfect, and it’s not yet clear if the vaccinated people felt safe to have more partners, raising the odds that they would get infected; if immunity was waning; or if there was a mistake in vaccine handling that made it less effective, Herlihy said.

None of the patients with breakthrough infections needed to be hospitalized, and they had a lower risk of lesions on their genitals or in the eye area than unvaccinated patients, according to the Centers for Disease Control and Prevention.

Two of the five people in Colorado who tested positive were vaccinated. The state health department hasn’t released any information about whether any of the five became seriously ill.

Most people with mpox recover without any specific treatment, but the CDC recommends antiviral medication for people who have compromised immune systems, have damaged skin, or have another infection at the same time. People without risk factors can also ask their doctors about enrolling in a clinical trial to test whether the antiviral medication truly reduces the severity of mpox, Herlihy said.

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