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CDC: Pregnant women at extreme increased risk for 'severe outcomes' from monkeypox

Women who are pregnant and contract monkeypox can have a pregnancy loss, according to Dr. Luis Ostrosky, an infectious disease expert.

HOUSTON — Pregnant women are at an extremely increased risk for "severe outcomes" from monkeypox, according to the Centers for Disease Control and Prevention.

Last month, the U.S. confirmed its first case of monkeypox in a pregnant woman.

“Monkeypox is what we call a zoonotic disease. It’s a disease that is transferred from animals to humans,” UT Physicians infectious disease expert Dr. Luis Ostrosky said.

Monkeypox has been around since the 1970s. But in the 70s, those occasional outbreaks were small and primarily seen in Africa, according to  Ostrosky.

“This time around, this outbreak is spreading throughout the world, primarily in men who have sex with men. But we’re starting to see some cases of household transmission to women and children as well,” he said.

That includes pregnant women.

“Unfortunately, women who are pregnant and contract monkeypox can have a pregnancy loss. It can affect the fetus and be very severe for mom as well,” Ostrosky said.

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Monkeypox can spread to anyone through close, personal, often skin-to-skin, contact. Ostrosky recommends for pregnant women play it safe.

“Number one is to try to avoid risky sexual behaviors and number two is going to get vaccinated,” he said.

There’s a shortage of vaccines so not everyone can get one. The CDC recommends people who have been exposed to monkeypox and people who are more likely to get monkeypox get vaccinated.

"Right now is not the time to be having sex with people you don’t know," Ostrosky said.

You’re no longer considered contagious once all of the legions have healed, which takes about 21 days on average.

Who is eligible for the monkeypox vaccine?

The latest Texas Department of State Health Services criteria for others who are eligible now includes these people:

  • People with a known or possible exposure to the Monkeypox virus remain the highest priority for vaccination.  

For people 18 and older the list includes: 

  • Men who have sex with men and have had multiple or anonymous sex partners within the previous 21 days;
  • Have a sex partner who is showing symptoms of monkeypox, such as a rash or sores;
  • Have had a diagnosis of HIV, chlamydia, gonorrhea, or early syphilis, within the previous 12 months;
  • Are on HIV pre-exposure prophylaxis;
  • Have a condition that may increase their risk for severe disease if infected with monkeypox virus, such as HIV, atopic dermatitis or eczema.

How does monkeypox spread?

  • The disease, which can cause a serious skin rash, appears to be spreading largely via direct contact with the skin or saliva of an infected person.
  • Monkeypox can spread from person to person through direct contact with the rash, scabs, or bodily fluids like saliva.
  • It can also be transmitted with prolonged face-to-face contact via respiratory droplets.  
  • Pregnant women can transmit the virus to their fetuses through the placenta.
  • At this time, it's not known if monkeypox can spread through semen or vaginal fluids. However, the DSHS says the majority of Texas cases, so far, involve men who've had sex with other men.

Monkeypox symptoms

  • Fever
  • Headache
  • Muscle aches
  • Swollen lymph nodes
  • Chills 
  • Exhaustion
  • Rash that looks like pimples or blisters; the rash often appears first on the face and/or inside the mouth and then on other parts of the body.

Anyone who develops a rash should avoid direct contact with other people and contact their health care provider as soon as possible for the next steps.

“We want people to know what the symptoms are, and if they have symptoms, to avoid the types of close contact with other people that can spread the disease," said Dr. Jennifer Shuford, the chief epidemiologist in Texas.

RELATED: Man with monkeypox says just being awake is excruciating

How long are you contagious?

Monkeypox can spread from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed. The illness typically lasts two to four weeks. People who do not have monkeypox symptoms cannot spread the virus to others.

How is monkeypox treated?

There is a preventative vaccine that’s at least 85 percent effective if given within four days of exposure. It’s available on request from the national stockpile on an as-needed basis. That’s because the CDC has designated monkeypox as a “low risk” infection.

“This isn’t a disease that’s like COVID or like the flu or measles where having a short conversation with someone or interacting with somebody at the store, at work is going to spread it,” said Chris Van Deusen, the director of media relations with the Texas Department of State Health Services.

Do I need to get vaccinated for monkeypox?

CDC does not recommend widespread vaccination against monkeypox at this time. However, vaccination may be recommended for some people who:

  • Are close personal contacts of people with monkeypox
  • May have been exposed to the virus.
  • May have an increased risk of being exposed to the virus, such as people who perform laboratory testing to diagnose monkeypox.

Is monkeypox deadly?

Infections with the strain of monkeypox virus identified in this outbreak—the West African strain—are rarely fatal. Over 99% of people who get this form of the disease are likely to survive. However, people with weakened immune systems, children under 8 years of age, people with a history of eczema, and people who are pregnant or breastfeeding may be more likely to get seriously ill or die.

Although the West African strain is rarely fatal, symptoms can be extremely painful, and people might have permanent scarring resulting from the rash.

Could my pet get monkeypox?

Monkeypox is zoonotic, meaning it can spread between animals and people. However, The CDC does not currently believe that monkeypox poses a high risk to pets. Officials say they are continuing to monitor the situation closely.

During the 2003 monkeypox outbreak in the United States, we did not see the disease spread to domestic animals other than prairie dogs, and we do not have reason to believe that we will see that now. However, we still recommend that people with monkeypox avoid interacting with animals and find someone else to take care of their pets while they recover.

Why is it called monkeypox?

Monkeypox was first discovered in 1958 when two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research, according to the CDC. Despite being named “monkeypox”, the source of the disease remains unknown. However, African rodents and non-human primates (like monkeys) may harbor the virus and infect people.

The first human case of monkeypox was recorded in 1970. Since then, monkeypox has been reported in people in several central and western African countries. Prior to the 2022 outbreak, nearly all monkeypox cases in people outside of Africa were linked to international travel to countries where the disease commonly occurs, or through imported animals.

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