The Centers for Disease Control and Prevention is working with Delta Air Lines and state and local health officials to contact airline passengers and others who may have been in contact with the patient during two flights: from Lagos, Nigeria, to Atlanta on July 8, with arrival July 9; and Atlanta to Dallas Love Field Airport on July 9. Public health authorities said they have identified and are in contact with individuals who were in direct contact with the patient.
Travelers were required to wear masks on the flights as well as in the U.S. airports because of the ongoing coronavirus pandemic.
“Therefore, it’s believed the risk of spread of monkeypox via respiratory droplets to others on the planes and in the airports is low,” the Dallas County statement said.
Monkeypox is a rare but potentially serious viral illness that typically begins with flu-like symptoms and swelling of the lymph nodes, progressing to a widespread rash on the face and body. Most infections last two to four weeks. Monkeypox is in the same family of viruses as smallpox but causes a milder infection.
In this case, CDC laboratory testing showed the patient is infected with a strain of monkeypox most commonly seen in parts of West Africa, including Nigeria. Infections with this strain are fatal in about 1 in 100 people, according to a CDC statement. However, rates can be higher in people with weakened immune systems. There is no proven safe treatment for monkeypox virus infection.
The patient developed a rash just before departing Nigeria, but the rash worsened after the person returned home to Dallas, according to an official familiar with the investigation who was not authorized to speak publicly on the matter because of the ongoing probe. The person went to the hospital Tuesday. Clinicians quickly made the diagnosis based on the symptoms and recent travel history from Nigeria. By then, the person had developed the characteristic symptoms: rashes on their face and elsewhere on the body.
Authorities said they have interviewed the patient and close contacts who were exposed and determined there is very little risk to general public. People who do not have symptoms are not capable of spreading the virus to others.
Dallas County said it is not releasing additional information about the patient or the patient’s location. The individual is isolated at the hospital to prevent the spread of the virus.
“While rare, this case is not a reason for alarm and we do not expect any threat to the general public,” Dallas County Judge Clay Jenkins said.
Philip Huang, director of Dallas County Health and Human Services, said the case demonstrates “the importance of maintaining a strong public health infrastructure, as we are only a plane ride away from any global infectious disease.”
Before the Dallas case, there have been at least six reported monkeypox cases in travelers returning from Nigeria, including cases in the United Kingdom, Israel and Singapore. This instance is not related to any of the previous cases. In the United Kingdom, several additional monkeypox cases occurred in those who had contact with infected people.
Most monkeypox outbreaks have occurred in Africa. In addition to Nigeria, outbreaks have also been reported in nine other countries in central and western Africa since 1970. Monkeypox also caused a large outbreak in people in the United States in 2003 after the virus spread from imported African rodents to pet prairie dogs, with 47 reported human cases.
People can get monkeypox when they are bitten or scratched by an animal, prepare wild game or have contact with an infected animal or possibly animal products. Human-to-human transmission is thought to occur primarily through large respiratory droplets. Respiratory droplets generally cannot travel more than a few feet, so prolonged face-to-face contact is required, according to the CDC. The virus can also spread through contact with body fluids, monkeypox sores or items that have been contaminated with fluids or sores, such as clothing and bedding.
Lori Aratani contributed to this report
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