DENVER – Queer Black and Latino men are at greater risk of catching monkeypox than any other racial or ethnic group in Colorado, underscoring the disparities that exist when accessing much-needed care as cases of the virus continue to increase across the state.
Demographic data on monkeypox from the Colorado Department of Public Health and Environment (CDPHE) released for the first time Thursday shows communities of color are being disproportionately affected by monkeypox – mirroring disparities in health care seen during the onset of the coronavirus pandemic – even though whites make up nearly 70% of the state’s population.
Hispanics and Latinos, who represent only 22% of the statewide population, accounted for 33.6% of all monkeypox cases as of Thursday. Blacks, who make up only 4.1% of the state population, accounted for 11.9% of all monkeypox infections. Whites, on the other hand, make up 67.3% of the population in the state but only accounted for 53.1% of all known monkeypox infections.
Young men between 25-34 years of age make up the majority of cases, followed by adults in the 35-44 age range, according to the state’s demographic data.
There have been no cases of monkeypox amongst children in Colorado, the data shows.
The disease continues to overwhelmingly affect gay, bisexual and other men who have sex with men (MSM), though there have been some cases among women.
Gay and bisexual men represent 85.3% of all statewide infections while women only represent 3.5% of all cases, according to the data. Transgender individuals and people outside the gender binary make up 10.5% of all cases.
As of Thursday, 168 people across 19 counties were infected with monkeypox in Colorado, with the majority of cases reported in Denver. Only 6 people across the state have been hospitalized for the disease.
No deaths from the virus have been reported so far.
Colorado working with local partners to expand monkeypox testing, vaccine access
Anyone concerned about possibly being exposed to monkeypox can get tested in a myriad of ways, state health officials said Thursday, outlining their work with local providers to make testing more widely available.
Testing done through private labs is recommended for people who have insurance and can be processed through a primary care provider, state epidemiologist Dr. Rachel Herlihy said.
Those without insurance can get tested through the state lab, though that test will require pre-approval, Herlihy said.
If you or someone you know wants to get tested for monkeypox but don't have a primary care provider, you can get tested at the following locations, just make sure you call ahead to set up an appointment:
- Denver Sexual Health Clinic
- UCHealth University of Colorado Hospital
- Jefferson County Public Health Sexual and Reproductive Health Clinic
- Weld County Public Health
- Gunnison County Public Health
- Mesa County Public Health
The state effort to vaccinate as many at-risk Coloradans as possible has been hampered by an “extremely limited” supply of the Jynneos vaccine coming from the federal government, but recent changes to how the vaccine will be administered to stretch the number of doses across the country will help get more people vaccinated.
“We are hopeful as the federal government makes more and more vaccine supply available across the country that we will continue to see vaccine coming into the state,” said Scott Bookman, director of Division of Disease Control and Public Health Response at the CDPHE.
On Thursday, the U.S. Department of Health and Human Services announced they will make an additional 1.8 million monkeypox vaccine doses available throughout the country, and will also launch a pilot program that will allow jurisdictions to order even more vaccines if they are hosting large events targeted to the LGBT+ community.
So far, the state has enrolled 59 vaccine providers including local public health departments, community health centers and large health systems and has distributed over 3,500 doses of the Jynneos vaccine.
Bookman said the state is now working to partner with community organizations to promote local public health clinics and other stand-alone community clinics to make sure those who need the vaccine are able to get it.
Such partnerships include One Colorado and The Center on Colfax, which are helping the CDPHE turn COVID-19 mobile vaccine units into units that will administer the Jynneos vaccine.
Vaccine data from the CDPHE shows that, of the 4,471 doses of the vaccine administered throughout the state so far, 73.6% of doses have been given to white Coloradans — a higher percentage than the population of whites who live in Colorado, while Blacks have received 4.3% of doses, about the same as their share of the population in the state. Latinos, who represent 22% of all Coloradans, have only received 10.9% of all vaccine doses.
The vaccine, given as a two-dose series 28 days apart, is thought to be 85% effective against monkeypox, though experts warn data on its efficacy is limited, and even the CDC admits it does not know how effective it will be in the current outbreak, which is why the World Health Organization and the CDC have recommended people at high-risk for contracting monkeypox temporarily limit their number of sexual partners to reduce their risk of infection from the virus until they are fully vaccinated.
Those who qualify for the vaccine – gay, bisexual and other men who have sex with men (MSM), as well as transgender individuals and people outside the gender binary who’ve had multiple or anonymous sex partners within the past 14 days, or anyone who believes they have been in close contact with someone who has monkeypox in the last 14 days – will be added to a waitlist and contacted by the CDPHE when more clinics open up as more vaccines become available from the federal government, officials said.
What to know about monkeypox
Monkeypox, which is endemic in parts of western and central Africa, is caused by an infection from a virus in the same family as smallpox, causing a similar (but less severe) illness.
Those infected with the virus may start experiencing flu-like symptoms that can include fever, headache, muscle aches, swollen lymph nodes, and exhaustion, followed by a telltale rash that appears within one to three days after the onset of fever, often beginning on the face then spreading to other parts of the body, including the genital area, anus or the mouth.
Monkeypox can look like syphilis, herpes, blisters, or even acne, health officials say, so it’s a good idea to get checked out with your primary care provider if you suddenly develop a new rash or bumps.
Atypical presentations of the virus are possible, as some cases have presented a rash that has not been spreading to as many parts of the body as previous outbreaks and the number of lesions have been just a few if they occur at all. Other symptoms currently being reported include bloody stools, rectal pain, rectal bleeding, as well as sore throat, nasal congestion and/or cough.
How does monkeypox spread?
In humans, the virus can spread through direct contact with the infectious rash and scabs of an infected person, as well as through the exchange of bodily fluids when kissing or having sex, as it's happening in the current outbreak. Inhaling large respiratory droplets during prolonged face-to-face contact (brief interactions are unlikely to result in transmission, the CDC says) can also spread the virus, so it’s not a bad idea to continue wearing high-quality masks if you come into contact with someone who suspects they may have monkeypox. Other less common ways the virus can spread is through contaminated clothing or linens.
Monkeypox can spread from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed, which can take up to 21 days.
Those infected with the virus must isolate at home and stay away from people and their pets until all lesions heal and new skin has formed, Dr. Herlihy said.
During the isolation period, someone from the CDPHE will make contact and ask about any recent travel, close contacts and medical visits. Herlihy stressed it's important to answer or return those calls to prevent further spread of the virus.
While anyone can get monkeypox through direct contact with the infectious rash or scabs of an infected person or through prolonged face-to-face contact, not everyone is at same level of heightened risk of infection at the moment.
Studies of the global outbreak from the New England Journal of Medicine, the BMJ, the U.K. Health Security Agency, the European Centre for Disease Prevention and Control (ECDC) and the U.S. CDC show that gay, bisexual and other men who have sex with men are overwhelmingly contracting the disease, and that transmission is mainly happening through intimate sexual contact.
The CDC is currently investigating whether the disease can spread asymptomatically, just like SARS-Cov-2, the virus that causes COVID-19. Health officials are also investigating whether the virus could be present in semen, vaginal fluids, and fecal matter and be transmitted that way.
Complications from the disease can include pneumonia, vision loss due to eye infection, and sepsis, a life-threatening infection. The strain currently spreading across the world has a fatality rate of about 1%, health officials say. Children, pregnant women and the immunocompromised are at risk of suffering from severe complications of the virus.
As of Thursday, there were 14,115 confirmed cases of monkeypox in the U.S. and more than 39,000 cases across the globe.