Infectious Disease Specialist on COVID BA.5 and Monkeypox

Getting the facts on infectious diseases has become a normal part of life since the pandemic’s beginning in early 2020. Now, a dominant subvariant strain of COVID-19, so-called BA.5, is the most contagious yet. Separately, cases of an entirely different virus, monkeypox, are rising – although transmission is limited to close contact with an infected person.

The bottom line, says Stacey Baker, M.D., infectious disease specialist with Baptist Health, is to get vaccinated if you haven’t yet against COVID-19, and stay vigilant – but not alarmed — about monkeypox.

A fully vaccinated and boosted President Biden is recovering from COVID with mainly mild symptoms. That’s a confirmation of the benefits of the COVID-19 vaccine, which may not protect you from getting infected – but prevents serious illness and hospitalizations. Here’s what you need to know from Dr. Baker on BA.5 and monkeypox. 

COVID-19 Subvariant BA.5

Question: Subvariant BA.5 is the dominant at this time, and is the most contagious variant or strain of COVID-19 that we’ve seen. What message would you give the public about BA.5?

Dr. Baker:
“Fortunately, people are not getting quite as ill with BA.5, compared to previous variants. But with its level of contagiousness and the impact it can have, even on vaccinated individuals, it’s still quite impactful for an individual person to get sick — despite that they’re not necessarily so sick they need to be hospitalized.

Stacey Baker, M.D., infectious disease specialist with Baptist Health.

“I hear a lot of people say it’s just a cold. But for many people, it’s not just a cold. It’s still five to seven days of feeling ill at home with fever and cough, and maybe even some shortness of breath. And potentially, there’s an even longer duration of symptoms for some individuals. Again, maybe they won’t get so sick that they need to be admitted to a hospital, but sick enough that it really takes time away from their daily life, and maybe impacts their day-to-day activities in a significant way.”

Question: Do we know enough yet about BA.5 to link it to “long COVID” – or symptoms that can linger for months as with previous COVID variants?

Dr. Baker:
“It’s so hard to say at this time in terms of long COVID and specifically in relation to BA.5 because it’s still new. It’s hard to comment what the impact will be on long COVID. But to me, even if it’s three to four weeks where you’re out of commission and not being able to work or live your life — it’s potentially a big deal for a lot of people.”

Question: Can you speak to the importance of getting vaccinated and boosted to protect against severe illness and hospitalization from BA.5, even though the vaccinated are getting infected?

Dr. Baker:
“I still very much worth getting vaccinated. The one patient that I saw end up in the ICU in the past few months from COVID-19 had not been vaccinated. I’m just one physician taking care of only so many patients, but I think vaccination still plays an important role in preventing severe and critical disease.

“Another upside with COVID is that there is Paxlovid (an antiviral treatment made by Pfizer) available for people who are at risk for severe disease, whether they’re elderly or with other severe comorbidities. So, it is exciting to think that we have potentially good outpatient oral treatments available now.”

Monkepox

Question: Should the general public be concerned about Monkeypox?

Dr. Baker:
“Even though we’ve seen the concentration of monkeypox be in men who have sex with men, that doesn’t mean it will stay among those communities. These types of viruses can spread outside of those concentrated communities. It needs to be a consideration for all, in terms of public health issues.” (In a statement Friday, the CDC confirmed the first two U.S. cases of monkeypox in children. The cases are unrelated to one another, and both are “likely the result of household transmission,” the CDC said. Both children “are doing well,” said CDC Director Rochelle Walensky, M.D.)

Question: Can you be infected by touching items (such as clothing or linens) that previously touched the infectious rash?

Dr. Baker:
“Monkeypox is primarily spread by close contact, certainly with someone with the active lesions, with mucosal membranes. We know that there could be some droplet transmission, especially if someone has lesions inside their mouth. But it needs to be pretty close contact. It’s not airborne. And there is some concern that it could be spread via clothing. We know that they virus can attach to other material and it can be spread that way. But that’s an issue mostly for healthcare workers, and if you’re living with someone. But not likely an issue for the general public. It’s not easily transmissible.”

Question: Public health officials say monkeypox symptoms have been mostly mild, involving a rash and flu-like symptoms, like swollen lymph nodes. Is this what you are seeing?

Dr. Baker:
“I have not seen a case of monkeypox yet. A couple of my partners have. What I’ve heard is that the monkeypox is presenting with symptoms that seem to be a little bit more serious than what has been researched in the past — in terms of the lesions and where the lesions are located. If the lesions are located in certain areas, like the rectum or the mouth, and they’re quite severe, that obviously impacts eating and other bodily functions. It can be quite uncomfortable. But, my partners have not seen severe cases, necessarily.”

Question: The CDC recommends vaccination for people who have been exposed to monkeypox and for people who are at higher risk of being exposed. How soon after exposure should someone be vaccinated?

Dr. Baker:
“The vaccine is a post-exposure prophylaxis for the most part. So, for someone who finds out that they were exposed, it’s then recommended that they get vaccinated. If they get vaccinated within four days of exposure, hopefully it really prevents them from developing the disease. If they get vaccinated between four and 14 days after exposure, it might not prevent them from getting it altogether — but it might decrease the symptoms, and it might decrease their length of illness. The vaccine is primarily available from the Florida Department of Health or your county health department.”