Massachusetts health officials confirmed the first U.S. monkeypox case of the year in March, and the U.S. Centers for Disease Control and Prevention has since deemed the spread of the historically rare disease an “outbreak.”

In May, health officials in New York City announced they were investigating a possible case of monkeypox in Manhattan and by July 26, the city had surpassed 1,000 positive cases.

Here’s what you need to know about the disease, as well as the five boroughs’ efforts to fight it.

What is monkeypox?

Monkeypox is a disease caused by a virus that belongs to the orthopoxvirus family of viruses, according to the Centers for Disease Control and Prevention. (The virus that causes smallpox belongs to the same family of viruses, the CDC says.) The first outbreaks were detected in research monkeys in 1958.  

The first known case in humans dates back to 1970, when a 9-month-old boy in the Democratic Republic of Congo contracted the disease, according to the World Health Organization

For decades after that, the disease was confined to Africa, but in 2003, the U.S. saw an outbreak “linked to contact with infected pet prairie dogs,” the WHO says. 

Up until 2022, the vast majority of cases were still seen in Africa, or “linked to international travel to countries where the disease commonly occurs, or through imported animals,” the CDC says. 

Scientists are still working to trace the origins of this year’s outbreak. 

When did it first arrive in the U.S., and how many cases has New York seen?

A man who had recently traveled to Canada tested positive for monkeypox in Massachusetts on May 18, the Massachusetts Department of Public Health said, marking the first case detected in the U.S. in 2022. 

Cases have since been detected in nearly all 50 states and the District of Columbia, according to the CDC.

Over 1,000 positive cases were reported in New York City by late July. Positive cases have also been detected in New York state, with numbers predicted to continue growing.

The city Department of Health on July 29 released a new dashboard that shows the latest data about monkeypox cases in NYC. The data also shows demographic information such as age, gender, borough, race/ethnicity and sexual orientation of New Yorkers who have tested positive for monkeypox. 

What are the symptoms?

Monkeypox is “rarely fatal,” but it can bring on serious symptoms, the CDC says, including fevers, headaches, muscle aches and backaches, swollen lymph nodes, chills and exhaustion. 

It can also cause “a rash that can look like pimples or blisters that appears on the face, inside the mouth and on other parts of the body, like the hands, feet, chest, genitals or anus,” according to the CDC. 

“The rash goes through different stages before healing completely,” the CDC notes, adding that symptoms can persist for anywhere from two to four weeks. “Sometimes, people get a rash first, followed by other symptoms. Others only experience a rash.”

Who is most susceptible to the disease and how does it spread?

While anyone can contract and spread monkeypox, cases within the 2022 outbreak have been “primarily spreading among social networks of gay, bisexual and other men who have sex with men,” the city’s Department of Health says, adding that that those communities are “currently at greater risk of exposure.” 

There are a number of ways that the disease can spread, according to the CDC, including: 

  • Direct contact with the infectious rash, scabs or body fluids 
  • Respiratory secretions during prolonged face-to-face contact, or during intimate physical contact, such as kissing, cuddling or sex
  • Touching items (such as clothing or linens) that previously touched the infectious rash or body fluids
  • Pregnant people can spread the virus to their fetus through the placenta 

An animal that has contracted monkeypox can also spread the disease to humans, the CDC says. Humans can fall sick “either by being scratched or bitten by the animal or by preparing or eating meat or using products from an infected animal.” 

How is it treated?

Anyone who is experiencing monkeypox symptoms should consult with their doctor or another healthcare provider, the CDC says.

While there are currently no monkeypox-specific treatments, according to the CDC, the monkeypox virus’ similarity to the smallpox virus “means that antiviral drugs and vaccines developed to protect against smallpox may be used to prevent and treat monkeypox virus infections,” it adds. 

However, most people with monkeypox “get better on their own without treatment,” the city’s Department of Health and Mental Hygiene notes

How can monkeypox be avoided?

The CDC recommends adhering to the following guidelines to avoid getting monkeypox: 

  • Avoid close, skin to skin contact with the monkeypox rash.

- Do not touch the rash or scabs of person with monkeypox

- Do not kiss, hug, cuddle or have sex with someone with monkeypox

- Do not share eating utensils or cups

  • Do not handle or touch the bedding, towels or clothing of a sick person
  • Wash your hands often with soap and water or use an alcohol-based hand sanitizer, especially after contact with sick people 

Anyone who has tested positive for monkeypox “should isolate at home,” the CDC says. Anyone with an “active rash or other symptoms” should avoid being in the same room as family members, pets or other close contacts, it adds. 

Who should get a monkeypox vaccine?

New York City is in the process of distributing one of two U.S. Food and Drug Administration-licensed monkeypox vaccines — the JYNNEOS vaccine, the city Department of Health website says

The CDC on its website notes that the U.S. currently has a “limited supply” of the JYNNEOS vaccine, adding that “more is expected in coming weeks and months.”

Due to the supply shortage, the city’s vaccine rollout is currently limited to “gay, bisexual, or other men who have had sex with men and transgender, gender non-conforming, or gender non-binary persons ages 18 and older who have had multiple or anonymous sex partners in the last 14 days,” according to the health department.

Where in New York City are vaccines being administered?

The city’s monkeypox vaccine rollout has hit a number of hurdles, including a “glitch” that posted appointments to its online vaccine portal too early and a temporary website outage said to be caused by “overwhelming traffic.” 

With a limited supply of vaccines in New York state, vaccine appointments are scarce. However, those interested in obtaining an appointment can continue to check vax4nyc.gov.

New York state has also launched a text messaging alert system to inform New Yorkers about the ongoing monkeypox fight, including what the symptoms are, where people can obtain treatment and when vaccine appointments will become available. New Yorkers can text "MONKEYPOX" to 81336 (or "MONKEYPOXESP" for texts in Spanish) for more information.