Bay Area man’s monkeypox diagnosis was ‘painful and terrifying’

“Kevin came in in the middle of the night when not many resources were available. I don’t think doctors always know what to do,” Chin-Hong said.

Monkeypox is Caused by a virus in the same family as smallpox Although not contagious or fatal. Patients usually have fever, muscle pain, and a rash on the face, mouth, hands, and sometimes the genitals, which can last for several weeks.

The current epidemic is spreading by person-to-person contact, Touch the lesion or exchange saliva or other bodily fluids. It can also be transmitted by touching objects or surfaces shared by a sick person, such as sex toys or sheets.

The first U.S. monkeypox case of this outbreak was reported on May 17, and since then the number has increased to Over 6,300 Possible or confirmed cases representing Washington DC, Puerto Rico, in addition to nearly every state.

California Governor Gavin Newsom on Monday declared a state of emergency Coordinate response and strengthen state vaccination efforts. About half of the 1,135 monkeypox cases in California Concentrated in the San Francisco Bay Area.

Anyone can be infected, but the outbreak appears to have primarily affected men who have sex with men. He said he may have contracted smallpox.

“This is the first multi-continental outbreak in history and it will not simply disappear. Andrew Neumer Associate professor at the University of California, Irvine, who studies infectious diseases.

“This won’t explode like COVID, but this epidemic will take a leg,” he said. is.”

But most doctors don’t know how to recognize it. When Kwon began experiencing symptoms in late June, most of the doctors and nurses he spoke to during virtual visits didn’t even mention monkeypox. Timothy BrewerProfessor of Medicine and Epidemiology at UCLA.

“I have worked and worked in several countries in sub-Saharan Africa for the past 25 years and have never actually treated a case of monkeypox,” Brewer said. “Before this outbreak, monkeypox was a very rare disease.”

A rash that is confined to the genital or rectal area may be mistaken for a sexually transmitted disease. But even if doctors aren’t trained to recognize monkeypox, their advice to patients could help curb the spread.

“We would be advising people not to engage in sexual activity until the lesion has healed and been treated,” Brewer said.

Many cases are mild and resolve spontaneously, but others, like Kwong’s, quickly become serious.

“Your body is being taken over by something you don’t understand, and it’s painful and scary because you have nowhere to go,” Kwon said.

Kwong initially treated the rash with topical steroids used for eczema. When that didn’t work, he attended an online appointment with a nurse who was diagnosed with herpes and prescribed antiviral medication.

Over the next few hours, the rash quickly spread to more parts of his body. The doctor agreed with the diagnosis of herpes and added another: scabies, A rash caused by a tick that has invaded the skin“My spots were concentrated on my hands, wrists, feet and elbows, which are the main places of scabies,” Kwon said.

The emergency doctor thought it was monkeypox, but Kwong’s spots were clustered together and looked different than the pictures the doctor had seen of the monkeypox rash. “I got different answers depending on where my symptoms were and who I was talking to,” Kwon said.

Over the 4th of July weekend, as her symptoms worsened, Kwong frantically contacted anyone who might be able to help.

“I tried to reach out to my doctor, but I knew a friend of a friend who was a dermatologist,” he said. “Every time I spoke to someone, I got worse quickly. And it was really funny.

During another virtual appointment, in the middle of the night, a nurse noticed a rash spreading toward his eyes and told him to go to the emergency room immediately. Alta Bates Summit, Auckland・At the medical center, a doctor said that Kwon might have monkeypox.

“While I was in this room, they were doing an investigation, calling back and forth with the CDC. As a patient, I expected myself to be in the dark, I didn’t realize how little information was given to health care providers and how unprepared they were,” he said.

He spent 12 hours in the emergency room, where nurses swabbed the affected area for monkeypox testing. They told him to come back if he had a fever or started vomiting.

“At this point, I was just miserable. I had pain in the back of my throat, in my mouth, all over my body,” he said. “At any given time he only got an hour or he only got two hours and it just drove him nuts.”

Later that night, Kwon UCSF Medical Center. He had heard from a friend that UCSF Health was treating patients with monkeypox and had been recommended to go by a virtual care nurse.

When he arrived, he was separated from other patients, given oxycodone for pain, and swabbed for another monkeypox test.

The next day, Qinghong started treating Kwon for monkeypox. “Wow, I thought this was a really widespread disease,” Chin-Hong said. “We have seen monkeypox cases before, but they are very limited. I think Kevin is probably in the top 5% of the severity of the disease.”

Because the rash was near Kwong’s eyes, Chin-Hong was worried that the disease would lead to blindness if left untreated. He prescribed the antiviral drug Tecovirimat, branded as TPOXX, which he received special approval from the FDA to treat monkeypox in certain circumstances.

After the first day of the drug, Kwon noticed that the rash had stopped spreading. Over the next two days, hundreds of swollen spots flattened into red discs. “I was shocked at how quickly Kevin improved. He was like a turborocket on his way to recovery,” said Qinghong.

As Kwong began to recover, he returned the initial test results. it was negative. Then second: Negative.

Chin-Hong said health care workers may not have rubbed his lesions vigorously enough to obtain live cells for monkeypox testing. “As a clinician, it’s very difficult to get good samples with these types of lesions because patients are often in pain. And you don’t like seeing people suffer.” said Chin-Hong.

Without proper testing, cases like Kwong’s can be missed.Centers for Disease Control and Prevention Online resources for clinicians Enough, says Brewer, but only if you have time to read all 59 pages.

Clinicians should collect at least two samples from multiple locations on the patient’s body, he said. According to Brewer, the key is to sample lesions “at different stages of development” and not just focus on the early bumps.

For two weeks, Kwon took six antiviral pills a day to rid her body of the virus. He doesn’t need painkillers anymore. “The first thing that healed was my face. Being able to recognize who I am in the mirror again helped me a lot,” Kwon said.

More than a month after the ordeal began, Kwong’s hands and feet are finally recovering. The cuticles and skin on his hands were peeling and in the process of regeneration, and his nails were turning black and starting to fall off.

Kwong said it will take longer to overcome the psychological toll. “It was a rapidly debilitating disease, so I feel less invincible, so I’m still working on my mental state more than my physical state.”