With monkeypox cases still rising exponentially in the U.S. — up to 4,639 on July 27 from 2,891 on July 22, according to the Centers for Disease Control and Prevention — and the World Health Organization declaring monkeypox a "public health emergency of international concern," more and more people are wondering how to best avoid contracting the virus.
One way, especially for gay or bisexual men, who currently represent 95% of those infected, is to temporarily limit their number of sexual partners, according to new advisement this week from the WHO.
But monkeypox, while spread largely through close physical contact between humans, is not an STD (sexually transmitted disease), as it is not spread solely through sex. Anyone can contract it, including children, as it is spread through bodily fluids — including sweat, saliva, through a placenta to a fetus, and via pus from the skin lesions that come with the virus — through face-to-face extended conversation, as well as through surfaces such as towels and bedsheets. Resulting symptoms typically include fever, headache, muscle aches, exhaustion and swollen lymph nodes, which all may come first or at the same time as the telltale skin rash or pustules.
But there is another point of transmission concern, as noted recently at a Los Angeles LGBT Center monkeypox seminar: gyms, yoga studios and other group exercise spaces, settings known for both sweat and shared surfaces, which the LGBT Center's medical director of research and education, Dr. Robert Bolan, called "a pretty obvious likelihood" for spreading the virus.
"Monkeypox is a particularly hardy virus ... and it is known to be able to survive in linens, clothing and on environmental surfaces, particularly in dark and cool conditions, for up to two weeks or even longer," Bolan added. "So, it's very important, I think, to pay attention to environmental surfaces like gym surfaces and, you know, workout benches and mats — things that are completely porous ... or partly porous" and to use disinfecting wipes or other household cleaners, which are effective when used correctly.
What else do we know about monkeypox and gym equipment? Yahoo Life checked in with experts for more details.
Gyms are possible but 'unlikely' routes for transmission
Dr. Jessica Justman, associate professor of medicine in epidemiology at Columbia Mailman School of Public Health, says it's "unlikely" for a variety of reasons, including that gym equipment, unlike linens, is "not very porous," which means it's easier to wipe the virus off — something that happens "now more than ever," because of likely in-place COVID-19 protocols.
Important to note, Justman says, is that the monkeypox virus is an "enveloped virus," meaning "each virus particle is coated with a fatty membrane, which is easily disrupted by detergents and other cleaning agents. Without an envelope, the virus is no longer infectious."
Further adding to the low risk factor here, she explains, is that the most infectious areas of this virus are the sores, or pustular lesions, "which tend to be in the genital area." So, for a transmission from such a sore to take place via a gym mat, for example, "someone with monkeypox would first work out on a mat while wearing clothing that does not cover the sores. This person would not wipe the mat down when done. Finally, a second person would work out on the mat while wearing only minimal clothing in order to have direct contact with the mat."
Justman adds, "It's very hard to imagine this complex scenario."
A recent assessment of ranked monkeypox risks from NBC News Chicago that's already been turned into a widely distributed chart agreed, citing Chicago Department of Public Health officials and calling gym equipment (along with public restrooms) "highly unlikely," and noting that "no such cases have been reported so far."
Still, vigilant cleaning is vital
Saskia Popescu, infectious disease epidemiologist and assistant professor with George Mason University's Schar School of Policy and Government biodefense program, stresses the hardiness of the monkeypox virus. "Currently, we do know that it can live on surfaces for up to 15 days, and other Orthopoxviruses can survive for longer periods, up to months. The issue we face is understanding the survivability and transmission dynamics when it comes to porous items like linen and clothing." She stresses the importance of awareness and proper cleaning and disinfection protocols.
According to a spokesperson from IHRSA: The Global Health & Fitness Association, a nonprofit promoting fitness that counts thousands of gyms and other exercise facilities among its members, "The top priority for health clubs is to provide a healthy and safe space for their members to be active and maintain their overall wellness. IHRSA urges health clubs to maintain a clean and safe environment at all times. We expect clubs to consistently wipe down equipment and surfaces and provide members and consumers with proper sanitation products to clean surfaces before and after use. A deep clean each night also helps to prevent the spread of viruses. It's standard practice to have hand sanitation stations available throughout the facility to eliminate any bacteria and germs. And, of course, regular hand washing is important for staff and members."
Early in the pandemic, the spokesperson added, IHRSA launched an initiative to reaffirm the industry's dedication to global health and safety, instituting best practices, still in place, around cleaning and disinfecting.
And luckily, stresses Popescu, nonporous surfaces — including gym equipment and mats — are easier to quickly and properly clean than porous ones, such as bed linens. She still would recommend single-use items when possible, such as individual yoga mats that people can bring from home. But, she notes, touching such items is "not as high-risk as having close, prolonged contact with an individual who is sick."
So, what about playground equipment and transmission to kids?
"Honestly, as an infectious disease person," says Popescu, "you're never going to hear me say that we don't need to clean that equipment — it's pretty high-touch and children carry germs!" Still, risk right now is low, although that could change "if more pediatric cases are identified," she says. (There have so far been two reported pediatric cases in the U.S., both believed to be through household transmission from affected adults.)
"I think we should focus on risk communication and routine, sustainable cleaning/disinfection for general health," Popescu says, adding that while advice around cleaning and sanitizing surfaces may be eerily reminiscent of the early days of COVID, there's a key difference.
"We know a lot more about monkeypox and have had decades to understand it," she says about the virus first recorded in humans in 1970. "But there are still gaps — traditionally, we've dealt with it in mostly health care settings, and our experiences and protocols reflect that. We need more community-based recommendations for the handling of things like clothing and bedding in hotels or shops."
But more importantly, Popescu adds, "we need to communicate that risk is still quite low, and that we are not flying blind — we have room for improvement, but definitely a better understanding of the disease than the novel virus that causes COVID-19."
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