A man in Spain recounts how he lived with monkeypox 4:09
(CNN) --
With nearly 9,000 confirmed cases of monkeypox nationwide, concern is growing that US college campuses could become "hot spots" for monkeypox this fall.
Educators are working to reduce the risk to public health, while some students worry about how their experiences on campus could be affected by the virus, a virus the nation is still trying to control and which was declared recently as a national public health emergency.
"As we head into the fall, I am concerned about outbreaks on college campuses, as they are often a place where individuals are engaging in higher-risk sexual activity and are in close contact with many different people," she said. Dr. Rachel Cox, an associate professor at the Massachusetts Institute of Health Professionals School of Nursing, in an email to CNN.
"We have to make sure that we are prepared to allocate resources like tests, vaccines and antivirals to places that may become hot spots."
Sydney Greenstein, an 18-year-old New York University freshman, said that while she is excited to begin her college experience, she is concerned about her risk of exposure in the city. New York, which has one of the highest numbers of monkeypox cases in the country.
There are 1,937 confirmed or probable cases in New York City, according to the city's Department of Health.
"It's definitely got me thinking about school and what my plans are and how I'm going to be social and hang out with people and hang out," Greenstein said.
Greenstein will be moving from Maryland to New York later this month to begin his studies and said he hasn't heard much from NYU about its monkeypox response plans.
NYU did not immediately respond to CNN's request for comment.
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But some universities told CNN their response plans include the infectious disease protocols they have already put in place.
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A continuation of the work
Elon University in North Carolina sees preparations for a possible monkeypox response as an extension of the work the school has been doing so far.
"We are aware that we may have cases of monkeypox. We have been working on preparedness since May, long before it was seen as a problem, and our focus is going to be very focused on education, prevention, but we have plans in in case a contagion occurs," said Dr. Ginette Archinal, medical director of Student Health and a physician at the university.
"To say we are 'concerned' is an exaggeration, but we are prepared for cases of monkeypox on campus."
Elon's infectious disease response team "has been in preparedness mode for a lot of infectious diseases" for the past several years, said Jana Lynn Patterson, associate vice president of Student Life and dean of students at Elon.
Archinal and Patterson form the leadership team for the Elon Infectious Disease Response Team.
The school had a mumps outbreak in the fall of 2019, which Patterson said made them better prepared for Covid-19, and they see the monkeypox response as "a continuation of our work."
"We have some basic infectious disease response protocols, and then we've refined them based on the current information we have around specific information or specific needs around a monkeypox case or outbreak," he said.
The protocols cover several areas, such as isolation, academic support, educational support, and ensuring that clinicians and healthcare staff are up to date on assessments.
Archinal and Patterson also highlighted the importance of their relationship with the local Health Department and the healthcare system.
During the covid-19 pandemic, they were very aware that any policy or protocol that was created could be applied to any infectious disease that emerged in the future.
"Elon has protocols for these types of infectious diseases that are deliberately designed to be adjusted based on what may come up," Archinal said.
"Because why reinvent the wheel at the last minute every time there's an outbreak, when you can have a solid, firm plan that you just adjust to make it appropriate for you, and that's really preparation."
According to the US Centers for Disease Control and Prevention (CDC), as of August 8, there were 111 cases of monkeypox in North Carolina.
Opportunities for the spread of monkeypox
Elon is not the only school claiming to focus on education about the virus.
At Florida A&M, there is some concern about the spread of monkeypox on campus.
Students "like to participate in a lot of different activities and socialize and everything, so I think there are certainly opportunities for monkeypox to spread through the population," said Tanya Tatum, director of the Health Services of the students at Florida A&M.
Tatum noted that monkeypox is not like Covid-19, which spreads primarily through the air.
But authorities know that students engage in intimate activities.
A recent study found that among the 528 infections diagnosed during the current outbreak, 95% are suspected to have been transmitted during sexual activity.
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The fact that the virus can remain on inanimate objects, such as bed sheets, also adds to the concern.
"Some of our students are not the best caretakers around the house, how often the sheets are changed and things like that," he said.
"So there is some concern."
The CDC says that the most common way monkeypox spreads is from person to person through direct contact with the rash, scabs, or bodily fluids of someone who has been infected.
This contact can occur during intimate activities, such as sexual intercourse.
However, the virus can also spread if a person touches a contaminated object, tissue, or surface.
The plan at Florida A&M is to launch an education campaign, Tatum said, to make students aware that the virus is spreading.
Florida A&M will have a website with information by the end of the week, Tatum said.
The plan also includes emails to employees and students, information on the student engagement platform, and flyers posted in residence halls.
"Our students begin moving back onto campus on Monday, August 15. We will begin spreading our information beginning this week and will provide regular messages throughout the semester," Tatum said.
"We want people to understand how it spreads and ways they can avoid it, either get it or spread it further," he said.
"We also want to make sure they understand and are informed about what the treatment might be and what to do if they think they may have been exposed."
The University of North Florida is also focusing on education, said Dr. Valerie Morrison, director of Student Health Services.
The university wants to make sure students know what to do when they think they may be sick with monkeypox or another infectious disease.
This includes staying home and knowing how to contact student health services or a primary care provider.
The University of North Florida plans to reach students by including educational information on social media platforms like Instagram.
According to the CDC tally, Florida has the third-highest number of cases in the United States, with 936 cases as of August 8.
Texas A&M is also making efforts to educate its students.
"We have an active web page and social media content ready to send to our students," said Dr. Martha Dannenbaum, director of Student Health Services at Texas A&M, in an email to CNN.
"We have well-established processes to push educational content to our students that we are going to follow."
"University health centers are intimately involved with public health efforts on their campuses, so managing potential outbreaks of monkeypox or other new infectious diseases is part of the work we do," Dannenbaum wrote.
"Most (including Texas A&M Student Health) were very involved in planning and executing the plans for their campus related to Covid. We can expect a monkeypox-like response."
Texas has 702 cases of monkeypox, as of August 8, according to the CDC.
Testing and Isolation Plans for Students
"I think universities should definitely have ways to make testing available and also have solutions and plans in case someone is infected. For example, what surfaces do they have a lot of contact with? How can they clean them to minimize contagion?" Greenstein said, NYU student.
Several universities said they could test for the virus, though it was often an outside lab.
"Currently, testing can only be done in laboratories authorized to perform it," a spokesperson for the American College Health Association told CNN in an email.
"University health professionals can collect samples and send them to these labs if it is determined that a patient needs a test."
The association is working on developing resources to help campuses prevent and manage outbreaks.
Florida A&M, Texas A&M, North Florida and Elon said they can test for monkeypox on campus.
In some cases, the samples will be sent to a partner laboratory.
When it comes to isolation, Morrison, of North Florida, said that because of the way monkeypox spreads, developing isolation policies can be complicated and may need to be determined on a case-by-case basis.
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The ways in which monkeypox is spread, including through contaminated objects such as dirty clothes, sheets and towels, affect the mechanics of how effectively a person can be isolated in a university setting.
"If we had to isolate someone on campus, we would want a single room with its own bathroom, and my recommendation would be no porous type of furniture. You would want to avoid all types of upholstery, or rugs, because it's easier that way." keep it clean afterwards," Morrison said.
Elon's Archinal also said the university can isolate students with monkeypox, if necessary.
"I've written protocols for my staff on what to look out for, how to handle it. We already have the ability to do screening tests. We know which lab we send tests to. We already have protocols on when we isolate, who we isolate, what things we look for and when we notify our Health Department," Archinal said.
Archinal added that the authorities have an automated system for covid-19, which notifies the relevant people on campus which students may need to be treated in isolation.
The same process, if necessary, will be used for monkeypox.
Mass vaccination is not recommended
Universities have also been considering how monkeypox vaccination for students might come into play.
Archinal and Patterson said that Elon is prepared if there is a need for a vaccination clinic on campus, and her partnership with the local Health Department is vital in this regard.
If the vaccine becomes more available, they will check with the state, and if they and the local health department think the school is a good candidate for a clinic, it can be rolled out in less than 24 hours, Patterson said, similar to what It happened during the mumps outbreak.
Many other schools also plan to follow local Health Department guidelines and policies regarding vaccine distribution.
The CDC has been sending states supplies of the monkeypox vaccine, called Jynneos, for people who have been exposed or are at risk of being exposed.
According to the CDC, people who can be vaccinated include confirmed contacts of someone with monkeypox, suspected contacts who have had a sexual partner in the last 14 days diagnosed with monkeypox, those who have had multiple sexual partners in the past 14 days in an area where monkeypox is spreading and who may be exposed to the virus through their work.
Dr. Huerta: Two doses of the monkeypox vaccine are necessary 2:21
Archinal stressed that the CDC does not recommend blanket vaccination and said that Elon will not suggest that strategy if it is not necessary.
During the mumps outbreak at the school, although all students had received the two standard vaccinations, the Department of Health recommended a booster dose.
"Within 24 hours, they were on campus doing vaccination clinics, booster doses," Archinal said.
"Our discussion with the Department of Health is that if that same situation were to occur and if the recommendation to get vaccinated were expanded and became available, our Department of Health would be able to do the same."
Florida A&M's Tatum said if vaccines became more widely available, officials there would follow guidance from the Health Department.
Florida has the vaccine, he said, but it is being distributed and administered through the Department of Health.
Tatum said that if there is a time when there are enough vaccines, the university sees the number of cases increase and the Department of Health recommends vaccination, "it may be a possibility that we offer it."
A call to awareness
Greenstein, the incoming student from NYU, said he hopes colleges will proactively communicate with students about their plans to mitigate the spread and how they expect monkeypox to affect the school year.
"I just ask that there be some form of communication," Greenstein said.
"It doesn't have to be your top priority, I totally understand the rush to get everything done on time, but some form of communication would be nice."
Doctors urge looking for monkeypox cases beyond men who have sex with men
She also hopes her school is mindful of how it communicates information about the virus and does not stigmatize men who have sex with men or imply that the outbreak is only of concern to this community, which has seen the vast majority of cases. of this outbreak.
"I think they should keep in mind that their words have power," Greenstein said.
"What they say can definitely be taken the wrong way."
-- CNN's Jacqueline Howard contributed to this report.
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