You Don’t Need To Worry About Monkeypox When You Travel

The U.S. has declared monkeypox a public health emergency. The U.S. is late and failing badly in its response to contain the virus. Our public health establishment hasn’t improved much since the start of Covid and that’s a very bad thing if we were to face an outbreak of a deadlier virus that spreads more easily.

Let’s be clear, just being around people probably isn’t going to give you monkeypox. It doesn’t appear to be airborne except in some very specific circumstances.

In fact if someone in your household has monkeypox you probably will not get it. Estimates of household attack rate have ranged from 1% – 8% (outside of sexual contact). The CDC has been on a kick promoting that ‘anyone can get monkeypox’ and while that is technically true it is – at this point – highly misleading.

The virus could cross over into broader communities with an R0 > 1. It could mutuate. But for now transmission is limited to close contact with people who have it, and so far that’s meant mostly men having sex with men. Pointing to the existence of outlier cases doesn’t change the overall risk framework.

The Points Guy website published a FAQ about monkeypox raising all sorts of scare issues – picking up monkeypox from your airplane seat, from the hotel pool, or from the bed linens in your room. It correctly states each of these things is very low risk. In fact they are almost no risk for most people.

They include the question, should I get vaccinated, but the truth is there’s very little vaccine supply in part because the Department of Health and Human Services “failed early on to ask that bulk stocks of the vaccine it already owned be bottled for distribution” so the vaccine’s manufacturer “booked other clients.”

The government is now distributing about 1.1 million doses, less than a third of the 3.5 million that health officials now estimate are needed to fight the outbreak. It does not expect the next delivery, of half a million doses, until October. Most of the other 5.5 million doses the United States has ordered are not scheduled to be delivered until next year, according to the federal health agency.

Unfortunately the word ‘men’ does not appear in the piece. The word ‘gay’ appears only once in the text. So let’s be clear: if you are engaging in sex with men and you are not a woman, especially if you have multiple partners, you are at some risk and should try to get vaccinated. The people who are most at risk deserve to know, and the CDC has been very bad about straight talk and clear messaging here.

Here’s California’s data so far. Out of 786 cases only 11 have been hospitalized (under 2%) and no one has died. (HT: TheZvi)

Here’s how to think about monkeypox. If you have it you should isolate. Take precautions if engaging in close contact within high risk groups and absolutely get vaccinated if you can. But if you don’t have monkeypox and aren’t engaging in high risk activities with people who might have monkeypox then you don’t have to think much about it. That could change, it could cross over into other communities, and if that happens you should update your priors.

Right now I am taking zero precautions against monkeypox. I hope that doesn’t change. But any change that I make will be based on scientific evidence.

About Gary Leff

Gary Leff is one of the foremost experts in the field of miles, points, and frequent business travel - a topic he has covered since 2002. Co-founder of frequent flyer community, emcee of the Freddie Awards, and named one of the "World's Top Travel Experts" by Conde' Nast Traveler (2010-Present) Gary has been a guest on most major news media, profiled in several top print publications, and published broadly on the topic of consumer loyalty. More About Gary »

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  1. Well I for one am waiting to see what kind of comments THIS subject will get.
    Let the trolling begin!

  2. @patrick

    It is unfortunate that virtually every even slightly controversial topic veers far away from travel and becomes political in the comments.

  3. Gary the health expert is back! You know you can trust the concierge key “doctor” haha

  4. Talking about transmission vectors in a scientifically correct way is political now? Or is not doing so political? Being hurt or offended by the science doesn’t make it political.

  5. “…public health emergency…”? These clowns are so desperate to stay relevant they will stop a nothing. A few thousand cases in a 330,000,000 person country that is almost exclusive to a subset of the population does not constitute an “emergency”. Ridiculous. Nice try though. Clowns.

  6. Mdtravel, I’ll guess you’re new to Gary’s blog. To answer your question, there is a type of commenter on this blog that will take any subject (say, Delta’s new boarding priority) and turn into a discussion on border control policy. Last week, absolutely off-topic, one of these jerks began a rant on Corona Virus masks. Those on the other side of masks couldn’t let the jerk be. They felt compelled to engage. Then others aligned with the jerk jump onto the dog pile.

    On the topic of monkey pox, certainly, someone will say it’s a gay disease. That will be followed up by someone with an authoritarian political lending saying that the existence of monkey pox proves why being gay should be outlawed. And, we’re off to the races. (Just so you know: there are neo-Nazi white nationalists who troll this blog.)

    So, read the articles but don’t read the comments.

  7. Lone Gunman, someone beat you to the punch. Ha.

    Koggerj, just curious, are you married?

  8. Lone Gunman, you explained my position that the discourse will usually deteriorate into politics on what is supposed to be a travel blog very succinctly. Thank you.

  9. I understand a troop of monkeys at the Kansas City Zoo has filed a complaint with the World Health Organization that the label “Monkey” pox should be changed to the M219 Pox.

    We await an official ruling, but it may take a while to process as their petition was written on banana leaves. Using monkey poop.

  10. Monkeypox is not something I’m worried about, it’s the Gorillapox that scares me (coming Fall 2022).

  11. The world renowned Dr. Gary, noted health expert, is back. I bet you like to cosplay with a white lab coat and stethoscope at home.

  12. No more flights for me until all you fearless warriors test it for me. Thanks in advance.
    Hope the airlines and hotels keep up the excellent cleaning practices.

  13. Just another ass injected death syndrome. Dr Leff will accept your credit card clicks now.

  14. @Lone Gunman

    Lefties like yourself seethe with rage when your world view is habitually Debunked. This example is one if many where the truth about who is spreading this virus it’s being deliberately ignored by cultural Marxists.

  15. It’s not a “gay” disease, it’s an “extreme promiscuity” disease, although the Venn diagram of those two groups does tend to overlap. For some reason, health authorities can’t seem to say “stop the orgies”, like they’d suddenly be branded a bunch of prudes. Or that they’re intruding on gay culture. No, instead we have to put our public health focus on renaming the disease because of stigma from the name or whatever.

    As a commentator said last week, they’re trying to avoid hurt feelings at the cost of something that really hurts, a case of monkeypox.

  16. I’m in a monogamous relationship, but here are the precautions I’m taking: I am continuing to wipe down my seat area (seat belt, arm rests, head rest, tray, etc) with Chlorox wipes (do this for COVID and now mpx – but it is generally a good practice for general hygiene) and I will look very carefully at my hotel bed sheets to make sure the they have been changed for my stay (I have done this in the past, especially since Gary posted about sheets not being changed, but now will look very, very carefully). Twice in the past two years, I’ve found sheets that were not clean. Sleeping for 6-8 hours in a sheet contaminated with mpx is definitely a risk, although a mpx infected person sleeping in that bed before me would be really really bad luck (and low probability). But sleeping on already used sheets is pretty icky, even if there is no mpx. I am a physician.

  17. Don’t forget that almost everyone who has been vaccinated against smallpox, like me, is immune to monkeypox. Yes, we are an old cohort but still a considerable number of people.

  18. @Jamieo – yep, me and the wife too.

    When we moved to Brazil for three years, we loaded up on all the vaccines.

    Still didn’t dodge the common cold or flu then. However with current precautions, I haven’t caught either of those two in nearly the last three years.

    Of course, your results may vary. ;o)

  19. “But any change that I make will be based on scientific evidence.”

    Yes, I’m sure it will. Classic!

  20. The rare bright side of Biden being president is the Left/MSM won’t need to blow this latest health scare out of all sane proportion and go into official “WE’RE ALL GOING TO DIE THANKS TO THE PRESIDENT”-mode like they obviously did with covid and our previous president. lol

  21. Since it actually comes from rodents the name is a misnomer anyway. But the press has made this the crisis of the week and I suppose people are primed to be skittish about new diseases here. In a couple of weeks it’ll be something else. Anyway my understanding is that if you are in your 50s or older you’ve been vaccinated against smallpox and so have high immunity against it anyway.

  22. @Rog

    You continue to prove that your brain is infected with worms.

    Marxism is a mental disorder.

  23. @Koggerj…He never “refutes” anything. His entire shtick consists of red herrings, straw man arguments and a healthy dose of ad hominems. In other words, worthless.

  24. Not sure why Gary is trying to stigmatize this as a “gay”. Yes there is a lot of transmission via sex between men. Some of those men are bisexual and have sex with women. There is a growing number of women with monkey pox. Those women have sex with straight men and can pass it on that way. On top of that the WHO has said it can be transmitted via contamination of be linens or towels etc. So no it isn’t some kinda gay only disease that nobody needs to be concerned about. People said the same crap about HIV and you sure as hell didn’t need to be gay to get that.

  25. Koggerj, speaking of seething, have you ever posted a comment on this blog that didn’t express a negative sentiment about something? It seems that you are angry at everything. You are exactly what Buddy said you are: an angry elf.

    By the way, Rohm was openly homosexual. Hitler tolerated Rohm being homosexual until he didn’t need Rohm any longer. What are your thoughts on that?

  26. @James N
    If both of you Chump Fools moved to Maricopa County, Arizona you would be gladly accepted.

  27. @lone gunman
    “You are exactly what Buddy said you are: an angry elf.”

    Too nice.

    I’m thinking viciously barking poodle that never gets to go outside.
    The glass is covered in nailmarks and spittle.

  28. @Bill – Not really. The latest numbers that I’ve seen are that 96% of cases are in men who have sex with men (MSM). Yes, that may shift if they don’t get it under control, but it really is primarily a disease of promiscuity. (MSM also have huge rates of all the classic sexually transmitted diseases like gonorrhea and syphilis.) Since monkeypox has a limited infection period, then you’re immune, it’s not like AIDS, so stopping the sex parties for just one month would put a tremendous dent in the spread.

    As for AIDS, that too, was and is primarily a MSM disease – though that’s diluted a bit over the years with drug use, blood transfusions before screening was instituted, etc.. Still, gay and bisexual men are 22x more likely to get AIDS than heterosexual men. Female to male transmission is relatively rare, though it can happen. (In a first-world country, on the order of 1 in 2500 per vaginal intercourse event for a male with an unsuppressed female partner, neither having other sexually transmitted diseases with open sores. Those odds can be way worse if you’re having sex with a prostitute in some third-world country.) Don’t use IV drugs and don’t have a string of partners, you aren’t at much risk. And even lower risk if you both determine you don’t have AIDS and remain faithful.

  29. Gary, you should update in regards with men having sex with men as this expands the notion of promiscuity that the gay community battles. Majority of the cases and also specially the way it started propagating (origin has been pinpointed to a party in Spain) was with contact with someone who had it while dancing at a party without shirts. And from there it picked up thru more parties. So yes although it can be transmitted sexually due to contact the majority of cases are associated with parties that Gay people frequent.

  30. Hey “Rog” any chance you can keep Trump references out of any of your replies? Just Once? Inquiring minds want to know.

    PS : in case you didn’t know he is no longer the POTUS.

  31. I think saying there’s ZERO risk while flying may be irresponsible. Symptoms according to CDC: “The rash will go through several stages, including scabs, before healing. The rash can initially look like pimples or blisters and may be painful or itchy.”
    Now think how at times the aircraft bathrooms (think toilet seat, faucets) are used sequentially, with several people waiting in line. The pimples/blisters are often on the buttocks. Personally I would not sit on a toilet seat without a cover. Maybe 3 or 4 people just sat on it one after another.
    Also: “ Human-to-human transmission can occur through exposure to infected body fluids or contaminated objects, by small droplets, and possibly through the airborne route.”

  32. Most of the photos you see in the media are on the face and hands and they are scary and in the words of those that experienced it excruciating painful.
    Those folks seem to be taking serious pain killers just to sleep at night from what I read .
    A woman was on TV few days ago (first to get it is what they stated) and she looked horrible with her blisters and open sores all over on her face..She claims no sex but just being a cashier and just exchanging money with her hands daily.You wonder how much they know early on like early days of Covid

    I have a younger family member who is non sexual.They caught scabies at a new modern waterfront Hilton 4 or 5 years ago in luxury suite either from towels or bedding.
    Someone infected had used those linens or towels that were infected.We assumed bed bugs at first as they were lightly bleeding.I can say with certainty that unless they are dirty, used and or on the floor most housekeepers re-use linens and towels without changing them
    No idea how likely Monkayyy Pox can be passed with infected towels and linens

    Myself I have cancelled my regular back/ PT/body massages as they touch clients with their hands all day long and I am not taking chances for now no matter how many claim only gay sex.
    Probably all low risk but as they say not no risk! CDC said not an STD but you wonder when its also mostly sexually transmitted?

  33. @C_M Then explain please why the African CDC and the WHO issued a joint statement saying: “We’ve been collecting data on monkeypox since 1970 and that particular indicator, men having sex with men, has never come up as a significant issue here in Africa,”” Same virus.

  34. @Bill – A logical guess would be because in Africa, the virus is more endemic. It could become that here. But right now, it’s concentrated in the MSM population. Remember that AIDS is much more widely spread in the African population as well. Here, it’s still much more concentrated in the MSM population, even after 40 years, though it has spread beyond that population somewhat, but not to the extent it has in Africa. One of the main vectors of transmission in Africa of AIDS is/was truck drivers, who use prostitutes when on the road, and then give it to their wives when back at home. Monkeypox is probably similar.

    The problem in this case is not the entire MSM community, it’s in that subset who engage in large-scale events that result in spreading the disease. But health authorities have been reluctant to call a politically vocal population on that, or to intervene more forcefully and break up such events, even for a short period of time. Shut down entire cities for months at a time and wreck entire businesses, ruin children’s education for a year or more, sure, break up the circuit parties for a month, no way. If one were conspiracy minded, it’s almost like certain forces want to have an entirely new crisis and vaccination campaign.

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