Indiana Colleges Ramp-Up Monkeypox Awareness, But Vaccines Still Limited

By Casey Smith

Schools across Indiana walked back COVID-19 restrictions at the start of the new fall term, but colleges and universities are now focusing on keeping the monkeypox virus at bay.

The Indiana Department of Health (IDOH) has confirmed 172 monkeypox cases in Indiana since June 17, according to the department’s new statewide dashboard. Nearly 20,000 cases have been confirmed in the U.S.

The virus primarily spreads through intimate sexual contact, according to the Centers for Disease Control (CDC). It can also spread by infected rashes or sores, exchanging of body fluids, and through respiratory droplets during prolonged exposure with someone who has monkeypox.

What colleges are doing

So far, no cases of monkeypox at any Indiana colleges or universities have been publicly confirmed.

Preparing for the possibility of future cases, public health experts on college campuses say they’re emphasizing efforts to educate students on the signs, symptoms and methods of transmitting the virus. They also caution students to take notice of any new rashes.

People with monkeypox develop a rash that may be located on or near the genitals or anus, as well as other areas like the hands, feet, chest, face, or mouth, according to the 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.

Sometimes, people have flu-like symptoms before the rash. Some people get a rash first, followed by other symptoms. Others only experience a rash.

Other symptoms of monkeypox can include:

Fever

Chills

Swollen lymph nodes

Exhaustion

Muscle aches and backache

Headache

Respiratory symptoms (e.g. sore throat, nasal congestion, or cough)

The illness typically lasts two to four weeks. A person is considered infectious with monkeypox from the onset of symptoms, until the rash has fully healed and a fresh layer of skin has formed.

Graham McKeen, Indiana University’s assistant university director of public and environmental, said part of the school’s response includes working alongside leaders and members of LGBTQ+ communities on the college’s two main campuses to make available information about prevention.

Monkeypox isn’t considered a sexually transmitted disease, but men who have sex with men are the group at the highest risk of infection from monkeypox, according to the World Health Organization.

McKeen said efforts to share information additionally extend to other high-risk groups on the campuses, including custodians and housekeepers.

Maxie Gardner, Butler University’s director of health services, said school administrators prepared for weeks to ensure students could return safely to the Indianapolis campus.

That includes free monkeypox testing, which remains available to students.

The university will also help coordinate isolation housing for any students who test positive. The isolation period for monkeypox is required for the duration of the illness, which can last up to four weeks, according to public health experts.

Virus testing and isolation housing is available to IU Bloomington and Indiana University-Purdue University Indianapolis (IUPUI) students, as well.

The Jynneos vaccine is FDA-approved for the prevention of monkeypox in anyone who is 18 years or older and at high risk for infection.

IDOH officials said they are working with colleges across the state to help with testing and to make vaccines available, but supply is limited.

Indiana has only been allocated a “small amount” of vaccines, according to IDOH. Those are primarily meant to be used to prevent severe disease in people who have been in close contact with someone who has tested positive for monkeypox. The vaccination must be given within 14 days of exposure.

The state health department has additionally started vaccinating people who are at high risk for severe illness and high risk for exposure with the limited remaining vaccine, but those patients are being contacted directly by healthcare providers.

Anyone else who wishes to be vaccinated must pre-register and await availability at a clinic.

IU Health opens new testing lab

To help ramp-up testing, IU Health last week opened a biosecure lab in Indianapolis that is dedicated to testing monkeypox samples. The lab — which was previously at the forefront of COVID-19 testing — is now the primary testing site for suspected monkeypox samples in Indiana.

The testing space was put together in less than two months, according to IU Health officials.

With on-site testing, the pathology lab can now turnaround results from monkey pox tests within 24 to 48 hours, rather than the previous range of eight to 14 days.

“To launch our test locally means patients throughout Indiana do not have to wait an extended time for their important test results,” said Clark Day, vice president of the IU Health Laboratory System.

The faster turnaround also means a person who tests negative for monkeypox can be released from quarantine faster.

New virus requires different response than COVID-19

As students returned en masse to college campuses last month, most were able to do so without masks or a negative COVID-19 test.

Dr. Aaron Carroll, a distinguished professor of pediatrics and chief health officer at the IU School of Medicine in Indianapolis, said concerns surrounding the spread of monkeypox are different, however.

Students infected with monkeypox are less likely to spread the virus to large groups, meaning large outbreaks and quarantines aren’t expected.

Still, the risk of transmission is higher for any college-aged students who are sexually active, he said. Concerns are also heightened in residence halls and other congregate settings where close contact between students could happen — even if it’s not sexually-oriented.

Unlike COVID testing — which is widely accessible and can be done at home — monkeypox testing is more limited to medical offices and other clinical settings. That could mean doctors and nurses are tasked most with diagnosing monkeypox cases and carrying out contact-tracing.