WORCESTER – The city’s medical director is concerned that segments of the city’s homeless population could become susceptible to mpox, formerly known as monkeypox.
Dr. Michael P. Hirsh said two homeless women who are sex workers were recently diagnosed as having the virus after checking themselves into emergency departments at UMass Memorial Health.
It’s unclear if the women had clade 1, the more serious mpox virus, or clade 2. UMass Memorial Health said in a statement it recently identified two cases of mpox, and doctors are closely monitoring the situation with the Massachusetts Department of Public Health.
The women had mpox symptoms, said Hirsh, including a rash that resulted in what he called a “bacterial super infection.” They checked themselves out of the hospital against doctors’ advice, according to Hirsh.
One woman’s rash was scabbing that signals a lower communicable threat, said Hirsh, while the other woman’s infection remained in a somewhat advanced stage.
There was a discussion among Worcester’s public health officials and the city’s law department about potentially quarantining the women, said Hirsh, including sending them to Lemuel Shattuck Hospital in Boston. It’s the only hospital in the state, he said, where patients can be legally quarantined against their will. It didn’t happen because Hirsh said it would have been viewed “as kind of draconian.”
Hirsh doesn’t know where the two women are living. He’s worried they could potentially spread mpox in the homeless shelter or encampments they visit. Substance abuse is common in those locations, said Hirsh, resulting in immunocompromised systems that are more susceptible to contracting mpox.
Hirsh stressed that the risk to the public of becoming infected with mpox is very low because the greatest risk results from intimate skin-to-skin sexual contact. Contraction from being in the presence of someone with mpox won’t spread the virus, said Hirsh.
However, engaging in the sex trade in Worcester can increase the risks.
“If for some reason, [people] are pursing pleasure with a sex worker, this is not the right time to do that,” said Hirsh. “Sexual contact is what’s going to get them in trouble.”
Contact tracing in the communities where these women were living would be difficult, said Hirsh. To get the word out about mpox in Worcester, city officials issued an advisory through its social media channels Wednesday, Nov. 26. Information was also sent to local medical providers, and community flyers in four languages were distributed.
Worcester received 20 vials of mpox vaccine from the state Department of Public Health, said Hirsh, and vaccine clinics with the help of AIDS Project Worcester were held at the shelter and encampments where the two women were known to frequent. Roughly 70 doses were administered.
A third person who was potentially at risk of contracting mpox was being tracked by infectious disease doctors at UMass Memorial Health, said Hirsh, adding that person’s situation hadn’t escalated into a full-blown case of the virus. UMass Memorial Health didn’t immediately respond to a request for information about this case.
Worcester reported mpox infections in the summer of 2022, when there were hundreds of cases statewide. The Massachusetts Department of Public Health stopped posting monthly reports about mpox infections and vaccination numbers in October 2023.
The current risk in the United States of clade 1 mpox is low, according to the Centers for Disease Control and Prevention. Clade 2 is circulating at low levels linked to an outbreak in Sierra Leone, Liberia and other West African countries.
Contact Henry Schwan at henry.schwan@telegram.com. Follow him on X: @henrytelegram