By Tim Mastro

The monkeypox virus is now in all three Delaware counties.

The Delaware Division of Public Health announced the state’s second and third cases of the virus late Thursday. Both are considered probable pending confirmatory testing by the Centers for Disease Control and Prevention.

One case involved a 46-year-old Sussex County man, while the other was a Kent County man, 25. Both test results were received earlier in the week.

The state recorded its first monkeypox case July 12, in a 41-year-old New Castle County resident.

The division said the Sussex County patient did not report any travel and first reported symptoms Monday. The Kent County patient also did not report any travel and first reported symptoms July 14, according to the division. He has been advised to self-isolate until lesions have fallen off and new skin appears.

Health officials are working with both men to inform them about treatment and obtain a list of their possible contacts.

In response to the cases, the state has opened a hotline for individuals with specific concerns. The number is 866-408-1899, and it will operate weekdays from 8:30 a.m. to 4:30 p.m.

“The overall risk to the public is low and remains low,” Public Health interim director Dr. Rick Hong said in a statement. “MPX (monkeypox) is transmitted through close intimate contact with individuals who have rashes or flu-like symptoms. We urge people to educate themselves about this rare disease, including how it is spread, and to help prevent exposure. DPH will continue to work with medical providers to screen and identify individuals for MPX testing. And we will prioritize our limited supply of vaccine for people who have been exposed to MPX for post-exposure prophylaxis (PEP).”

The symptoms of monkeypox are similar to but milder than the symptoms of smallpox. Illness usually starts within three weeks of exposure.

Most who contract the virus will develop a rash, and some will encounter flu-like symptoms beforehand. Such symptoms may include fever, headache, muscle aches, backache, sore throat, cough, swollen lymph nodes, chills or exhaustion. If someone displays these signs, he or she usually will develop a rash one to four days later.

The virus can be fatal in up to 10% of cases, according to the Centers for Disease Control and Prevention.

There is no specific treatment for the monkeypox virus infection. However, antivirals can be prescribed, the division said.

Public Health has received a limited supply of the vaccine, which needs to be given in two doses, 28 days apart. Those who are at the highest risk of exposure include:

• People who have been identified as a contact of someone with monkeypox.
• People who are aware that one of their sexual partners in the past two weeks has been diagnosed with monkeypox.
• People who have had multiple sexual partners in the past two weeks in an area with known monkeypox.