Colleges and universities have been eagerly awaiting the arrival of students this fall, heralding a much-anticipated return to normalcy on campuses, with COVID-19 cases beginning to abate again across the country.
However, following the nation’s growing monkeypox outbreak, there are growing concerns from health experts that this second virus could once again disrupt the upcoming school year given the potential spread of the virus through sexual networks and close contacts during physical and social activities.
“Monkeypox is most likely to spread through dense social networks where frequent close contact occurs. College campuses are a potentially high-risk environment where this virus could take hold and should be a target for surveillance efforts,” said John Brownstein, Ph.D., an epidemiologist at Boston Children's Hospital and an ABC News contributor.
Experts say the greatest risk of transmission is prolonged, skin-to-skin contact with a person with monkeypox. It is also possible to spread the virus through bedding and towels contaminated with infected lesions.
More casual contact, such as brushing past someone or speaking face to face, is significantly less risk, experts say.
A handful of universities, including Bucknell University, Georgetown University and West Chester University in Pennsylvania, have already reported cases in their communities, prompting college officials to roll out monkeypox education programs, and stock up on test kits.
“I think college campuses need to be very aware of the possibility” of monkeypox spreading into their student populations, Dr. Stephanie Silvera, an epidemiologist and professor of public health at Montclair State University, told ABC News. “It would be foolish to think that it won't happen on these college campuses where we know that infectious diseases have the opportunity to spread quickly.”
The shift to a more urgent strategy comes after the Biden administration declared the monkeypox outbreak a public health emergency, last week, with the number of reported cases growing exponentially in recent weeks.
Across the globe, nearly 32,000 cases of monkeypox have now been reported, including more than 11,000 cases in the U.S. — the most of any country. All but one U.S. state — Wyoming — have now confirmed at least one positive monkeypox case.
The majority of cases, in the current monkeypox outbreak, have been detected in gay, bisexual, or other men who have sex with men. However, health officials have repeatedly stressed that anyone can contract the virus.
“As much as this has, thus far, been largely confined to a single population, it doesn't take much for that expand when you have so many people living together or in close contact as frequently as you do at schools and colleges,” Dr. Alexandra Brugler Yonts, an infectious disease specialist at Children’s National Hospital in Washington, D.C., told ABC News.
Keeping students safe
Although the Centers for Disease Control and Prevention (CDC) has yet to release specific guidance for curbing the spread of monkeypox at colleges and universities, the agency recently published guidance for congregate living settings, which includes dormitories at institutes of higher education.
The CDC recommends that institutions provide clear updates on the status of the outbreak to residents, respond to cases by testing and keeping in contact with local health officials and ensure that those who test positive wear a mask and stay in isolation for monkeypox.
Similar to quarantine periods associated with COVID-19, experts noted that universities will once again have to consider how to best support students who are isolating with monkeypox.
“Drawing from the covid playbook, setting up infrastructure for testing and contact tracing, is a reasonable strategy ahead of any possible outbreak this fall,” Brownstein said.
At this time, no quarantine is recommended for individuals who have been exposed to the virus. However, for those who do test positive, isolation is recommended until the monkeypox lesions have completely healed with a new layer of skin which can take up to four weeks — significantly longer than what is currently recommended for those who are COVID-19 positive.
“Some universities had isolation housing for COVID, but most of those have sort of relinquished that inventory so that we can have more students living on campus, and so making sure we have the space for those students to stay safely is going to be very important,” Silvera said.
How colleges are preparing
In light of the recent upsurge in monkeypox cases, colleges and universities from coast to coast have begun to create informational programs to ensure students are educated on the risks associated with monkeypox, as well as the key symptoms and signs, in order to adequately spot potential cases within the community.
At the University of Texas at Austin, university officials recently sent a letter out to students and faculty, alerting them to the global spread of monkeypox.
“UT has a longstanding public health infrastructure and implements mitigation protocols when faced with known or emerging communicable diseases, and we collaborate on strategies needed to reduce the incidence or spread within our population. Monkeypox will be handled as we would most other communicable illnesses with similar modes of transmission,” wrote Dr. Terrance Hines, executive director and chief medical officer at the university.
Some universities, including Northwestern and Bucknell, have set up monkeypox pages on their websites, with information pointing students to resources about the virus.
“I think that level of information is really the first step,” Silvera said.
And at North Carolina State, officials confirmed to ABC News that the university has “limited testing and vaccines available by appointment” for monkeypox.
With students set to return to campus at Salem Academy and College in Winston-Salem, North Carolina, school leadership is preparing to urge students to follow the same health protocols as they have with COVID-19.
“I think that the key to being prepared is education and communication with our students, and so many of the same best practices that we encourage our students to follow around COVID-19 — hand hygiene, social distancing, monitoring for symptoms — are the same for monkeypox or any other infectious disease,” Summer McGee, Ph.D., president of Salem Academy and College, told ABC News.
In addition, health experts stressed that it will be critical that colleges not single out or stigmatize certain populations in their messaging.
Students should be on alert, health experts say
The increase in cases across the country has left some students feeling anxious about their return to school.
Camila Heard, a Los Angeles Community College District student who heads to campus this month, said she doesn’t “feel too good” about going due to the threat of monkeypox.
Heard noted the multiple precautions she’s taken to avoid contracting the virus, including always carrying sanitizer, disinfecting wipes and wearing a mask.
Experts say students with monkeypox should refrain from sharing towels, sheets and other materials and that all students should be honest about their symptoms and contact history with potential partners, roommates, or friends.
“I think you have to be very mindful of what, at this point, what your behaviors are,” Silvera said. “So think about who you're interacting with, who you're having that close physical contact with. Be open and honest in your communication about where you have been, and signs and symptoms.”
“This is not the time to ignore the signs and symptoms,” she added. “If you're not feeling well, make note of that. Put on a mask, try to limit the amount of physical contact you're having with other people, and that can hopefully help to prevent the spread of this disease.”
Avery Edelmon, who is immunocompromised, currently lives in a dorm and begins classes next week at Tarleton State University in Texas — one of the states leading the country in monkeypox cases.
“I'm pretty nervous about going to class and I kind of know that if I want to be as safe as can be, I'll have to put that on myself,” she told ABC News.
Immunocompromised people are at higher risk for developing severe disease due to monkeypox, according to the CDC.
It will also be critical for students to responsibly monitor themselves and seek care, should they develop symptoms, health experts stressed.
“The same thing we tried to say with COVID-19, if you're sick, stay home. Well, if you've got a pustules or vesicle or rash, cover it up, and go get it checked out,” Brugler Yonts said. “Don’t just go to that party, like it's no big deal.”