The number of monkeypox cases in San Diego County is rising — though local health officials say they are not yet seeing “community spread.” The disease, which can cause fever, body aches, painful lesions and rash, is primarily transmitted through skin-to-skin contact. There were six confirmed or probable cases in the county as of last Friday.
But another case will soon be added to that count. KPBS spoke with Clark Marino, who received his diagnosis on Tuesday, about his experience with monkeypox and the urgent need to expand local testing and vaccinations.
This conversation has been edited for brevity.
First of all, how are you feeling right now?
Marino: I'm feeling really well, almost fully recovered. There's a few lingering symptoms, but I was very, very fortunate to have a very mild case. Since I let people know that I had tested positive — I did it over my Instagram — I actually got a lot of people, not in San Diego but outside of it, who have let me know that they also have contracted it. And after coming out with my story, I feel much luckier because a lot of people have had terrible symptoms, such as full body aches, bad chills, lesions and pustules appearing all over their body. I know one person (who) had lesions in their throat, and they've had a very hard time swallowing. So I feel very lucky.
Walk me through your experience a few weeks ago. Tell me about how and where you think you got exposed to monkeypox.
Marino: It sort of started on the Fourth of July. I felt a few symptoms, just a little itching, a little irritation, and then it continued Tuesday. But it was something I could sort of just put out of my mind. But on Tuesday, someone who I was in close contact with in Seattle, at Seattle Pride, let me know that they had just tested positive for monkeypox. I instantly was like, “Okay, well maybe this itching has to do with that.”
I then got on the phone the next morning with the epidemiology department here in San Diego, went over my symptoms with a nurse, she had me do a very thorough self-exam and we did find a lesion. So it was basically too late for me to get the vaccine. The virus had already arisen, and it was already time to instead go into isolation and do testing.
Tell me more about your experience trying to get tested for monkeypox, and tell me how long it took you to actually get the results.
Marino: I had reached out to my primary care physician, but they let me know that they were unable to do the testing there. And so I had to go to a county clinic in order to do the testing there. I will say the testing is not a very fun experience. In order to test, you have to show a lesion, and in order to run the test, they need to break that lesion. So it can be very painful in that one moment, and then that lesion needs to heal again. It's important to get tested, but I will say it's not a fun experience.
In order to get my test results — they don't have any local testing here in San Diego. They'll ship the sample to LA, where it will undergo preliminary testing. And then it’ll get shipped to the CDC for further testing. I was hoping to get my results back on Saturday or on Monday, but I did not get my test results back until Tuesday. So it took a long time. And with this disease, that is of major concern because the incubation period can be as short as five days. It would be ideal to get test results back within a day or two so that your close contacts can then go get vaccinated or be on the lookout.
The county has started offering vaccines to people. But we just learned that all of the vaccine appointments are now filled and they're not taking any more people on the waitlist. Based on that, and on your own personal experience, how prepared do you think San Diego County is to prevent or at least manage this illness?
Marino: The testing apparatus and getting me in — although it worked very well for me, I was the only case that day that I'm aware of. It took a lot of effort from a lot of people to get one person tested. And so I am afraid that if there are multiple cases, the process is not streamlined enough. I know that vaccines are sort of controlled by the federal government, so it's really hard there. But one of the things that we could definitely do is try and get testing locally. The fact that it took me close to five days to get my results back, and given that that can be as long as it takes for the virus to appear in other people, and then the vaccine is too late — they should try and get it down here as soon as possible.
There's a debate going on among public health officials about how much to emphasize the fact that this illness is primarily affecting gay and bi men right now. They want to prepare people who are most at risk, get them informed, but they also don't want to create stigma or a perception that this is a “gay disease.” Do you have any thoughts on that?
Marino: I think that anybody who is paying attention will understand that this is a communicable disease (that spreads when) people come into close contact with each other, either sexually or non-sexually. Or if someone has lesions in their throat, they can spread it by droplets and face-to-face contact. It's a lot less spreadable than COVID, and it is also a lot less deadly than COVID, so thank God for that. But gay men are the most at risk right at this moment, and so they're the most in need of messaging and vaccines. However, unless we can get this contained, this is going to spread into the wider public and probably already has. And so this is something that everybody needs to be aware of.
What has been the worst part of this experience for you?
Marino: The worst part of this experience has been the symptoms: the itching, being unable to sleep some nights, the pain that has come up with it. I am lucky enough that I can work from home. I am lucky enough that I have people that can deliver me groceries while I'm in isolation. So I have a very good support system. But I can only imagine for other individuals who aren't able to stay at home — this is a disease where you'll go into isolation until all your symptoms are fully resolved. It can be anywhere from a week, a month — it can be a very long time. So this is really something that people should avoid. And although I'm a very healthy individual, anybody who has a compromised immune system — they are at risk of developing serious disease. And there are drugs that might help, experimental drugs, but it's something that they should really try and avoid and try to get the vaccine as soon as possible.
