Question: Regarding monkeypox, how can the state Health Department say it’s not sexually transmitted when it’s spread through close contact?

Answer: Hawaii’s Department of Health initially said that monkeypox is not sexually transmitted but no longer does. We’ll get to the department’s explanation, but first: Yes, monkeypox can spread during sex, and more information is needed, health authorities say.

“Monkeypox spreads between people primarily through direct contact with infectious sores, scabs, or body fluids (such as pus from the blisters). It also can be spread by respiratory secretions during prolonged, face-to-face contact. Monkeypox can spread during intimate contact between people, including during sex, as well as activities like kissing, cuddling, or touching parts of the body with monkeypox sores. At this time, it is not known if monkeypox can spread through semen or vaginal fluids,” according to the U.S. Centers for Disease Control and Prevention.

As a growing number of cases are reported across the country, including in Hawaii, the CDC published examples of how monkeypox cannot and can spread among humans:

>> No: “Casual conversations. Walking by someone with monkeypox in a grocery store. Touching items like doorknobs.”

>> Yes: “Direct skin-skin contact with rash lesions. Sexual/intimate contact. Kissing while a person is infected.”

>> Yes: Sharing a bed with an infectious person, or sharing their towels or unwashed clothing.

>> Yes: “Respiratory secretions through face-to-face interactions (the type that mainly happen when living with someone or caring for someone who has monkeypox).”

>> Maybe/still learning: “Contact with semen or vaginal fluids.”

>> Unknown/still learning: “Contact with people who are infected with monkeypox but have no symptoms (We think people with symptoms are most likely associated with spread, but some people may have very mild illness and not know they are infected).”

Common symptoms include flu-like symptoms such as fever, headache, aches, chills and swollen lymph nodes, that progress to a rash or sores, often on the hands, feet, chest, face or genitals. Nationally, most cases have been among men who have sex with men, although they are not the only ones at risk, the CDC said.

Getting back to your question, you are one of several readers who questioned the Health Department’s statement that the disease is not sexually transmitted. DOH did say that in a news release June 3 but did not repeat the information in news releases Wednesday and Thursday, nor did it highlight the change. See DOH news releases at health.hawaii.gov/news.

“When we issued our press release on June 3, the most updated information we had was that monkeypox was not sexually transmitted. Between June 3 and June 8, CDC changed its guidance to state that it is ‘not known if monkeypox can spread through semen or vaginal fluids.’ We adjusted our guidance accordingly,” said Katie Arita-­Chang, a DOH spokes-­ woman. “I also want to emphasize that monkeypox can be spread through any close, prolonged contact, even if that contact is not of a sexual nature. Anyone who has been in close contact with someone with monkeypox is at higher risk of infection, regardless of a person’s gender, sexual orientation, or travel history.”

For more information about monkeypox in Hawaii, the U.S. and throughout the world, see:

>> DOH: 808ne.ws/DOHmp.

>> CDC: 808ne.ws/CDCmp.

>> World Health Organization: 808ne.ws/WHOmp.

Q: Why is it called monkeypox?

A: “The disease is called monkeypox because it was first identified in colonies of monkeys kept for research in 1958. It was only later detected in humans in 1970,” according to WHO’s website.

Write to Kokua Line at Honolulu Star-Advertiser, 500 Ala Moana Blvd., Suite 7-500, Honolulu, HI 96813; call 808-529-4773; or email kokualine@staradvertiser.com.