Since the monkeypox outbreak in the United States began in May, there have been about 7,100 documented cases, according to the Centers for Disease Control and Prevention.

On Thursday the Biden administration declared a public health emergency to help deal with the outbreak.

“Ending the monkeypox outbreak is a critical priority for the Biden-Harris Administration. We are taking our response to the next level by declaring a public health emergency,” Health Secretary Xavier Becerra said. “With today’s declarationx, we can further strengthen and accelerate our response further.”

The administration has faced criticism over a shortage of vaccine and for not responding fast enough when the virus first began circulating.

The virus has been spreading mostly through gay communities, which has public health officials worrying that there will be stigma around the virus. That stigma could prevent some people from getting tested or treated for the virus, they say.

“Stigma plays an important role in how we message,” said Vincent Guilamo-Ramos, a nursing professor at Duke University who studies the prevention of HIV/AIDS.

“We need to make sure that we’re not blaming, and that we are actually reaching out to communities to try to seek partnerships and thinking about ways we can work together,” he said.

“We have had unprecedented times over the past couple of years. Our public health infrastructure has really taken a beating. In my view there’s many ways that we have gotten things right,” Guilamo-Ramos said. “I certainly think the recent declaration that monkeypox as a national emergency does provide opportunities for innovation, for rapid escalation of our response, for data agreements and partnerships that are now more possible.”

Monkeypox is not like COVID-19. Doctors and researchers already knew a lot about treating the virus and had a vaccine before the outbreak began in Europe and the United States.

“This was an infection that has been found for many generations in parts of western central Africa,” said Dr. Cameron Wolfe, an infectious disease specialist at Duke Health. “This is the first time that it has established itself as a presence here, is transmitting readily and is largely now in all states in the U.S.”

Wolfe, Guilamo-Ramos and Duke pediatrician Dr. Ibukun Kalu spoke with reporters about the outbreak Friday, breaking down the latest on what they know about the virus and the response.

“This is a virus that is most closely related to smallpox but presents quite differently,” Wolfe said. It actually looks more like a shingles infection, though it’s a completely different virus.

“It starts as a flat red rash that moves into, classically, a blister. As it evolves that blister actually becomes more of a firm postule – often quite painful,” he said.

Wolfe said those blisters will dry out over two to three weeks. The dead skin will peel off and new skin forms underneath, he said.

“Once those blisters have sealed and rehealed, that’s when we think people are no longer infectious,” he said.

Monkeypox is unique, Wolfe said, because it spreads mostly through “close, intimate skin-to-skin contact.”

“We’ve seen that intimate contact mainly so far occurs actually through sexual networks and partner networks, friendship networks dominated so far by men, particularly men who have male sexual partners,” he said.

“There’s nothing about how the virus moves that cares about your gender, who you love, who you hang out with. There’s no reason this needs to stay in those populations,” Wolfe said.

But with universities and schools getting ready to go back for the fall, some parents may be warry about monkeypox spreading in schools.

“Although we’ve seen more infections in a specific social network, it is possible and it is expected and we have started to see infections in children,” said Kalu, who specializes in infectious diseases in children.

“Most often there is, in some way, shape or form, there is household contact. It’s important to emphasize it’s prolonged exposure, prolonged contact. We’re not expecting that childcare settings and schools will see rampant monkeypox infections run through the kids. But it is possible for children to get infected,” she said.

“The key presenting symptom has been a rash, and children get a lot of rashes,” Kalu said. She said there are lots of infections that cause rashes, including chicken pox and measles, both of which children should be vaccinated for.

Monkeypox is generally not fatal, but it can cause painful lesions. Doctors say people can take medicine like Tylenol or ibuprofen to treat the pain or fever.

“There are no treatments specifically for monkeypox virus infections,” according to the CDC. “However, monkeypox and smallpox viruses are genetically similar, which means that antiviral drugs and vaccines developed to protect against smallpox may be used to prevent and treat monkeypox virus infections.”

The CDC said antiviral drugs can be used to help treat patients with weak immune symptoms.

People who had the smallpox vaccine in the past may still have some lasting protection, said Wolfe. But it’s hard to know how much protection that could give someone.

“So whilst it gives you some protection, I’m certain, how far away you were from that vaccine is relevant, and if you think you’ve had someone who had a meaningful exposure, you should go ahead and get one of the new vaccines,” he said.

“That new vaccine is not a living vaccine. It’s a non-replicating virus so it’s actually safer in a much larger group of patients,” he said. The vaccine is approved for people 18 and older, and it’s safe for people with suppressed immune systems and pregnant women, he said.

“It was approved prior to COVID, even, so this is not a new vaccine. It’s gone through the standard FDA and CDC approval steps,” Wolfe said.

The new vaccine, JYNNEOS, is a two-dose vaccine, but supplies are short. Some states are limiting people to one shot for now while the federal government works to get more doses.

The CDC recommends people should get vaccinated if they have come into contact with someone who has monkeypox or if they have multiple sex partners in an area where the virus is spreading. But that’s if they can get an appointment to get vaccinated.

People should contact their local or state public health department for details on potentially getting vaccinated.

People who think they may have been exposed should try to get a vaccine from their local public health department.

If someone thinks they are showing symptoms of the virus, get tested.

“The testing is really important here. Not only does it help the individual know that they’re positive or not, it also helps us set up contact tracing,” Wolfe said. “Tracing is something we did at the beginning of COVID. It’s really important here. People may not know they’ve been exposed, and we actually have interventions with vaccines for people who have been exposed.”

The best way to stop the virus from spreading is for people with monkeypox to isolate.

“This is a close contact, skin-to-skin related condition so actually remaining at home during that home is really crucial,” Wolfe said. “Most people manage okay at home. But the key is, if you think the symptoms are consistent, please seek out to get a test, please isolate yourself while you’re wait for the results.”

“President Biden has called on us to explore every option on the table to combat the monkeypox outbreak and protect communities at risk,” White House National Monkeypox Response Coordinator Robert Fenton said in a statement Thursday.

“We are applying lessons learned from the battles we’ve fought – from COVID response to wildfires to measles, and will tackle this outbreak with the urgency this moment demands,” he said.

The aim of the emergency declaration from Health and Human Services is to get monkeypox vaccines out to more people and get more data for public health officials working to stop the outbreak.

The declaration includes a new strategy for health departments to spare doses of the vaccine, which could increase the number of shots for people five-fold. The idea from HHS is to inject the virus into layers of skin instead of a usual vaccine shot into the fat under the skin.

Federal officials say they could mean they only need to use a fifth of the vaccine dose per person.

“The strategy includes significantly scaling the production and availability of vaccines, expanding testing capacity and making testing more convenient, reducing burdens in accessing treatments, and conducting robust outreach to stakeholders and members of the LGBTQI+ communities,” according to HHS.