A new cluster of mpox cases in the United States — after nearly seven months of a steady decline — is prompting health officials to warn of the possibility of a flare-up again this summer.
Recent Chicago health officials 20 new cases reported and is urging everyone there to get vaccinated.
Major cities like Los Angeles, San Francisco and New York are stepping up public awareness campaigns and vaccination programs, specifically targeting men who have sex with men and transgender people.
They warn that cases of mpox, formerly known as chickenpox, can easily spread as the summer LGBTQ pride parades get underway.
“Spring and summer of 2023 could lead to a return of mpox outbreaks as people gather for festivals and other events,” the Centers for Disease Control and Prevention said in a report. . health warning in Monday.
The CDC warned that without additional vaccines and other virus mitigation measures, a return outbreak could be “larger or larger than 2022”.
Although anyone can be infected with mpox, the virus has so far largely affected gay and bisexual men in the United States. This is not a sexually transmitted virus, but close physical contact is the primary mode of transmission.
On May 11, the World Health Organization declared mpox a global health emergency, a year after the virus spread beyond its endemic regions.
The drop in cases over the past year has led to a sharp drop in vaccinations. For example, in Los Angeles County, weekly vaccinations reduced from 8,000 last year to about 100-150 in recent months, officials said.
But Biden administration officials said on Tuesday they were not caught off guard, especially in light of the recent spike in infections in some places.
“Certainly what we’re seeing in Chicago is a reminder that…we’re not out of the woods yet. “We have an unfinished vaccine mission,” said Dr. Demetre Daskalakis, deputy coordinator of the National Mpox Response Program at the White House.
Among other things, his office is moving quickly to ensure that local health departments have the resources to deal with new cases.
He told The Times: “We are where we would expect to see clusters, but we have our duty, which is to vaccinate everyone so we can make sure that We can stop them.
The current outbreak of mpox disease is the largest and most geographically widespread since the virus was discovered in 1958.
There have been more than 87,000 global cases in 111 countries with 140 deaths reported to WHO in the past year.
The United States has recorded almost 31,000 infections and 42 deaths compared to last year. The current outbreak in the United States was first recorded in Boston. California leads with 5,759 cases, according to the latest data available from the CDC.
Despite concerns about the potential for a resurgence, the dramatic drop in cases — from 600 nationwide on August 1, 2022 to a weekly average of one in April — partly reflects success story in containing the virus, at least for now.
It also provides lessons for future outbreaks.
Several health experts credit President Biden for taking active action to address the mpox health crisis.
Days after the Boston case was confirmed, Biden said the virus was “something people should be concerned about.”
His Department of Health and Human Services signed a contract with a Danish vaccine manufacturer the same day. He gathered a The dispatch team is widely respected to lead the response and had previously reversed President Trump’s decision to withdraw the United States from the WHO.
Even so, the current mpox outbreak has become much larger and more widespread than previous outbreaks. previous outbreak was limited to a few cases that could be traced back to recent travelers to mpox-endemic areas in Africa and was rapidly contained.
The current outbreak has seen widespread community spread and has been detected in all 50 states, the District of Columbia and Puerto Rico.
Persecuted by the ongoing COVID-19 pandemic, health systems have struggled to handle mpox in the first place.
Initially, mpox testing was limited to select laboratories and medical professionals, who had to wriggle through a web of bureaucracy to order and prescribe. Tpoxx, an investigational drug used to treat viruses.
“There’s a lot of paperwork that you need to fill out in an outdated public health system where you have to go through your local health department, the CDC to get it,” said Dr. Peter Chin-Hong, professor of medicine. be licenced. infectious disease specialist at UC San Francisco.
The standard time to fill out a form for Tpoxx took doctors two hours, Daskalakis said, before efforts were shortened to 15 minutes.
Then came the controversy with the Danish vaccine manufacturer. While some vaccines were in stock, local health officials struggled to manage distribution with Websites are often down when nervous men and transgender people look for dates.
Some delays have occurred as officials debated how best to communicate with the LGBTQ community and what advice to give regarding sexual behavior.
“It’s very difficult because of the fact that people want to be as sexually active as possible,” Chin-Hong said. “There’s a lot of hesitation because you don’t want to seem like you’re embarrassing people.”
These early challenges may have given the virus a foothold across the country.
“The concern is that the delay has allowed the virus to grow stronger,” said Dr. Bruce Y. Lee, professor of health policy and management at the City University of New York School of Public Health. in the United States. “And if that is the case, then we will continue to pay the price of not responding faster and more efficiently for years to come.”
One thing that helps in the fight against mpox is the LGBTQ community.
That community experienced the HIV/AIDS pandemic that claimed many lives. It has also seen how public health interventions and scientific breakthroughs, especially with the development of pharmaceuticals, can not only enable people living with HIV to lead full lives. long-term integrity, but also to prevent new HIV infections. PrEP And PEP.
So when a new virus threatens that community, adherence to the public health message is strong and — in stark contrast to COVID-19 — has little resistance to vaccination. Ask for.
“I can’t think of anyone who wouldn’t want it. In fact, it’s the opposite; it has become a very sought-after item,” Chin-Hong said, referring to the vaccine. He added: “I think the legacy of HIV has shown so many ways in which communities have rallied not only to accept interventions like vaccines or seek help, but to become active as well. positive action.
A survey by researchers at Emory University found that in addition to accepting vaccines, many gay and bisexual men also modify their sexual behavior in response to mpox outbreaks. It establish that 48% of respondents reduce their sex partners and 50% of respondents reduce sex with partners found on dating apps like Grindr and at sex parties.
That change in behavior, “I think, surprised even people who know the community like I do,” Chin-Hong said, and contributed to the decline.
However, there is still much work to be done. CDC estimated that only 23% number of people in at-risk groups who received the vaccine. This is probably a symptom of pandemic fatigue after multiple unsuccessful vaccination efforts combined with risk reduction as cases dwindle.
The authorities hope that trusted voices of the community like Daskalakis, who is gay, will convey the message of mpox vaccination along with other sexual health practices. “I’ll tell everyone that it’s really good to be proactive in planning your summer… get your oil checked and the tires on as you get closer to the pride season.”
The ultimate lesson, experts say, is the importance of global cooperation to identify and combat deadly viruses.
Unlike COVID-19, mpox is not a novelty. For decades, countries in West and Central Africa have battled smaller outbreaks.
Experts say if wealthier nations like the United States had done more to share existing treatments and vaccines with these African nations, they could have prevented the mpox pandemic from spreading globally.
“As long as something is a threat in one part of the world, it can very easily spread to other places,” Lee said. “If more effort is made to control infectious diseases in lower-resourced countries, that will really help protect the United States.”
