- Monkeypox was recently renamed mpox to get rid of the stigma that associated the disease with monkeys.
- The United States is reporting an average of six mpox cases per week, up from more than 600 in August.
- Experts say Mpox may never entirely leave the country, but current case numbers suggest vaccines and treatments are working.
The Biden administration on Friday declared the end of the public health emergency for the disease formerly known as monkeypox, which now accounts for less than 10 new cases a day in the United States.
The Department of Health and Human Services has announced that it does not expect to need to renew the declaration of emergency when it ends on January 31, 2023.
“But we won’t let go of the accelerator – we will continue to monitor case trends closely and encourage everyone at risk to get the vaccine for free,” Secretary Xavier Becerra said in a prepared statement.
So how did an infectious disease that seemed out of control this summer become almost irrelevant three months later? It’s a combination of luck, good behavior and effective vaccines, experts say.
Last week, the World Health Organization renamed monkeypox to mpox to get rid of the stigma that associated the disease with monkeys. Monkeys don’t spread the virus, but it was first identified decades ago, hence the original name.
The virus – similar to smallpox but much milder – had been contained on the African continent until last spring, when it suddenly appeared in Europe and then the United States, spreading widely among men who have sex with men. men.
The first cases were detected in the United States in mid-May, with a peak reached on August 1, when 638 cases were reported. Now the seven-day rolling average of cases is just six.
“The outbreak has been contained, but it’s not ‘mission accomplished’ because the virus is still there,” said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University Medical Center in Nashville, Tennessee.
More coverage on mpox from USA TODAY:
Mpox cases are down but not gone
Mpox may never leave the country entirely, said Dr. Daniel Griffin, division chief of infectious diseases and travel medicine for Optum Health.
The high volume of cases – around 30,000 in total, which was likely an undercount – “suggests that mpox is already widely distributed in the United States,” he said by email.
Both he and Schaffner fear more cases will be missed as the virus hits populations who have never seen it before and doctors don’t think about the disease.
Additionally, people with the virus remain contagious for up to three weeks, likely too long for a person to remain fully isolated. With widespread transmission, it is also possible that it infects animal carriers – usually rodents – and then reverts to humans.
But the fact that the number of cases has been brought down so low suggests that current vaccines and treatments are working, Griffin said.
The mpox virus usually requires significant contact to spread. Unlike COVID-19, which can pass easily through the air, physical contact with open wounds or bodily fluids is the most likely route of transmission.
The outbreak has primarily affected men who have sex with men, not because mpox is a “gay disease” or an African disease, Griffin said, but because “mpox is an infectious disease.” Griffin said the virus’ old name had “racial and stigmatizing associations and wished it had been recognized and asked for much sooner.”
Lawyers also supported the name change.
“Public health officials and authorities need to break down all barriers to better understand how viruses spread and who is most affected,” said Sarah Kate Ellis, president and CEO of advocacy organization GLAAD. lesbian, gay, bisexual, transgender and homosexual rights. in a report.
“Decades of public health research show that stigma slows vaccine testing, treatment, access to care and equity, especially in communities of color, which are often disproportionately impacted by global epidemics.”
The gay community has rallied to stop the spread of mpox
Griffin credits behavioral changes within the gay community with stopping the spread of the virus.
“We were lucky with the spread of mpox that the most affected population didn’t suffer from the widespread adoption of anti-science misinformation and we were quick to embrace vaccines, proactive to get treatment, really reduced behaviors at risk,” he said via email.
The initial message from the Centers for Disease Control and Prevention about mpox scared off many people who were not at risk of contracting the disease and did not spur action among those at high risk, said Dr Peter Chin- Hong, an infectious disease specialist and professor at the University of California San Francisco School of Medicine.
Once the messages became more specific, the gay community took action and drove infection rates down, he said.
“People were so terrified of the scars and how they looked that everyone rushed to get (vaccinated),” he said.
Some people report on dating apps whether they’ve been vaccinated or cured of mpox, Chin-Hong said. If another outbreak were to occur, he said, “there would probably hopefully be a more rapid call-up of troops and the establishment of all interventions.”
Modification of the mpox vaccination policy
When the outbreak was at its peak, the CDC decided to conserve vaccines by delivering a smaller dose into the skin rather than under it.
The intradermal puncture appears to have been effective in the short term, Schaffner said, but now he would like to see a return to intradermal punctures, which are likely more effective and less likely to leave a mark on the skin.
The intradermal puncture often leaves a circular colored patch on the forearm, “almost like a scarlet letter,” Chin-Hong said. Having that scar or those scars from an mpox infection, he said, “you kind of declare yourself to be part of the community, which not everyone is necessarily comfortable with.”
An intradermal injection does not leave a permanent scar.
The real benefit of an intradermal vaccine is the ability to get more doses from the same vial, Chin-Hong said, meaning more could be provided to the rest of the world.
DURING THE SUMMER:Biden officials announce 1.8 million doses of mpox vaccine
The outbreak peaked at a time when there were a lot of social events. Now, with the end of the Pride season, the virus has died down but could reappear when social activities resume, Chin-Hong said.
Most of the outbreak has been driven by cases in major cities, particularly New York, Los Angeles and San Francisco. Chin-Hong fears there may be undetected cases in rural and other areas where doctors are less likely to recognize symptoms.
The open sores were both painful and visible, making them socially stigmatizing, he said. “It was a visible reminder of the community you belong to.”
It also evoked memories of Kaposi’s sarcoma, purplish skin tumors that had been one of the most obvious symptoms of the AIDS epidemic of the 1980s and 1990s, before drugs turned it from a universal infection. fatal in chronic infection.
“For me, what was striking about mpox was the fact that it caused so much suffering,” he said.
Contact Karen Weintraub at kweintraub@usatoday.com.
Coverage of patient health and safety at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.
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