Monkeypox Outbreak Slows as Feds Promise Action, Outreach

Sept. 15, 2022 The variety of Americans newly identified with monkeypox has decreased by about 50% since early August, White House and different federal well being officers introduced Thursday.

Although the general image is bettering, there are nonetheless some areas within the US seeing rising an infection numbers. For this and different causes, the CDC plans to maintain the pedal to the steel and proceed educating, vaccinating, and treating communities at highest danger, mentioned CDC Director Rochelle Walensky, MD.

Over the final a number of weeks, we have been happy to see a decline within the development of latest circumstances right here and overseas, Walensky mentioned Thursday at a press briefing by the White House Monkeypox Response Team and public well being officers.

What’s thrilling is that the administration technique right here is working, Walensky mentioned.

It’s actually necessary to say we’re not the one ones who’ve our foot on the gasoline pedal, mentioned Demetre Daskalakis, White House Monkeypox Response deputy coordinator. He mentioned communities of homosexual, bisexual, and different males who’ve intercourse with males, together with males of shade, have “their foot on the gas pedal too. This population is helping officials understand how best to use the treatment drug TPOXX and the Jynneos vaccine , for example, and will be essential to ongoing research.

Monkeypox has also been identified in a small number of womenbut in each of these cases no further transmission has occurred, officials noted.

TPOXX and Concerns About Resistance

Some experts have questioned whether tecovirimat, or TPOXX, an antiviral drug authorized by the FDA to treat the related smallpox virus, might someday become less effective against the virus.

Whenever you have a viral illness that spreads with replication largely in the community and you have a single drug that you’re using, there is always the theoretical possibility of resistance, said Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases.

That’s the reason why we’re uncomfortable when you only have a single drug that has been shown to have efficacy, or you’re proving that it has efficacy, which is part of the clinical trial, Fauci said.

Faucis team is sponsoring a clinical trial that launched Sept. 8 and plans to enroll 500 adults and children. Researchers plan to evaluate the drugs safety and whether tecovirimat works better than placebo on healing time, pain scores, preventing people from progressing to severe monkeypox, and more. The risk of resistance will also be addressed in this trial, Fauci said.

Future research will investigate other antiviral medications so there is more than one option, especially if resistance to tecovirimat does emerge.

Vaccination: Successes, Equity Efforts, and Research

More 540,000 doses of the Jynneos vaccine have been administered across 39 jurisdictions reporting data to the CDC, Walensky said.

CDC data shows 47% of people getting a first dose are white, 21% are Hispanic, and 12% are Black.

Officials also report an increase in people receiving their second dose of Jynneos over the past few weeks. The recommended time between the first and second vaccine dose is 28 days.

As a reminder, Jynneos is a two-dose vaccine and it is important to receive the second dose in the series to have the best protection against monkeypox, Walensky said. She added that current data suggests peak protection occurs 14 days after the second dose.

Its the early adopters, or as Walensky describes them, the people who roll up their sleeves before theyve reached the pharmacy, that account for most vaccinations so far.

Officials recognize were entering a more challenging phase in terms of getting more reluctant people vaccinated as well.

In an effort to hunker down and go deeper into communities at risk, the White House plans to build on their previous success with outreach at large pride events and expand the pilot program to smaller community events, said Bob Fenton, White House Monkeypox Response Coordinator.

Effective interventions hinge on targeting men of color as well, which is part of the CDC Monkeypox Vaccine Equity Pilot Project.

We have also seen the racial and ethnic makeup of this outbreak evolve, Walensky said. At first, monkeypox cases were reported in primarily non-Hispanic white men. In the past few weeks, however, the demographics have shifted. Now non-Hispanic white men account for 26% of cases, non-Hispanic black men for 38%, and Hispanic or Latino men for 25% of cases.

As we’ve said, equity must remain the cornerstone of our response, Daskalakis said.

In terms of vaccine research, the NIAID is sponsoring a study to evaluate the effectiveness of administering the Jynneos vaccine between layers of skin instead of under the skin for protection against monkeypox. As of Aug. 10, the FDA allowed the splitting of a single dose of Jynneos typically given under the skin, or subcutaneously, into five doses given between layers of the skin, or intradermally. Now researchers are looking at the practices safety and efficacy further in the trial.

MonkeypoxDoes Not Travel Alone

Data shows monkeypox does not travel alone, so using existing services that focus on HIV and sexually transmitted infections in affected communities is another strategy to educate and reduce monkeypox, Daskalakis said.

For example, 38% of 1,969 people diagnosed with monkeypox had HIV and 41% had an STI in the prior year, according to a study published in the CDCs Morbidity and Mortality Weekly Report on Sept. 9.

We rapidly use this knowledge to vary how monkeypox companies could be supported by public well being departments, clinics, and community-based organizations, Daskalakis mentioned. The identical individuals we have to check for HIV and sexually transmitted infections and result in prevention and care are the identical individuals who want monkeypox-related companies, like testing, training and vaccines.

This necessary change in steering … permits our frontline well being departments and community-based organizations to make use of their HIV and STI sources to speed up us all to the top of the monkeypox outbreak.

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