Monkey pox is spreading faster than reported, hampering mitigation efforts

“This is a new and really fast-moving epidemic, and I think there have been some challenges to the US Centers for Disease Control and Prevention in a smooth and efficient way to send data across jurisdictions,” said Janet Hamilton, executive director. Director of the Council of State and Territorial Epidemiologists.

The CDC recently shared the demographics of monkeypox cases with the public for the first time, showing that the vast majority of cases were among men who have sex with men, with an average age of 36.

But the agency has detailed information about about half of the reported cases, CDC director Dr. Rochelle Valensky reported.

Monkeypox is now a notifiable disease, so public health departments work with local health officials to collect information about people who have been diagnosed and how they became ill. But states are still willing to share monkeypox data with the CDC.

CNN reached out to health departments in all 50 states; 29 responders, and all of them said they are willing to share case data with the CDC. And some said they were collecting more information than they were sharing.

As the U.S. grapples with yet another public health challenge amid the ongoing Covid-19 pandemic, Walensky said he was “surprised” by how little authority we have at the CDC to access data.

“We’re very eager to get as much information and informed decisions to the American public as possible. Again, as we did with Covid, we’re really challenged by the fact that we don’t have the authority to make them at the agency again. We’re working on that right now.” he said in an interview with The Washington Post on Friday.

For example, Valensky said, the CDC does not have data on who has been vaccinated against monkeypox and is not yet authorized to collect that data.

The only information shared publicly about monkeypox vaccines is weekly updates from the US Department of Health and Human Services on how many doses have been distributed to each state.

Last month, the CDC shared a draft data use agreement with states and other jurisdictions, an agreement that would essentially expand the agency’s access to data that states are collecting.

After soliciting feedback from states, the CDC shared a revised version of the agreement that focused only on vaccine administration data. States are reviewing the document and several have signed it.

According to the CDC, the latest version of the data use agreement has “the same requirements and infrastructure that states use to provide data on the Covid-19 vaccine.”

Monkeypox is not yet a public health emergency in the United States

Last month, the CDC activated its Emergency Response Center to coordinate the response to the monkeypox outbreak and mobilize additional resources. And over the weekend, the World Health Organization declared monkeypox an international emergency.
The WHO has declared monkeypox a public health emergency of international concern

However, monkeypox has not yet been declared a public health emergency in the United States. Over the weekend, US health officials said the US was still assessing the situation. US Health and Human Services Secretary Xavier Becerra said in a statement on Saturday that the US is “determined to accelerate our response in the coming days”.

A U.S. declaration of a public health emergency may result in a formal requirement to report certain information, but it is often used to mobilize funds, Hamilton said.

While the public health emergency for Covid-19 imposes reporting requirements on health care facilities such as hospitals, it does not apply to states and public health.

“Health departments are interested in providing agency data,” Hamilton said. “The public health system wants and needs to submit data.”

Even if the motivation is there, the infrastructure can complicate the process.

“We want to have a seamless, standardized process so that even as new diseases and conditions emerge, there is at least a way to automatically send basic data from the state’s notifiable disease system,” Hamilton said. “But the current infrastructure doesn’t have that.”

Instead, it’s a “highly manual process,” where states must manually enter all the information for each case or upload a file into the system, which may miss some fields if they’re not formatted the same way.

NYC monkey pox numbers 'deserve' not the full picture, health official says

Monkey pox, for example, shows evidence that it is often spread through prolonged physical contact, such as sex. People who have been tested for the virus may be willing to disclose to their clinic how many sexual partners they have had. However, if the surveillance database requires a specific number for this query, then categorical data collected by the clinical or health department may not be included in the case report.

Data modernization at the CDC is severely underfunded, Hamilton said.

“2020, believe it or not, was the first year the agency received appropriations for a comprehensive approach to managing disease surveillance data. And, of course, that was right after the pandemic hit.”

“We do not have enough details of the case”

In general, a lack of data hampers efforts to predict the spread of monkeypox.

“At this time, we do not have enough detailed data to develop reliable estimates,” a CDC spokesperson said.

The CDC’s new Center for Forecasting and Epidemic Analysis, officially launched this spring, is “working to better understand monkeypox,” including how to optimize interventions such as vaccines.

“We anticipate that we will be able to share as the outbreak progresses,” the spokeswoman said.

At the same time, the supply of the vaccine is not enough to meet the demand — and that includes a subset of the population that the CDC recommends getting it.

There may also be a small number of cases.

Walensky said three key reports he commercials expect cases to increase in the weeks due to: a form that makes it easier to report cases to states faster and easier, an increase in testing as labs begin offering the tests, and recent exposures. starting to show symptoms.

“It is true that we have work to do here and internationally, and we may see more cases of monkeypox in the near future, but through education and training, cases of monkeypox can be greatly reduced and the spread of current monkeypox can be limited. “On all fronts, we’ve made significant progress,” the CDC said in a statement to CNN.

CNN’s Brenda Goodman and Katherine Dillinger contributed to this report.

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