States of emergency have been declared in California, New York, and Illinois

Governor of California. Gavin Newsom (D) speaks to reporters after meeting with Speaker of the House Nancy Pelosi at the U.S. Capitol, July 15, 2022.

Tom Williams | CQ-Roll Call, Inc. via Getty Images

Governor of California. Gavin Newsom on Monday declared a state of emergency due to the rapidly spreading monkeypox outbreak, the third US state in as many days.

Newsom said the emergency declaration would help support the state’s vaccination efforts. Demand for vaccines has outstripped supply as infections have increased. Officials at sexual health clinics and other sites struggle to keep up with the influx of people seeking shots.

California is mobilizing EMS workers to help administer vaccines. Newsom said the state is working at all levels of government to slow the spread through testing, contracting and public outreach.

California’s declaration comes after Illinois declared a public health emergency on Monday. New York declared a state of emergency late Friday in response to the outbreak.

The US has reported nearly 6,000 cases of monkeypox in 48 states, Washington and Puerto Rico, according to the Centers for Disease Control and Prevention. The outbreak has spread rapidly since health authorities in Boston confirmed the first US case in May.

California, Illinois and New York – home to the nation’s three largest cities – account for 47% of monkeypox infections in the US, with New York the epicenter of the US outbreak, with nearly 1,400 confirmed cases as of Monday.

Monkeypox is rarely fatal, and no deaths have yet been reported in the United States. However, some patients experience excruciating pain from the rash caused by the virus. Scientists and public health officials are concerned that monkeypox may be endemic in the United States.

The World Health Organization declared monkeypox a global health emergency last month. According to the WHO, more than 19,000 cases of monkeypox have been reported in at least 78 countries. The outbreak is unusual because the virus is widespread in North America and Europe. In the past, monkeypox was spread at low levels in West and Central Africa, where the virus was carried by rodents and other animals.

Monkey pox is primarily transmitted through skin-to-skin contact. Gay and bisexual men are now at the highest risk of infection, according to public health officials. According to the CDC, 98% of patients who provided demographic information to clinics identified as men who had sex with men.

But health officials have repeatedly emphasized that monkeypox can be spread through physical contact with contaminated materials such as towels and sheets, or with the characteristic rash. Last month, the CDC confirmed the first two cases of the virus in children in the United States, which were linked to their families.

Monkeypox can also be spread through respiratory droplets when an infected person has sores in their mouth, but this requires prolonged face-to-face interaction, according to the CDC. According to health officials, physical contact is the main way of transmission.

US public health emergency

The Biden administration is considering whether to declare a public health emergency in the US, according to senior federal health officials. This will help mobilize resources for public health officials fighting the outbreak. The last time the US declared a public health emergency in response to Covid-19 was in January 2020.

Lawmakers in Congress and local communities have criticized the pace of the federal government’s response, but Health Secretary Xavier Becerra said last week that the Biden administration was doing everything it could to increase resources to fight the outbreak. Becerra said states should do more to prevent infections and Congress should pass funding to respond to the outbreak.

The Department of Health and Human Services has delivered 330,000 doses of monkeypox vaccine to state health departments since May. HHS released another 786,000 doses to states and other jurisdictions on Friday. But some clinics that administer vaccines say they still don’t have enough vaccines to meet demand.

In 2019, the Food and Drug Administration approved a two-dose Jynneos vaccine for people at high risk of getting mumps or smallpox. Jynneos, made by Danish biotech company Bavarian Nordic, is the only FDA-approved monkeypox vaccine in the US.

The U.S. has the capacity to conduct 80,000 tests a week after bringing in several commercial labs last month, the CDC said. But the number of confirmed infections in the U.S. may be low because people don’t get tested until they develop a rash, which can take weeks in some cases. Clinicians will swab the rash to obtain a sample for testing.

The US also has 1.7 million courses of antiviral treatment in a strategic national stockpile. Doctors can use tecovirimat to treat monkeypox, but the drug is only approved for smallpox because it requires an extra layer of bureaucracy. The CDC cut red tape last month to make it easier for doctors to prescribe the vaccine.

Monkeypox is in the same family of viruses as smallpox, but it causes milder disease.

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