U.S. may still contain disease, experts say: NPR

People line up in Brooklyn to get the monkeypox vaccine.

Kena Betancur/AFP via Getty Images

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Kena Betancur/AFP via Getty Images

People line up in Brooklyn to get the monkeypox vaccine.

Kena Betancur/AFP via Getty Images

After the World Health Organization declared a public health emergency, epidemiologists and public health experts warn that time is running out to contain an outbreak of monkeypox in the United States that has infected nearly 3,000 Americans.

“We’re losing daylight,” UCLA epidemiologist Anne Rimoin, who has studied monkeypox for decades, told NPR. “Every day we don’t make progress on all fronts, the less chance we have of catching it.”

US officials have expanded testing, made tens of thousands of vaccines available, and plan to release 1.6 million more doses in the coming months.

But limited supplies have not kept up with demand, some health officials said. Despite limited testing, the number of cases has risen so rapidly in recent weeks that a greater response may be needed to prevent an outbreak, experts say — if containment is still possible.

“It will be difficult, but it should still be the goal,” said Dr. Preeti Malani, an infectious disease specialist at the University of Michigan, told NPR. “What we do in the coming days and weeks will really determine where we are in a few months.”

The US is approaching 3,000 cases of monkeypox

Over the weekend, the World Health Organization declared the outbreak a public health emergency. Biden administration officials said they are debating whether to declare a state of emergency in the United States

The discussions represent a change in tone since the outbreak began in May. Then, outside of Africa, there were only a few cases where the disease was endemic, and health officials in the United States and around the world believed the disease was contained.

Friday afternoon, the CDC said 2,891 cases of monkeypox in the US – 10 times more than a month ago.

The CDC conducted tests before the outbreak — a significant difference from COVID-19 — but experts complained that the agency was testing cases too slowly. The Biden administration began shipping tests to commercial labs in late June, expecting testing capacity to “surge” by July.

“We are behind in many ways, including rapid testing and the ability to treat patients who need treatment,” Malani said.

Searching for contacts can also help fight the virus.

“Ultimately, we can’t vaccinate and treat monkeypox,” Malani said. “Prevention is key.”

Monkey pox has a long incubation period, he said. After initial exposure, it may take several weeks for symptoms to appear. Strong contact tracing efforts can help isolate people with monkeypox and seek tests or vaccines before symptoms appear.

The virus is usually spread through prolonged physical contact. It is not a sexually transmitted disease; It can be spread through non-sexual physical contact, or through clothing or bedding used by an infected person. The disease can also be transmitted through respiratory droplets.

As in other Western countries, the epidemic in the US has mostly affected men who have sex with other men. But the CDC also reported infections in a small number of cisgender women. And on Friday, the agency announced the first documented cases of children — a toddler from California and a family traveling in Washington, D.C.

Lessons from COVID-19

Specialists noted that the monkeypox disease occurred at a time when the population had a high level of information about infectious diseases. The COVID pandemic has introduced Americans to public health concepts such as isolation, rapid testing and contact tracing.

But other lessons from COVID haven’t stuck, such as how early and how hard to act when an outbreak is still confined to a few people.

“I hate to say it, but I say, ‘Here we go,'” Rebecca Fisher, an infectious disease specialist at Texas A&M University, told NPR.

Scientists immediately note that the two diseases are very different from each other. They belong to different families of viruses and require different levels of communication to spread. In general, COVID is more contagious.

According to Fisher, many of the lessons from COVID can be applied to other infectious diseases.

“Public health thinks we’ve learned this great thing — that if we hope to achieve reductions and containment, we need to respond aggressively in advance, and we need a lot of resources and a lot of attention in advance,” Fisher said. “It is also my understanding that aggressive preemptive action did not actually occur.”

Even so, public health officials and epidemiologists say containment is possible.

Unlike COVID, monkeypox was known to researchers until now. The disease was first discovered in humans more than 50 years ago, and its similarity to smallpox means that smallpox treatments and vaccines are also effective against monkeys. Millions of doses are stockpiled in the US.

“I think it’s completely contained. But it depends on the resources to do it and how quickly we can act,” UCLA’s Rimoin said. “It really takes a concerted effort locally, nationally and globally.”

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