Monkeypox outbreak slows as feds promise action and awareness

Sept. 15, 2022 — The number of Americans newly diagnosed with monkeypox has fallen by about 50% since early August, the White House and other federal health officials announced Thursday.

Although the general situation is improving, some regions of the United States are still seeing an increase in the number of infections. For this and other reasons, the CDC plans to keep “the pedal to the metal” and continue to educate, vaccinate and treat communities most at risk, said CDC Director Rochelle Walensky, MD.

“Over the past few weeks, we have been pleased to see a decline in the growth of new cases here and abroad,” Walensky said Thursday during a press briefing from the Monkeypox response team. White House and public health officials.

What’s exciting is that the administration’s strategy here is working,” Walensky said..

“It’s really important to say that we’re not the only ones with our foot on the gas pedal,” said Demetre Daskalakis, deputy coordinator of the White House Monkeypox Response. He said communities of gay, bisexual and other men who have sex with men, including men of color, have their “foot on the gas pedal as well.” This population helps officials understand how best to use the treatment drug TPOXX and the Jynneos vaccine, for example, and will be essential for ongoing research.

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

TPOXX and resistance concerns

Some experts have wondered whether tecovirimat, or TPOXX, an antiviral drug cleared by the FDA to treat the related pox virus, might one day become less effective against the virus.

“Any time you have a viral disease that is spreading with replication largely in the community and you’re using a single drug, there’s always the theoretical possibility of resistance,” said Anthony Fauci, MD, director from the National Allergy Institute. and infectious diseases.

“That’s why we’re uncomfortable when you only have one drug that’s been shown to work, or you prove it works, which is part of the clinical trial,” Fauci said.

Fauci’s team is sponsoring a clinical test which launched on September 8 and expects to enroll 500 adults and children. The researchers plan to assess the safety of the drug and determine whether tecovirimat works better than placebo on healing time, pain scores, preventing progression to severe monkeypox, etc. The risk of resistance will also be addressed in this lawsuit, Fauci said.

Future research will focus on other antiviral drugs, so there is more than one option, especially if resistance to tecovirimat emerges.

Immunization: Success, Equity Efforts, and Research

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

CDC data shows that 47% of people receiving a first dose are white, 21% are Hispanic and 12% are black.

Authorities are also reporting an increase in the number of people receiving their second dose of Jynneos in recent weeks. The recommended interval between the first and second dose of vaccine 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 maximum protection occurs 14 days after the second dose.

It’s the early adopters, or as Walensky describes them, “the people who roll up their sleeves before they reach the pharmacy,” who account for most of the vaccines so far.

Officials recognize that we are entering a more difficult phase in terms of vaccinating more reluctant people.

In an effort to “hide and go deeper” in at-risk communities, the White House plans to build on its previous success with outreach activities at major Pride events and expand the pilot program to more smaller community events, said Bob Fenton, White House Monkeypox Response Coordinator.

Effective interventions also depend on targeting men of color, which is part of the CDC Monkeypox Vaccine Equity Pilot Project.

“We’ve also seen the racial and ethnic makeup of this epidemic shift,” Walensky said. At first, cases of monkeypox were reported in mostly non-Hispanic white males. Over the past few weeks, however, the demographics have changed. Now, non-Hispanic white men represent 26% of cases, non-Hispanic black men 38%, and Hispanic or Latino men 25% of cases.

“As we said, fairness must remain the cornerstone of our response,” Daskalakis said.

In terms of vaccine research, NIAID sponsors a study to assess the effectiveness of administering the Jynneos vaccine between layers of skin rather than under the skin for protection against monkeypox. As of August 10, the FDA authorized the division of a single dose of Jynneos usually administered under the skin, or subcutaneously, into five doses administered between the layers of the skin, or intradermally. Now researchers are studying the safety and effectiveness of the practice further in the trial.

Monkeypox“Don’t travel alone”

Data shows that 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 previous year, according to a study published in the CDC’s Morbidity and Weekly Mortality Report on September 9.

“We are rapidly using this data to change the way monkeypox services can be supported by public health departments, clinics and community organizations,” Daskalakis said. “The same people we need to test for HIV and sexually transmitted infections and lead to prevention and care are the same people who need monkeypox-related services, such as testing, education and vaccines.”

“This significant change in guidance…allows our frontline health services and community organizations to use their HIV and STI resources to accelerate us all to the end of the monkeypox epidemic. .”

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