Fridae

We're seeing different responses from different governments in relation to the community transmission of a strain of the Monkeypox virus.

In the US, the government is pursuing a vaccine-led response - targetting the most at-risk communities and those with the highest number of cases.

Following announcements by the Biden administration, the US Department of Health and Human Services will send 56,000 doses of the Jynneos vaccine immediately to areas with high transmission. An additional 240,000 doses will be distributed over the next few weeks, with even more to come in the following months. Officials expect to make at least 1.6 million doses available by the end of the Autumn.

States with the highest numbers of cases include California, New York, Illinois and Florida, as well as Washington, D.C., according to the latest count from the Centers for Disease Control and Prevention.   

"We are recommending that vaccines be provided to both people with known monkeypox exposures who are contacted by public health and also to those people who’ve been recently exposed to monkeypox,” the CDC’s director, Dr. Rochelle Walensky, said at a news briefing Tuesday. 

The CDC is prioritising initial access to the vaccine for people who have been in close contact, including sexual contact, with someone who has diagnosed with the virus. The agency will also provide vaccines to men who have sex with men who report having had multiple recent sex partners at a venue or party where the virus is known to have spread, or who have had sex with multiple partners in an area of the country with elevated spread. 

The vast majority of confirmed monkeypox cases, both in the US and in the global outbreak as a whole, have been among men who have sex with men. There are a number of factors that could be centring detection around gay men - most importantly, gay men are regularly testing for STIs so are more likely to detect the presence of the Monkeypox virus.

While case numbers continue to rise in the US, the White House Covid-19 coordinator, Dr. Ashish Jha, seemed hopeful the U.S. could contain the outbreak and said it was important to remain vigilant.

“Monkeypox is not novel,” Jha said at the briefing. “We as a global community have known about it for decades. We know how it spreads. We have tests that help identify people who are infected. We have vaccines that are highly effective against it.”

Official statistics put the number of confirmed cases of Monkeypox in the US as around 300. However, it's accepted that this likely to be a significant undercount of the actual incidence of the virus.

“We’ve already lost control of this outbreak,” said David Harvey, the executive director of the National Coalition of STD Directors. “We think there’s many more cases, and we need to act now to get control of this outbreak.”

The two-dose Jynneos vaccine, which is approved by the Food and Drug Administration, not only prevents infection, but it can also be used to stop an infection after a person is exposed. Walensky said that people should get vaccinated within two weeks of exposure but that the vaccine works better the sooner it’s given. The doses are given 28 days apart.

An older vaccine that is FDA-approved for smallpox but also protects against monkeypox is also available, but it isn’t recommended because it can’t be given to anyone who is immunocompromised, or people with HIV.

The virus is marked by a rash that looks like pimples or blisters, along with symptoms like fever, headache, muscle aches, swollen lymph nodes and chills. Symptoms typically begin seven to 14 days after exposure, but they may start earlier or as late as 21 days after exposure. 

In the current outbreak, the monkeypox virus is being spread primarily through intimate contact, including sex and prolonged face-to-face interactions, Dr. Jennifer McQuiston, the deputy director of the CDC’s High Consequence Pathogens and Pathology Division, said at the briefing.

Epidemiologists who have studied monkeypox are concerned that the CDC’s numbers don’t reflect the true scope of the outbreak and that the US may be reacting too slowly to stop case numbers from escalating. 

What is Monkeypox?

The name "monkeypox" comes from the first documented cases of the illness, in 1958, when two outbreaks occurred in colonies of monkeys kept for research.

But monkeys aren't major carriers. Instead, the virus is generally spread by squirrels, pouched rats, dormice or another rodent.

How do you catch Monkeypox?

Primarily, from an animal bite, scratch or contact with the animal's bodily fluid. Then the virus can spread to other people through coughing and sneezing or contact with pus from the lesions.

The lesions from monkeypox are similar to those from a smallpox infection.

It's previously been thought that transmission of Monkeypox between people was a very low risk.

But, now it is transmitting between people, which is something that health experts are keeping a close eye on.

How dangerous is Monkeypox?

Monkeypox can be a nasty illness - it causes fever, body aches, enlarged lymph nodes and, eventually, painful, fluid-filled blisters on the face, hands and feet. One version of monkeypox is quite deadly and kills up to 10% of people infected. The version currently spreading around the world is milder. Its fatality rate is less than 1%. A case generally resolves in two to four weeks.

What should I do if I think I might have been exposed to Monkeypox?

If you notice any unusual rashes or lesions, and you think you might have been exposed to the virus through sexual contact, then contact your local sexual health service for advice.