Sept. 15, 2022 – The number of Americans newly diagnosed with monkeypox has decreased by about 50% since early August, White House and other federal health officials announced Thursday.
While the overall picture is improving there are still areas in the U.S. that see an increase in infection rates. For this and other reasons, the CDC plans to keep “the pedal to the metal” and continue educating, vaccinating, and treating communities at highest risk, said CDC Director Rochelle Walensky, MD.
“Over the last several weeks, we’ve been pleased to see a decline in the growth of new cases here and abroad,” Walensky said Thursday at a press briefing by the White House Monkeypox Response Team and public health officials.
What’s exciting is that the administration strategy here is working,” Walensky said.
“It’s really important to say we’re not the only ones who have our foot on the gas pedal,” said Demetre Daskalakis, White House Monkeypox Response deputy coordinator. 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 too.” This population is helping officials understand how best to use the treatment drug TPOXX and the Jynneos vaccine, for example, and will be essential to ongoing research.
Also, Monkeypox was identified in Very few womenOfficials noted that no further transmission occurred in any of these cases.
TPOXX and Concerns about Resistance
Some experts are questioning whether TPOXX or tecovirimat (an FDA-approved drug that treats smallpox virus), will ever be less effective.
“Whenever you have a viral illness that spreads with replication largely in the community and you have a single drug that you’re using, there is always the theoretical possibility of resistance,” said Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases.
“That’s the reason why we’re uncomfortable when you only have a single drug that has been shown to have efficacy, or you’re proving that it has efficacy, which is part of the Clinical trial,” Fauci said.
Fauci’s team is sponsoring a clinical trialThe drug was launched on Sept. 8, and 500 children and adults will be enrolled in the program. Researchers plan to evaluate the drug’s safety and whether tecovirimat works better than placebo on healing time, pain scores, preventing people from progressing to severe monkeypox, and more. Fauci also stated that this trial will address the risk of resistance.
Future research will examine other antiviral drugs to ensure there are more options, especially if resistance does develop to tecovirimat.
Vaccination: Successes and Equity Efforts. Research
Walensky stated that more than 540,000 Jynneos vaccinations have been given in 39 countries reporting data to CDC.
According to CDC data 47% are white and 21% are Hispanic.
Officials have also reported an increase in the number of people who have received their second doses of Jynneos in recent weeks. 28 days is the recommended time period between your first and second vaccination doses.
“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 said that the peak protection is found 14 days after the second dose, according to current data.
It’s the early adopters, or as Walensky describes them, “the people who roll up their sleeves before they’ve reached the pharmacy,” that account for most vaccinations so far.
Officials recognize we’re entering a more challenging phase in terms of getting more reluctant people vaccinated as well.
In an effort to “hunker down and go deeper” into communities at risk, the White House plans to build on their previous success with Outreach at large pride eventsBob Fenton is the White House Monkeypox Response coordinator.
Effective interventions depend on targeting men who are not of color, which is part CDC Monkeypox Vaccine Equity Pilot Project.
“We have also seen the racial and ethnic makeup of this outbreak evolve,” Walensky said. Monkeypox was first seen in non-Hispanic whites. The demographics have changed in the past few months. The non-Hispanic White Men account for 26% and the non-Hispanic Black Men for 38% respectively, while Hispanic or Latino Men account for 25%.
“As we’ve said, equity must remain the cornerstone of our response,” Daskalakis said.
The NIAID sponsors vaccine research. StudyThe effectiveness of administering Jynneos vaccine under the skin rather than between layers of skin was evaluated. The FDA approved the division of one dose of Jynneos that is usually given under the skin or subcutaneously into five doses to be administered between layers of skin or intradermally. Now researchers are looking at the practice’s safety and efficacy further in the trial.
Monkeypox‘Does Not Travel Alone’
Data show that monkeypox doesn’t travel alone. Daskalakis stated that existing services, which focus on HIV and sexually transmitted infection in affected communities, are another way to educate and reduce the disease.
For example, 38% of 1,969 people diagnosed with monkeypox had HIV and 41% had an STI in the prior year, according to a study published in the CDC’s MorbidityMortality Weekly Report Sept. 9.
“We quickly use this data to change how monkeypox services can be supported by public health departments, clinics, and community-based 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, like testing, education and vaccines.”
“This important change in guidance … allows our frontline health departments and community-based organizations to use their HIV and STI resources to accelerate us all to the end of the monkeypox outbreak.”
