What does the future hold?

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Why does the CDC predict that monkeypox will not be “eliminated in the near future”? We asked the experts. Image credit: Joe Raedle/Getty Images.
  • The Centers for Disease Control and Prevention (CDC) has released a new technical report outlining the past, present, and future of monkeypox in the United States.
  • The agency expects the disease will not be eradicated in the United States for the foreseeable future.
  • For now, the agency is focusing its vaccination efforts on those most likely to be infected.

in a new technical reportthe Centers for Disease Control and Prevention (CDC) says the spread of monkeypox in the United States is slowing — at least for now.

So far, as of September 23, 2022, 24,846 cases have been reported in all 50 states, the District of Columbia and Puerto Rico, 94% of which are in males. The global total of reported cases is 68,428.

The long-term outlook, however, can be more complicated.

The CDC report predicts that “[d]domestic transmission [of monkeypox] in the United States is unlikely to be phased out in the near future.

Although monkeypox is not usually fatal – the few reported deaths have involved people with severely compromised immune systems – it is still an unwelcome experience. It is characterized by swollen lymph nodes, fever, muscle aches, and a painful, blister-like rash that appears on the face or at the site of infection. The rash usually dries up within a week or two.

CDC data shows that in the United States, monkeypox infection currently tends to occur primarily in men who have sex with men.

Monkeypox infection requires close personal contact. Monkeypox can be spread through an infected person’s breath through intimate physical contact, such as kissing, sex, or hugging. It can also be transmitted through saliva, through direct contact with fluid from wounds, and through its infectious rash.

The good news is that there are effective monkeypox vaccines based on genetically similar smallpox vaccines. The CDC encourages those at risk to get vaccinated, but does not currently recommend vaccination for the general population of the United States.

The recent slight reduction or stabilization of cases in the United States has not been reported in other countries.

For people who have been infected and for whom gender data is available to the CDC, 17,189 cases are male, 408 cases are female, 36 are transgender male, 117 are transgender female, 155 are people with another gender identity, and there is a person with multiple gender identities.

There have been 28 possible cases of children under 12 infected with monkeypox, although the CDC says some of those cases remain under investigation.

Dr. Patrick EH Jackson, an infectious disease expert at the University of Virginia, agreed with the CDC, saying Medical News Today this “[m]Most people who have no identifiable gender or occupational risk factors are unlikely to benefit from vaccination.

However, he added “people should consider vaccination based on their specific risk factors.”

“There are people who might want to get vaccinated against monkeypox who are not men who have sex with men – for example, people who are not [men who have sex with men] but have sexual partners who are [men who have sex with men]sex workers who are not [men who have sex with men]and some lab workers.

So far, demand for the vaccine hasn’t been as robust as it could be, said Dr. William Schaffner of Vanderbilt University School of Medicine in Nashville, TN.

He said DTM that “it took a while to make it available, but it was available, [and] it’s not like there was a huge demand. The requests have been steady, but nothing overwhelming.

“So our health services weren’t overwhelmed and they started trying to do a lot more outreach to the affected population. […] to try to get them to come and take advantage of the vaccine,” he said.

Dr. Schaffner suggested what might be causing the low demand for vaccines. “I think some of the things we’ve heard,” Dr. Schaffner added, “is that it’s not really a deadly disease, sometimes very mild,” and so people may not feel a sense of urgency. .

Dr Schaffner further cautioned: “Remember there are a lot of people who are still in the closet going to a public health location to ask for the vaccine – even if it is done in all confidence – could make many, at least some of these people, uncomfortable because it potentially exposes them to being exposed. Asking for the vaccine basically means, “I’m a member of this community,” and they may not all be ready for it. »

“We still have a lot of work to do to normalize proactive sexual health and empower people to protect themselves,” Dr. Jackson said.

“I fear that the recent reactionary turn in our political discourse, particularly aimed at transgender people, will only deepen this stigma and make it even more difficult to take care of everyone’s sexual health,” he added.

Moreover, in his opinion, “there will always be little appetite from political leaders and the general public to mobilize more resources to fight a new infectious disease after more than two years of the COVID-19 pandemic” .

“The fact that the vast majority of monkeypox cases occurred among [men who have sex with men]Dr. Jackson continued, “has only helped some politicians, who were engaged in an increasingly intense attack on the LGBTQ community even before this outbreak, to ignore the issue.

“It is, unfortunately,” noted Dr. Jackson, “a recurring theme in the field of infectious diseases: the burden of almost all infectious diseases falls most heavily on marginalized communities.”

Dr. Schaffner, however, is pleased that “[t]This is a population that public health has been focusing on for years because of HIV, and they have very, very good relationships with community leaders and organizations.

The CDC writes:

“Our current assessment for the most likely longer-term scenario is that the outbreak will remain concentrated in [men who have sex with men], with cases slowing over the next few weeks and dropping significantly over the next few months. We have moderate confidence in this assessment.

As for the long-term future, however, the agency is less optimistic, citing a number of unknowns for the future.

“I agree with the CDC,” Dr. Schaffner said. “I don’t think it’s an infection that we can eliminate.”

“But it is an infection,” he continued, “that can join the other infections that are transmitted largely through sexual intimacy that occur in our population.” However, “the longer it lasts in our population, the more likely it is to spread beyond currently affected communities.”

“And so down the road,” predicted Dr. Schaffner, “our diagnostic, treatment, and certainly prevention strategies may well have to change.”

“At the moment they continue to focus on that community because that’s where the vast majority of cases are still,” he said.

“Monkeypox,” Dr Jackson concluded, “is not a new disease, but when it seemed confined to Africa, very few people cared enough to develop vaccines and treatments.”

“The world is only getting smaller, and we will inevitably see both the emergence of new diseases, like COVID-19, and outbreaks of known diseases in new areas, like Ebola and monkeypox,” warned Dr. Jackson.

“Western governments need to start taking global health more seriously, if not out of humanitarian motivation, then out of sheer self-interest. If we don’t learn to fight infectious diseases abroad, we will eventually have to fight them at home,” he said.

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