By Jacqueline Howard, CNN
(CNN) – As the number of monkeypox cases rises amid an ongoing global outbreak, U.S. health officials said Friday they were stepping up testing and contact tracing and expanding access to vaccines. and treatments.
As part of those efforts, about 1,200 doses of the monkeypox vaccine have been offered in the United States, said Dr. Raj Panjabi, White House senior director for global health security and biodefense.
“We want to ensure that those exposed to high risk have timely access to vaccines and, if they become ill, can receive appropriate treatment. To date, we have delivered approximately 1,200 vaccines,” Panjabi said. “And 100 treatment courses in eight jurisdictions, and we have more to offer the states.”
Massachusetts healthcare workers treating patients with monkeypox were among the first to receive vaccines to protect them against the virus.
In the United States, the two-dose Jynneos vaccine is licensed to prevent smallpox and specifically to prevent monkeypox. Another smallpox vaccine licensed in the United States, ACAM2000, can also be used for monkeypox.
To date, more than 120 orthopox PCR tests have been performed in the United States as part of outbreak surveillance.
“That’s only a fraction of what’s available,” Panjabi said, adding that 67 labs across 46 states — part of a network known as the Laboratory Response Network — have the “collective capability.” to perform more than 1,000 tests per day.
“So what we’re working on now is making sure that testing capacity is used,” he said. People with symptoms of monkeypox are encouraged to see a health care provider, and providers are asked to test if they suspect someone might have monkeypox.
There could be ‘community-level’ spread, CDC official warns
On Friday, officials from the US Centers for Disease Control and Prevention urged clinicians to be on the lookout for possible cases of monkeypox, as the virus could spread at the community level.
Twenty cases of monkeypox have been identified in 11 states, along with an additional case in the United States who was infected and tested elsewhere, said Dr. Jennifer McQuiston, deputy director of the CDC’s Division of Pathogens and High-Consequence Pathologies. .
All patients are recovering or have recovered, and those who still have a rash are advised to stay home and isolate themselves from others until fully recovered.
“I want to emphasize that this could happen in other parts of the United States. There could be community-level transmission, and that’s why we really want to increase our surveillance efforts,” McQuiston said. “We really want to encourage doctors that if they see a rash and they’re worried it’s monkeypox, to go ahead and test that.”
She added that the rashes appearing as a result of monkeypox infections in this outbreak can be subtle and easily confused with other types of infections, especially sexually transmitted infections – and there could be co-infections. of monkeypox with STIs.
McQuiston said the rash from a monkeypox infection usually appears as “deeply seated” and “well-rounded” lesions that progress to raised or fluid-filled pustules. It could be confused with other infectious diseases like herpes or syphilis, she added.
“That being said, we don’t want to downplay this condition. The rash caused by monkeypox virus can spread widely through the body or show up in sensitive areas like the genitals,” McQuiston said. “It can be very painful, and some patients have reported needing prescription painkillers to manage this pain. Wounds can also cause long-term scarring of the skin.”
An analysis of genetic sequence data from cases in the United States indicates that two genetically distinct variants of monkeypox may be circulating, McQuiston said.
Genetic sequence data is “certainly interesting from a scientific point of view”, but “to determine how long the monkeypox virus has been circulating for, it will be necessary to analyze many more sequences from many more patients to start to piece this puzzle together in a clearer way,” she said. “It’s certainly possible that there have been cases of monkeypox in the United States that have gone unnoticed before, but not to a degree raised.”
She added that the risk to the public is still low and that finding cases with distinct lineages is a “positive sign” that the country’s surveillance network is working.
CDC researchers and health officials released a report on Friday describing multiple cases of monkeypox in the United States, noting that “ongoing investigation suggests person-to-person community transmission, and the CDC urges healthcare, clinicians and the public to remain vigilant, institute appropriate infection prevention and control measures, and notify public health authorities of suspected cases to reduce the spread of disease.”
Of the 17 cases described in the report in nine states, all patients had a rash, 14 of them said they had traveled abroad in the 21 days before their symptoms, and all but one identified as male who have sex with men (MSM). Three were immunocompromised. All patients were adults.
“The high proportion of initial cases diagnosed in this outbreak among people who identify as gay, bisexual or other MSM, may simply reflect an early introduction of monkeypox into interconnected social networks; this finding may also reflect verification bias in because of strong and established relationships between some MSM and clinical providers with strong STI services and broad knowledge of infectious diseases, including rare conditions,” the CDC researchers wrote in the report.
“However, infections are often not limited to certain geographic areas or population groups; because close physical contact with infected people can spread monkeypox, anyone, regardless of gender or sexual orientation, can contract and spread monkeypox.”
Globally, according to World Health Organization officials, more and more countries are reporting cases of monkeypox that have never seen the virus before.
“Cases have been reported in 26 countries” where the virus is not endemic, said Maria Van Kerkhove, head of emerging diseases and zoonoses and WHO technical lead on Covid-19, during a point press Thursday. She added that more than 600 cases have been identified in these countries.
“As surveillance increases, as attention increases, we expect more cases to be identified,” she said. “Many public health outbreak investigations are ongoing.”
Rosamund Lewis, the WHO’s technical lead for monkeypox, said on Tuesday that this outbreak was different from previous ones because “we are all seeing cases appear in a relatively short period of time.”
“What we’re seeing now started as a small cluster of cases, then investigation quickly led to the discovery of infections in a cluster of men who have sex with men, and that led to other investigations, and so we don’t yet know what the source of the actual outbreak is,” Lewis said. “What’s most important now is not to stigmatize.”
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