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Reuters
Julie Steenhuysen
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CHICAGO — Monkeypox cases in some major U.S. cities appear to be declining, matching trends seen in Europe, and experts are cautiously optimistic that the outbreak may have peaked in places hit hardest by the virus.
The World Health Organization said earlier on Thursday that cases of monkeypox reported worldwide fell by 21% last week, following a month-long upward trend in infections, but noted that cases in the United States continued to rise.
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However, some US experts believe that cases are beginning to decline, based mainly on immunity from previous infection and changes in behavior as awareness of the disease has grown. That doesn’t mean the disease will be contained, they warned.
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Since the end of May, the United States has recorded nearly 17,000 cases of monkeypox. The epidemic, which has so far reached 80 countries outside of Africa, where the virus is endemic, is primarily transmitted among gay and bisexual men.
Monkeypox, which is spread by close contact with an infected individual and the pus-filled sores characteristic of the disease, is rarely fatal.
Rollout of Bavarian Nordic’s Jynneos vaccine has been slow due to low supplies of the vaccine, which is also approved to prevent smallpox. But increased awareness of the risks and increased immunity appear to be slowing the spread.
“It’s very likely that the outbreak peaked last week,” said Dr. Gerardo Chowell, an infectious disease modeler at Georgia State University’s School of Public Health.
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Chowell’s latest model, released Thursday, projects a continued slowdown in new infections in the United States over the next four weeks. The drops may not be enough to quell the outbreak, but should bring infections to “very low levels,” he said.
The US Centers for Disease Control and Prevention (CDC) did not respond to requests for comment on the apparent trend.
Dr. Celine Gunder, an infectious disease epidemiologist and editor-in-chief at Kaiser Health News, said she believes behavior change is reducing transmission of monkeypox, but warned that “people get tired of behavior change” and transmission can rose again.
“I suspect the behavior change will only last until people get two doses of the Jynneos vaccine,” she said.
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For now, cases appear to be declining in some major U.S. cities hardest hit by the outbreak.
New York City Health Commissioner Dr. Ashwin Vasan acknowledged the declining cases in a tweet Thursday. “We are cautiously optimistic about these figures, but will be monitoring them closely to ensure this is a sustainable trend.”
Similarly, data tracking monkeypox infections in San Francisco and Chicago show that cases have started to decline in the past few weeks.
Chicago Department of Public Health spokesman James Scalzitti said the city may be changing, but more data is needed to confirm a downward trend.
There are other signs. According to data on the CDC’s website, the rate of positive tests in public health and some commercial laboratories — an indicator of the extent of transmission — has dropped sharply, from 55 percent positive on July 16 to 24 percent on Wednesday.
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“I think there has probably been some bending of the curve,” said Dr. Amesh Adalya, a senior scientist at the Johns Hopkins Center for Health Security.
He also attributes the shift to a combination of increased immunity, particularly among high-risk individuals who became infected early in the outbreak, behavioral changes and increased awareness.
Howard Brown Health, a system of 10 federally funded clinics in Chicago that has treated a third of monkeypox cases in Illinois, has seen a drop in both the number of cases and the rate of positive tests.
“I think this reflects a true decline in incidence,” said Laura Russi, director of epidemiology at Howard Brown. “It’s hard to say if it’s going to stick, but it’s promising.” (Reporting by Julie Steenhuisen Editing by Caroline Hummer and Bill Berkrot)
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