The monkeypox epidemic is spreading at an alarming rate. Ideally, it should have been nipped in the bud when the first cases appeared in May and June outside West and Central Africa, where monkeypox has been endemic for decades. The number of cases has now risen to more than 11,000, including 1,470 in the United States, and is expected to rise in the coming weeks. The lessons of the coronavirus pandemic should be taken to heart and should lead to a faster response.
Although monkeypox sometimes causes serious illness in humans, the virus is not as contagious or deadly as the coronavirus. Monkeypox is usually transmitted through close contact with lesions and skin or with objects that have been in contact with an infected person, such as sheets or towels. Most cases reported so far involve men who have reported recent sex with one or more male partners, though not exclusively, according to the World Health Organization. That suggests “there is currently no signal of sustained transmission outside these networks,” the agency said. But this should not lead to complacency. There is a danger that the disease will take root in this community or spread to other populations.
Every effort must be made to fight the virus where it is. This is not a gay disease, but a disease circulating in the gay community, a vital but difficult distinction that public health officials face. The HIV/AIDS pandemic has shown the devastating impact of stigma, which has dissuaded people from receiving services. Public health workers must be careful to avoid discrimination and stigma while aggressively monitoring the disease. Waiting for patients to come to the clinics is not enough. Public health agencies should partner with LGBTQ and AIDS organizations to bring testing and tracking into the community. A recent report in The Post found that early testing efforts in the U.S. are lagging behind, although the number of tests now appears to be increasing. A limitation is that the current tests do not capture the initial symptoms, but only check for lesions that appear after an incubation period of approximately one to two weeks.
Another worrying problem is the shortage of vaccines. Two are licensed by the Food and Drug Administration. Both are designed to fight smallpox, but also protect against monkeypox. One of them, the two-dose Jynneos, developed by Bavarian Nordic, a small Danish company, causes fewer side effects, is easier to administer and can be given to more people. But the factory for its production has been closed since last year and can resume operations only this summer. Limited quantities of the vaccine exist in US national stockpiles and in Europe. Rochelle Walensky, director of the Centers for Disease Control and Prevention, said Friday that priority distribution in the U.S. at this point will be directed to areas with the highest-risk patients. However, existing supplies are not sufficient to meet demand; further augmentation will be required as soon as possible. The second vaccine, ACAM2000, carries a greater risk of serious side effects.
Monkeypox doesn’t threaten everyone like Covid-19 did. This is not very comfortable. We are witnessing a serious epidemic that requires an urgent response before it causes even more damage.
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