The outbreak of monkeypox in the United States has expanded to nine cases in seven states, senior health officials said Thursday, adding that the outbreak is expanding in countries where the virus is not normally circulating.
Officials from the Centers for Disease Control and Prevention said new cases of monkeypox were found in Virginia, California and Washington state. Earlier this week, the agency said four cases had been identified in Massachusetts, Florida, Utah and New York. Some, but not all, US patients have traveled abroad recently.
“We should not be surprised to see more cases in the United States in the coming days,” said Raj Punjabi, coordinator of the White House Office of Epidemic Control. “It’s actually a sign that Americans are still vigilant and that health care providers and public health workers are doing their jobs.”
Monkeypox belongs to the same family of viruses as smallpox. The United States has been preparing for a potential smallpox outbreak for decades, so there are ample supplies of vaccines and treatments that should be effective against monkeypox. The Jynneos Bavarian-Scandinavian vaccine is already FDA-approved for use against monkeypox and is a safer alternative to the ACAM2000 vaccine from Emergent Biosolutions Inc. Moderna Inc. The manufacture of Covid vaccines is also in the early stages of studying a potential monkeypox vaccine.
A spokesperson said Abbott Laboratories is also working on a polymerase chain reaction (PCR) test for monkeypox.
Officials said they have already begun mobilizing to provide treatment to states where cases have been identified. Doses of the Genus vaccine arrived Sunday in Massachusetts, where the first case of monkeypox virus has been identified in the United States, said Jennifer McQuston, deputy director of the Centers for Disease Control and Prevention’s division of pathogenesis and pathology. Health officials are in the process of passing the vaccine on to high-risk contacts, such as health care workers.
The best use of monkeypox vaccines is to use the so-called ring vaccination strategy, which focuses on vaccinating people who have been directly exposed to infected people with the type of contact that can facilitate its spread. Aside from health care workers who may have treated monkeypox patients, health officials said the virus appears to be spreading through close and intimate contact, possibly between sexual networks. The CDC said most cases to date have been in men who had sex with men, but by no means is the risk of infection isolated from the LGBTQ community.
Besides vaccines, in the United States there are two antivirals for smallpox that have been shown to be effective against monkeypox when tested on animals. Centers for Disease Control and Prevention (CDC) officials said the drugs could be released under an investigational new drug application, which allows an experimental drug to be used during an emergency situation. One of the antivirals, Tpoxx from SIGA Technologies, has already been deployed in Florida and California, officials said. Most cases so far are “mild and self-limited,” McCuston said.
“In a situation like this, an antiviral drug would not necessarily be something that would be recommended or given automatically,” she said.
Symptoms of monkeypox usually go away on their own, but because the infection appears with a pimple-like rash, it can be easily confused with common sexually transmitted diseases such as herpes or syphilis. Misdiagnosis of conditions can lead to undetected spread and inappropriate treatment. McQuiston said Thursday that typical safe sex practices may not be enough to prevent monkeypox from spreading during sex.
“Unless a condom is actively covering an area with an infection, I wouldn’t give a false sense of reassurance that a condom alone would be enough to prevent transmission of monkeypox virus,” she said.
© Bloomberg LP 2022