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MONKEYPOX VIRUS

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theschnauzers:
The United States has now declared the outbreak of Monkeypox to be a public health emergency in the United States

http://www.cnn.com/2022/08/04/politics/monkeypox-public-health-emergency/index.html

(CNN — The Biden administration on Thursday declared monkeypox a public health emergency, with cases on the rise across the US.

The announcement came during a briefing with the Department of Health and Human Services.

The administration has been criticized at times for its handling of the outbreak, and some have called on the government to declare a national emergency without delay.

Since the first US monkeypox case was identified in mid-May, more than 6,600 probable or confirmed cases have been detected in the United States. Cases have been identified in every state except Montana and Wyoming.

The declaration follows the World Health Organization announcement last month that monkeypox is a public health emergency of international concern. WHO defines a public health emergency of international concern, or PHEIC, as “an extraordinary event” that constitutes a “public health risk to other States through the international spread of disease” and “to potentially require a coordinated international response.”

Some cities and states, including New York City, San Francisco, California, Illinois and New York, have already declared monkeypox an emergency, allowing them to free up funding and resources for their responses to the outbreak.

On Tuesday, President Joe Biden named Robert Fenton as the White House’s national monkeypox response coordinator. Fenton – a regional Federal Emergency Management Agency administrator who oversees Arizona, California, Hawaii and Nevada – will coordinate the federal government’s response to the outbreak. Dr. Demetre Daskalakis, the US Centers for Disease Control and Prevention’s director of the Division of HIV/AIDS Prevention, serves as the deputy coordinator.

The Biden administration has been heavily criticized by some public health experts for not moving faster to address the crisis.

One of the criticisms of the administration’s response, as CNN reported earlier Thursday, was that HHS waited more than three weeks after the first confirmed case of monkeypox in the US to order bulk stocks of the monkeypox vaccine, which the government owns and stores in Denmark, be bottled and sent to the US for distribution. The delay was in part out of concern that once those vaccines were taken out of bulk storage, they would lose years of shelf life.

Monkeypox can infect anyone, but the majority of cases in the US outbreak have been among men who have sex with men, including gay and bisexual men and people who identify as transgender. Close contact with an infected individual is required for the spread of the monkeypox virus, experts say.

The CDC initially announced vaccines for monkeypox were being released from the Strategic National Stockpile and offered to the “high-risk” contacts of monkeypox patients, as well as the health care workers treating them. Federal health officials have since expanded vaccination efforts to focus on the broader community of men who have sex with men, the demographic that makes up most US monkeypox cases.

In addition to providing vaccines, the CDC has said since June it has made a concerted effort to do extensive education and outreach to the LGBTQ community.

Possible change to how vaccine is administered
Health officials are considering changing the way monkeypox vaccine doses are administered because the country is “at a critical inflection point” with the virus’ spread, US Food and Drug Administration Commissioner Dr. Robert Califf told reporters on Thursday.

“In recent days, it’s become clear to all of us that given the continued spread of the virus, we’re at a critical inflection point, dictating the need for additional solutions to address the rise in infection rates,” Califf said. “The goal has always been to vaccinate as many people as possible.”

The commissioner said officials are considering allowing health care providers to be able to use a dose-sharing method where one vial of Jynneos vaccine – previously used as one dose – will be used to administer up to five separate doses.

This approach would change the way Jynneos is administered, Califf said. Instead of the vaccine being administered in the fat layer under the skin, it will be delivered underneath the skin layer.

“There are some advantages to intradermal administration including an improved immune response to the vaccine,” Califf said. “It’s important to note that overall safety and efficacy profile will not be sacrificed for this approach. Please know, we’ve been exploring all scientifically feasible options and we believe this could be a promising approach.”

theschnauzers:
From the Associated Press via The Hill newspaper:

https://trib.al/Mpx7hl9

Africa CDC says gay sex ‘not relevant’ in monkeypox there

NAIROBI, Kenya (AP) — Africa’s public health agency says it doesn’t know how many of the continent’s reported monkeypox cases this year are in men who have sex with men, and it warned Thursday against “any stigmatization” that might delay case reporting and affect the outbreak response.

The monkeypox cases reported in Europe and North America have almost exclusively involved gay and bisexual men, though health officials have said the virus can infect anyone who is in close, physical contact with an infected individual, their clothing or bedsheets.

But “that indicator is not relevant in the African context,” the acting director of the Africa Centers for Disease Control and Prevention, Ahmed Ogwell, told reporters. Many of Africa’s 54 countries criminalize consensual same-sex relations to some extent.

Ogwell was asked how the issue of men having sex with men could be ruled out as a factor in the largely conservative continent’s current outbreak if his agency had no statistics on it.

“It’s not an issue here,” he said. “And frankly, we don’t want to make it an issue because we have serious outbreaks to manage and don’t want to get into a discussion that will distract us (from preparedness and response).”

Although monkeypox has been endemic in parts of Africa for decades, it mostly jumps into people from infected wild animals and has not typically spread very far beyond the continent.

Ogwell said health officials in Africa have collected data on monkeypox since 1970 and that men who have sex with men has never come up as a significant issue. He said the drivers of this outbreak are “traditional” ones, including close contact in confined spaces and living in communities in contact with animals that have the virus.

“We have not seen any evidence of any specific group of persons being affected by monkeypox,” he said. “All communities, all ages, all genders are at risk.” He urged people to “avoid definitions and communications that may stigmatize those exposed.”

A more lethal form of monkeypox is spreading in Africa than in the West. Africa has had more than 2,800 confirmed and suspected cases in 11 countries this year, including 103 deaths.

The number of confirmed and suspected cases increased by 766 since the Africa CDC’s briefing last week, with 28 new deaths. The case fatality rate is “relatively high” at 3.6%, the Africa CDC said.

Only a handful of deaths have been reported outside Africa in this outbreak. On Thursday, the World Health Organization said the number of cases globally increased by about 19% in the past week. More than 25,000 cases have been recorded.

The Africa CDC director also said the continent still doesn’t have any doses of monkeypox vaccines, though discussions continue with a number of countries and institutions on obtaining them. He said testing kits are urgently needed as well.

Experts suspect the monkeypox outbreaks in North America and Europe may have originated in Africa long before the disease started spreading via sex at two raves in Spain and Belgium. More than 70% of the world’s monkeypox cases are in Europe, and 98% are in men who have sex with men.

In a separate briefing Thursday by the WHO, emergency officer Otim Patrick Ramadan said there is no evidence yet that monkeypox is transmitted by gay sex as 60% of cases in Africa are men while 40% are women, “so it would be clear from there that it is not the pattern we are seeing in our region.”

A gap in available data and limited sequencing means that health officials cannot confirm whether the monkeypox in Europe and elsewhere is genetically identical to that found in Africa in the past, Ramadan said, and nothing shows whether the cases in Africa are seeded from Europe and are not the indigenous form.

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