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July 29, 2022

Monkeypox: The latest updates on the outbreak

Daily Briefing

    As monkeypox continues to spread, the World Health Organization (WHO) is urging at-risk groups to take specific precautions against the virus, and the United States is expected to declare the current outbreak a public health emergency.

    How the US plans to vaccinate against monkeypox

    WHO urges at-risk groups to take precautions

    Last week, WHO declared monkeypox a public health emergency of international concern (PHEIC). So far, more than 18,000 monkeypox cases have been reported worldwide. Of those cases, 10% have required hospitalization for pain management, while five deaths have been reported.

    The monkeypox outbreak is currently concentrated largely among men who have sex with men (MSM), and WHO Director-General Tedros Adhanom Ghebreyesus said this "means that this is an outbreak that can be stopped with the right strategies in the right groups."

    During a briefing on Wednesday, Tedros advised MSM to take steps to reduce their risk of infection, including adjusting their sexual behavior during the current outbreak. "For men who have sex with men, this includes, for the moment, reducing your number of sexual partners, reconsidering sex with new partners and exchanging contact details with any new partners to enable follow-up if needed," he said.

    However, Tedros also noted that "stigma and discrimination can be as dangerous as any virus and can fuel the outbreak" and warned people to be cautious of any misinformation and disinformation about the virus.

    "Although 98 percent of cases so far are among men who have sex with men, anyone exposed can get monkeypox, which is why WHO recommends that countries take action to reduce the risk of transmission to other vulnerable groups, including children, pregnant women and those who are immunosuppressed," he said.

    In addition, several health experts have called for monkeypox to be renamed to prevent stigmatizing and discriminatory responses. In June, WHO announced that it would change the name of the virus, and while the renaming process has been initiated, Soumya Swaminathan, chief scientist at WHO, said that "[a]s far as [she] knows, we have not received any proposals for a name to replace monkeypox."

    US to declare monkeypox a health emergency

    Following WHO's declaration of the monkeypox outbreak as a PHEIC, the Biden administration is expected to similarly declare the outbreak a public health emergency in the United States, according to two people familiar with the situation. So far, more than 4,600 monkeypox cases have been reported in the United States, according to CDC data—more than any other nation.

    HHS is expected to make the declaration by the end of the week, although an agency spokesperson said a final decision has not yet been made, and the agency is "continuing to explore options." By designating the monkeypox outbreak as an emergency, HHS would be able to take new actions to combat the virus, including accessing new funds and assigning new personnel.

    In addition, CDC on Tuesday said it will designate monkeypox a nationally notifiable condition. Under this designation, which will go into effect Aug. 1, state public health agencies will use a certain definition to identify cases and use a specific rubric to submit surveillance data, which will allow CDC to track the spread of the virus more closely.

    San Francisco and New York state on Thursday declared their own health emergencies over the monkeypox outbreak.

    FDA clears almost 800k monkeypox vaccines for use

    Many jurisdictions have been struggling to vaccinate those at risk due to limited supply of monkeypox vaccines. So far, the United States has distributed more than 310,000 doses of Bavarian Nordic's Jynneos vaccine to state and local health departments, but major cities, such as San Francisco and New York, have said they do not have enough to meet demand.

    On Wednesday, FDA announced it had cleared an additional 786,000 Jynneos doses after finishing an inspection of the vaccine manufacturing plant in Denmark. To speed up distribution, the doses had already been shipped to the United States prior to FDA's approval.

    "This action by the FDA is a critical step forward in our plans to strengthen and accelerate our monkeypox response, which includes distributing a safe and effective vaccine to those at highest risk of exposure to monkeypox," said HHS Secretary Xavier Becerra.

    According to Tinglong Dai, an expert in vaccine supply at Johns Hopkins University, the available supply is now "probably sufficient to meet the most pressing need," assuming that they are quickly distributed to areas facing shortages.

    "I hope it alleviates the burning anxiety that thousands of people have been experiencing in recent weeks," he added. (Choi, The Hill, 7/27 [1]; Choi, The Hill, 7/27 [2]; Fiore, MedPage Today, 7/27; Banco/Cancryn, Politico, 7/27 [1]; Banco/Cancryn, Politico, 7/27 [2]; Weixel, The Hill, 7/27; Whyte/Roland, Wall Street Journal, 7/27; AP/Modern Healthcare, 7/27; Mandavilli, , New York Times, 7/27; Bastone/Shapero, Axios, 7/28)

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