Bay Area health officials are scrambling to contain monkeypox outbreaks

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Cases of monkeypox have more than doubled in the past week in California and the Bay Area. Here, health authorities are participating in global scrambling to contain the outbreak while the virus is still prevalent in limited social networks.

According to the Centers for Disease Control and Prevention, California reported 95 cases of monkeypox as of Friday, up from 40 cases last week. As of Friday, about 460 cases were reported nationwide, up from 150 cases last week.

According to health officials, the Bay Area has already reported more than 20 confirmed or suspicious cases, 16 in San Francisco alone as of Friday, but the number is updated only once a week. , Almost certainly increasing.

Infection, a cousin of smallpox, manifests as skin lesions and spreads through close contact between people. Most people recover completely without treatment, but monkeypox can cause serious illness in children and other vulnerable groups. Even people who are not seriously ill can take weeks to get over and cause discomfort and pain.

So far, almost all cases have been reported in gay or bisexual men, most of whom are believed to have been exposed by sexual or other close contact with an infected person. The risk to the general public remains very low, local and federal health officials say.

Monkeypox isn’t like COVID, and now, and almost certainly, it’s not a threat at the same level of crisis, experts say. However, the outbreak is at a critical stage and there is an opportunity for health authorities to eradicate it before the case spreads further and can affect more vulnerable people.

“Monkeypox is not a problem of the same scale (as COVID), but it is important to try to do it if there is an opportunity to control emerging infectious diseases,” said Infectious Diseases at the University of California, San Francisco. Expert Dr. Seth Blumberg said. “We can’t get rid of this. We now need political and social will to control the disease.”

If monkeypox is allowed to be widely distributed, it can lead to endemic disease in the United States and threaten the general public, but many health professionals say that the nature of the virus, how it spreads, and how effective it is. Given the existence of the vaccine, the results are unlikely to be stopped.

Monkeypox can also establish itself as a recurring threat that causes new outbreaks every few years, especially when it becomes incorporated into US animal populations. Or you could join the ranks of sexually transmitted diseases that have proven to be stubborn in affecting and controlling certain communities, such as syphilis and gonorrhea.

“It would be terrible if monkeypox joins the list of sexually transmitted diseases that people have to worry about,” San Francisco called for a hearing this month to discuss the city’s public health response to monkeypox. Said Rafael Mandelman, supervisor of the. “We need to get vaccinated quickly and stop spreading right now.”

In the Bay Area, in the case of monkeypox, a wider range of vaccines that work before and after exposure to the virus is made available and to quickly determine if the disease has spread beyond the current community. There is pressure on health authorities to carry out surveillance. to be influenced.

Most tests are done by state laboratories and the results are confirmed by the CDC. Stanford University began offering monkeypox clinical tests two weeks ago and predicted that the occurrence and demand for surveillance could grow rapidly, Benjamin, head of the Stanford Clinical Virus Institute. Dr. Pinsky said.

National vaccination efforts are currently hampered by supply shortages. Two vaccines have been approved for the prevention of monkeypox, but the supply of a favorable product called Jynneos is much lower. A second vaccine, called ACAM2000, has the side effect that it can be worse for some people than the disease itself.

Last week, the United States announced plans to rapidly step up Jynneos’ vaccination efforts. To date, approximately 66,000 doses have been given to states with monkeypox cases. According to the CDC, another 240,000 doses are planned for the next few weeks, with at least 1.6 million doses expected by the end of the year. On Friday, the US Department of Health and Human Services announced that it had ordered an additional 2.5 million doses. It will be available at the end of this year and in 2023.

California, which accounts for about a quarter of all cases in the United States, is expected to receive about 15,000 doses by the end of last weekend or earlier this week. Jynneos is given twice at 28-day intervals.

The Bay Area county reported receiving doses of 10 to 500 or more in San Francisco. Local health officials say they are only targeting people with known exposures at this time, as it is not enough to provide vaccinations to everyone who may want it. This includes those identified by contact tracing of reported cases, those who have informally heard that their partner has recently been diagnosed, or those who attended an event or venue related to one or more monkeypox cases. included.

Frank Strona, Head of Incident Management for Monkeypox at the San Francisco Public Health Service, said: As of Friday morning, more than 200 doses had been given in the city, Strona said. “We expect more batches every few days,” he said.

As more vaccines became available, authorities said they wanted to provide it to people who were at risk of getting infected but did not necessarily have known exposures. Vaccines may not be needed by the general public if the outbreak is contained.

Monkeypox tends to cause flu-like symptoms and a trademark rash, with lesions filled with high-density fluid. Most people are ill for 2-4 weeks and do not require treatment, but in severe cases some medications are available. A few deaths have been reported worldwide this year, but none have been reported in the United States.

This year’s global epidemic, which has infected more than 5,000 people so far, has puzzled infectious disease experts who have never seen the virus spread far beyond the endemic West African countries. In the United States, there are usually several travel-related cases every few years, but previously only one was reported. Forty-seven cases were identified in 2003, all related to rodents imported from Ghana.

It is not clear why monkeypox took off suddenly, but experts are a combination of finding traction that can mutate the virus to become more contagious and spread quickly and easily within the group. I think there is a possibility.

Monkeypox is transmitted primarily through direct, sustained contact. People are most at risk when exposed to fluids within the lesion, such as by touching the infected person’s rash or sharing bedding or towels with the infected person. The virus can also be transmitted from person to person through respiratory droplets, but it only occurs at close range. It does not spread in the air of restaurants and grocery stores.

According to the CDC, in the United States, 271 of the first 305 were men, and more than 70% were men having sex with men. Some large clusters date back to events and venues where people have sex with multiple partners, such as private sex parties, clubs and baths.

Dr. Jason Andrews, an infectious disease expert at Stanford University, said: “But that doesn’t necessarily mean it’s maintained that way.”

Health officials have pointed out that, unlike HIV and other sexually transmitted diseases, there is no link between specific sexual activity and the spread of monkeypox. The virus just happened to take root in the gay network first. It can spread just as easily between heterosexual partners or between close family contacts.

Andrews suspects that global outbreaks may have begun to slow after weeks of explosive growth. He and other infectious disease experts said that due to the long incubation period of monkeypox, the currently diagnosed cases were probably due to exposure 1-2 weeks ago.

The possibility remains that the virus will build a foothold in a wider population. “The most worrying result is whether it spreads more widely at all ages, either as an endemic infection or through accidental contact pathways,” Andrews said. “I don’t think there is strong evidence that this is happening right now, but we need to be prepared for it.”

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