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New York (AFP) – The spread of monkeypox in the United States It could mark the beginning of a new sexually transmitted disease, though some health officials say the virus that causes pimple-like bumps could be contained before it becomes firmly established.
Experts disagree about the possible course of the disease, with some fearing that it could spread so widely that it is on the verge of becoming a common sexually transmitted disease, like gonorrhea, herpes and HIV.
But no one is really sure, and some say that tests and vaccines can still stop the epidemic at its source.
So far, more than 2,500 cases have been reported in the United States as part of an international outbreak. Posted two months ago. Health officials say that about 99% of men report having sex with other men.
Health officials don’t know how fast the virus will spread. They only have limited information on who has been diagnosed and they don’t know how many infected people could be unknowingly spreading it.
They also don’t know how well vaccines and treatments work. One drawback: Federal health officials don’t have the authority to collect and correlate data on who has been infected and who has been vaccinated.
With these huge question marks, projections for the size of the outbreak in the United States this summer vary widely, from 13,000 to perhaps more than 10 times that number.
Dr. Rochelle Walinsky, director of the Centers for Disease Control and PreventionThe government response is getting stronger by the day, he said, and vaccine supplies will soon increase.
“I think we still have a chance to contain this,” Walinsky told The Associated Press.
Monkeypox is an endemic disease in parts of Africa, where people have been infected by bites from rodents or small animals. It usually does not spread easily from person to person.
But this year more than 15,000 cases have been reported in countries that have never experienced the disease. In the United States and Europe, the vast majority of infections have occurred in men who have sex with men, although health authorities have confirmed that anyone can contract the virus.
It is spread primarily through skin-to-skin contact, but it can also be spread through the sheets worn by someone with monkeypox. Although it is transmitted between people like sexually transmitted diseases, authorities are on the lookout for other types of spread that could further spread the disease. There have been several such cases: Officials said Friday they were aware of two children With monkeypox in the United States, at least eight women.
Symptoms include fever, body aches, chills, fatigue, and lumps in certain parts of the body. The illness was relatively mild in many men and no one has died in the United States, but people can be contagious for weeks and the lesions can be very painful.
When monkeypox emerged, there was reason to believe that public health officials could control it.
The warning bumps should make it easy to identify the infection. Since the virus spreads through close personal contact, officials thought they could reliably track its spread by interviewing infected people and asking who they were intimate with.
It wasn’t that easy.
Because monkeypox is so rare in the United States, many affected men, and their doctors, may develop a rash from another cause.
Contact tracing was often hampered by infected men who said they did not know the names of everyone they had sex with. Some said they had multiple sexual interactions with strangers.
It hasn’t helped local health departments, already overwhelmed by COVID-19. And dozens of other diseases, now we also had to find the resources to do extensive contact tracing work on monkeypox.
Indeed, some local health officials have given up expecting too much contact tracing.
There was another reason for optimism: the US government already had a vaccine. The two-dose regimen called Jynneos was approved in the United States in 2019 and recommended as a tool against monkeypox last year.
When the outbreak was first identified in May, US authorities only had around 2,000 doses. The government distributed it, but limited it to people identified by public health investigations as recently exposed to the virus.
Late last month, as more doses became available, the CDC began recommending that the shots be offered to those who knew for themselves they might have been infected.
Demand has outpaced supply, as clinics in some cities are quickly running out of vaccine doses and health officials across the country say they don’t have enough.
That is changing, Walinsky said. As of this week, the government has distributed more than 191,000 doses and still has 160,000 doses ready to ship. Up to 780,000 doses will be available next week.
Once current demand is met, the government will consider expanding immunization efforts.
The CDC estimates that 1.5 million American men are considered to be at high risk of infection.
The test has also been expanded. Walinsky said more than 70,000 people could be tested each week, far more than current demand. He added that the government has also launched a campaign to educate doctors and gay and bisexual men about the disease.
Donal Pisanzio, a researcher at RTI International, believes that US health authorities will be able to contain the outbreak before it becomes a pandemic.
But he also said that it would not be the end. New batches of cases are likely to emerge as Americans become infected from people in other countries where monkeypox continues to spread.
Walinsky agrees that such a scenario is possible. “If it’s not contained around the world, we’re still at risk of explosions” by travelers, he said.
Shawn Kiernan of the Fairfax County Health Department in Virginia noted that so far the outbreak has focused on one group of people: men who have sex with men. Kiernan, the department’s infectious disease chief, said the spread of the virus among heterosexual people would be a “tipping point” that could occur before it is widely recognized.
Dr. Edward Hooke III, an emeritus professor of infectious diseases at the University of Alabama at Birmingham, said the spread of heterosexual relationships is only a matter of time.
If monkeypox becomes an endemic sexually transmitted disease, it will be another challenge for health services and doctors who are already struggling to keep up with existing STIs.
For too long, this work has been underfunded and understaffed, and much of it has simply been put on hold during the pandemic. Kiernan said HIV and syphilis are priorities, but working on common infections like chlamydia and gonorrhea is “counting the cases and that’s it.”
Over the years, the incidence of gonorrhea, chlamydia, and syphilis has increased.
“To a large extent, doctors are doing a poor job of taking sexual histories, asking about their patients, and acknowledging them as sexual beings,” Hawke said.
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Associated Press writer Jenny Harr in San Francisco contributed to this report.
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The Associated Press Health and Science Department is supported by the Howard Hughes Medical Institute’s Division of Science Education. AP is solely responsible for all content.