The number of monkeypox cases is rising, but US officials say the overall risk is low

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Biden administration officials warned Friday that the monkeypox outbreak in the United States has worsened, with at least 45 cases of the viral illness identified in 15 states and the district, up from 20 cases a week ago. But they stressed that the risk to the public remains low and that public health agencies have the tools to protect people.

“We have tests for monkeypox. We have vaccines for monkeypox and we have treatments for monkeypox,” Raj Panjabi, who leads the White House’s global health security efforts, said during a briefing. “We have a multi-pronged approach to deploying these tools to ensure we are fighting this outbreak as effectively as possible.”

More than 1,300 cases of monkeypox have been detected worldwide, as the disease – which has appeared repeatedly in central and west Africa in recent decades but rarely spreads among humans – appears to be gaining a foothold in countries such as Germany, Portugal and the United Kingdom. The current episode is likely to become the worst outbreak of monkeypox on record in the United States, surpassing a 2003 outbreak in which 47 cases were confirmed or detected in six states, according to the Centers for Disease Control and Prevention.

But public health experts have pointed out that monkeypox poses far less of a risk than the coronavirus pandemic, which has rocked the world since 2020 and been linked to the deaths of more than a million Americans.

“My feeling is that it will be nothing like what we have seen with covid. The general public need not worry too much at this point,” said Don Milton, a University of Maryland environmental scientist who has advised the White House and others on the fight against the coronavirus pandemic, in an interview.

“Whereas [monkeypox] cases have continued to rise, I want to re-emphasize that there have been no deaths associated with this outbreak yet,” CDC Director Rochelle Walensky said during Friday’s briefing. “Although the overall risk of monkeypox in the American public is currently low, we want people to be aware of the signs and symptoms and simply seek care immediately if they think they might have symptoms of monkeypox.”

Symptoms of monkeypox frequently include fever, headache, and sores that can persist for weeks. Although federal regulators have not approved specific treatments for monkeypox, officials said treatments and vaccines prepared to combat smallpox — a closely related virus that has more severe symptoms — are available through the stock. strategic national.

“The [Strategic National Stockpile] contains enough vaccine…to vaccinate millions of Americans if needed,” said Dawn O’Connell, assistant secretary for preparedness and response at the Department of Health and Human Services. She said officials have more than 100 million doses of an old smallpox vaccine, ACAM2000, and about 72,000 doses of a new smallpox vaccine that has also been approved for monkeypox, Jynneos, in stock. . The stockpile also contains reserves of antiviral treatments such as tecovirimat and cidofovir, officials said.

Federal officials said the monkeypox outbreak was caused by Americans traveling overseas.

“I think the majority of cases in the United States — so 75% or more — are still reporting exposure to international travel that likely led to their monkeypox infections,” said Jennifer McQuiston, incident manager for monkeypox response. from the CDC.

A number of cases in the United States have also been linked to sexual contact, officials said, prompting them to warn of the risk of direct physical contact playing in the spread of the virus.

But some experts have questioned whether monkeypox can also spread through the air, echoing a debate that emerged at the start of the coronavirus outbreak. While the CDC and other public health agencies initially said the coronavirus was not transmitted through the air, the agencies reversed in 2021, and the Biden administration has increasingly warned that the air indoors is a major driver of coronavirus infections.

The CDC last week encouraged travelers to wear a mask as a precaution against monkeypox, but removed the recommendation this week, saying the advice was unnecessary and confusing.

Administration officials said Friday they have no reason to believe monkeypox is being spread through the air.

“When we consider airborne transmission at the CDC, we’re talking about small virus particles that become airborne and can stay there for long periods of time,” Walensky said. “We have not seen any documentation of this through our experience with this virus or previous similar viruses.”

Outside experts such as Milton said they were critical of the CDC’s decision to downplay the possibility of airborne transmission of monkeypox, particularly because the World Health Organization has argued that airborne spread may be possible.

“I really don’t understand,” Milton said, citing evidence that smallpox was transmitted through the air. “If we don’t pay attention to the potential for short-range airborne transmission, it could increase” the risk of contracting monkeypox.

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