Monkeypox cases are declining sharply. Is the outbreak over?

WASHINGTON — New cases of monkeypox have been on a nationwide decline for more than two months, with the decades-old virus that caused the first major outbreak in the United States this year largely under control or fading away. It gives me hope that there is.

However, when experts break down data from the Centers for Disease Control and Prevention by race and ethnicity, they find that while the proportion of cases affecting blacks has increased, it has declined among Hispanics and Latinos, and whites. However, the data are not complete and exclude more than 30% of cases.

Overall, monkeypox cases in the United States appear to have peaked in early August, about two and a half months after the first cases of this outbreak were diagnosed in mid-May, leading to nationwide We are spurring the vaccination movement. criticized By public health professionals and members of Congress.

But these vaccination efforts, combined with massive educational campaigns about the virus and behavioral changes among those most at risk, seem to have largely had their intended effect.

The seven-day daily average of new infections peaked at 443 on August 6, before steadily rising to 265 on September 6 and 79 on October 6, according to Diminished. data from the CDC.

During the six-month epidemic, 27,500 Americans were diagnosed with monkeypox. Monkeypox is often accompanied by fever, fatigue, chills, itching, headache, swollen lymph nodes, muscle pain, as well as a rash in the majority of cases reported to CDC.

Is zero case possible?

Despite the setbacks over the past five months, public health experts interviewed by States Newsroom said monkeypox cases could continue to decline in the coming months, but before that happens. I warned you that you have a lot of work to do.

“I think it’s quite possible that it will be zero, I think it could even be zero by the end of this year,” the association said.

Decreased social activity, increased vaccinations, and a broader understanding of how monkeypox spreads have all helped reduce the number of new cases, but Guest said it will take some time for public health experts to look back. said. Interventions and educational campaigns were. “

Guest said his best-case scenario is for public health officials to keep talking about monkeypox if cases drop to zero. He also wants doctors to include education about the virus in routine checkups and STD tests to keep vaccinations going and to stockpile approved vaccines for possible future outbreaks. I’m here.

But he warned that positive test results could continue to rise regularly in certain parts of the country or in large cities, even if the virus remains dormant for most of the period.

Researchers and public health officials also need to ensure that the decline in case numbers does not coincide with indifference, he said.

“What I think I know, unfortunately, is that a lot of the time we have very short attention spans,” Guest said. And so on to the next thing, or the next thing now that the emergency is over … we are not going to dedicate money and resources to addressing these challenges.”

Race/Ethnicity Data

Jessica Justman, an associate professor of epidemiological medicine at the Columbia Mailman School of Public Health, said the CDC data on race and ethnicity are concerning.

“Given the steady growth of the black and African-American population, we can’t just stand still here,” Justman said.

“We’ve seen similar stories time and time again with other epidemics, HIV and COVID. These infections are likely concentrated in certain parts of the population with less access to vaccines and less access to health information. ,” she added.

After the first month of this outbreak, whites accounted for about half of all cases in the United States, Hispanic or Latino individuals accounted for about 31%, and blacks or African Americans accounted for less than 12%. rice field. data The week of June 19th.

Since early July, the proportion of Hispanic or Latino individuals diagnosed with monkeypox remained approximately 30% of the total until mid-September, when it declined to the low 20% category.

But since early July, the proportion of whites who contracted the virus has fallen from 37% to 29% of cases nationally. from 22% to 42% of all cases in data.

CDC director Rochelle Wallenski said in a Sept. 15 briefing that public health officials have begun to see “the racial and ethnic makeup of this epidemic is evolving.”

Larger share of cases

of the Kaiser Family Foundation break down One piece of CDC data on race and ethnicity, which included only 68% of reported cases as of Sept. 23, said, “Black and Hispanic people have a higher proportion of cases compared to the proportion of the population. A large percentage,” he said.

For example, people of color make up about 40% of the U.S. population, yet about 70% of monkeypox patients at the time were people of color.

Data on vaccination are also skewed when broken down by race and ethnicity.

At a briefing in mid-September, Wallenski said Hispanic individuals made up about 21% and blacks about 12%, while whites made up 47% of those who received the first dose of the Jynneos vaccine. Stated.

However, CDC data are not complete and come from 39 jurisdictions, accounting for approximately 91% of primary doses.

Justman said public health officials should continue to vaccinate at-risk populations no matter how low the number of cases.

“Really, when we say we’ve done enough, it’s when we’ve covered a very high percentage of the population at risk,” she said.

Justman said the decline in monkeypox cases in the U.S. was due to vaccination campaigns and behavioral changes, but data on the exact number of people who changed physical contact in a way that has detailed information is lacking. I warned you not many. about vaccines.

Justman also said it’s too early to predict whether monkeypox cases will continue to decline over the next few weeks and months.

“It still feels a little premature to be looking at a crystal ball like that,” Justman said. “For me, I need more time to see what the pattern will be.”

Largest outbreak in U.S. history

According to the CDC, monkeypox was first discovered in a study of monkeys in 1958 and spreads through direct contact with bedding, towels, and other fabric used by an infected person, or through contact with respiratory secretions. increase.

Since the first human case was diagnosed in 1970, the majority of cases have been in central and western Africa, and cases outside of that area have been linked to animals that have traveled to or been imported into that area.

The largest outbreak in US history this year began in mid-May when doctors diagnosed the disease in a Massachusetts man. Europe and other parts of the world, where monkeypox is traditionally undiagnosed, also had significant outbreaks this year.

In total, there were over 72,000 monkeypox diagnoses in countries with no history of the virus. Twenty-eight people have died, including two in the United States, according to the CDC.

understanding vaccines

Elizabeth Finley, communications director for the National Association of STD Directors, said she expects new monkeypox diagnoses to continue to decline, but she doesn’t expect the virus to go away.

“I think the number of monkeypox cases will continue to decline,” she said. “I don’t think it will go away.”

One important aspect of the ongoing response is to better understand how effective the Jynneos vaccine is after one dose and after two complete boluses, and how long the protection lasts. She said we need to understand.

“This is a vaccine designed to help a country or other countries deal with smallpox outbreaks. It wasn’t necessarily designed as a long-term plan against something like monkeypox,” Finley said. “We just need to know more about vaccines,” he added.

Anyone can get monkeypox, but the outbreak has primarily affected gays, bisexuals, and other men who have sex with men, and public health officials are asking locals to avoid physical contact. We urge you to limit the

But Finley says experts aren’t clear about how long and to what extent people should withhold or severely limit physical contact.

“I don’t know if it’s sustainable. Frankly, I don’t know if it’s fair to ask people to sustain that kind of change,” Finley said.

As monkeypox cases continue to decline, Finley hopes public health officials will direct outreach to people who have little or no access to medical care and who may not have been vaccinated. There is

Amesh Adalja, a senior fellow at the Johns Hopkins Center for Health Security at the Bloomberg School of Public Health, believes it is possible with sustained education, vaccination and treatment, but zero cases in the US. He said he thinks it will take some time. .

However, he cautioned that this does not mean doctors will never diagnose monkeypox again.

“The United States can get a certain level of resilience, but there is always the possibility that it will be imported, for example, from other European countries where diseases are rampant,” Adalja said. Sporadic epidemics could continue until enough numbers here gain immunity or are vaccinated, and if a vaccine is deemed strong enough to stop it.”