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The Future of Monkeypox – Atlantic Ocean

 


The World Health Organization suggested a new name As for monkeypox, it is asking countries to forget the original term in favor of a new term, “mpox,” which scientists hope will help stigmatize the disease. However, it seems that the arrival of the request is delayed in the United States. The outbreak here has been slowly receding over the past few months and has already left many Americans’ minds.

Currently, about 15 cases are recorded daily among Americans, less than 4% of the tally. When the surge was at its worstAfter early rollouts were slow and unsuccessful, tests and treatments for the virus have become more available. 1 million times or more Two doses of the Jynneos smallpox vaccine have been used in practice. San Francisco When New York— the first two cities in the country to declare mpox a public health emergency last summer — since then Allowed those orders to expireas well as New York and Illinois. “I think this is the endgame,” says Caitlin Rivers, an infectious disease epidemiologist at the Johns Hopkins Center for Health Security.

But ‘endgame’ does not mean ‘the end’. mpox will be with us for the time being. The US outbreak is just beginning to show its long, ugly tail. Even if the number of new infections decreases, inequality is growingComposed of black and Latinx people many new mpox case sick in 3 to 5 times Percentage of white Americans, but they receive proportionately less vaccine“What we’re seeing right now are people who are truly marginalized,” says Ofor Mugbako, a physician and population health researcher at New York University. “Of course, that’s also why it disappeared from the news.” It can be debilitating, stigmatizing, and afflicting you with another neglected disease.

At this point, there’s not even a guarantee that the downturn in this case will continue. Her Sara Bares, an infectious disease specialist at the University of Nebraska Medical Center in Omaha, said: immunityacquired by infection or vaccine. I’m not sure These defenses can prevent another infection, which has a very low infection rate and therefore a knowledge gap that may be difficult to fill.and for many months advocacy and outreach From the LGBTQ community reduce risky sexual behavior, many notable trends will eventually reset to pre-outbreak baselines. “It’s widely known from other sexually transmitted diseases that behavioral changes are usually not the most persistent responses,” says Bogma Kavisen-Titanzi, an infectious disease specialist at Emory University.

At the same time, this year’s mpox outbreak is people who do not know And less cumbersome than the previous one.Mounting evidence suggests people can get infected before symptoms appearcontrary to previous understanding; some physicians are concerned that patients, especially those with weakened immune systems, may remain infectious. After bearing the brunt of visible illnesssays Philip Ponce, an infectious disease physician at the University of Texas Health Science Center in San Antonio and medical director of the Kind Clinic in San Antonio.about 40 percent Eight Americans diagnosed with mpox are living with HIV. physically fluid When contact type May be the most dangerous on the trajectory of the disease. Cases are still missed by primary care providers who are inexperienced in and out of diagnosis and testing, especially in darker-skinned individuals. And while this epidemic continues to affect men who have sex with men for the most part, Women and nonbinary people are getting sick Likewise, to an underestimated degree.

Intel, a smallpox drug called tecovirimat, the only antiviral drug in stock that fights mpox, also said experts believe the virus build resistanceThe treatment is conditional green light For use in people who currently have or are at risk of serious illness.Anecdotally, it seems to work wonders, shaving days or weeks from the painful and debilitating course of symptoms that can push infected individuals into prolonged isolation. Not enough We use rigorous human data to see how well it works. National survey Antiviral, told me.and but Clinical Trials of Tecovirimat that is in progressIn the United States, she added, they are “struggling to enroll patients” now that infections have plummeted to such persistently low levels. At the same time, it is also a numerical problem. “As the number of cases goes down, it becomes less urgent for people to answer questions,” Varma told me.

Recent CDC Reports It indicates an increasing proportion of new infections with unreported known sexual contact histories, hampering contact tracing efforts. It may be partly a product of the outbreak’s gradual movement from liberal, affluent urban centers to more communities affected early in the epidemic. south and southwest“In small towns, the risk of data breaches is high,” Bares told me. When asking for care or immunizations, “you’re out yourself.” Do you feel afraid to come to the hospital?’ Ponce told me these concerns could be particularly high in certain communities of color. For example, Latinx residents of San Antonio “tend to be more conservative. many.

Hidden infections can spread rapidly. Surveillance for infectious diseases becomes much easier when those most at risk have insurance, have access to knowledgeable clinicians, and tend to trust public health agencies. “It’s predominantly white,” says Ace Robinson, chief executive of the Pierce County AIDS Foundation in Washington. Now that mpox outbreaks have moved from that population to more disadvantaged populations, Robinson fears the number of cases will be “significantly lower.”

Americans contracting the virus during the denouement of the outbreak are paying the price. Means to combat mpox are likely to decline even though the virus is taking hold in populations that need those tools most. One concern remains country’s vaccination strategy, has undergone a mid-epidemic shift: To address the limited supply of shots, the FDA has approved a new method of administration for which the evidence behind it is limited. It can be difficult and have severe side effects. Some Titanji patients have experienced swelling near the injection site that persists for weeks after the first dose. “

Robinson told me that mpox’s continued shift to minority groups has also drawn more public attention. Stephen Cremow, an infectious disease specialist at the Methodist Dallas Medical Center and medical director of the Kind Clinic in Dallas, said public attention to the crisis was modest even at its height. Now, experts are observing that the cycle of ignorance is intensifying as the outbreak continues to impact and compress. alienated communityincluding those who for decades have disproportionately shouldered the burden of sexually transmitted diseases such as syphilis, gonorrhea and HIV. told me

Some of the most at-risk people are on the move as well, Robinson told me. It was disappointing to see a high vaccine refusal rate at two outreach events. “They knew nothing about the virus,” he told me. Titanji has seen similar trends in her community in Georgia. “There’s this complacency of, ‘Why do I need to be vaccinated when it doesn’t matter anymore?'” she said.

The tide seems unlikely to change. Sexual health clinics on the front lines of the mpox response remain underfunded and staffed, despite tens of thousands of cases in the depths of the US outbreak. Although the influx of cases has slowed, Ponce and Cremow are still treating multiple mpox patients a week while trying to maintain the services they normally provide. The incidence of sexually transmitted infections is increasing year by year.“We really envision this becoming another sex-related disorder that will be part of the wheelhouse that we will have to manage for the indefinite future.” I had to.” The problem can get worse if: national emergency The one declared in August has been allowed to lapse and this is likely Availability of antivirals and vaccines.

Rivers still has hopes of eradicating mpox in the US. low To zero It’s not as easy as it looks.This current downward trend is especially true for viruses find a new animal host“We’ve seen this story play out many times before,” Varma told me.Efforts to Eliminate Syphilis from the United States Late 90’s to early 2000’s, for example, gained traction for a while but waned when what could have been the final stretch. As the case rate drops, so does the interest in bringing it down further.

The memory of public health crises does not seem to last long. When this mpox outbreak began, Mr Titanji told me there was an opportunity to strengthen our system and buffer against future epidemics, both imported and domestic. and failed to send aid abroad. If mpox cases spike again, that’s very likely, she said. “We’re going to be back to the drawing board again.”

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