Mpox faded in the US. who deserves credit?

Dr. William Schaffner, an infectious disease specialist at Vanderbilt University, said: “It’s really impressive that that peak has come down to a very low level.”

So who deserves credit? This is an open question, but experts point to a combination of factors.

Some praise public health officials. Others say more credit should go to members of the gay and bisexual community who took their own steps to reduce the spread of the disease when the threat became apparent. Some believe that the characteristics of

“The situation is mixed,” said Dr. Tom Frieden, former director of the US Centers for Disease Control and Prevention.

Mpox, formerly known as monkeypox, is a rare disease caused by infection with a virus in the same family as the virus that causes smallpox. It is endemic in parts of Africa where it is infected through the bites of rodents and small animals, but it was not known to spread easily among people.

Mpox cases began in Europe and the United States in May, mostly among men who had sex with men. In June and July, cases spread rapidly in dozens of countries around the time of gay pride events. Infections were rarely fatal, but many suffered from painful skin lesions for weeks.

In late July, the World Health Organization declared a global health crisis. Early August, declared by the United States public health emergency.

Shortly thereafter, the outbreak began to decline. His daily average of newly reported US cases has gone from nearly 500 in August to about 100 in October.now less than 5 new us case per day. (Europe saw similar drop.)

Experts say a combination of factors likely turned the tide.

Health officials got an early break. His existing two-dose vaccine named Gineos, which was developed to combat smallpox, was also approved for use against monkeypox.

Initially, only a few thousand doses were available in the United States, and most countries had none.

In early August, US health officials decided to expand the limited supply by administering one-fifth of the usual dose. The plan called for the vaccine to be administered by injection just under the skin rather than in deeper tissues.

Some in the public health community were concerned that it was a big decision based on a small amount of research, one study in 2015. But since then, the Centers for Disease Control and Prevention has no change Vaccine performance between the two methods.

“They were criticized for their revised dosing strategy, but it was the right decision,” said Frieden, current president of Resolve to Save Lives, a nonprofit focused on epidemic prevention. rice field.

But by the time the government made the switch, cases had already started to decline.

Dr. Rochelle Walensky, current CDC director, cited efforts to educate physicians on how to better diagnose and treat mpox. Other experts said outreach to the most at-risk sexually active gay and bisexual men is even more important.

During the first few months of the outbreak, the government was wary of giving too much attention and warning to gay and bisexual men. (In fact, in November he said that WHO renamed Disease expansion from monkeypox to mpox is being done to reduce stigma. )

“They were a little shy about the population that is largely affected,” Schaffner said.

Many say queer activists and community organizations have stepped up to fill the void, quickly providing candid education and support. An online survey conducted in early August found that many men who have sex with men reported having fewer sexual encounters and partners because of the outbreak.

“The success is really due to grassroots action,” said Amira Ross, professor of epidemiology and global health at George Mason University. In a way that recalls what happened when the government’s slow and sluggish response to her HIV/AIDS epidemic in the 1980s, gay community leaders said, “The government response is really lacking.” “I took it upon myself to intervene when I needed it,” she said.

Among these efforts was called RESPND-MI—Rapid Epidemiological Study of Monkeypox Infection Prevalence, Networks, and Demographics. The grant-funded organization has spread anti-contagion messages, conducted community-led research into his mpox symptoms, and mapped social and sexual networks of queer and transgender people in New York City. bottom.

The effort’s leader, Nick Diamond, said the government’s response improved only after gay activists put pressure on authorities and did a lot of outreach and education themselves.

“Many HIV activists knew it was up to us to start the monkeypox response,” he said.

But Diamond also pointed to another possible reason for the decline. The prevalence of his mpox at his LGBTQ celebrations in June, combined with a lack of testing and vaccinations, may have contributed to the surge in July. “Many people came out of pride with symptoms after close contact,” he said. They suffered blisters and scabs, passing the message to other at-risk men that the virus was very dangerous.

Some explanations may have more to do with biology than behavior.

CDC scientists said in a recent report that the number of new infections may have been limited by increased infection-acquired immunity among men who were active on the social networks that fueled the outbreak.

Previous research suggests there may be a limit to the number of times the monkeypox virus can spread from person to person, said Steven Morse, a virologist at Columbia University.

“The monkeypox virus basically runs out of steam after a few rounds in the human body,” Morse said. “Everyone takes credit for the intervention, but we don’t know the real reason.”

Maria Cheng from London contributed to this report.

The Associated Press’ Health Sciences Division is supported by the Scientific and Educational Media Group at the Howard Hughes Medical Institute. AP is solely responsible for all content.