All of the suspected cases are presumed to be monkeypox, and are in the process of being confirmed at CDC headquarters, said Jennifer McQuiston, deputy director of the division of pathogens and high-consequence pathologies.
One of the orthopoxvirus cases is in New York, another in Florida, and the remaining two in Utah. All men.
Genetic sequencing of the Massachusetts case matches that of a patient in Portugal and belongs to a West African strain, the less aggressive of the two existing monkeypox strains.
“Right now we’re hoping to maximize the distribution of vaccines to those we know can benefit from it,” McQuiston said.
That is, “people who have had contact with a monkeypox patient, health workers, their closest contacts, and in particular those who may be at high risk of severe disease.”
Higher risk for immunosuppressed
In terms of supply, the United States has about a thousand doses of the compound JYNNEOS, a vaccine approved by the United States Food and Drug Administration (FDA) for smallpox and monkeypox “and that level is expected to increase rapidly in weeks as the company provides us with more doses,” McQuiston explained.
There are also about 100 million doses of an earlier generation vaccine called ACAM2000.
Both vaccines use live virus, but only JYNNEOS suppresses the ability of the virus to replicate, making it the safer option, according to McQuiston.
People who are immunocompromised or who have particular skin conditions, including eczema, are at high risk, added John Brooks, a medical epidemiologist.
Transmission of monkeypox occurs through close and sustained contact with someone who has an active skin rash, or by respiratory droplets from someone with lesions of the disease in their mouth who is around other people for a considerable time. .
The virus can cause skin rashes, with lesions occurring on certain parts of the body, or spread more generally. In some cases, in early stages, a rash may start on the genitals or in the perianal area.
While scientists are concerned about the growing number of cases around the world potentially indicating a new type of transmission, McQuiston said there is currently no evidence to support such a theory.
Instead, the increasing number of cases could be related to some specific contagion events, such as the recent mass parties in Europe that could explain a higher prevalence in the gay and bisexual community.
However, Brooks cautions, “the current risk of exposure to monkeypox is not unique” to that community.
The CDC is also developing treatment guidance to enable the deployment of the antivirals tecovirimat and brincidofovir, both of which are licensed for the treatment of smallpox.
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