The monkeypox outbreak is spreading with alarming speed. Ideally, it should have been nipped in the bud when the first cases appeared in May and June outside West and Central Africa, where monkeypox has been endemic for decades. Now the caseload has expanded to more than 11,000, including 1,470 in the United States, and is expected to increase in the weeks ahead. The lessons of the coronavirus pandemic should be taken to heart and should result in a more rapid response.
While monkeypox has sometimes caused serious illness in humans, the virus is not as transmissible or deadly as the coronavirus. Monkeypox generally transmits through close contact with lesions and skin, or with objects that have been in contact with an infected person, such as sheets or towels. Most reported cases so far have involved men who have reported recent sex with one or multiple male partners, although not exclusively, according to the World Health Organization. This suggests “no signal of sustained transmission beyond these networks for now,” the agency says. But that must not lead to complacency. There is a danger the disease could become entrenched in this community, or that it could expand into other populations.
All efforts must be made to fight the virus where it is. This is not a gay disease but a disease circulating in the gay community, a vital but difficult distinction confronting public health officials. The HIV/AIDS pandemic showed the disastrous impact of stigmatization, which dissuaded people from obtaining services. Public health officials must be careful to avoid discrimination and stigma while aggressively monitoring for the disease. Waiting for patients to come into health clinics is not sufficient. Public health agencies should partner with LGBTQ and AIDS organizations to bring testing and tracing into the community. A recent account in The Post found that early U.S. testing efforts seriously lagged, although the number of tests now appears to be ramping up. A limitation is that current tests don’t catch initial symptoms, but only check lesions, which appear after an incubation period of roughly one to two weeks.
Another concerning problem is a shortage of vaccine. Two are licensed by the Food and Drug Administration. Both were created to fight smallpox but protect against monkeypox as well. One of them, the two-dose Jynneos, developed by Bavarian Nordic, a small Danish firm, produces fewer side effects, is easier to administer and can be given to more people. But the factory to produce it has been shut down since last year, and may only resume operations this summer. A limited supply of the vaccine exists in the U.S. national stockpile and in Europe. Rochelle Walensky, director of the Centers for Disease Control and Prevention, said Friday that priority U.S. distribution at this time will be aimed at areas with the most high-risk patients. Still, existing supplies are not sufficient to keep up with demand; a further scaling up will be needed as soon as possible. The second vaccine, ACAM2000, carries a greater risk of serious side effects.
Monkeypox does not threaten everyone as covid-19 did. That is not much comfort. We are witnessing a serious outbreak that demands an emergency response before it does still more damage.
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Read More: Opinion | Monkeypox testing and vaccines need to be scaled up
