The monkeypox virus is unlikely to be eliminated from the United States in the near future, according to a report released this week by the Centers for Disease Control and Prevention.
The CDC, in a technical brief, said the epidemic is slowing as the availability of vaccines has increased, people have become more aware of how to avoid infection, and immunity has likely increased in homosexual and bisexual men, the group most affected by the virus. .
But low-level transmission of the virus could continue indefinitely among men who have sex with men, the report said. The CDC said it does not have a projection of the total number of people likely to be infected with the virus.
The Biden administration declared a public health emergency in August in a bid to ramp up vaccines, testing, treatment and community outreach in an effort to eradicate the virus from the United States.
The United States is trying to contain the largest outbreak of monkeypox in the world, with nearly 26,000 cases reported in all 50 states, Washington DC and Puerto Rico, according to CDC data. At least two people have died from the disease in the United States, according to the data.
The global outbreak of monkeypox, the largest in history, is highly unusual as the virus circulates widely in countries where it is not normally found. Historically, monkeypox has circulated in remote areas of West and Central Africa. In this context, people normally caught the virus from animals. There was little diffusion between people.
Monkeypox now spreads widely between people, primarily through close contact during sex between gay and bisexual men. The disease is rarely fatal, but patients develop blister-like lesions in extremely painful tender areas. In some cases, the pain is so great that people have to be hospitalized, and in rare cases people with weakened immune systems have died.
The CDC, in its report, said the virus is still spreading primarily among men who have sex with men. But anyone can catch the virus through close contact with an infected person or contaminated material. Health authorities have confirmed 29 cases of children catching the virus so far, and a total of 78 pediatric cases are under investigation as of the end of September.
Although 96% of patients are men, 408 women have caught the virus so far in the United States. Four pregnant women and one nursing mother have contracted monkeypox.
The CDC said the percentage of patients who identify as gay or bisexual men has declined over time, with 75% of people who provided a recent sexual history reporting male-to-male contact.
But a large number of cases lack sexual history data and more than 90% of infections are in men, according to the CDC. The drop in the percentage of cases reporting male-to-male sexual contact is likely due to missing data rather than a change in how the virus spreads, according to the public health agency.
The CDC said the outbreak will likely remain concentrated among men who have sex with men over the long term, with infections continuing to decline over the next few weeks and declining significantly over the next few months.
More than 684,000 people have received the Jynneos monkeypox vaccine so far. Earlier this week, the CDC reported preliminary data indicating that the vaccine offers at least some protection against infection. The vaccination campaign is primarily focused on gay and bisexual men.
The outbreak could begin to accelerate again if the virus begins to spread widely among the U.S. population through heterosexual networks or non-sexual contact, the CDC says. But no country in the current global outbreak has found clear evidence of sustained spread of the virus outside of the sexual networks of gay and bisexual men, according to the CDC.
The public health agency also warned that the virus could start spreading again more quickly among humans if it establishes itself in an animal population in the United States. The CDC said it’s unclear which North American animals are most susceptible to infection.
In Africa, the virus has mainly spread from animals to humans. If monkeypox were to become established in animals in the United States, it would be very difficult to eradicate.
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