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U.S. Declares Monkeypox A Public Health Emergency

On Thursday, the federal government declared the ongoing monkeypox outbreak — which has now affected 7,012 Americans — a public health emergency in an attempt to help strengthen responses. With that declaration, additional money will be directed toward resources for the virus.

“Ending the monkeypox outbreak is a critical priority for the Biden-Harris Administration,” Department of Health and Human Services (HHS) Secretary Xavier Becerra explained in a release.

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“With today’s declaration we can further strengthen and accelerate our response further,” Becerra said. “We urge every American to take monkeypox seriously and to take responsibility to help us tackle this virus.”

White House National Monkeypox Response Coordinator Robert Fenton emphasized the strategies being deployed against monkeypox are helped by prior learning experiences with outbreaks, such as COVID-19.

“We are applying lessons learned from the battles we’ve fought – from COVID response to wildfires to measles, and will tackle this outbreak with the urgency this moment demands.”

HHS is now able to utilize emergency funds and hire or assign staff to deal with the outbreak. The department also noted work being done in concert with the Food and Drug Administration (FDA) that will help to provide the Jynneos monkeypox vaccinations across the country.

The partnership plans to utilize a “new dose-sparing approach that could increase the number of doses available, up to five-fold.” This sparsing would be accomplished through a shallower injection than the one recommended for Jynneos.

However, the approach would need approval from regulators and another declaration from the federal government altering guidelines on vaccine administration.

The announcement comes as vaccines are seeing struggles with availability. Minnesota has just 3,000 of the 90,000 vaccines needed to help those most at-risk, while California has received just around 37,000 of the 800,000 requested.

Health officials also have concerns that should the shortage not be addressed immediately and effectively, the virus could become far more widespread, marking it as the second public health disaster in a span of over two years.

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HHS has shipped over 602,000 doses of the vaccine, a number that’s up 266,000 from last week, bringing the total amount of allocated vaccines to 1.1 million. The department also announced it’s ordered an additional 150,000 vaccines, which are expected to arrive in September. Similar to most COVID-19 vaccines, Jynneos requires two doses, 28 days apart.

According to the Center for Disease Control’s (CDC) case count, as of Thursday, New York continues to lead all states in cases with 1,748. California sits second with 826 cases, while Florida is third with 577. Just two out of the 50 states (Wyoming and Montana) have no reported cases.

California, New York, and Illinois all declared public health emergencies last week, as did the cities of New York City and San Francisco. Despite the rising cases, no Americans have died, though several deaths have been reported in other countries. In recent times, monkeypox fatality rates have ranged from 3% to 6%.

Monkeypox had previously been declared a Public Health Emergency of International Concern (PHEIC) by the World Health Organization (WHO) in late July following a substantial global increase. Worldwide, over 26,800 cases in more than 70 countries have been confirmed.

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World Health Organization Declares Monkeypox Outbreak As A Global Health Emergency 

The World Health Organization (WHO) has officially declared the global monkeypox outbreak as a public health emergency of international concern, the strongest call to action the agency can make. 

Since 2009, the WHO has declared seven global health emergencies, the most recent being for Covid-19, which was declared an emergency back in 2020. 

According to the WHO’s international health regulations, a Public Health Emergency of International Concern (PHEIC) is “an extraordinary event which is determined to constitute a public health risk to other states through the international spread of disease and to potentially require a coordinated international response.”

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The UN health agency states that the term implies that the situation is very serious, sudden, unusual, and/or unexpected. A global health emergency also implies this is a threat for public health beyond national borders, and may require immediate international attention. 

Dr Tedros Adhanom Ghebreyesus, the WHO’s director general, said at a press conference that the “committee met on Thursday to review the latest data, but were unable to reach a consensus.”

“In short, we have an outbreak that has spread around the world rapidly through new modes of transmission about which we understand too little and which meets the criteria in the international health regulations,” he said. 

“For all of these reasons I have decided that the global monkeypox outbreak represents a global health emergency of international concern.”

While he said the “risk of monkeypox is moderate globally, it’s high in Europe and there is a clear risk of further international spread.”

So far there have been around 16,000 cases of monkeypox globally, 4,132 of which were in the past week according to data from WHO. It’s now been found in 75 countries and territories, and there have been five deaths. 

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European regions have the highest number of total cases at 11,865, and the highest increase in cases within the last week, with 2,705. 

Dr. Rosamund Lewis, the technical lead for monkeypox at the WHO health emergency program, stated that there’s “a lot of work to be done. Action must be taken to establish what causes risk and to reduce situations that could put people at risk so they can protect themselves. This is how we will get to the end of this outbreak.” 

Monkeypox is classified as a viral infection typically found in animals in central and western Africa, although it can cause outbreaks in humans, as we’ve been seeing. 

Besides Europe, cases have been reported throughout the US, Canada, Australia, Nigeria, Israel, Brazil, Mexico, and others. 

Experts have stressed that anyone can get monkeypox as it’s spread through close or intimate contact. The UN has warned that some media portrayals of the virus impacting mainly Africans and individuals in the LGBT+ community “reinforce homophobic and racist stereotypes and exacerbate stigma.” 

Dr Michael Ryan, the executive director of the WHO emergencies program, said: “We all know how difficult it has been historically to deal with issues like this because of stigma. If nothing else this is about enlightened self-interest, as well as solidarity with those affected.”

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According to WHO, Monkeypox Cases Have Risen 77% In A Week

On Thursday, the World Health Organization (WHO) reported a 77% weekly increase in the number of lab-confirmed monkeypox cases, contributing to more than 7,000 total reported cases worldwide in 54 locations.

Due to the rapid increase, WHO Director-General Tedros Adhanom Ghebreyesus said the agency will reconvene a meeting of the committee that will decide on whether to declare the outbreak a Public Health Emergency of International Concern (PHEIC).

The committee previously met on June 25, ultimately deciding that while the spread did not warrant the PHEIC label, it was to be “closely monitored.” Tedros said that the committee will meet during the week of July 18 or sooner, if needed.

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“I continue to be concerned by the scale and spread of the virus across the world,” Tedros said, also noting that due to testing being a “challenge,” more cases that are going unreported is a strong possibility. He explained monkeypox is occuring in African countries previously not affected, while record numbers are appearing in countries that have had past experience with the virus.

PHEIC is defined by the WHO as an extraordinary event that sees a “public health risk to other States through the international spread of disease” which requires a worldwide coordinated response. Since 2009, there have been six PHIEC’s declared by WHO, the most recent being COVID-19.

The hotbed for monkeypox currently resides in Europe, where 80% of lab-confirmed cases have been since mid-May. As of July 7, Germany leads all countries with 1,385 confirmed cases, while the United Kingdom sits in second with 1,351 cases.

The United States sits fourth with 699 confirmed cases, 20% (122) of which are located in New York — specifically New York City, where cases doubled from 55 last week. 33 states, including Washington, D.C. and Puerto Rico, have at least one confirmed case.

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Part of the same family as smallpox, monkeypox symptoms can include fevers, chills, a lack of energy, headaches, muscles aches, and skin lesions on the arms, face, and legs. While these can last for up to three or four weeks, the disease is rarely fatal, with recent mortality rates ranging from 3% to 6%.

In addition to spreading through direct contact with rashes and and body fluids, the virus can enter the body through respiratory secretions during face-to-face contact or intimate physical contact.

Health officials have explained the majority of cases are found in gay or bisexual men who have had contact with other men. Tedros explained that because of this, WHO is prioritizing working with the LGBTQ+ community in order to emphasize prevention.

“WHO is also working closely with civil society and LGBTQI+ community, especially to break the stigma around the virus and spread information so people can protect themselves.”

Action against the virus has already begun, with the U.S. Department of Health and Human Services (HHS) reporting it ordered an additional 2.5 million doses of the JYNNEOS monkeypox vaccine on July 1, bringing the federal government’s available supply to 4 million.

“We will continue to be responsive to jurisdictions and deliver vaccine as quickly as we can while we maintain a focus on fair and equitable distribution nationwide,” HHS Assistant Secretary for Preparedness and Response Dawn O’Connell said, with the Biden Administration’s strategy for distribution focusing on locations with the most at-risk and highest case rates.

The vaccine distributions have seen their highest totals in California, New York, and Illinois, particularly in the states’ major cities: Los Angeles (7,346), New York City (7,169), and Chicago (5,409). Massachusetts are Colorado have also seen sizeable distribution.

Florida Officials Investigating U.S.’ Third Possible Monkeypox Case

Florida health officials are currently investigating what they call a “presumptive” monkeypox case, which would make it the third possible case in the U.S. as the disease continues to see afflictions worldwide.

According to a press release by the Florida Department of Health, the investigation is being led by the Florida Department of Health in Broward County (DOH Broward), along with the Bureau of Public Health Laboratories and the Centers for Disease Control and Prevention (CDC).

The release noted the infection is related to international travel, while the person remains in isolation. DOH Broward — which is conducting epidemiological investigations to notify possible exposures — has not identified any additional cases.

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On May 20, two days before the announcement of the investigation, the CDC issued a health advisory regarding recent cases in the United States. The first monkeypox case was identified on May 18, when the Massachusetts-based patient displayed skin lesions that had several features — firm, well circumscribed, and umbilicated — relating to the disease. A man in New York City is also being monitored for exhibiting a Monkeypox consistent illness.

Across the globe, more and more countries are seeing cases popping up. There is now 190 confirmed or suspected cases across 16 countries where the disease is not normally found. Spain confirmed the capital of Madrid had 30 cases Monday, while Germany has four confirmed cases.

The World Health Organization’s (WHO) lead advisor Dr. David Heymann called the outbreak a “random event,” stating it could have been amplified by sexual activities at two raves in Europe.

“We know monkeypox can spread when there is close contact with the lesions of someone who is infected, and it looks like sexual contact has now amplified that transmission.”

A zoonotic endemic discovered back in 1958, Monkeypox has historically circulated throughout central and west African countries. However, the recent transmission of cases through sexual contact is different from past cases that have been transmitted through wild rodents and primates.

According to the CDC, symptoms of Monkeypox always include the characteristic rash, which can be followed by fevers, malaise, muscle aches, and lymphadenopathy. With recent cases including lesions in the genital and perianal regions, it could be mistaken for sexually transmitted diseases like syphilis or herpes.

Researchers believe the human-to-human transmission of Monkeypox is through “inhalation of large respiratory droplets,” rather than contact with bodily fluids or indirect contact through clothing. It can also enter through broken skin or mucous membranes in the eyes, nose, or mouth.

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Still, the illnesses caused by Monkeypox are mild, while no deaths related to the cases have been reported thus far. In recent times, the fatality rate of Monkeypox has hovered around 3% to 6%.

Additionally, those who catch the virus usually recover over two to four weeks. Those factoids have contributed to the lack of concern by leaders like President Joe Biden, who commented on Monkeypox during his press conference in Tokyo Monday.

“I just don’t think it rises to the level of the kind of concern that existed with COVID-19, and the smallpox vaccine works for it,” Biden said, adding that the U.S. has enough of the vaccine to deal with any potential outbreaks. The response was more laid back than Biden’s previous comments on Monkeypox, where he called it something “everyone should be worried about.”

Similar to COVID-19 protocols, the WHO advised those who contract Monkeypox and are showing symptoms to remain isolated and avoid contact, and for anyone around the infected individual to wear a mask while thoroughly cleaning hands surfaces.