Biden Admininstration to Declare Monkeypox a Public Health Emergency

[kyphysics]

https://www.cnn.com/2022/08/04/politics/monkeypox-public-health-emergency/index.html

It's funny in that I've literally seen zero health facilities in my area mention monkeypox or have signs posted for safety. On the other hand, those same facilities still have COVID masking requirements at them and check my temp upon entry. Some even still have social distancing "spaces" between seats in the waiting areas (for COVID...not monkeypox).

Anyone seeing case spikes of monkeypox in your area and/or seeing health facilities screen for it or put up warning signs?

 

[bob012345]

https://www.cnn.com/2022/08/04/politics/monkeypox-public-health-emergency/index.html

It's funny in that I've literally seen zero health facilities in my area mention monkeypox or have signs posted for safety. On the other hand, those same facilities still have COVID masking requirements at them and check my temp upon entry. Some even still have social distancing "spaces" between seats in the waiting areas (for COVID...not monkeypox).

Anyone seeing case spikes of monkeypox in your area and/or seeing health facilities screen for it or put up warning signs?

Dallas County authorities said there were a few cases.

 

[Astronuc]

As of August 4 2022, a total of 1,748 confirmed orthopoxvirus/monkeypox cases [in NY State] - a designation established by the Centers for Disease Control and Prevention (CDC).

https://www.health.ny.gov/diseases/communicable/zoonoses/monkeypox/
https://www.npr.org/2022/07/30/1114747427/nyc-monkeypox-public-health-emergency
Counties close to NY City have seen more cases than those further away. NY City has 1630 cases, Westchester County has 47 cases, and Suffolk County has 23 cases.

Like SARS-Cov2, it is being brought into the US by international travelers.

As Aug 2, San Francisco has 397 cases, State of California has a total of 1135 cases, US has a total of 6636 cases (or about 25% of cases worldwide).
Source: https://sf.gov/information/monkeypox-cases

https://www.cdc.gov/poxvirus/monkeypox/response/2022/us-map.html

 

[berkeman]

It's funny in that I've literally seen zero health facilities in my area mention monkeypox or have signs posted for safety. On the other hand, those same facilities still have COVID masking requirements at them and check my temp upon entry. Some even still have social distancing "spaces" between seats in the waiting areas (for COVID...not monkeypox).

Anyone seeing case spikes of monkeypox in your area and/or seeing health facilities screen for it or put up warning signs?

Standard EMS precautions for Monkeypox are similar to standard precautions for HIV. The transmission mechanism for the Monkeypox virus is much more like that for HIV, not like that for SARS-Cov-2 (COVID-19). Covid is mainly transmitted via airborn aerosols, not through intimate contact.

Here is the current info from my local EMS Agency in Santa Clara County in Northern California:

https://publichealth.sccgov.org/disease-information/monkeypox

And the advisory I received as a Medical Provider here:

https://publichealth.sccgov.org/disease-information/monkeypox

 

[kyphysics]

 

[berkeman]

@kyphysics -- what does your latest post mean? The $R_0$ or that R(e) number would still apply to the at-risk population, right? Please clarify.

 

[kyphysics]

I'm not 100% sure, but assumed R was being used same as with COVID's reproductive rate.

Below 1 means it is not growing exponentially and could decrease and peter out over time at that rate.
1 or above means it would continue to grow exponentially over time.

I'm scanning Feigl-Ding's thread/feed for more info...

 

[berkeman]

But your OP question was why aren't Covid precautions being enforced against this Monkeypox outbreak, right? Did I adequately answer that question?

 

[kyphysics]

But your OP question was why aren't Covid precautions being enforced against this Monkeypox outbreak, right? Did I adequately answer that question?

Oh...yes. I am not that familiar with monkeypox spread. Your post makes sense and is helpful.

And this thread/OP is actually meant to talk about anything/everything monkeypox too. Not just spread. I just wrote those comments as a way of starting a conversation. The intention was open up chat to everything/anything monkeypox-related.

 

[kyphysics]

Not seeing anything on Eric Feigl Ding's feed explaining what the "e" is in R(e). I just assumed it was either a typo or the equivalent of R("not"). He's a prolific poster, so I'm sure future posts can clarify this.

 

[berkeman]

And this thread/OP is actually meant to talk about anything/everything monkeypox too. Not just spread. I just wrote those comments as a way of starting a conversation. The intention was open up chat to everything/anything monkeypox-related.

So yes, there are currently a few (I think 4 as of today?) pockets of Monkeypox outbreaks in the US, and they are mainly among the LGBTQ communities in those areas, much like the beginning of the early HIV outbreaks. That is what has prompted some of the early responses by local US governments, to try to get out in front of this and avoid the much larger spread of the virus. Hopefully the at-risk population members will be smarter this time versus the HIV epidemic; hopefully they have not become too complacent given the large strides we have made in treating HIV.

CDC reference: https://www.cdc.gov/poxvirus/monkeypox/response/2022/index.html

 

[pinball1970]

So yes, there are currently a few (I think 4 as of today?) pockets of Monkeypox outbreaks in the US, and they are mainly among the LGBTQ communities in those areas, much like the beginning of the early HIV outbreaks. That is what has prompted some of the early responses by local US governments, to try to get out in front of this and avoid the much larger spread of the virus. Hopefully the at-risk population members will be smarter this time versus the HIV epidemic; hopefully they have not become too complacent given the large strides we have made in treating HIV.

CDC reference: https://www.cdc.gov/poxvirus/monkeypox/response/2022/index.html

This was mentioned in the UK press a few weeks ago but indications were that is was low risk.


I did not know it had an LGBT connection, Africa was mentioned initially

https://www.nhs.uk/conditions/monkeypox/

 

[bob012345]

I did not know it had an LGBT connection, Africa was mentioned initially

There is a great deal of sensitivity in the official statements and reporting. They tend to not speak of it being spread by gay men but rather men having sex with men for fear of causing a backlash. The emergency declaration is to the public at large rather than targeted because the LGBT community is now considered an equal part of the public and to target them in particular would be considered discrimination. The recommendations are very carefully worded so as not to be passing judgement on certain cultural practices regarding sexuality.

https://www.npr.org/2022/07/31/1114670483/monkeypox-messaging-stigma



Only time will tell if these approaches mitigate the spread or not.

 

[pinball1970]

There is a great deal of sensitivity in the official statements and reporting. They tend to not speak of it being spread by gay men but rather men having sex with men for fear of causing a backlash. The emergency declaration is to the public at large rather than targeted because the LGBT community is now considered an equal part of the public and to target them in particular would be considered discrimination. The recommendations are very carefully worded so as not to be passing judgement on certain cultural practices regarding sexuality.

https://www.npr.org/2022/07/31/1114670483/monkeypox-messaging-stigma



Only time will tell if these approaches mitigate the spread or not.

It does not seem right to an outsider (me)

If there is an at risk group it is best to let them know so they can do something about it. Get tested, look at behaviour etc. Decrease risk to themselves and the community.
That makes sense to me, no one gets hurt by pointing it out. People could get sick by not doing so.

 

[kyphysics]

There is a great deal of sensitivity in the official statements and reporting. They tend to not speak of it being spread by gay men but rather men having sex with men for fear of causing a backlash.

Apologies if this is extremely ignorant, but is there any reason why "gay" or "male-on-male" sex is any greater danger in spreading monkeypox vs. casual sex between heterosexuals?

If it is spread by bodily fluids and close contact, then wouldn't ANY sex be a potential transmission risk?

eta: Or, what about simply crowded places (+ lack of hygiene) for that matter? Maybe a homeless shelter? Why the emphasis on the gay community?

 

[bob012345]

Apologies if this is extremely ignorant, but is there any reason why "gay" or "male-on-male" sex is any greater danger in spreading monkeypox vs. casual sex between heterosexuals?

If it is spread by bodily fluids and close contact, then wouldn't ANY sex be a potential transmission risk?

eta: Or, what about simply crowded places (+ lack of hygiene) for that matter? Maybe a homeless shelter? Why the emphasis on the gay community?

The World Health Organization recently reported * that the monkeypox outbreak “continues to primarily affect men who have sex with men who have reported recent sex with new or multiple partners.” The CDC has recommended the Jynneos vaccine for men who report more than four male sexual partners within the past 14 days.**

The outbreak, which epidemiologists believe initially began in mid-spring gatherings of gay and bisexual men in Europe, has since alarmed such experts by ballooning to nearly 16,000 cases worldwide. **

Public health experts also theorize that major LGBTQ Pride gatherings in June may have facilitated transmission of the virus. And given the infection’s incubation period — the new paper puts it at seven days, with a range of three to 20 days — the nation is now possibly seeing the resulting downstream effects of sexual encounters in late June and early July.**


“The finding that 95% of cases may have been transmitted during sex provides reassurance that this outbreak is primarily caused by very close contact and may explain why it’s been largely limited, so far, to dense social networks of men who have sex with men,” said Dr. Jay K. Varma, an infectious disease expert at Weill Cornell Medicine.**

The referenced study*** states:
To date, the current spread has disproportionately affected men who are gay or bisexual and other men who have sex with men, which suggests amplification of transmission through sexual networks.


So dense,social networks interconnected by travel seems to be behind the rapid spread across the Western world.


* https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON393

** https://www.nbcnews.com/nbc-out/out...helmingly-sex-men-major-study-finds-rcna39564

*** https://www.nejm.org/doi/full/10.1056/NEJMoa2207323

 

[pinball1970]

Apologies if this is extremely ignorant, but is there any reason why "gay" or "male-on-male" sex is any greater danger in spreading monkeypox vs. casual sex between heterosexuals?

If it is spread by bodily fluids and close contact, then wouldn't ANY sex be a potential transmission risk?

eta: Or, what about simply crowded places (+ lack of hygiene) for that matter? Maybe a homeless shelter? Why the emphasis on the gay community?

Blood probably and other things. Also habits in terms of partners.
Promiscuity in the community in the 70s was a factor for spread of HIV.
The gay community (men) changed habits and cases came down, meanwhile cases in the heterosexual community went up, they were safe right? A gay disease? Wrong.
Add to that the IV drug community, sex worker community and those were administered contaminated blood products that ran along side and overlapped.

Partners and habits mainly, if this is a gay community disease then there will be cross over.
Bisexual men, IV drug users. Not sure How screening works regarding monkey pox in terms of blood products.

 

[jim mcnamara]

Some points this thread are wandering off target:
Monkeypox is an Orthovirus and is related to smallpox. Smallpox vaccines are effective against the Monkeypox infection.

This means people who were vaccinated against smallpox (ended 1972 in the US), are also likely to have a 95% chance the vaccine is still effective. And protection carries over to Monkeypox.

There are two clades - one in the Congo -high mortality rate (~10%), another in West Africa, less virulent with 1% mortality

Am J Med. 2008 Dec; 121(12): 1058–1064.

Transmission is due to close contact. Fomites also have been shown to infect new patients. A fomite is some object like clothing, towels, jewelry, etc., used by a person with Monkeypox. The pustules burst leaving an infectious residue behind on the object. In general, skin contact a burst pustule's residue is the usual infection route.

CDC reports 7509 cases in the US. Map is updated weekly.
Link to map:
https://www.cdc.gov/poxvirus/monkeypox/response/2022/world-map.html

 

[StevieTNZ]

https://www.stuff.co.nz/national/he...mmunity-transmission-confirmed-in-new-zealand

...
There is currently no confirmed link between the two cases, and no identified link to a known overseas acquired case – so Te Whatu Ora and the Ministry of Health consider “there is the potential for more cases to emerge”.
...

 

[pinball1970]

UKHSA published a technical briefing.

https://www.gov.uk/government/publi...ak-epidemiological-overview-13-september-2022