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Analysis: Get up to speed on the monkeypox outbreak

But while Covid-19 has killed millions worldwide, monkeypox generally clears up after a few weeks. These are very different diseases.

Add in the fact that monkeypox is spread primarily through skin-to-skin contact and so far has affected many gay men and other men who have sex with men, raising concerns about a stigma that is affecting the response.

It’s certainly true the lack of testing access and slow supply of vaccines have raised questions about what the government and public health officials learned from Covid-19 about how to prepare for the next public health emergency.

Note: CNN’s most comprehensive report on Thursday comes from Virginia Langmaid and Deidre McPhillips, and I’ve taken much of what’s below from there.

What is the scale of this outbreak?

Monkeypox traditionally appears in 11 countries in tropical Africa. The new, alarming development is that it has spread worldwide this year in an unprecedented way.

There have been previous documented cases in the US, including two in 2021, but nothing on the scale of this current outbreak, which has exceeded 1,000 documented US cases, according to the CDC.

The most documented cases have occurred in Europe: in Spain, Germany and the United Kingdom.

The CDC’s map of documented cases in the US shows it has spread across the country to all but a handful of states.

The most-affected states include California, New York and Illinois, as well as Washington, DC.

What’s the worst-case scenario?

The fear is monkeypox could spread to the wider population in the US, and the worldwide outbreak could make the virus a permanent fixture.

Monkeypox can be dangerous and even deadly in certain people, such as those with weakened immune systems.

What are the symptoms?

It can take up to two weeks for symptoms to form. They often begin with fever, chills and swollen lymph nodes. Extremely painful red poxes filled with liquid can then form, often on the genitals but could be all over the body.

And see one man’s warning: You do not want to get this disease.

The true spread is probably much wider

The true scope of the outbreak in the US is likely unknown. Read this NPR account about how difficult it was for one man who suspected he had monkeypox to get tested in New York last month.

Why has it been so hard to get a test?

Even someone who really wants to get a test often has to commit time and energy to receive one.

Langmaid and McPhillips report how two different men went repeatedly for testing. Here’s an excerpt from their story:

Christian Redondo, a graduate student in Atlanta, noticed a sore and called his local board of health, which said it wasn’t doing testing and referred him to his primary care doctor.

His primary care doctor told him to go to the emergency room to get tested, but Redondo was able to contact a friend at his county health department who said yes, in fact, he would need to go there for a test.

“Then, I was in the waiting room for, I don’t know, something like four or five hours. It was a very long time. And when I was asking them about it, they said they had to wait for permission from the CDC to even test me for monkeypox,” he said.

How will the testing problem be solved?

The CDC has said it will now work with five private companies to expand access to tests. That will help, according to Dr. Saju Mathew, a primary care physician and CNN medical analyst, who talked to “New Day” over the weekend.

But the lack of testing is not simply a matter of capacity, he said.

“I think it’s really a combination of not having access, the fact that a lot of physicians are uncomfortable with the diagnosis. And, mind you, the rash of monkeypox … looks very much like the rash in somebody who has shingles or chickenpox. So a lot of different challenges to overcome.”

He also talked about the danger of a stigma attached to this disease. It is spreading primarily in the gay community, but anyone can get it.

“We should be careful about not stigmatizing the disease and preventing people who are not really open about their sexuality from seeking care,” Mathew said.

What about the vaccine?

While the Covid-19 vaccine is entirely preventative, the monkeypox vaccine can be used both for those who are in high-risk groups and for people who think they might have been exposed. It’s called the Jynneos vaccine and is manufactured by Bavarian Nordic in Denmark.

It’s getting hard or impossible to find in many parts of the US. Doses have been snapped up as soon as they are allocated to cities and states. New shipments are expected soon from Denmark, according to the White House.

Politicians and public health officials are trying to get creative to stretch access to the vaccine, which is normally two doses spread over four weeks. New York Mayor Eric Adams suggested in a letter to the White House that a one-dose starter course be allowed to get more people inoculated.

It’s an idea that Bavarian Nordic has also suggested.

Worldwide concern

Meanwhile, the World Health Organization declined back in June to label monkeypox a public health emergency of international concern. Now, with cases spiraling, the agency will reassess that decision in a meeting next week.
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