Four months after the first report of monkeypox in the United States, the virus is showing promising signs of retreat, which is good news for older adults, pregnant women and young children.
Federal health officials have begun clinical trials to gain a better understanding of who benefits and how much from both the vaccine and the drug used to treat those who become infectious.
The bad news is that. Case numbers are increasing in a few states and localities. Black and Hispanic men make up two-thirds of the infections, but less than one-fourth of those who have gotten the vaccine.
David Harvey is the Executive Director of the National Coalition of STD Directors.
He said that the outbreak was far from over.
Reports suggest that a single dose of the vaccine, Jynneos, may not be protective enough, raising fresh concerns about the Biden administration's plan to distribute fractional doses.
The only safe treatment for those who are HIV positive is tecovir, and federal health officials warn that it could become resistant.
Anthony S. Fauci is the top medical adviser to the Biden Administration. As you try and develop additional drugs, you have to stick with what you have.
The District of Columbia and Puerto Rico have the highest number of monkeypox cases in the country. The US accounts for 40% of the global tally.
The daily average of new cases has been decreasing for weeks.
The nation's first death from monkeypox was confirmed by the LA Department of Public Health. The death in Texas may be related to the disease.
There have been two cases of encephalomyelitis in gay men in their 30s.
Federal health officials are optimistic that the epidemic is coming to an end. While testing and vaccines are important, officials think of a future in which monkeypox is manageable with contact tracing and early treatment.
The deputy coordinating of the White House's monkeypox response thinks it will look a little bit more like more episodes.
Monkeypox is what it is. The symptoms of monkeypox are not as severe as those ofpox. There was an outbreak in monkeys kept for research. Most of the people who have sex with men who have the virus are from Central and West Africa.
What does it do? The monkeypox virus can be spread by coughing or sneezing, or by touching items that have previously touched the rash, or by touching items that have not touched the rash. During and after birth, monkeypox can be transmitted from the mother to the fetus.
I'm afraid I might have a disease. I don't know what to do. You can't test for monkeypox if you only have flu symptoms. You can get a monkeypox test from an urgent care center or your primary care doctor. If you have to come in contact with other people for medical care, you should be isolated at home.
I live in the city. Is it possible to get the vaccine? Adult men who have sex with men and have had multiple sexual partners in the last 14 days are eligible for a vaccine in New York City. People with conditions that weaken the immune system or have a history of allergies are encouraged to get the vaccine. There is a website that people can use to book an appointment.
The recent decline is most likely the result of a combination of vaccinations, immunity gained from infections in the population most at risk, and a change in behavior.
According to a survey conducted by the C.D.C., half of men who have sex with men have reduced the number of partners they have.
These men may soon believe that the threat is over. People can't be asked to change their behavior forever. That didn't work with H.I.V. so it's not going to work here as well.
He said that vaccinations are likely to be a more effective containment strategy.
More than one half a million doses of Jynneos were given by health officials in 48 countries. It accounts for only 22 percent of the doses needed to protect the 1.6 million Americans who are at high risk of contracting the disease.
Black and Hispanic men have seen the proportion of infections increase from 37 percent in May to 70 percent in September. Black men have gotten less than 9 percent of the doses, while Hispanic men have gotten 16 percent.
At large gatherings where Black and Hispanic men congregate, the federal health officials are increasing their efforts to reach high risk groups.
Under the new dose-sparing strategy announced by the C.D.C., up to 10,000 vials of vaccine will be made available to communities where hesitancy, language barriers, immigration status or other obstacles prevent widespread vaccinations.
According to an analysis by the Kaiser Family Foundation, the criteria for eligibility for the vaccine can be difficult to understand. Indiana and New Mexico don't give online information about who qualifies. Only 18 states and cities allow laboratory and health care workers to be exposed to the virus.
A single dose may not be enough to protect men at high risk. 77 percent of the first dose have been administered so far.
According to a new study, that won't be enough to prevent infections. Dutch researchers found that a single full dose of Jynneos produced low levels of monkeypox resistance.
The study found that two full doses were better than one full dose.
She said that it raised the question of how good protection would be. I think we need to figure out what's going on since we don't know much about it.
In order to stretch the vaccine supply, the Biden administration has embraced a dose-splitting strategy in which one-fifth of a regular dose is delivered into the skin. In other instances, this approach has been used.
Activists and some scientists have decried the administration's reliance on fractional-dosing, noting that federal officials moved slowly to make available millions of Jynneos doses.
The founder of the group that promotes access to H.I.V. care said that they should not have gotten into the situation.
There isn't a lot of research to support fractional doses, but there's a good chance that they're not.
The Dutch team didn't pay much attention to how well Jynneos protects against monkeypox. They tested a bird flu vaccine similar to Jynneos and found that two fractional doses did not produce the same amount of immunity.
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Because Jynneos was approved on the basis of animal data, little is known about its effectiveness. The evidence shows that two doses are better than one, said Peter Marks, the Food and Drug Administration's top vaccine Regulator.
He said that having two doses of Jynneos was the correct way to go, and that having a sufficient number of doses was a smart idea.
He said that they were working in a public health crisis. I think we are doing our best with the data that we have and the data that we trust.
A third shot a year after the first two gives the immune system a boost. If that is the case, a three-dose regimen may be the best way to manage monkeypox infections. Scientists are debating whether to test third doses.
The standard dose will be compared with the one-fifth and one-tenth dose in a new trial led by the National Institutes of Health.
In countries where the vaccine is currently unavailable, the dose splitting approach would greatly expand world supply.
The researchers will be collecting information on the participants. According to the N.I.H. researcher leading the trial, they won't be tracking other immune cells that are equally important for protection.
He said that it was a decision for quick results.
The aim of the N.I.H. trial is to see how well tecovir works in people.
The only drug that works to treat monkeypox in the United States is tcholimart. The drug was approved for use in animals, but has never been tested in people.
Recent anecdotal observations and small clinical studies show that the drug works well. Some patients have headaches and nausea.
The Biden administration made it hard for clinicians to prescribe the drug. The C.D.C urged clinicians to reserve tecoimat for patients who are severely immunocompromised, pregnant or breastfeeding, as well as for children under the age of eight.
Federal officials said that the decision to limit indiscriminate access was made because of the risk of Tpoxx-resistant monkeypox. According to the F.D.A., several studies show that small genetic changes could leave the virus resistant.
The new trial should give a better idea of the risk. Dr. Fauci said that they wanted to make it easier and more confident to make Tpoxx available for people who are infectious.
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