{"id":52157,"date":"2024-05-16T17:08:12","date_gmt":"2024-05-16T17:08:12","guid":{"rendered":"https:\/\/news.talkwithrattan.com\/index.php\/2024\/05\/16\/c-d-c-warns-of-a-resurgence-of-mpox\/"},"modified":"2024-05-16T17:08:12","modified_gmt":"2024-05-16T17:08:12","slug":"c-d-c-warns-of-a-resurgence-of-mpox","status":"publish","type":"post","link":"https:\/\/news.talkwithrattan.com\/index.php\/2024\/05\/16\/c-d-c-warns-of-a-resurgence-of-mpox\/","title":{"rendered":"C.D.C. Warns of a Resurgence of Mpox"},"content":{"rendered":"<div style=\"text-align:center\"><img loading=\"lazy\" decoding=\"async\" width=\"1050\" height=\"550\" src=\"https:\/\/i1.wp.com\/static01.nyt.com\/images\/2024\/05\/16\/science\/16mpox\/16mpox-facebookJumbo.jpg?fit=1050,550&amp;ssl=1\" class=\"attachment-post-thumbnail size-post-thumbnail wp-post-image\" alt=\"C.D.C. Warns of a Resurgence of Mpox\" title=\"C.D.C. Warns of a Resurgence of Mpox\" \/><\/div><p> <br \/>\n<\/p>\n<div>\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">With <a class=\"css-yywogo\" href=\"https:\/\/www.iglta.org\/events\/pride-calendar\/\" title=\"\" rel=\"noopener noreferrer\" target=\"_blank\">Pride events<\/a> scheduled worldwide over the coming weeks, U.S. officials are bracing for a return of mpox, the infectious disease formerly called monkeypox that struck tens of thousands of gay and bisexual men worldwide in 2022. A combination of behavioral changes and vaccination quelled that outbreak, but a majority of those at risk have not yet been immunized.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">On Thursday, the Centers for Disease Control and Prevention warned of a deadlier version of mpox that is ravaging the Democratic Republic of Congo and urged people at risk to be vaccinated as soon as possible. No cases of that subtype have been identified <a class=\"css-yywogo\" href=\"https:\/\/www.ecdc.europa.eu\/en\/news-events\/ecdc-assesses-risk-associated-ongoing-mpox-epidemic-democratic-republic-congo\" title=\"\" rel=\"noopener noreferrer\" target=\"_blank\">outside Africa<\/a> so far. But the escalating epidemic in Congo nevertheless poses a global threat, just as infections in Nigeria set off the 2022 outbreak, experts said.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cThis is a very important example of how an infection anywhere is potentially an infection everywhere, and why we need to continue to improve disease surveillance globally,\u201d said Anne Rimoin, an epidemiologist at the University of California, Los Angeles.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Dr. Rimoin has studied mpox in Congo for more than 20 years, and first warned of its potential for global spread in 2010.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div>\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">The C.D.C. is focusing on encouraging Americans at highest risk to become vaccinated before the virus resurges. The agency\u2019s outreach efforts include engaging with advocacy groups and <a class=\"css-yywogo\" href=\"https:\/\/www.instagram.com\/dashaunwesley\/reel\/C6HWydFLVTX\/\" title=\"\" rel=\"noopener noreferrer\" target=\"_blank\">social media influencers<\/a> who have broad appeal among the L.G.B.T.Q. community. In December, the agency <a class=\"css-yywogo\" href=\"https:\/\/emergency.cdc.gov\/han\/2023\/han00501.asp\" title=\"\" rel=\"noopener noreferrer\" target=\"_blank\">urged clinicians<\/a> to remain alert for possible cases in travelers from Congo.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">There are two main types of mpox: Clade I, the type that is dominant in Congo, and Clade II, a version of which caused the 2022 global outbreak. (A clade is a genetically and clinically distinct group of viruses.) Both clades have circulated in Africa for decades, sporadically erupting into outbreaks.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">People with mpox may have fever, intense headache and back pain, followed by a rash. Many patients also develop painful sores, often at the site of infection. People who have weakened immune systems, including those living with H.I.V., are <a class=\"css-yywogo\" href=\"https:\/\/www.nytimes.com\/2022\/10\/26\/health\/monkeypox-hiv.html\" title=\"\">most likely to become severely ill<\/a> and die.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">The version of mpox that caused the 2022 outbreak, called Clade IIb, led to more than 30,000 cases in the United States that year. The epidemic quieted in 2023 with only about 1,700 cases but is now showing signs of a resurgence: The number of cases in the United States this year is nearly double the tally at this time last year.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">In Congo, as of April 14, the Clade I virus has led to about 20,000 cases and nearly 1,000 deaths since January 2023. Infection with Clade I has a mortality of roughly 5 percent, compared with less than 0.2 percent for Clade IIb.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div>\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">More than three-quarters of deaths in Congo related to Clade 1 mpox have been among children under 15.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Even if the deadlier clade were to emerge in the United States, American <a class=\"css-yywogo\" href=\"https:\/\/www.wsoctv.com\/news\/local\/health-officials-warn-mpox-is-rise\/G7M52QO6HVEHXDEXEKE7VE2OLE\/\" title=\"\" rel=\"noopener noreferrer\" target=\"_blank\">children<\/a> would be less likely to be exposed <a class=\"css-yywogo\" href=\"https:\/\/www.cbsnews.com\/philadelphia\/news\/mpox-exposure-philadelphia-richmond-school\/\" title=\"\" rel=\"noopener noreferrer\" target=\"_blank\">to mpox<\/a>, and less vulnerable to it, than those in Congo, experts said.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div>\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">Most cases among children in Congo are thought to result from direct contact with infected animals such as monkeys, prairie dogs, squirrels and shrews, or from eating contaminated bush meat. The children may live in crowded households and be in poor health generally.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">The country is troubled by armed conflicts, floods, poverty, malnutrition and multiple infectious diseases, including cholera, measles and polio.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div>\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">\u201cThere\u2019s just a difference in living in D.R.C. that probably promotes higher spread among kids,\u201d said Dr. Jennifer McQuiston, the deputy director of the Division of High Consequence Pathogens at the C.D.C.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Adult cases in Congo have likewise been attributed to interactions with infected animals or close, sustained contact with infected people. But last year, for the first time, scientists discovered sexual transmission of Clade I mpox among male and female sex workers and their contacts.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">In one outbreak in Kamituga, a mining town in Congo, <a class=\"css-yywogo\" href=\"https:\/\/www.medrxiv.org\/content\/10.1101\/2024.03.05.24303395v1.full\" title=\"\" rel=\"noopener noreferrer\" target=\"_blank\">heterosexual prostitution<\/a> <a class=\"css-yywogo\" href=\"https:\/\/www.medrxiv.org\/content\/10.1101\/2024.05.10.24307057v1\" title=\"\" rel=\"noopener noreferrer\" target=\"_blank\">in bars<\/a> appeared to be the main form of transmission. <a class=\"css-yywogo\" href=\"https:\/\/www.medrxiv.org\/content\/10.1101\/2024.04.12.24305195v2\" title=\"\" rel=\"noopener noreferrer\" target=\"_blank\">Genetic analysis<\/a> showed that, sometime around September, the virus gained mutations, enabling it to spread more readily among people.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">This chain of transmission appears to be a second, distinct outbreak in the country, caused by a new version of the virus called Clade Ib, with cases split about equally among young men and women, said Marion Koopmans, a virologist at Erasmus Medical Center in Rotterdam, the Netherlands.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cI do think there is more than one outbreak ongoing, and it is important to continue to evaluate what that means,\u201d Dr. Koopmans said. \u201cWe cannot assume\u201d all forms of mpox behave in the same way, she said.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div>\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">The development has also alarmed scientists because miners and sex workers in the region are transient and may ferry the virus to the neighboring nations of Rwanda, Burundi, Uganda and Tanzania.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">In many of these countries, limited access to tests, vaccines and treatments gives the virus ample opportunity to thrive and evolve. A vast majority of mpox cases are diagnosed based on symptoms alone.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Some countries rely on tests that detect only Clade I or only Clade IIb. Those tests may not pick up Clade Ib, the new version that emerged in September, according to a <a class=\"css-yywogo\" href=\"https:\/\/www.eurosurveillance.org\/content\/10.2807\/1560-7917.ES.2024.29.11.2400106\" title=\"\" rel=\"noopener noreferrer\" target=\"_blank\">recent study<\/a>.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">That finding prompted the World Health Organization to alert nations to revisit their testing procedures \u201cand make sure they don\u2019t miss a diagnosis,\u201d said Dr. Rosamund Lewis, who leads the W.H.O.\u2019s mpox response.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div>\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">In the United States, a test approved by the Food and Drug Administration detects all versions of mpox but cannot distinguish between them. A positive result on that test should be followed by more specific tests that can identify the clade, Dr. McQuiston said.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div>\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">So far at least, the available vaccines and antiviral drugs are expected to be effective against all forms of the virus. The 2022 outbreak began in Europe in May and picked up steam in the United States during Pride Month in June and afterward.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Early in the outbreak, there was a <a class=\"css-yywogo\" href=\"https:\/\/www.nytimes.com\/2022\/08\/05\/health\/monkeypox-vaccine-hiv.html\" title=\"\">shortage of the two-dose mpox vaccine<\/a>, called Jynneos. But many gay and bisexual men, accustomed to heeding public health messaging on H.I.V., <a class=\"css-yywogo\" href=\"https:\/\/wwwnc.cdc.gov\/eid\/article\/30\/5\/23-0676_article\" title=\"\" rel=\"noopener noreferrer\" target=\"_blank\">curbed their sexual activity<\/a>, precipitating a <a class=\"css-yywogo\" href=\"https:\/\/www.nytimes.com\/2024\/02\/29\/health\/mpox-vaccines-gay-bisexual.html\" title=\"\">decline in cases<\/a> even before vaccines were broadly available.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">The drop in numbers may have produced a false sense of security, however.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cA sense of complacency set in that this wasn\u2019t really something that people needed to have an ongoing worry about, and we saw those vaccination rates rapidly decline,\u201d said Dr. Boghuma Titanji, a virologist and infectious disease physician at Emory University.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Behavioral changes are difficult to sustain, so vaccination is important for long-term control of the virus, Dr. Titanji said.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div>\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">Two doses of the vaccine are more powerful than one, with an effectiveness of up to 90 percent, according to <a class=\"css-yywogo\" href=\"https:\/\/www.medrxiv.org\/content\/10.1101\/2024.04.25.24306078v1\" title=\"\" rel=\"noopener noreferrer\" target=\"_blank\">an analysis<\/a> last month of 16 studies. Even when the vaccine did not prevent infections, it tempered the severity and duration of illness.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Still, fewer than <a class=\"css-yywogo\" href=\"https:\/\/www.cdc.gov\/mmwr\/volumes\/72\/wr\/mm7213a4.htm\" title=\"\" rel=\"noopener noreferrer\" target=\"_blank\">one in four Americans<\/a> at risk received two doses.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cWe\u2019ve continued to saturate the space with the messaging, and uptake is not really shifting a lot,\u201d Dr. McQuiston said, suggesting a need for more creative approaches.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">In 2022, the vaccine was available only in the United States through federal agencies and plagued by <a class=\"css-yywogo\" href=\"https:\/\/www.nytimes.com\/2022\/08\/15\/health\/monkeypox-vaccine-distribution.html\" title=\"\">problems with delivery<\/a>, limiting its availability; it is now <a class=\"css-yywogo\" href=\"https:\/\/www.cdc.gov\/poxvirus\/mpox\/clinicians\/vaccines\/vaccine-considerations.html#anchor_1712866632005\" title=\"\" rel=\"noopener noreferrer\" target=\"_blank\">commercially available<\/a>. The W.H.O., which recommends vaccines for African countries, has been slow to approve it, and has not even initiated the approval process.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Still, the W.H.O.\u2019s advisory group on immunizations has recommended that, where available, the vaccine can be used to protect adults and children at risk of mpox, Dr. Lewis said.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">In addition to preparing for mpox\u2019s return to the United States, the C.D.C. is supporting Congo\u2019s efforts to obtain vaccines and drugs and contain the epidemic.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cIt\u2019s much better to help them get this outbreak under control before it spills over into other areas and becomes more of a global risk,\u201d Dr. McQuiston said. \u201cAnd, ethically, it\u2019s the right thing to do.\u201d<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<p><script async src=\"\/\/www.instagram.com\/embed.js\"><\/script><br \/>\n<br \/><br \/>\n<br \/><a href=\"https:\/\/www.nytimes.com\/2024\/05\/16\/health\/cdc-mpox-congo.html\">Source link <\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>With Pride events scheduled worldwide over the coming weeks, U.S. officials are bracing for a return of mpox, the infectious disease formerly called monkeypox that struck tens of thousands of gay and bisexual men worldwide in 2022. A combination of behavioral changes and vaccination quelled that outbreak, but a majority of those at risk have [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":52158,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"tdm_status":"","tdm_grid_status":"","fifu_image_url":"https:\/\/static01.nyt.com\/images\/2024\/05\/16\/science\/16mpox\/16mpox-facebookJumbo.jpg","fifu_image_alt":"","footnotes":""},"categories":[1],"tags":[51949,51950,32654,5219],"amp_enabled":true,"_links":{"self":[{"href":"https:\/\/news.talkwithrattan.com\/index.php\/wp-json\/wp\/v2\/posts\/52157"}],"collection":[{"href":"https:\/\/news.talkwithrattan.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/news.talkwithrattan.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/news.talkwithrattan.com\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/news.talkwithrattan.com\/index.php\/wp-json\/wp\/v2\/comments?post=52157"}],"version-history":[{"count":1,"href":"https:\/\/news.talkwithrattan.com\/index.php\/wp-json\/wp\/v2\/posts\/52157\/revisions"}],"predecessor-version":[{"id":52159,"href":"https:\/\/news.talkwithrattan.com\/index.php\/wp-json\/wp\/v2\/posts\/52157\/revisions\/52159"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/news.talkwithrattan.com\/index.php\/wp-json\/wp\/v2\/media\/52158"}],"wp:attachment":[{"href":"https:\/\/news.talkwithrattan.com\/index.php\/wp-json\/wp\/v2\/media?parent=52157"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/news.talkwithrattan.com\/index.php\/wp-json\/wp\/v2\/categories?post=52157"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/news.talkwithrattan.com\/index.php\/wp-json\/wp\/v2\/tags?post=52157"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}