Officials express optimism that monkeypox can be eliminated in the US

WASHINGTON — With smallpox cases in monkeys declining nationwide, federal health officials expressed optimism on Thursday that the virus could be eliminated in the United States, though they warn reported that unless it was wiped out globally, Americans would still be at risk.

“Our goal is to eradicate; That’s what we’re aiming for,” said Dr. Demetre Daskalakis, deputy coordinator of the White House monkeypox response team, during a visit to a monkeypox vaccination clinic in Washington. He added, “The prediction is, we’re going to be very close.”

Dr. Daskalakis was joined by President Biden’s health secretary, Xavier Becerra, and the response team’s coordinator, Robert J. Fenton Jr., who echoed his optimism. The visit to the clinic was intended to highlight the District of Columbia’s efforts to close the racial gap in monkeypox vaccination – a key goal of the Biden administration.

Mr Becerra told reporters: “The president said from the very beginning, ‘Let’s start this, and then go ahead of it. “And we can’t say we’re really ahead of it if we leave certain communities behind.”

Daskalakis, an infectious disease specialist who previously ran the HIV prevention division at the Centers for Disease Control and Prevention, was included in the monkeypox response team Mr. Biden last month.

On Thursday, Dr Daskalakis did not give a timeline for the end of the outbreak in the US, only saying he was looking at his “midterm crystal ball”. But he said he hopes that, over time, cases will drop to a trickle and infections will appear only sporadically, allowing health officials to isolate and vaccinate those who continue to be infected. close contact with infected people – and end outbreaks in the process.

That strategy, called round vaccinationwas used in the global campaign to eradicate smallpox, which was declared eradicated in 1980.

But there is one key difference between monkeypox and smallpox: Smallpox occurs only in humans, while monkeypox also occurs in animals. Dr. Michael T. Osterholm, an infectious disease expert at the University of Minnesota, said: The existence of an “animal reservoir” means that there will always be a risk of transmission to humans.

“Wipe out is a very sacred word in public health; To eradicate means it’s gone forever, and the only virus we’ve done so far is smallpox,” said Dr. Osterholm.

He said a better word would be “remove”, and a better comparison would be measles. Dr Osterholm said: “We already have a large measles elimination program in this country and have significantly reduced the occurrence of measles, but the challenge today is still the entry of the virus from other areas. individuals around the world.

The first US cases of the current monkeypox outbreak appeared in May. The disease occurs mainly in men who have sex with men and presents with fever, muscle aches, chills, and lesions. It is rarely fatal in rich countries like the United States, but it can cause extreme pain. The current outbreak is unusually large; The last major monkeypox outbreak in the United States occurred in 2003, when 47 confirmed and probable cases were reported in six states.

In the current outbreak, the US accounts for more than a third of the approximately 65,000 cases reported worldwide; as of Thursday, CDC reported nearly 25,000 cases in the country. An average of about 200 cases per day are still reported in the United States, although that number is down significantly from the time of the outbreak in August.

The drop was a relief to Biden administration officials, who were harshly criticized for their response in the early days of the outbreak. Critics, including many gay rights activists, say the authorities have failed to actively order doses of the vaccines and distribute them before many gay men have been infected in the past. Pride celebration in June.

One of those activists, James Krellenstein, founder of PrEP4All, an advocacy group, said Dr Daskalakis’ comment was premature. He said the lack of federal funds for monkeypox research, and the lack of answers to basic questions, make it premature to predict the end of the outbreak.

“This is the first time we’ve actually seen a large monkeypox outbreak with human-to-human transmission and there are still many scientific unknowns,” said Krellenstein. know more. President George W. Bush“Let’s not go into” mission accomplished “landing on carrier territory here.”

Vaccination shortages lead to stark racial disparities that the administration is now trying to address. Dr Wafaa El-Sadr, professor of epidemiology and medicine at Columbia University’s Mailman School of Public Health, said she shares Dr Daskalakis’ optimism that the outbreak can be controlled, but only with extreme efforts to reach underserved populations.

“The risk,” she said, “is that you have hard-to-reach populations, often the poor, and people of racial and ethnic minorities, who are less aware, less able to access them. than. Sometimes they tend to fall behind, as we are seeing, in terms of vaccinations.”

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