California, New York and Illinois declare state of emergency for outbreak

California Governor Gavin Newsom (D) speaks with reporters after a meeting with House Speaker Nancy Pelosi, D-Calif., at the US Capitol, Friday, July 15, 2022.

Tom Williams | CQ-Roll Call, Inc via Getty Images

California Governor Gavin Newsom declared a state of emergency Monday due to the fast-spreading monkeypox outbreak, the third US state to do so within days.

Newsom said the emergency declaration would help support the state’s vaccination efforts. The demand for vaccines has outpaced supply as infections have increased. Staff at sexual health clinics and other sites struggled to keep up with the influx of people seeking injections.

California is mobilizing staff from the Emergency Medical Services to help administer the vaccines. Newsom said the state is working across all levels of government to slow the spread through testing, contract tracing, and outreach to the community.

California’s announcement comes after Illinois declared a public health emergency earlier on Monday. New York declared a state of disaster emergency in response to the outbreak late Friday.

The United States has reported nearly 6,000 cases of monkeypox in 48 states, Washington, D.C., and Puerto Rico, according to the Centers for Disease Control and Prevention. The outbreak has spread rapidly since Boston health authorities confirmed the first US case in May.

California, Illinois and New York – home to the country’s three largest cities – have reported 47% of all confirmed monkeypox infections in the US New York is the epicenter of the outbreak in the US, with nearly 1,400 confirmed cases as of Monday.

Monkeypox is rarely fatal and no deaths have been reported in the United States to date. But some patients experience excruciating pain from the rash caused by the virus. Scientists and public health officials worry that monkeypox could spread permanently in the United States if the outbreak is not contained.

The World Health Organization declared monkeypox a global health emergency last month. More than 19,000 cases of monkeypox have been reported in at least 78 countries, according to data from the World Health Organization. Outbreaks are unusual because the virus is spreading widely in North America and Europe. In the past, monkeypox was spread at low levels in West and Central Africa where rodents and other animals carried the virus.

Monkeypox is transmitted primarily through skin-to-skin contact during sex. Public health officials say gay and bisexual men are currently most likely to contract the infection. About 98% of patients who provided demographic information to clinics identified as MSM, according to the CDC.

But health officials have repeatedly emphasized that anyone who gets monkeypox through physical contact with someone with the rash that characterizes the disease or contaminated items such as towels and bed linens. The CDC last month confirmed the first two US cases of children who contracted the virus, likely through transmission within their families.

Monkeypox can also spread through respiratory droplets when an infected person has lesions in their mouth, but this requires a prolonged, face-to-face interaction, according to the CDC. Health officials say physical contact is the primary method of transmission.

US weighs public health emergency

The Biden administration is considering whether to declare a public health emergency in the United States, according to top federal health officials. This will help mobilize resources for state health officials fighting the outbreak. The last time the United States declared a public health emergency in response to Covid-19 was in January 2020.

Lawmakers in Congress and local communities have criticized the pace of the federal government’s response, but Health Secretary Xavier Becerra said last week that the Biden administration had done all it could to increase resources to combat the outbreak. Becerra said states need to do more to prevent transmission, and Congress needs to pass funding to support the outbreak response.

The Department of Health and Human Services has provided more than 330,000 doses of the monkeypox vaccine to state health departments since May. HHS made another 786,000 doses available to states and other jurisdictions on Friday. But some clinics that administer the vaccines say they have not yet received enough doses to meet demand at the moment.

The U.S. Food and Drug Administration approved the two-dose Jynneos vaccine in 2019 for people at risk of developing monkeypox or smallpox. Jynneos, made by Danish biotech company Bavarian Nordic, is the only monkeypox vaccine approved by the Food and Drug Administration in the United States.

The United States now has the capacity to perform 80,000 tests a week after bringing several commercial labs aboard last month, according to the CDC. But it’s possible that the number of confirmed infections in the United States is understated because people cannot be tested until they develop a rash, which can take several weeks in some cases. Doctors wipe the rash to get a sample for testing.

The United States also has 1.7 million courses of tekovirimat antiviral therapy in the Strategic National Stockpile. Doctors can use tekovirimat to treat monkeypox, but this requires an extra layer of bureaucracy because the drug is only approved for smallpox. The CDC cut the routine last month to make it easier for doctors to prescribe tekovirimat.

Monkeypox belongs to the same family of viruses as smallpox, but it causes milder disease.

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