Monkeypox is already a global pandemic. How long before WHO (World Health Organization) declares it as such? According to the latest situation update from WHO published July 7, global cases of the virus increased 77% in the past week. There are more than 11,000 cases globally with over 2,000 in Spain and nearly as many in the U.K. and Germany.
While the Centers for Disease Control and Prevention (CDC) announced it was activating its Emergency Operations Center (EOC) in response to the spreading monkeypox outbreak in the U.S. on June 28, biologist Joseph Osmundson at New York University told NPR, “we have no concept of the scale of the monkeypox outbreak in the U.S.”
Other experts asserted that “the monkeypox outbreak in the U.S. is bigger than the CDC reports” and “testing is abysmal.”
In the U.S. there are cases as widespread as Idaho, Iowa and Wisconsin, belying the theory that the disease is only in large urban centers. The CDC reports 929 confirmed monkeypox cases in the U.S. as of July 11, and cites cases in 40 states plus the District of Columbia and Puerto Rico. But some states that have yet to report, like Mississippi and Alabama in the Deep South and Vermont and Maine in New England, likely also have cases since there are cases all around them. The same is likely true of Kansas.
The largest outbreaks are in New York, California, Illinois, D.C., Florida, Texas, Virginia and Massachusetts. New Jersey and Delaware have low case counts, but Pennsylvania’s is rising with a student at West Chester testing positive and a dozen cases in Allegheny County. The first cases in the state were in Philadelphia.
The WHO announced July 12 that there are confirmed monkeypox cases across 63 countries. But as the number of monkeypox cases has doubled and quadrupled weekly in places like London and New York City, it’s clear that the WHO is behind in case counts with their own website having fewer updated data than statements made to the media.
The WHO update revealed that among monkeypox patients with known HIV status, 41% were HIV-positive. Among cases where the patient’s sexual orientation was known, 60% identified as gay, bisexual, and other men who have sex with men.
According to the WHO, “the most often suspected and reported route of transmission, among known contacts, has been through sexual contact. Due to sensitivity in reporting a full list of sexual contacts, identification of all contacts of probable and confirmed cases has therefore proven to be very challenging in this outbreak, and might be one of the reasons why it is hard to break all chains of transmission.”
Body rash is the most common symptom among patients in the current outbreak. WHO notes that “81% presented with systemic rash (widespread rash on the body), 50% presented with fever and 41% presented with genital rash.”
The WHO also warned that 25 cases have been confirmed among healthcare workers, and added that transmission in a healthcare setting “cannot be ruled out.”
Dr. Anne Rimoin, UCLA epidemiology professor who spent two decades in the Democratic Republic of Congo studying monkeypox where the disease is endemic, spoke to NPR and detailed the missteps from world leaders, stating there was only a global response to monkeypox when it spread beyond Africa.
“This virus has been spreading in marginalized and vulnerable populations [in Africa] for decades, and we’ve done nothing about it,” Rimoin told NPR. “We have known that monkeypox is a potential problem for decades.”
PGN has been reporting from the outset of the current outbreak that WHO and other international health organizations have taken a lax and many claim racist approach to monkeypox and that it was only when white Europeans became infected that health officials started paying attention.
Yet equally problematic is the fact that because a significant proportion of cases in the current outbreak have been among gay and bisexual men and men who have sex with men, the response has been localized to gay communities, which may have allowed for significant and undocumented spread. Nearly every expert discussing the monkeypox outbreak has cited both slow responses from healthcare officials and failure to create testing and vaccination programs.
In New York City the monkeypox case load has been doubling weekly. And local news reports that demand for the monkeypox vaccine is far outpacing the supply. This is creating tensions among New Yorkers who report that they can’t get an appointment to get the vaccine.
As of Tuesday, July 12, 267 people in New York City have tested positive, according to the city’s Health Department. That is up from 111 cases on July 5 and more than quadruple the number from a week prior to that.
The Hill reported that the monkeypox vaccine appointment website in New York City has crashed repeatedly. Mayor Adams raised alarm about New York City’s monkeypox vaccine “supply constraints” in a phone call with two of President Biden’s top public health officials late Tuesday, July 12, after the city ran out of vaccines.
In a statement July 13, Adams said he and his health commissioner, Dr. Ashwin Vasan, pleaded for more help in the call with Health and Human Services Secretary Xavier Becerra and CDC Director Rochelle Walensky.
In San Francisco, with another vulnerable population, anxiety over the monkeypox outbreak has made for long lines for vaccines, according to KTVU.
San Francisco General Hospital and the San Francisco AIDS Foundation held an online town hall on monkeypox on Tuesday evening, July 12, partnering with a long list of community groups and leaders to help educate the public about the monkeypox outbreak, as concern increases with the growing number of cases.
Gay men with monkeypox shared their stories on NBC News online earlier in July, complaining of lesions, headaches and debilitating pain. Many expressed frustration with the way the current outbreak had been handled.
PGN reported that some gay men were speaking out specifically to alert others because the response from health departments nationally and even the CDC has been so slow moving. As one healthcare provider working with HIV/AIDS clientele told PGN, “we have no vaccines, no testing, nothing. It’s like we didn’t go through these years of COVID. It’s disgraceful.”
UCLA’s Rimoin said more attention should have been paid to outbreaks of monkeypox in rural Africa to contain spread of the virus through travel. She told NPR, “if we do want to get in front of emerging infectious diseases, we are going to have to prioritize dealing with emerging global disease threats at the site where they are spreading early on.”
Rimoin also pointed out, “we are totally interconnected by trade and travel, population growth, population movement, and we cannot make the mistake again of thinking that an infection that’s happening somewhere in a remote area of the world isn’t going to affect us right at home.”
The current outbreak is thought to have begun in a massive gay rave in the Canary Islands that spread in bathhouses in Spain and Portugal, moving on to the U.K.
If you think you have been exposed, the CDC says to look for these symptoms: fever, headache, muscle aches and backache, a rash that can resemble pimples or blisters, swollen lymph nodes, chills and exhaustion.
For more comprehensive data on risk, treatment and how to seek testing and vaccines, visit https://www.cdc.gov/poxvirus/monkeypox/symptoms.html. There have been no new updates from the Philadelphia Department of Public Health since June 23.