The virus formerly known as monkeypox hasn’t completely disappeared, but Colorado public health officials expect to see only sporadic cases here in 2023.
Mpox, which was renamed by the World Health Organization due to the racist discourse surrounding it, took off in the US in the summer of 2022 before infections declined rapidly. The virus, although first scientifically described in monkeys, is believed to be circulating in rodents in parts of Africa, affecting people.
At the peak in August, more than 450 cases of mpox were reported nationwide on average each day. In early January, there were only about four cases a day, according to the Centers for Disease Control and Prevention. The United States recorded 29,913 cases of mpox in 2022 and 20 deaths.
In Colorado, mpox cases also peaked in August, with 157 recorded that month. In December, the Colorado Department of Public Health and the Environment reported just 16 cases.
Milder cases of mpox can look like common STIs or even pimples, so it’s likely that some people never knew they had it. Tests were also hard to come by when the virus was spreading more widely in early summer, so the state’s total could surpass the official 403 cases. There have been no confirmed deaths from mpox in Colorado.
State epidemiologist Dr Rachel Herlihy said the health department is making plans in case mpox starts circulating more widely again, but expects “sporadic” or small clusters of cases this year. The infrastructure is still in place to track people who were in close contact with someone who has mpox and to offer them the vaccination, she said.
The vaccine is most effective before exposure, but it can prevent or reduce symptoms if a person takes it in the days after encountering the virus. Mpox typically causes flu-like symptoms and a rash and has a low mortality rate.
“In a way, the mpox response has been a success,” he said.
Katheryn Jacobsen, an epidemiologist at the University of Richmond, said the small number of cases would make it difficult for mpox to spread, at least for the foreseeable future. Also, when a few people catch a virus, they don’t have much opportunity to mutate and become more contagious or better evade the immune system, as the virus that causes COVID-19 has done, she said.
“This is a pretty incredible thing,” he said.
Relatively difficult to spread
In Colorado, 95% of the cases involved men, and 85% of those who answered questions about their identity said they were gay or bisexual. The pattern was similar nationwide, and Black and Hispanic men were disproportionately affected both in Colorado and across the country.
Because the community of men who have sex with men is relatively small, the virus spreads quickly he began to run out of people to infect as men received the vaccine or recovered from an infection. Some women and heterosexual people contracted mpox, but it never spread in their networks.
It is unclear how much of the credit for the drop in cases goes to vaccination, behavioral changes or even running out of the virus in susceptible people. At least as of this summer’s peak, gay and bisexual men have reported in surveys that they have cut back on their number of partners, and more than 600,000 people have received at least the first dose of the two-dose regimen.
It also helped that unlike COVID-19, mpox is relatively difficult to spread. Most cases appeared to be spread through sex, although other forms of close contact could also transmit it. This means that for most people, the risk of contracting the virus has remained low.
Very little is known about whether people who have had monkeypox may face long-term consequences. A small number of patients have developed eye problems, including loss of vision, so doctors advise people who have the virus not to wear contact lenses or touch their eyes until their rash has cleared up.
There isn’t much data on how long immunity lasts after vaccination or infection, although scientists think people will be protected for at least a few years, Jacbosen said.
Of course, that doesn’t rule out the possibility that mpox could be reintroduced in unexpected ways, as was the case in 2003, when prairie dogs that had been housed with imported animals spread the virus to their new owners in several Midwestern states, he said. stated. .
Although some people have contracted mpox after being vaccinated, they have generally reported less severe symptoms, with less likelihood of fever, body aches and a rash outside the genital area. They were also less likely to be hospitalized, according to the CDC.
Vaccines and immunity
So far, there appears to be no difference in protection between those who received a smaller dose in the skin and those who received the vaccine traditionally, though it’s possible one group could see less lasting protection, according to STAT News.
At the beginning of the epidemic, the supply of vaccines was extremely limited and places in clinics filled up almost immediately. By October, however, demand was declining and supply was increasing enough that the state expanded the criteria for who could get the shots.
Now, anyone can get vaccinated if they or their sexual partners: have had close contact with someone who has monkeypox; having multiple partners or anonymous partners; had close physical contact in a place where people have sex; have been diagnosed with gonorrhea or syphilis in the last six months; have HIV; use medications to prevent HIV; or engage in sexual relations for money, shelter, or other benefits.
The state health department will send reminders to people who haven’t been given second chances and is planning an advertising campaign later this winter on social media and dating sites to encourage vaccination, Herlihy said.
“Our priority is to ensure that those at greatest risk are protected,” he said.
Right now, mpox isn’t as big a threat to the US as COVID-19 or vaccine-preventable diseases like measles and whooping cough, which are poised to come back because many children haven’t received their vaccinations in the past three years. Jacobsen said. Of course, it’s a different story in countries where the virus circulates regularly, which need sustained money and scientific attention to study it, he said.
“Within the community that had the highest risk profile, there’s a high level of immunity,” he said.
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