Its a long wait for a monkeypox vaccine in San Francisco."I arrived here at 7:30 in the morning, so it's been three and a half hours right now," said Parind Shah, a San Francisco resident. The wait for the antiviral drug to treat monkeypox is drawn out, too."We don't have an equitable system to really distribute them because they require so much paperwork," said Dr. Peter Chin-Hong, an infectious disease specialist at UCSF. The medication is called tecovirimat, with the brand name TPOXX.Dr. Chin-Hong cares for severe monkeypox patients. "It works by the envelope of the virus," Dr. Chin-Hong said. "It disrupts the envelope. Monkeypox virus is a very straightforward virus. It's not complicated with spikes like COVID."Theres not a shortage of TPOXX, but its only FDA-approved for smallpox. For monkeypox, its still considered an investigational drug. The CDC has lifted some requirements, so doctors can prescribe it under something called expanded access. But that involves hours of forms and extra appointments.Dr. Chin-Hong has seen it deter patients. "He said, 'Oh, you know, it's okay. I don't want to come in, go through all this paperwork again. I think I'm just going to deal with pain. And you know what? You are asking me too many questions. I'll let you know if i need it,'" Dr. Chin-Hong said.The latest CDC data from late July show doctors wrote about 230 TPOXX prescriptions for monkeypox. Since then, cases have more than doubled.The CDC says monkeypox spreads when a person touches the skin of someone who is infected and is showing symptoms, like sores or scabs. It can also spread through respiratory droplets or oral fluids in close, intimate contact.You can also get monkeypox from touching recently contaminated clothing or bedding used by an infected person who has symptoms."We are seeing lesions erupt that are very small," said Dr. Jason Farley, infectious disease nurse epidemiologist at The Johns Hopkins School of Medicine. "They're deeply seated, possibly under the skin, maybe look like a pimple that is forming."If you fit any of those descriptions, health experts say call your doctor for a test as soon as you can, because antivirals like TPOXX work best when taken early into illness.That's where public health emergencies come in. Declaring one frees up money in reserves that cant be touched, and HHS rules wont let providers dip from their COVID emergency funds for monkeypox. Dr. Chin-Hong says for TPOXX, that means more help on that extra paperwork so he can care for more sick patients.
WASHINGTON (AP) — The U.S. will declare a public health emergency to bolster the federal response to the outbreak of monkeypox that already has infected more than 6,600 Americans, two people familiar with the matter said Thursday.
The announcement will free up federal funding and resources to fight the virus, which may cause fever, body aches, chills, fatigue and pimple-like bumps on many parts of the body. The people spoke on the condition of anonymity ahead of the announcement.
The declaration comes as the the Biden administration has faced criticism over the pace of vaccine availability for monkeypox. Clinics in major cities like New York and San Francisco say they haven’t received enough of the two-shot vaccine to meet demand and some have had to stop offering the second dose of the vaccine to ensure supply of first doses. The White House said it has made more than 1.1 million doses of vaccine available and has helped to boost domestic diagnostic capacity to 80,000 tests per week.
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What is monkeypox and where is it spreading?
What is monkeypox?
Updated
Monkeypox is a virus that originates in wild animals like rodents and primates, and occasionally jumps to people. Most human cases have been in central and west Africa, where the disease is endemic.
The illness was first identified by scientists in 1958 when there were two outbreaks of a “pox-like” disease in research monkeys — thus the name monkeypox. The first known human infection was in 1970, in a 9-year-old boy in a remote part of Congo.
What are the symptoms and how is it treated?
Updated
Monkeypox belongs to the same virus family as smallpox but causes milder symptoms.
Most patients experience only fever, body aches, chills and fatigue. People with more serious illness may develop a rash and lesions on the face and hands that can spread to other parts of the body.
The incubation period is from about five days to three weeks. Most people recover within about two to four weeks without needing to be hospitalized.
Monkeypox can be fatal for up to one in 10 people and is thought to be more severe in children.
People exposed to the virus are often given one of several smallpox vaccines, which have been shown to be effective against monkeypox. Anti-viral drugs are also being developed.
On Thursday, the European Centre for Disease Prevention and Control recommended all suspected cases be isolated and that high-risk contacts be offered the smallpox vaccine.
How many monkeypox cases are there typically?
Updated
The World Health Organization estimates there are thousands of monkeypox infections in about a dozen African countries every year. Most are in Congo, which reports about 6,000 cases annually, and Nigeria, with about 3,000 cases a year.
Patchy health monitoring systems mean many infected people are likely missed, experts say.
Isolated cases of monkeypox are occasionally spotted outside Africa, including in the U.S. and Britain. The cases are typically associated with travel to Africa or contact with animals from areas where the disease is more common.
In 2003, 47 people in six U.S. states had confirmed or probable cases. They caught the virus from pet prairie dogs that been housed near imported small mammals from Ghana.
What's different about these cases?
Updated
It's the first time monkeypox appears to be spreading among people who didn't travel to Africa.
In Europe, infections have been reported in Britain, Italy, Portugal, Spain and Sweden. Most of the cases involve men who have had sex with men.
Britain's Health Security Agency said its cases are not all connected, suggesting that there are multiple chains of transmission happening.
The infections in Portugal were picked up at a sexual health clinic, where the men sought help for lesions on their genitals.
On Wednesday, U.S. officials reported one case of monkeypox in a man who had recently traveled to Canada, where authorities are investigating potential infections.
Is monkeypox being spread through sex?
Updated
It's possible, but it's unclear at the moment.
Monkeypox has not previously been documented to have spread through sex, but it can be transmitted through close contact with infected people, their body fluids and their clothing or bedsheets.
Michael Skinner, a virologist at Imperial College London, said it's still too early to determine how the men in the U.K. were infected.
“By nature, sexual activity involves intimate contact, which one would expect to increase the likelihood of transmission, whatever a person’s sexual orientation and irrespective of the mode of transmission," Skinner said.
Francois Balloux of University College London said monkeypox said sex qualifies as the kind of close contact needed to transmit the disease.
The U.K. cases "do not necessarily imply any recent change in the virus’ route of transmission,” Balloux said.
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Barry Hatton in Lisbon, Portugal, contributed to this report.
