San Francisco Chronicle

U.S. reports 20 monkeypox cases

- By Catherine Ho Catherine Ho (she/her) is a San Francisco Chronicle staff writer. Email: cho@sfchronicl­e.com Twitter: @Cat_Ho

Federal health officials have identified 20 cases of monkeypox in 11 states, including four in California, the U.S. Centers for Disease Control and Prevention said Friday.

None of the U.S. cases have resulted in deaths, and the “overwhelmi­ng majority” are among people who recently traveled internatio­nally in a time frame that suggests their exposure happened there, said Capt. Jennifer McQuiston, incident manager for the CDC’s monkeypox response, during a media briefing Friday.

The other patients may have had contact with a known case or were identified through contact tracing. But at least one person did not travel and the source of infection is unknown — suggesting the virus may be spreading in the U.S., CDC officials said.

“Ongoing investigat­ion suggests person-toperson community transmissi­on, and CDC urges health department­s, clinicians, and the public to remain vigilant, institute appropriat­e infection prevention and control measures, and notify public health authoritie­s of suspected cases to reduce disease spread,” CDC scientists wrote in a report released Friday that analyzed U.S. monkeypox cases.

The risk to the public is still low, McQuiston said. Officials expect the number of cases to rise as more testing and contact tracing is done. In California, three confirmed cases have been detected in Sacramento County and one in Los Angeles County. There is a fifth probable case that has not been confirmed, but the state did not say which county it’s in.

Monkeypox is a type of orthopoxvi­rus, the same family of viruses that includes smallpox, though monkeypox is less contagious and less severe. Monkeypox symptoms include rash and skin lesions that become raised and fill with fluid as they progress.

There are two federally approved vaccines for orthopoxvi­rus — Acam2000 and Jynneos — that are now being deployed for monkeypox, and one antiviral treatment.

Acam2000 is to be taken after exposure, and Jynneos can be taken before or after exposure. The antiviral — tecovirima­t, also known as Tpoxx — was originally licensed for smallpox but can be administer­ed for monkeypox under a federal protocol that allows some drugs to be used for purposes other than those tested in clinical trials when there are no better alternativ­es available.

Federal health agencies have sent 1,200 doses of vaccine and 100 courses of treatment to eight states, said Dr. Raj Panjabi, who is coordinati­ng the White House’s monkeypox response. He did not specify which states have received them. The California Department of Public Health on Friday said the state has received 200 doses of the Jynneos vaccine to use as preventive treatment for people who have been exposed to monkeypox.

Federal officials on the call would not say how many doses of vaccine or treatments are currently in the national stockpile. But there is “more than enough vaccine available” and they have been “prepositio­ned around the country,” said Dawn O’Connell, assistant secretary of emergency preparedne­ss at the U.S. Department of Health and Human Services.

“The good news is we already have the vaccines and treatments needed to respond,” O’Connell said.

Monkeypox can spread from person to person from close physical contact, including sexual contact, through infected sores, body fluids or respirator­y droplets.

Health officials in Europe, where several countries are reporting outbreaks, recently indicated that most or all cases have been in men, and many reported having multiple sex partners before contractin­g the virus.

The CDC report released Friday analyzed 17 U.S. patients with confirmed monkeypox infections as of May 31, and found that 14 of the 17 people had traveled internatio­nally during the 21 days before symptom onset. Sixteen out of the 17 identified as men who have sex with men. In many cases, the rash began in the genital area.

“We’re focusing efforts to raise awareness within the LGBTQ-plus community,” McQuiston said.

Globally, there have more than 700 cases reported in at least 28 countries where monkeypox is not endemic. Monkeypox, a zoonotic disease that exists most commonly in rodents and can pass to humans, is endemic in several Central and West African countries.

The last outbreak U.S. outbreak was in 2003, when about 70 cases were detected. Investigat­ors traced the outbreak to a shipment of pet prairie dogs imported from Ghana.

The CDC urged health care providers to be on the lookout for monkeypox symptoms and to test patients if they suspect it.

 ?? CDC 2003 ?? An electron microscope image shows mature monkeypox virions (left) and immature virions.
CDC 2003 An electron microscope image shows mature monkeypox virions (left) and immature virions.

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