Explanation: Monkeypox in the United States

By Julie Steenhuysen

CHICAGO (Reuters) – The United States declared monkeypox a public health emergency last week, in an effort to bolster the U.S. response to contain the outbreak.

The virus continues to be widely transmitted among gay and bisexual men, but experts say the disease could spread to other populations, particularly due to vaccine shortages. Monkeypox is transmitted by contact with pus-filled sores and is rarely fatal.

Here is the current status of monkeypox and other populations that US experts believe may be at risk:


Last month, the World Health Organization declared monkeypox a global public health emergency. So far, 80 countries where the virus is not endemic have reported 26,500 cases of monkeypox, according to a Reuters tally.

In the United States, 99.1% of monkeypox cases in the United States occurred among people assigned male at birth as of July 25, according to a technical report from the United States Centers for Disease Control and Prevention (CDC). United. Of the male patients, 99% reported having had sexual contact with other men.

About 38% of cases have occurred in non-Hispanic white men. Another 26% were black men and 32% Hispanic men.

The pattern of sexual transmission in men is not typical. In Africa, where monkeypox has been circulating since the 1970s, 60% of cases are in men and 40% of cases in women.

One reason may be that the virus appears to be “very effectively transmitted through receptive anal intercourse and, to some extent, oral sex,” said infectious disease epidemiologist and editor Dr Celine Gounder. from Kaiser Health News.


Although the current explosion in cases has been among men, experts say there is no biological reason for the virus to remain widely within the community of men who have sex with men.

“We definitely know this is going to spread to family members and other non-male partners that people have,” said Dr. Jay Varma, director of the Cornell Center for Pandemic Prevention and Response. He said the virus could also spread in massage parlors or spas.

The real question, he said, is whether it spreads as effectively in these groups as it does in close sexual networks of men who have sex with men.

Experts point to how HIV has spread as a possible indicator of where the virus will go next.

“My biggest fear is that as we try to contain this, it’s seeping down along the fractures of our social geography and going where HIV has gone, and it’s going into communities of color in the rural south,” said Dr. Gregg Gonsalves, an associate professor of epidemiology at Yale University and a leading HIV/AIDS activist.

These are places with limited infrastructure for testing, vaccines and treatments.

Gounder is particularly concerned about infections among black women, who account for the largest share of new HIV infections in the United States, and already suffer significantly higher rates of maternal complications and deaths.


Other high-risk settings include college dorms, health clubs, and sports teams.

Gounder is aware of some sports leagues preparing for possible infections, noting that sports such as wrestling involve close skin-to-skin contact.

According to the CDC, wrestling, soccer, rugby, and other sports teams have had outbreaks of superbug MRSA in the past.

“I think it’s something we have to think about and prepare for,” she said.

Employers may also need to start preparing. Gounder said some theaters in New York, for example, are considering how they can protect their workers from possible monkeypox infections through contact with shared costumes.

“We are only at the beginning, but I am encouraged to see that some are already thinking about it.”

(Reporting by Julie Steenhuysen; Editing by Caroline Humer and Josie Kao)

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