US declares monkeypox a public health emergency - ABC News

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U.S. declares monkeypox outbreak a public health emergency - CBS News

The Biden administration is declaring a public health emergency for the monkeypox outbreak in the United States, which now counts more infections from the virus than any other country in the world. Health and Human Services Secretary Xavier Becerra announced the decision at a briefing with top public health officials Thursday.

"This public health emergency will allow us to explore additional strategies to get vaccines and treatments more quickly out to the impacted communities. And it will allow us to get more data from jurisdictions so we can effectively track and attack this outbreak," Robert Fenton, the newly appointed White House national monkeypox response coordinator, said at the briefing.

Over the last decade, nationwide emergency declarations like this have previously been made only for the COVID-19 pandemic, the opioid crisis, and the Zika virus outbreak in 2017.

As it did for COVID-19, official said the move by Becerra to declare an emergency could unlock a broad swath of flexibilities in funding and regulations to respond to the spread of monkeypox.

The public health emergency declaration could pave the way for the CDC to deploy more staff to respond to the outbreak, officials said, as well as to compel hospitals to share more data to track monkeypox patients. It could also help clear the way for resources to scale up vaccinations. 

Since last week, the administration says it has distributed another 266,000 doses of the Jynneos monkeypox vaccine to states and territories that have ordered doses. Another 150,000 doses initially slated for delivery from vaccine maker Bavarian Nordic in October have been moved up to September. 

Federal health officials also told reporters that they were weighing a separate move that would allow the Food and Drug Administration emergency use authorizations that could ease access to treatments and vaccines for the monkeypox outbreak. 

One such authorization, first floated by a National Institutes of Health official earlier this week at a meeting with the World Health Organization, could allow for vaccinators to quintuple their supply by injecting smaller "intradermal" doses into the skin, instead of the "subcutaneous" method currently approved for Jynneos.

"We're feeling very good about the intradermal approach and probably, within the next few days, short period of time, we'll make a final decision about it," said FDA Commissioner Dr. Robert Califf. 

Federal health authorities also have on hand millions of long-expired doses of Jynneos stockpiled years ago, which are now being tested by Bavarian Nordic. If found to be viable — which a spokesperson acknowledged to CBS News earlier this month was "highly unlikely" — the doses could be cleared under an emergency use authorization for use.

Officials have said for weeks that they were mulling the move as the number of cases have swelled and demand for shots has far exceeded supply around the country. 

The move comes as a growing number of jurisdictions, including several states and cities, as well as the World Health Organization have all deemed the outbreak an emergency.

Dr. David Agus answers monkeypox and COVID-19 questions 04:10

This week, President Biden also tapped officials from the Federal Emergency Management Agency and the CDC to helm the country's monkeypox response from the White House.

On Wednesday, the CDC said it had tallied at least 6,617 infections across the country. All but two states — Montana and Wyoming — have reported spotting at least one infection. 

"We do expect cases will continue to rise, as we've had more access to testing, people had more access to testing, before they go down again," CDC Director Dr. Rochelle Walensky said. 

The majority of infections are still believed to be spreading through close intimate contact among men who have sex with men. While no deaths have been reported, patients often endure at-times excruciatingly painful rashes and lesions that can last for weeks.

The CDC currently estimates that between 1.6 and 1.7 million Americans are in the groups currently being prioritized for vaccine: people who are living with HIV, who are men who have sex with men, and others who are at high risk for HIV. 

Doctors have also responded to a handful of infections in other groups who are at higher risk of severe disease, like pregnant women and young children. 

Beyond freeing up additional levers in the federal bureaucracy to respond to the outbreak, officials said they hoped the declaration would raise awareness around the growing outbreak. 

"This is a very clear statement of the value of the lives of people who are in the LGBTQ community," said Dr. Demetre Daskalakis, the White House's deputy coordinator on the monkeypox response. 

Only around 10% of nation's monkeypox testing capacity is being used up right now, which works out to about 8,000 swabs from monkeypox cases per week. Officials say they expect the number of people with suspected monkeypox symptoms seeking out diagnoses, as well as doctors moving to test for the disease, will climb in the wake of the declaration. 

"I think along with moving forward and accelerating some of the work we're doing, I think it also represents an important commitment by the administration to the community," said Daskalakis. 

Monkeypox Outbreak

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Alexander Tin

CBS News reporter covering public health and the pandemic.

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As Monkeypox Spreads, U.S. Declares a Health Emergency - The New York Times

The designation will free up emergency funds and lift some bureaucratic hurdles, but many experts fear containment may no longer be possible.

WASHINGTON — The Biden administration on Thursday declared the growing monkeypox outbreak a national health emergency, a rare designation signaling that the virus now represents a significant risk to Americans and setting in motion new measures aimed at containing the threat.

The declaration by Xavier Becerra, President Biden’s health secretary, marks just the fifth such national emergency since 2001, and comes as the country remains in a state of emergency over the coronavirus pandemic. The World Health Organization declared a global health emergency over the outbreak late last month.

Mr. Becerra’s announcement, at an afternoon news briefing where he was joined by a raft of other top health officials, gives federal agencies power to quickly direct money toward developing and evaluating vaccines and drugs, to gain access to emergency funding and to hire additional workers to help manage the outbreak, which began in May.

“We’re prepared to take our response to the next level in addressing this virus,” Mr. Becerra said, adding that “we urge every American to take monkeypox seriously, and to take responsibility to help us tackle this virus.”

Mr. Biden has faced intense pressure from public health experts and activists to move more aggressively to combat monkeypox, which has infected more than 6,600 people in the United States. Lawrence O. Gostin, a health law expert at Georgetown University, called Thursday’s declaration “a pivotal turning point in the monkeypox response, after a lackluster start.”

Supplies of the monkeypox vaccine, called Jynneos, have been severely constrained, and the administration has been criticized for moving too slowly to expand the number of doses. Less than a decade ago, the United States had 20 million Jynneos doses; by May, the vast majority of them had expired.

In echoes of the early coronavirus response, tests have been difficult to obtain, surveillance has been spotty and it has been challenging to get an accurate count of cases. The administration has also been faulted for not doing enough to educate people in the L.G.B.T.Q. community, who are at high risk, before gay pride celebrations in June.

“We have 5 percent of the world’s population and 25 percent of the world’s cases,” said Dr. Carlos del Rio, an infectious disease physician at Emory University in Atlanta. “That, to me, honestly, is a failure. We were caught sleeping at the wheel.”

To address the vaccine shortage, Dr. Robert Califf, the Food and Drug Administration commissioner, who joined Mr. Becerra on Thursday, said his agency was exploring a strategy that would expand the number of available Jynneos doses by administering the shots differently — into layers of the skin, rather than the fat underneath. If it works, one-fifth of the current dose could be used to protect against the virus.

Dr. Califf said the agency was optimistic about the idea and expected to make a final decision “within the next few days,” adding, “It’s important to note that overall safety and efficacy profile will not be sacrificed for this approach.”

Under current regulations, doctors have to navigate byzantine rules to request tecovirimat, the drug recommended for treating the disease, for their patients. The declaration does not change those rules, and federal officials have said they believe the regulations are necessary to ensure that the drug is safe and effective in patients.

Monkeypox, a virus similar to smallpox but with symptoms that are less severe, has in the past primarily been found in parts of Central and West Africa. But in the current outbreak, the United States has the world’s largest number of monkeypox cases, and the virus is spreading fast. Less than a month ago, there were about 700 cases; now there are nearly 10 times that many.

More than 99 percent of people infected with monkeypox in this country are men who have sex with men, which has posed a delicate task for public health officials communicating with the public about the threat. They do not want to stigmatize gay people, as happened in the early days of the H.I.V./AIDS epidemic, but neither do they want to downplay their particular risk.

This week, Mr. Biden named a veteran emergency response official, Robert Fenton, and an infectious disease specialist, Dr. Demetre Daskalakis, to coordinate the response from the White House — a sign that the administration was stepping up its attention to the outbreak. Dr. Daskalakis, who is gay, has built deep credibility in the L.G.B.T.Q. community over his career. Both he and Mr. Fenton were on Thursday’s call.

Monkeypox is transmitted mostly during close physical contact. The infection is rarely fatal — no deaths have been reported in the United States — but it can be very painful. The number of cases is expected to rise as the virus continues to spread and as surveillance and testing improve, Dr. Rochelle Walensky, the director of the Centers for Disease Control and Prevention, said on Thursday.

“Two things are happening at once that I think can account for the rise in cases that we’re seeing: One is more widely available testing, and two, potentially more infections that are actually happening,” Dr. Walensky said, adding that “it’s hard to disentangle those right now.”

The emergency declaration that Mr. Becerra issued on Thursday falls under a specific section of federal law that allows the health secretary to declare an emergency that generally lasts for 90 days, but may be extended. But it does not grant the F.D.A. authority to give emergency authorization to vaccines, tests and treatments; that requires a separate declaration.

“It should help galvanize more testing and more health care provider awareness, especially in places outside the big cities where the level of attention to this has been far less,” said Tom Inglesby, the director of the Johns Hopkins Center for Health Security at the Bloomberg School of Public Health, who has helped the Biden administration with its coronavirus response.

Anne Rimoin, an epidemiologist at the University of California, Los Angeles, and a member of the W.H.O.’s advisory panel on monkeypox, said the declaration would send “a strong message that this is important, that it must be dealt with now.”

Dr. Rimoin is one of the scientific advisers who urged the W.H.O. to categorize monkeypox as a “public health emergency of international concern,” a designation the organization has used only seven times since 2007. With panelists divided on the matter, Dr. Tedros Adhanom Ghebreyesus, the W.H.O.’s director general, overruled the advisers to declare monkeypox a global emergency, a status currently held by only two other diseases, Covid-19 and polio.

“We’re prepared to take our response to the next level in addressing this virus,” said Xavier Becerra, the health and human services secretary.Pete Marovich for The New York Times

In the United States, demands for stronger action against monkeypox have intensified recently and several states — California, Illinois and New York — have declared their own health emergencies. Recently, Representative Adam B. Schiff, Democrat of California, called on the Biden administration to step up the manufacturing and distribution of vaccines, and develop a long-term strategy for combating the virus.

Senator Patty Murray, Democrat of Washington and the chairwoman of the Senate health committee, pushed the Department of Health and Human Services to provide a detailed account of the steps it is taking the contain the outbreak.

Gay rights activists, who have been sharply critical of the administration, have been demanding an emergency declaration for weeks. “This is all too late,” said James Krellenstein, a founder of PrEP4All, an advocacy group that works to expand treatment for people with H.I.V. “I don’t really understand why they didn’t do this weeks ago.”

The F.D.A.’s plan to consider fractional doses of Jynneos took some federal scientists by surprise.

There is some data to suggest that injecting one-fifth of a regular dose of Jynneos between skin layers would be just as effective as the approach being used now, administering a full dose under the skin. The skin is rich in immune cells that mediate the response to vaccines, so this approach is sometimes used, especially with vaccines in short supply, although it requires more skill.

Researchers at the National Institutes of Health had planned to test the strategy for Jynneos in a clinical trial that was set to begin in a few weeks, with results expected later in the fall.

“That was our plan, so we’ll have to see how it fits into the new landscape, which has changed,” said Dr. Emily Erbelding, who directs the N.I.H.’s division of microbiology and infectious diseases. “We thought that there was a desire to get a more robust data set, but if it’s a race against time, then this is a different situation.”

“Things are moving fast,” she added.

Declaring an emergency gives the C.D.C. more access to information from health care providers and from states.

During the outbreak, federal health officials have regularly shared information on testing capacity or on the number of vaccines shipped to states. But the C.D.C.’s data on the number of cases lags that of local public health departments, and the number of people vaccinated, or their demographic information, is mostly unavailable.

“We are again really challenged by the fact that we at the agency have no authority to receive those data,” Dr. Walensky, the C.D.C.’s director, said recently at an event hosted by The Washington Post.

The agency is working to broaden its access to state data, but in the meantime, the information is spotty and unreliable. Local health departments are underfunded, understaffed and exhausted after more than two years of grappling with the Covid-19 pandemic.

“A declaration of this monkeypox outbreak as a public health emergency is important, but more important is to step up the level of federal, state and local coordination, fill our gaps in vaccine supply and get money appropriated from Congress to address this crisis,” said Gregg Gonsalves, an epidemiologist at the Yale School of Public Health and an adviser to the W.H.O. on monkeypox.

“Otherwise,” he said, “we’re talking about a new endemic virus sinking its roots into this country.”

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As Monkeypox Spreads, U.S. Declares a Health Emergency - The New York Times
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California Declares State of Emergency as Monkeypox Spreads - The New York Times

Three states have now issued emergency declarations in the past week, as have New York City and San Francisco.

SACRAMENTO — Gov. Gavin Newsom of California declared a state of emergency on Monday to address a monkeypox outbreak, making the state the third in four days to elevate its public health response to the rapidly spreading disease.

The declaration followed similar actions by New York on Friday and Illinois on Monday, and by the city of San Francisco on Thursday. Mayor Eric Adams of New York also declared a local emergency on Monday.

“California is working urgently across all levels of government to slow the spread of monkeypox, leveraging our robust testing, contact tracing and community partnerships strengthened during the pandemic to ensure that those most at risk are our focus for vaccines, treatment and outreach,” Mr. Newsom said in a statement.

“We’ll continue to work with the federal government to secure more vaccines, raise awareness about reducing risk and stand with the L.G.B.T.Q. community fighting stigmatization,” he added.

The moves, which help streamline and coordinate the monkeypox response among different levels of government, come amid an uptick in infections as well as increasingly vocal complaints about the public health response.

Nearly 6,000 cases of monkeypox have been reported nationally since May, according to the Centers for Disease Control and Prevention, with nearly half of them reported in California, Illinois and New York. The World Health Organization has already declared the virus to be a global health emergency.

No deaths have been reported so far in the United States, and monkeypox is rarely fatal, but the rash caused by the virus has led to intense pain in some patients. The virus spreads primarily via prolonged physical contact, but it can also be transmitted via shared linens and clothing, health officials say.

Men who have sex with men have so far made up about 99 percent of the confirmed cases. Public health officials emphasize that the virus can spread to anyone who has prolonged skin-to-skin contact with a person who has the rash.

The U.S. case count is among the highest in the world, and health officials say the figure is almost certainly an underestimate.

Federal health officials say they have not yet declared a health emergency at the national level in part because monkeypox is a known disease with tests, vaccines and treatments available.

But as the virus has spread and scientists have gathered research, the emerging picture has been a bit more complicated than in past outbreaks, and pressure has intensified for more aggressive measures.

Last week, President Biden’s health secretary urged states and municipalities to take more initiative, noting that most public health powers in the United States are concentrated at local levels.

“We don’t control public health in the 50 states, in the territories and in the tribal jurisdictions,” Xavier Becerra, the secretary of health and human services, said in response to a reporter’s question about whether the virus could be eliminated. “We rely on our partnership to work with them. They need to work with us.”

California’s emergency declaration will allow Emergency Medical Services workers to administer federally approved monkeypox vaccines.

Gov. Kathy Hochul of New York issued an emergency declaration on Friday, saying the move would pressure the federal health officials to send additional monkeypox vaccines to the state. On Monday, Gov. J.B. Pritzker of Illinois followed suit, calling monkeypox “a rare but potentially serious disease that requires the full mobilization of all available public health resources.”

Mr. Pritzker added that the effort would “ensure our L.G.B.T. Q.+ community has the resources they need to stay safe while ensuring members are not stigmatized as they access critical health care.”

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California Declares State of Emergency as Monkeypox Spreads - The New York Times
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Monkeypox Has Been Declared a Public Health Emergency in Illinois. Here's What That Means - NBC Chicago

Illinois Gov. J.B. Pritzker on Monday declared monkeypox a public health emergency, classifying the state as a "disaster area" in regards to the disease.

According to the Centers for Disease Control and Prevention, Illinois is the state with the third-highest number of reported monkeypox infections reported, at 520. New York has the most reported cases, at over 1,300, followed by California, which has more than 800 reported cases.

Nationwide more than 5,100 infections have occurred.

Here's what the governor's declaration means for Illinois residents, and what to know as the virus continues its spread across the state in ways that experts say they haven't seen before.

Monkeypox Vaccines

With the declaration in effect, officials can more easily secure monkeypox virus (MPV) vaccine shipments and ramp up distribution to ensure the most impacted communities receive treatment as soon as possible, according to a news release from Pritzker's office.

"Proclaiming a state of disaster will allow the Illinois Department of Public Helath to expand vaccine and testing capacities with the help of the Illinois Emergency Management Agency (IEMA) and via state and federal recovery and assistance funds," the release said. "This proclamation will aid in facilitating the complicated logistics and transportation of vaccines across the state to reach the most impacted communities efficiently."

According to a July 27 update from the Chicago Department of Public Health, the monkeypox vaccine supply remains very limited, "though it is expected to continue to ramp up over the next few months as the U.S. acquires additional doses." 

CDPH also noted that "Vaccine is only available from the national stockpile and federal partners distribute it to states and cities based on population and MPV case counts. Chicago received an additional 15,000 doses of the vaccine over the weekend, by far the city’s largest allotment to date."

"However," CDPH continued, "many more individuals want vaccine than can receive it."

CDPH says that is prioritizing the vaccine for those at "highest risk," which includes "any individual who has had close physical contact with someone diagnosed with MPV or whose sexual partner was diagnosed with MPV in the last 14 days."

The city says that limited vaccine is available through some healthcare providers. and that as vaccine supply improves, more individuals will be eligible for vaccine.

According to public health officials, the full course of vaccine consists of 2 doses given at least 4 weeks apart. It takes about 2 weeks for the first dose to take full effect.

Those at Risk

While doctors have said that the overall risk to the general public remains low, with transmission is most often occurring from close personal or sexual contact -- WHO’s top monkeypox expert Dr. Rosamund Lewis last week said that 99% of all monkeypox cases beyond Africa were in men and that of those, 98% involved men who have sex with men -- the illness is spreading in ways that experts haven't seen before.

Still, doctors are stressing that says the virus des not discriminate.

“MPV is not a ‘gay disease’,” CDPH Commissioner Dr. Allison Arwady said. “There’s nothing inherent in the biology of the virus that limits it to men who have sex with men. The virus spreads through tight-knit social networks; it does not discriminate.”

According to the Chicago Department of Public Health, "Person-to-person transmission is possible through "close physical contact with monkeypox sores, items that have been contaminated with fluids or sores (clothing, bedding, etc.), or through respiratory droplets following prolonged face-to-face contact."

Arwady said most cases "are coming from much more intimate skin-to-skin contact or kissing" and noted that most casual contact and day-to-day activities - including things like shopping in crowded stores, going to a bar or coffee house, riding crowded CTA trains and buses, or using gym equipment or public restrooms - pose little to no risk for contracting MPV.

According to Dr. Albert Ko, a professor of public health and epidemiology at Yale University, “The bottom line is we’ve seen a shift in the epidemiology of monkeypox where there’s now widespread, unexpected transmission. There are some genetic mutations in the virus that suggest why that may be happening, but we do need a globally-coordinated response to get it under control."

Monkeypox Symptoms

The CDPH says Monkeypox is a rare, but potentially serious viral illness, which often begins with flu-like symptoms and swelling of the lymph nodes, and progresses to a rash on the face and body, health experts said.

Virus symptoms range from fever, aches and rashes all over the body.

"Suspected cases may present with early flu-like symptoms and progress to lesions that may begin on one site on the body and spread to other parts," CDPH previously stated.

Dr. Irfan Hafiz, an infectious disease specialist with Northwestern Medicine’s McHenry and Huntley hospitals, said the virus causes symptoms that are similar to several maladies, including chickenpox or smallpox.

“It can, to the layperson, look like chickenpox or warts,” he previously said. “But these (sores) tend to be in exposed areas.”

Health experts also stated the illness can be confused with a sexually transmitted infection like syphilis or herpes, or with varicella zoster virus.

In the U.S., some experts have speculated whether monkeypox might be on the verge of becoming an entrenched sexually transmitted disease in the country, like gonorrhea, herpes and HIV.

National Response

The Biden administration is considering declaring a nationwide public health emergency in response to the growing outbreak, but has yet to do so. Dr. Ashish Jha, the White House COVID response coordinator, said last week the administration was looking at how a public health emergency declaration might bolster the U.S. response to the outbreak.

“There’s no final decision on this that I’m aware of,” Jha said. “It’s an ongoing, but a very active conversation at HHS.”

Health and Human Services Secretary Xavier Becerra has the authority to declare a public health emergency under the Public Health Services Act. A declaration can help mobilize federal financial assistance to respond to a disease outbreak.

The World Health Organization last week activated its highest alert level, declaring the virus a public health emergency of international concern.

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Polio found in New York wastewater as state urges vaccinations - Reuters

WASHINGTON, Aug 1 (Reuters) - The polio virus was present in wastewater in a New York City suburb a month before health officials there announced a confirmed case of the disease last month, state health officials said on Monday, urging residents to be sure they have been vaccinated.

The discovery of the disease from wastewater samples collected in June means the virus was present in the community before the Rockland County adult's diagnosis was made public July 21. read more

The U.S. Centers for Disease Control and Prevention (CDC) said in an emailed statement that the presence of the virus in wastewater indicates there may be more people in the community shedding the virus in their stool.

However, the CDC added there have been no new cases identified, and that it is not yet clear whether the virus is actively spreading in New York or elsewhere in the United States.

Laboratory tests also confirmed the strain in the case is genetically linked to one found in Israel, although that did not mean the patient had traveled to Israel, officials added. The CDC said genetic sequencing also tied it to samples of the highly contagious and life-threatening virus in the United Kingdom.

The patient had started exhibiting symptoms in June, when local officials asked doctors to be on the lookout for cases, according to the New York Times.

"Given how quickly polio can spread, now is the time for every adult, parent, and guardian to get themselves and their children vaccinated as soon as possible," State Health Commissioner Dr. Mary Bassett said.

There is no cure for polio, which can cause irreversible paralysis in some cases, but it can be prevented by a vaccine made available in 1955.

New York officials have said they are opening vaccine clinics to help unvaccinated residents get their shots. Inactivated polio vaccine (IPV) is the only polio vaccine that has been given in the United States since 2000, according to the CDC. It is given by shot in the leg or arm, depending on the patient’s age.

Polio is often asymptomatic and people can transmit the virus even when they do not appear sick. But it can produce mild, flu-like symptoms that can take as long as 30 days to appear, officials said.

It can strike at any age but the majority of those affected are children aged three and younger.

Representatives for the New York health department could not be immediately reached for more details on the wastewater findings.

The polio vaccine developed by Dr. Jonas Salk in the 1950s was heralded as a scientific achievement to tackle the global scourge, now largely eradicated nationwide. The United States has not seen a polio case generated in the country since 1979, although cases from a traveler and an oral vaccine were found in 1993 and 2013.

Reporting by Susan Heavey; Editing by Aurora Ellis

Our Standards: The Thomson Reuters Trust Principles.

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NYC declares monkeypox state of emergency - FOX 5 New York

NYC declares monkeypox state of emergency

New York City Mayor Eric Adams on Monday declared a state of emergency due to the monkeypox outbreak.

NEW YORK - New York City Mayor Eric Adams has declared a state of emergency due to the monkeypox outbreak.  The city estimates that 150,000 people, mostly men who have sex with other men, are at risk.

The city has more than 1,200 reported cases of monkeypox, about 25 percent of all cases in the United States.

"We are continuing to see the numbers rise," Mayor Adams said in a statement.  "This order will bolster our existing efforts to educate, vaccinate, test, and treat as many New Yorkers as possible and ensure a whole-of-government response to this outbreak."

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The governor had already issued a state of emergency for the entire state.

The city's Department of Health and Mental Hygiene had declared the outbreak a public health emergency on Saturday.

Monday's emergency executive order allows the mayor to suspend local laws, and enact new health rules.

The city is facing a drastic shortage of monkeypox vaccines with appointments filling up just minutes after they're released.  The city expects to get around 80,000 monkeypox vaccine doses in the coming days. 

Monkeypox Symptoms

Monkeypox begins as a rash or sores that can look like pimples or blisters. These bumps can appear all over the body — including your face, hands, feet, mouth, genitals or anus — and can become infected.

The symptoms usually start between a week to two weeks after exposure but may not appear for up to 21 days. The sickness can last from two to four weeks with flu-like symptoms including fever, chills, fatigue, swollen lymph nodes, headache, and body aches and pains—like a weaker version of smallpox. 

"If you have a new or unexpected rash or other symptoms of monkeypox, contact a health care provider," the New York City Health Department states. "A person is contagious until all sores have healed, and a new layer of skin has formed, which can take two to four weeks."

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