"We need to take care of entire population, she said. This is a contagious disease spread through close contact said Abbo, associate chief medical officer for infectious diseases at Jackson Health System in South Florida. I don't want to create stigma around men who have sex with men – we're seeing the spread already in women, and other countries have reported this in children." "This feels a little bit like when the HIV epidemic started. "And they are really standing up and saying, 'Hey, you need to take this seriously.'"Ībbo said monkeypox is already spreading beyond this community. "This is a very savvy community that is great at advocating for themselves," Foote said. So far, most monkeypox cases reported to the CDC are among men who have sex with men. "It's really been striking to me, how many of these patients have had difficulty getting the care they need to treat these symptoms – having to go between clinics, hospitals and urgent care centers – never getting referred to us," said Foote. Many infected people jump from one clinical setting to another before getting a diagnosis.įoote agreed. Greater awareness about monkeypox is needed among patients and providers, said Lilian Abbo, MD, who also spoke at the news briefing. "We've seen many people with symptoms that are so severe that they are unable to go to the bathroom, urinate, or eat without excruciating pain," she said. "But the reality on the ground is a lot of people with this infection are really suffering, and some actually may be at risk for permanent damage and scarring." Many doctors learned in medical school that monkeypox is a mild disease that goes away on its own, "and many people have said that about this outbreak as well," Foote said. She said patients appear to be tolerating the drug well, with some headaches and nausea but no serious side effects reported. "Many patients have reported significant improvement in their symptoms within just a few days." "Anecdotally, the clinical response has been very good,” Foote said. Human data on tecovirimat is limited to a few case reports, but so far, signs are positive. But animal evidence suggests 90% to 100% effectiveness at preventing death.
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"For obvious reasons, you can't do a randomized controlled trial with smallpox or monkeypox, so it's based on an animal model," Foote said. What’s more, tecovirimat was not tested in humans. "In a busy community clinic, urgent care center, or emergency department where most of these patients are being seen, this is nearly impossible to implement." “The CDC response leaves a lot to be desired.”Īlso, with all the forms and administrative requirements, a patient visit to start monkeypox treatment can take anywhere from 1½ to 3 hours, Foote estimated. “If this is a trial run post-COVID to see if we are better, I don’t think it is going that well,” Amesh Adalja, MD, a senior scholar at the Johns Hopkins Bloomberg School of Public Health’s Center for Health Security in Baltimore, said in an interview. These soaring case numbers are the result of a slow and inadequate response to the outbreak, experts say. "We do think this is a genuine exponential increase in cases that will probably continue for a while," she said. There are a lot of cases that are not being diagnosed," said Foote, medical director of the Office of Emergency Preparedness and Response for the New York City Department of Health and Mental Hygiene. "Just to be very clear, we do not believe that this count the true burden of disease. "As of yesterday, we are now up to 336 cases in New York City alone – and that is a tripling of our cases, essentially, over the past week," Mary Foote, MD, said at a news briefing sponsored by the Infectious Diseases Society of America.
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And even though monkeypox is a global concern, some places in the U.S., like New York City, are seeing larger outbreaks.