More than 40 percent of the nation’s confirmed 4,907 monkeypox cases have been reported in California and New York.
San Francisco Mayor London Breed (D) announced a local public health emergency Thursday, noting that cases of monkeypox had nearly doubled, to 261, in a week. She said the move would mobilize resources, accelerate emergency planning and allow for future spending to be reimbursed by the state and federal governments.
California state Sen. Scott Wiener (D), who had called for the emergency declaration, said the decision would make it easier to expand testing and vaccines and pressure the federal government to take the outbreak more seriously.
“It’s a powerful declaration to the country and the world about the need to act decisively and strongly,” Wiener said in an interview.
After the state of New York recorded more than 1,200 cases, State Health Commissioner Mary T. Bassett on Thursday declared an imminent threat to public health, retroactive to June 1.
“This declaration means that local health departments engaged in response and prevention activities will be able to access additional State reimbursement, after other Federal and State funding sources are maximized, to protect all New Yorkers and ultimately limit the spread of monkeypox in our communities,” Bassett said in a news release.
Monkeypox infections result in an illness that lasts several weeks with symptoms including fever, swollen lymph nodes and a rash that can spread throughout the body. No U.S. deaths have been recorded, but some patients have reported intense pain from lesions.
The outbreak has overwhelmingly been concentrated in men who have sex with men. Gay leaders such as Wiener and longtime HIV activists have urged health officials to act decisively to contain monkeypox and avoid repeating mistakes from the AIDS crisis when the suffering of gay men was minimized and the world failed to act quickly. Vaccines are believed to be effective before and after exposure, and an antiviral approved for a closely related disease, smallpox, can be used to treat monkeypox.
Local officials, including Breed, say the supply of vaccine is not sufficient to provide shots to everyone at high risk of exposure.
“Our declaration of emergency is to sound the alarm and make it very clear we are in desperate need of more vaccine and more treatment,” Breed said Thursday.
Monkeypox spreads primarily through close contact, and experts say they believe skin-to-skin exposure during sexual activity is a major source of transmission in the current outbreak. But they caution that the virus spreads through other forms of touch and can circulate outside the gay community, noting a handful of cases in women and children.
WHO officials advised men who have sex with men to temporarily reduce their number of sexual partners in an attempt to reduce transmission. The New York and San Francisco announcements did not include containment measures or restrictions designed to curb spread.
“We are not implementing behavior restrictions or other measures like we did under COVID. This is all about having the resources and ability to move quickly to deploy these resources,” Breed said in a post explaining the emergency.
Health and Human Services Secretary Xavier Becerra said Thursday that officials had not made a decision on a national emergency declaration, noting the virus had yet to become as formidable a threat as the coronavirus. Becerra touted vaccines and treatments that the Biden administration has continued to send to local health departments and providers, including about 800,000 doses that federal officials cleared for distribution this week.
“We will weigh any decision on declaring a public health emergency based off the response we’re seeing throughout the country,” Becerra told reporters at a briefing. “Bottom line is: We need to stay ahead of this and be able to end this outbreak.”
Federal officials have spent the week privately wrestling over whether to declare an emergency, with some senior health officials arguing that it would elevate public awareness of the outbreak and allow for a more robust response, including compelling hospitals to report more data on monkeypox patients.
But other health and White House officials have raised questions about declaring a U.S. emergency, saying it would be mostly symbolic and create pressure to declare additional emergencies for other issues, such as abortion, that advocates have sought. HHS also has continued to renew a 2½-year-old public health emergency declaration for coronavirus amid some conservatives’ demands to end it.
Dan Diamond contributed to this report.
Monkeypox: First deaths outside Africa in Brazil and Spain
By Malu Cursino
Brazil and Spain have reported their first monkeypox deaths.
A 41-year-old man in Brazil became the first fatality from the virus outside Africa. Spain announced two deaths soon afterwards – the first in Europe.
Last week, the World Health Organization (WHO) declared the monkeypox outbreak a global health emergency.
But infections are usually mild and the risk to the general population is low.
On Friday Brazil’s health ministry said the victim there had suffered from lymphoma and a weakened immune system, and “comorbidities aggravated his condition”.
Brazil has so far reported 1,066 confirmed cases and 513 suspected cases of the virus. Data from Brazil’s health ministry indicates that more than 98% of confirmed cases were in men who have sex with men.
Shortly afterwards, Spain’s health ministry confirmed Europe’s first death from the virus – a patient who suffered from encephalitis.
A second death linked to monkeypox was confirmed by Spanish authorities on Saturday.
The health ministry said that of 3,750 monkeypox patients with available information, 120 or 3.2% had been hospitalised.
According to the US Centers for Disease Control and Prevention, there are 21,148 cases worldwide.
The monkeypox virus is a member of the same family of viruses as smallpox, although it is much less severe and experts say chances of infection are low.
It occurs mostly in remote parts of central and west African countries, near tropical rainforests.
Health officials are recommending people at highest risk of exposure to the virus – including some gay and bisexual men, as well as some healthcare workers – should be offered a vaccine.
Last week, WHO director general Dr Tedros Adhanom Ghebreyesus said declaring the outbreak a global health emergency would help speed up the development of vaccines and the implementation of measures to limit the spread of the virus.
Dr Tedros said the risk of monkeypox is moderate globally, but high in Europe.
But, he added, “this is an outbreak that can be stopped with the right strategies in the right groups”. The WHO is issuing recommendations, which it hopes will spur countries to take action to stop transmission of the virus and protect those most at risk.