"They are certainly worried."  Monkeypox cases are increasing in South Florida

“They are certainly worried.” Monkeypox cases are increasing in South Florida

Less than eight weeks ago, the Florida Department of Health reported the state’s first presumptive case of monkeypox — a viral disease that was rare in the United States.

Now, given the rapid rise in the number of new monkeypox cases in the United States and more than 50 other countries, the number of cases in Florida has also risen to 73 as of Thursday, the third-highest number of states, after California and New York, accordingly. to the Centers for Disease Control and Prevention. The Centers for Disease Control and Prevention said there were 700 confirmed cases in the United States as of Thursday.

South Florida is the epicenter of the outbreak in the state, with Miami-Dade and Broward counties accounting for more than 70% of all reported cases in Florida. Broward leads the state with 40 cases, while Miami-Dade comes in second with 14, according to the Florida Department of Health.

“Anyone doing healthcare right now should be absolutely concerned and be well aware that this is happening,” says Dr. Aileen Marty, MD, professor of infectious diseases in the Department of Medicine at FUI Herbert Wertheim School of Medicine.

Most Florida residents diagnosed with monkeypox are middle-aged, with more than 70% of cases occurring in people ages 35 to 54, according to the Florida Department of Health. They usually get sick in Florida, as opposed to coming here from elsewhere with the virus, according to the department’s disease repository.

Monkeypox can be transmitted from person to person through contact with the rash, scabs, or infectious body fluids of a person infected with the virus, and the disease can also be transmitted by “respiratory secretions during prolonged, face-to-face contact, or during intimate physical contact” with a person who appears He has symptoms, according to recent guidance from the CDC.

Although anyone can get monkeypox, “the main populations we’ve seen so far have been men who have sex with men,” said Marty of the Financial Intelligence Unit. “Not because it’s a sexually transmitted disease, but because they’ve had sorts of interactions with each other at big party venues. This is basically a super spreader.”

More than 6000 cases worldwide

All over the world, epidemiologists see the same trends. Of the more than 6,000 monkeypox cases reported in 58 countries as of Wednesday, 99 percent of the cases were in men – the majority were in men who have sex with men, the head of the World Health Organization in Europe said Friday. The press reported.

Others are also at increased risk, Marty said: Children, pregnant women, the immunocompromised and the elderly should remain especially vigilant.

Symptoms include a rash, fever, muscle aches, vomiting, and chills. No deaths have been reported.

The Florida Department of Health and the CDC consider people at urgent risk of vaccination and are distributing the CDC’s monkeypox screening test widely through commercial laboratories. To have this test, people must first visit their healthcare provider, who will collect samples and begin the testing process.

Read more: What are the signs and symptoms of monkeypox?

Why is monkeypox dangerous?

Monkeypox was first observed in 1958 among a colony of monkeys used for medical research, according to the CDC. The first human case was recorded in 1970 in the Democratic Republic of the Congo.

The virus belongs to a group called orthopoxviruses, which includes a number of species that can infect animals and humans, such as the viruses that cause smallpox, smallpox, camelpox, and cowpox.

There are different types of people: tall, short, fat, and skinny […] Spores also come in different flavors and different patterns,” says Marty. Although there is more than one type of monkeypox virus circulating around the world, the predominant type is clade 3B.1.

Marty said public health experts were “a little more surprised,” when they analyzed the “Book of Life,” or genetic sequences of the monkeypox strain currently circulating around the world, and found it to be much different from previous variants. In particular, experts found a change in a specific enzyme called APOBEC3 that allows the virus to mutate faster.

The APOBEC3 enzyme is also found in the hepatitis B virus and herpes virus, as well as in the HIV virus that causes AIDS.

Although scientists do not yet fully understand how this enzyme affects the current variant of monkeypox, mutations generally allow viruses to more easily enter human cells, spread from person to person, multiply within a host, and evade the immune system.

How does it spread?

The monkeypox virus is spread from person to person by direct contact with infected areas, respiratory droplets and genital secretions, and even touching objects used by infected individuals. People can also contract the virus by being bitten or scratched by an infected animal, especially a rodent.

Marty said there have been documented cases in Europe of sanitation workers contracting monkeypox after handling the sheets and towels of infected patients.

But the disease is rarely fatal.

Fortunately, Marty said, “Most of the cases we saw were not very severe except for the blisters they cause,” though there have been rare cases of blindness, severe respiratory problems and sepsis.

Vaccines, checkups and treatment

There are two vaccines licensed by the Food and Drug Administration to prevent monkeypox infection: JYNNEOS and ACAM2000. The previous vaccine was a “very safe” vaccine that contained a virus that could not replicate effectively inside our bodies. However, the latter has a virus that is able to replicate.

In addition to vaccines, testing protocols are being ramped up. As of yesterday, Labcorp, a company that operates one of the world’s largest clinical laboratory networks, began testing monkeypox using the CDC’s orthopoxvirus test. This will double the current testing capacity through the Centers for Disease Control and Prevention Laboratory Response Network.

“The ability of commercial laboratories to test monkeypox is a key pillar of our comprehensive strategy to combat this disease,” CDC Director Dr. Rochelle Walinsky said in a statement to the press Wednesday. “Not only will this increase testing capacity, but it will also make it more convenient for providers and patients to access tests using existing provider-laborator relationships.”

Although there are no approved treatments specifically for monkeypox, many of the antiviral drugs developed for smallpox may also work for monkeypox. The Centers for Disease Control and Prevention (CDC) Interim Clinical Guidelines for the treatment of monkeypox mention four different antivirals that doctors may use.

Prioritizing Vaccines for the LGBTQ Community

The Florida Department of Health is working with the South Florida CDC to raise awareness in the community and among medical providers, said Olga Connor, director of communications and legislative affairs for the state Department of Health’s Miami-Dade office.

“It is imperative that medical providers be aware of the clinical manifestations of early diagnosis and treatment. Furthermore, DOH-Miami-Dade has distributed educational materials to various community organizations to raise awareness,” said Connor.

The Department of Health has also “distributed treatment and vaccines from the National Strategic Stockpile of individuals who meet the criteria for treatment and vaccination and follow the guidelines issued by the Centers for Disease Control and Prevention (CDC) to monitor individuals identified as having close contact.”

Because of the JYNNEOS vaccine shortage and the spread of monkeypox in the LGBTQ community, public health officials are prioritizing vaccinations for gay, bisexual, and other men over 18 who have sex with men, transgender, non-conforming, or non-binary people Those over 18 years of age with multiple or anonymous sexual partners in the past two weeks.

Individuals concerned about monkeypox infection should contact a medical provider, said Nina Levine, public information officer with the Department of Health’s Broward County Office of Health, adding that the Department of Health’s epidemiologists are also available 24/7 to consult with health care providers.

If public health officials cannot contain an outbreak of monkeypox quickly, the disease could become a long-term risk.

“We are very concerned that with so much human-to-human transmission, pet rodents in homes can become infected, and wild rodents like squirrels can become infected. Then it becomes endemic in our country and other countries. And then it becomes an ongoing problem that we are going to have All for a long time.”

But the tide is quickly rising against those racing to contain the spread of the monkeypox virus.

“In the entire 20th century, there were 917 cases,” Marty said. Within two months, we had over 7,000 confirmed cases [globally]. “

This story was originally published July 7, 2022, 7:03 p.m.

Anurag Bukuri is the 2022 AAAS Fellow in Media at the Miami Herald. He is a doctoral candidate in integrated mathematical oncology at the USF-Moffitt Cancer Center and uses mathematics to gain insight into problems in medicine and biology.

Daniel Chang covers health care for the Miami Herald, untangling the often irrational world of health insurance, hospitals, and health policy for readers.

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