Monkeypox: base cases have decreased so dramatically

Think back just a few months, and just as many of us were feeling more relaxed about Covid-19, another virus arrived, threatening to start a new pandemic.

It was a potentially deadly virus that had traveled north from Africa, literally twirled around a dance floor in Europe, and then ricocheted around the world.

Australia saw its first case in May. By June, an Australian doctor had said cases were rising at an “alarming trajectory”.

Some of those affected detailed their symptoms and showed off their rashes on TikTok and TV shows. Social media became increasingly agitated as fears grew that it was spreading and potentially reaching schools.

A group of doctors even went so far as to unilaterally declare it a “pandemic” and urged the World Health Organization to do the same.

This virus is, of course, monkeypox.

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Yet just months later, cases of this smallpox-adjacent virus are dropping like a rock.

It is an extraordinary and possibly unexpected turn for a virus that many had predicted would devastate the population. And health watchers are still investigating which measures may have had the most profound impact on the numbers.

It might turn out to be a case study of jumping on top of a developing disease and crushing it.

The Assistant Coordinator of the White House Monkeypox Response Team, Dr. Demetre Daskalakis said that New York Timex that monkeypox was stopped so well it may soon be just a memory.

“Our goal is extermination; That’s what we’re working towards.”

“The prediction is that we will get very close.”

But one public health expert has warned “monkeypox is unlikely to go away anytime soon”. And there are concerns that cases could even start to pick up again.

Dramatic turn

In the most recent outbreak, 68,000 people in 100 countries worldwide were infected with monkeypox.

In the United States, which has seen 25,000 infections, the most in the world in this outbreak, cases peaked at 736 in a single day on August 22, according to the Centers for Disease Control and Prevention (CDC).

As of September 28, only 107 new cases were diagnosed.

In New York City, one of the epicenters of monkeypox in the United States, new cases are now a tenth of what they were about six weeks ago.

Australia has seen 136 cases of monkeypox, with Victoria recording half of them. Nobody died. But last week it was revealed that Victoria had not seen a new case in weeks.

Chief Health Officer Professor Brett Sutton said it showed the spread of monkeypox had “reversed”.

This remarkable success – from Melbourne to Miami to Manchester – is believed to be due to two things: initial behavioral changes and subsequent protection from vaccination.

Monkeypox is thought to have migrated to Europe from central or west Africa, where it is endemic in some regions, and then spread worldwide via two dance parties attended mostly by gay men.

The virus is primarily transmitted through skin-to-skin contact, which can include sex.

Fortunately, the virus circulating around the world appears to be relatively mild. Although there have been 26 deaths and for a few it has led to serious complications such as kidney damage.

Cooperation with the LGBTI community “successful”

The fact that the virus circulated within the LGBTI community may have helped prevent or at least delay it from spreading further.

It also meant health news could be targeted to a smaller group of people.

“There was a tremendous amount of public health education, mostly to the MSM (men who have sex with men) community and the LBGTQ community, which was mostly affected,” said William Schaffner, a professor of preventive medicine at the US -Vanderbilt University.

“You have been literally inundated with information about monkeypox and what you as an individual can do to protect yourself from contracting it,” he told ABC News.

“A lot of the communication was successful in my opinion. And I think people may have changed some of their behaviors to reduce their risk.

There is data to support this assumption. A study by the CDC, Emory University and Johns Hopkins University details how in a survey of 824 sexually active gay men, half reported that sexual encounters had decreased since they became aware of monkeypox.

“These data suggest that MSM are taking steps to protect themselves and their partners from monkeypox,” the newspaper said.

It has also helped that gay men who have struggled with HIV for decades are particularly conscious of their health, what to look out for and how to seek medical care.

And a smaller group meant monkeypox wasn’t an abstract concept affecting others. Many gays knew someone who had contracted it.

14 times less likely to get monkeypox

This initial reduction in sexual activity gave time to increase vaccination efforts. This took a while. The main vaccine is the Jynneos vaccine, little of which was immediately available.

However, production was ramped up and more shots were squeezed out of each vial by administering them just under the skin rather than directly into the muscle as was done with Covid shots.

Vaccination has also been prioritized for people at highest risk of contracting monkeypox to create a protective wall known as “ring vaccination”.

“This has changed because of responsiveness and engagement (from the LGBTI community),” said Dr. Sutton on the outbreak in Australia.

“Behold, these pillars of a public health response are working. Case isolation, contact tracing and early testing by working closely with the risk community.

There was concern that the Jynneos vaccine, which was not specifically designed for this outbreak, might not be as effective as hoped.

However, CDC data released this week showed that people who had been exposed to monkeypox and had not been vaccinated were 14 times more likely to contract the virus.

Monkeypox is still around

Nevertheless, some urge caution.

“While it’s encouraging to see that case numbers have come down, monkeypox is unlikely to go away anytime soon,” wrote Andrew Lee, professor of public health at Britain’s University of Sheffield, on academic website The Conversation.

While the data on the vaccine’s effectiveness is promising, he posited that it could be the changes in sexual behavior that also played a big part in reducing cases.

If this is the case, this poses a problem because asking sexually active people to refrain from sex for an extended period of time has never been a particularly effective strategy.

“The danger then is what happens when people’s behavior goes back to how it was before the current outbreak began. This could lead to infection numbers rising again,” said Prof. Lee.

“We have to be careful not to stigmatize the disease, lest we drive it underground and make it harder for infected people to seek medical care.”

If monkeypox cases continue to fall, it will mark a remarkable turnaround for a virus some feared was the new Covid. And it could be a template for dealing with future outbreaks.

However, as has been shown with the rollout of Covid-19 vaccinations, it is often people living in less affluent countries who are left behind.

Monkeypox could disappear in US, UK and Australia. But if it stays in Africa, it can always go international.

And next time, the virus may find a home in a less distinct group that may be far more difficult to approach and communicate with, and far less willing to get involved and change their behavior.

Originally posted as monkeypox, cases are declining dramatically — here’s why