Two US states declare state of emergency over Monkeypox

Last Updated: February 6, 2024By

Experts fear it may be too late to stop the disease from becoming endemic in the United States

Two US states declare state of emergency over Monkeypox

The US states of California and Illinois on Monday both declared states of emergency over growing monkeypox infections as several countries report their first deaths related to the virus.

There have been more than 5,800 probable or confirmed cases reported in the US so far, according to statistics from the US Centers for Disease Control and Prevention (CDC). More than 800 have been reported in California alone as of Tuesday, with Illinois contributing an additional 500. 

The US federal government has so far resisted declaring a nationwide public health emergency, even after the World Health Organization declared the global monkeypox outbreak a public health emergency of international concern.

According to California’s declaration on Tuesday, emergency medical services will be allowed to administer federally approved monkeypox vaccines to a larger pool of residents. 

“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,” Governor Gavin Newsom said in an official proclamation. 

According to the CDC, monkeypox is a poxvirus, a relative of the now-eradicated smallpox, that causes blister-like lesions on the skin and can cause flu-like symptoms like headache, fever and respiratory symptoms. 

Illness typically lasts between two and four weeks and can range from mild to severe, even being fatal. Several countries recently reported their first monkeypox-related deaths, including India and Spain. 

The disease spreads from infected individuals through close skin-to-skin contact and bodily fluids, and can also spread from animals to humans. Gay and bisexual men have been stigmatized because of disproprortionate infection rates – but health officials around the world have stressed the disease can affect anyone and is not a sexually transmitted disease.

The US is facing vaccine shortages in the face of what experts fear could become an endemic disease. In late July, the MIT Technology Review found monkeypox in wastewater in California’s San Francisco bay area, indicating that the infection is more widespread in the community than officially reported. Other metropolitan areas across the country have found similar results. 

According to the WHO, the first human case of monkeypox was identified in a child in the Democratic Republic of the Congo in 1970. It is endemic in countries in Western and Central Africa, which compose two distinct clades of the virus. It is believed that the Western Africa clade causes less severe disease than the other, endemic to the Congo Basin. 

The Biden administration has estimated that it may need almost $7 billion from Congress to respond to the spread of monkeypox, given “the scope and urgency of the current situation,” the Washington Post reported on Tuesday, citing a White House memo.

The figure was specified in a document addressed to US President Joe Biden and obtained by the outlet. The memo, however, was not a formal funding request addressed to Congress, but rather an option that Washington may choose to tackle the monkeypox outbreak. According to the Post, it reflects deliberations between White House officials and Congress Democrats over the steps needed to ramp up monkeypox testing, vaccination and treatment capacities.

US officials reportedly believe that the $6.9 billion earmarked for monkeypox response efforts would allow the Department of Health and Human Services to support “domestic end-to-end vaccine manufacturing capacity and technology transfer.” The issue has gained urgency, given that Jynneos – the only monkeypox vaccine approved for use in the US by the Food and Drug Administration (FDA) – is currently produced in Denmark and is in limited supply. In fact, as of July 19, only 190,000 doses of this vaccine had been delivered to the Strategic National Stockpile, according to the US Department of Health and Human Services.

With this in mind, US officials reportedly believe that the new funding would allow them to procure 19 million new doses of monkeypox vaccine and replenish about four million doses for paused smallpox preparedness efforts, secure more antiviral treatments, boost testing and generally increase the effectiveness of the response.

The memo also describes a “medium” second option to the tune of $2.2 billion that would use the funds to mitigate the fallout of the outbreak primarily among the members of gay and bisexual community, which monekypox is now affecting the most. This, however, would work only if the outbreak is contained within these limits, the document reportedly warns.

The Biden administration’s apparent push to stave off the monkeypox outbreak comes as the US has become one of global leaders in terms of confirmed cases of this disease. As of Tuesday, the Centers for Disease Control and Prevention (CDC) put the total number of confirmed monkeypox cases in the US at 3,590.

Monkeypox is similar to human smallpox, which was eradicated in 1980, and is endemic in parts of West and Central Africa. Its initial symptoms include fever, headache, muscle aches, backache, swollen lymph nodes, chills, and exhaustion, and those afflicted develop distinctive skin lesions.

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