The United States must use lessons learned from the 2022 global mpox outbreak to prepare for future public health emergencies—including the threat of an mpox resurgence this summer, according to a new report from the O'Neill Institute for National and Global Health Law and amfAR, the Foundation for AIDS Research.

The outbreak mainly affected men who have sex with men (MSM) and transgender people—particularly those living with HIV. Public health efforts were hampered by an insufficient supply of the Jynneos mpox vaccine; questions about its safety, effectiveness, and route of administration; and vaccine outreach and delivery disparities among some racial groups.

"Mpox has not been eliminated, and modeling studies suggest that a resurgence is a possibility this summer," the authors said. "We must use lessons learned—most importantly that public health should focus on community-guided partnerships that promote health as opposed to risk-based communications that foster stigma and shame."

Four recommended actions

The organizations recommend four actions to help prevent and manage any future outbreaks:

• Community-led vaccine promotion and education are needed to encourage uptake of both vaccine doses, including vaccination clinics at community spaces and events. "It is also important to educate the community about the heightened risk for severe disease and even death in people with undiagnosed or uncontrolled HIV," the report said.
• Public health messages should build trust and minimize the stigma often associated with mpox. "Mpox responses, building on lessons learned from HIV and critical mpox community advocacy, must reinforce the benefits of promoting sexual health," the authors wrote.
• Mpox testing and vaccination must be integrated within public health programs addressing HIV, other sexually transmitted infections, and hepatitis, and event promoters and influencers should be included in every stage of development and delivery.
• Federal agencies and state and local health departments must foster relationships with organizations that can fund emergency mpox responses. "Outbreaks may recede, but they rarely end," the report said. "Therefore, public health needs the capacity to mount emergency responses that can be scaled-back, but not eliminated, when cases decline."

A small randomized trial in patients with post-COVID syndrome has found that hyperbaric oxygen therapy (HBOT) promotes restoration of the heart's ability to contract properly, according to data presented today at EACVI 2023, a scientific congress of the European Society of Cardiology.

The study enrolled 60 patients in a randomized controlled double-blind trial that measured how and if HBOT helped patients who have mild to moderate long COVID. The therapy involves inhalation of 100% pure oxygen at high pressure, and has been shown to help non-healing wounds, radiation injury, and other types of infection by increasing oxygen delivery to damaged tissues.

All patients had five sessions per week over 8 weeks, for a total of 40 sessions. The HBOT group received 100% oxygen through a mask at a pressure of 2 atmospheres for 90 minutes, with 5-minute air breaks every 20 minutes. The control group breathed 21% oxygen by mask at 1 atmosphere for 90 minutes. Echocardiograms were done before the first session (baseline) and 1 to 3 weeks after the last session.

More research is needed to collect long-term results and determine the optimal number of sessions.

Echocardiography measured the heart's ability to contract and relax based on left ventricular global longitudinal strain (GLS). At baseline, nearly half of study participants (29 of 60; 48%) had reduced GLS. In healthy adults, GLS should be approximately -20%.

In the HBOT group, GLS significantly increased from -17.8% at baseline to -20.2% after the intervention. In the control group the GLS had no significant differences.

"The findings suggest that HBOT promotes recovery of cardiac function in patients with post-COVID syndrome," said Marina Leitman, MD, of the Sackler School of Medicine, Tel Aviv University and Shamir Medical Centre, Be'er Ya'akov, Israel. "More research is needed to collect long-term results and determine the optimal number of sessions for maximum therapeutic effect."

The Kentucky Department of Fish and Wildlife Resources (KDFW) this week said the state is seeking civil damages for the first time against a hunter for importing a diseased deer carcass.

The hunter from Louisville legally harvested the eight-point buck in Wisconsin, then brought the intact head into Kentucky for taxidermy, which violates Kentucky law in importing deer carcasses or other high-risk parts. The head contains lymph nodes, spinal column, and brain tissue, all of which are high-risk tissues.

So far, no deer or elk in Kentucky have tested positive for CWD, and KDFW said the head remained frozen during transport and storage.

Conservation officers followed up on information it received about the man's deer head, which had been frozen when it was inspected. Because it came from Wisconsin, which first documented CWD about two decades ago, officials ordered testing of tissues from the deer head, and two types of tests were positive for the disease.

We want to keep it from spreading to Kentucky's deer and elk herds.

The man cooperated with KDFW when it questioned him about the deer in November. He paid a $50 fine and court costs in January. The lawsuit filed in Franklin County on Apr 26 seeks nearly $1,900 in damages, which cover the cost of the investigation, prosecution, and disposal of the infected carcass.

Ben Robinson, who directs the KDFW's wildlife division, said in a statement, "The disease has been documented in every surrounding state except Indiana, so we want to keep it from spreading to Kentucky's deer and elk herds."

The World Health Organization's (WHO's) mpox emergency committee is meeting today for the fifth time to assess if the outbreak still warrants a public health emergency of international concern (PHEIC).

The WHO declared the emergency in July 2022 following the international spread of the virus. The emergency committee last met in February and typically meets every 3 months, or more often as needed.

In an address to the committee today, Tedros Adhanom Ghebreyesus, PhD, the WHO's director-general, said countries have made steady progress against the disease, which has come with a steep decline in cases. But he added that transmission continues in some communities, such as in the Western Pacific region, and travel-related cases continue to be reported.

Regarding Africa, where the virus is endemic, Tedros said there is no clear trend, and cases continue to be reported in several countries.

The WHO will host a telebriefing tomorrow on global health issues and will likely announce the emergency committee's latest recommendation.