US now has more monkeypox cases than any other non-endemic country

glove monkeypox
gloved monkeypox


Passing Spain and the United Kingdom, the United States now has the highest case count for monkeypox cases in non-endemic countries, with the nation's total standing at 3,487 cases after more than 500 new cases were confirmed yesterday by the Centers for Disease Control and Prevention (CDC).

Mississippi has identified its first case, meaning only a handful of states have yet to report a case of the poxvirus. Last week, Maine also recorded its first case, leaving only Vermont, Montana, Wyoming, and Alaska still reporting no cases.

During a Clinician Outreach and Communication Activity (COCA) call today hosted by the CDC, officials said 99.1% of cases are in men, with 13 cases in women. Men who have sex with men (MSM) make up 98.4% of US cases, and the median age is 35 years.

Almost all US patients (99%) have experienced a rash, while 70% have reported malaise, 64% fever, and 63% swollen lymph nodes.

DC moves to postponing second vaccine dose

The COCA call also described further steps to prescribe tecovirimat treatment, with clinicians now able to prescribe the antiviral via telemedicine, and required safety reporting of serious adverse effects only. No pictures of rashes, samples for testing, or patient diaries are now required for treatment.

In an update on vaccine distribution, at least 240,000 doses of Jynneos are reported to have been distributed to states, and the Department of Health and Human Services anticipates making approximately 1.9 million doses available in 2022 and another 2.2 million doses in the first half of 2023.

The CDC maintains that two doses of Jynneos should be administered 28 days apart, with full protection achieved 14 days after the second dose. But some local health officials are changing protocols. In Washington DC, health officials are postponing some second doses of monkeypox vaccine in a strategy to give first doses to more people.

UK adds to monkeypox case definition

The global total is now 18,662 confirmed cases and 40 suspected in 82 non-endemic countries. Spain has 3,738 cases, and the United Kingdom has 2,325.

In light of clinical experience during this outbreak, the UK Health Security Agency (UKHSA) said it is updating its monkeypox case definition to include a single lesion or lesions on the genitals, anus, and surrounding area; lesions in the mouth; and symptoms of proctitis (anal or rectal pain or bleeding), especially if the individual has had a new sexual partner recently.

"We have updated our case definitions to reflect the clinical presentations that have been seen during this outbreak," said Director of Clinical and Emerging Infections at UKHSA, Meera Chand, MD, in a statement. "It is important to recognise that just one or two genital or anal lesions, or lesions in the mouth can be signs of monkeypox, especially if you have had a new sexual partner."

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