Mpox public health campaign was successful but cases still occur at low levels in US: Study

During the summer of 2022, the United States faced the imminent threat of a global mpox outbreak. Cases were increasing exponentially every week, and there seemed to be no signs of it slowing down.

Fortunately, a successful public health campaign was launched, focusing on promoting behavior changes and encouraging vaccination. This campaign played a crucial role in dramatically reducing the number of mpox cases.

However, a recent small study conducted by the University of California, Los Angeles (UCLA) has revealed that mpox cases are still present at low levels in the U.S. These cases are primarily found among high-risk groups who have not been vaccinated.

Dr. David Talaen, co-lead author of the study and a professor of emergency medicine and infectious diseases at UCLA, explained that despite the decline in cases after the 2022 global outbreak, small localized outbreaks were observed in cities like Chicago and Los Angeles. This prompted the research team to investigate if mpox was resurfacing.
According to an interview with ABC News, the researcher explained that mpox is not solely a sexually transmitted infection. It can be transmitted through any skin-to-skin contact and the rash can appear on any part of the body. Therefore, the study aimed to determine if cases of mpox had been overlooked in groups other than the previously identified risk group of gay and bisexual men who have sex with men in 2022.

The study analyzed data from 13 U.S. emergency departments from June 2023 to December 2023. Specifically, the researchers focused on patients who visited these departments with a rash resembling the mpox rash.

Out of the 196 patients with a rash, only 1.5% were diagnosed with mpox. Interestingly, all of the mpox patients were gay or bisexual men who have sex with men and had not received the mpox vaccine.

Additionally, the study found that the mpox patients had engaged in sexual activities with one or more partners they had met through smartphone dating apps.
No cases of mpox were found in other groups such as women, children, or unhoused individuals.

Mpox can affect anyone regardless of their gender or sexual orientation, but the outbreak in the U.S. primarily spread among gay or bisexual men and has continued to do so at a low level.

Public health experts credit this community with responding quickly to the outbreak through awareness campaigns and high vaccine uptake, which likely helped prevent further spread.

The authors of the study emphasized the importance of educating individuals at risk for mpox about the behavioral risks and encouraging vaccination.

Currently, the JYNNEOS vaccine, a two-dose vaccine approved by the FDA for preventing smallpox and mpox, is the only vaccine being used in the U.S.
Recent data from Africa has revealed that administering two doses of JYNNEOS can provide a minimum of 85% protection against mpox infection. To address the urgent need for more JYNNEOS doses during the outbreak, the FDA approved a strategy in August 2022 to administer the vaccine intradermally, just below the outermost layer of skin, instead of subcutaneously, which involves injecting it under all layers of the skin. This innovative approach allows one vial of the vaccine to be divided into five separate doses, significantly increasing the available supply. While the public health campaign has been successful in reducing the number of cases associated with the 2022 outbreak, it is crucial to note that the disease has not been eradicated entirely. Talaen, an expert in the field, emphasized the importance of continued protection through both responsible behavior and vaccination, especially for those at risk.

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