WASHINGTON — With monkeypox cases declining nationwide, federal health officials on Thursday expressed optimism that the virus could be eliminated in the United States, although they warned that if it is not eradicated globally, Americans remain at risk.
“Our goal is to eradicate; that’s what we’re working on,” said Dr. Demetre Daskalakis, deputy coordinator of the White House monkeypox team, during a visit to a monkeypox vaccination clinic in Washington. He added: “The prediction is that we will get very close.”
To Dr. Daskalakis was joined by President Biden’s Health Secretary Xavier Becerra and Response Team Coordinator Robert J. Fenton Jr., who echoed his optimism. The goal of the clinic visit was to highlight the District of Columbia’s efforts to close the racial disparity in monkeypox vaccination — a major goal of the Biden administration.
“From the very beginning, the president said, ‘Get at it and then stay in front of it,'” Mr. Becerra told reporters. “And we can’t say we’ve really stayed ahead of him if we’re leaving certain communities.”
Dr. Daskalakis, an infectious disease expert who previously led the HIV prevention division at the Centers for Disease Control and Prevention, he was brought into the monkeypox response team by Mr. Biden last month.
What you should know about monkeypox virus
What is Monkey Pox? Monkey pox is a smallpox-like virus, but the symptoms are less severe. It was discovered in 1958 after outbreaks occurred in monkeys kept for research. The virus was primarily found in parts of central and west Africa, but has recently spread to dozens of countries, infecting tens of thousands of people, mostly men who have sex with men.
On Thursday Dr. Daskalakis did not give a timetable for ending the epidemic in the United States, saying only that he was looking into his “mid-term crystal ball.” But he said he expects cases to decline over time and infections to become sporadic, allowing health workers to isolate and vaccinate close contacts of those infected — and end the outbreak in the process.
This strategy, known as ring vaccinationit was used in a worldwide campaign to suppress smallpox, which was declared eradicated in 1980.
But there is a crucial difference between monkeypox and smallpox: Smallpox only occurs in humans, while monkeypox also occurs in animals. The existence of an “animal reservoir” means there will always be a risk of spreading to humans, said Dr. Michael T. Osterholm, an infectious disease expert at the University of Minnesota.
“Eradication is a very sacred word in public health; to eradicate means they’re gone permanently, and the only virus we’ve done that with so far is smallpox,” said Dr. Osterholm.
He said a better word is “elimination” and a better analogy would be measles. “We’ve had a major measles elimination program in this country and we’ve greatly reduced the incidence of measles, but the challenge today remains the introduction of the virus from individuals around the world,” said Dr. Osterholm.
The first cases of the current monkeypox outbreak in the US appeared in May. The disease, which occurs primarily in men who have sex with men in the United States, is characterized by fever, muscle aches, chills, and lesions. In rich countries like the United States, it is rarely fatal, but it can cause excruciating pain. The current epidemic is unusually large; the last major outbreak of monkeypox in the United States occurred in 2003, when 47 confirmed and probable cases were reported in six states.
In the current epidemic, the United States accounts for more than a third of the roughly 65,000 cases reported worldwide; as of Thursday CDC he reported nearly 25,000 cases in the country. An average of about 200 cases a day are still being reported in the United States, although that number is significantly lower than in August.
The drop comes as a relief to Biden administration officials who have come under fire for their response — and particularly the lack of a vaccine — in the early days of the outbreak. Critics, including many gay rights activists, said the administration failed to aggressively order vaccine doses and distribute them before many gay people were infected during June’s Pride celebrations.
One of those activists, James Krellenstein, founder of PrEP4All, an advocacy group, said Dr. Daskalakis were premature. He said that because of the lack of federal funding for monkeypox research and the lack of answers to basic questions, it is too early to predict the end of the epidemic.
“This is the first time we’ve really seen a large outbreak of monkeypox with sustained human-to-human transmission, and there remain many scientific unknowns,” Mr Krellenstein said, referring to President George W. Bush“Let’s not get into ‘mission accomplished’ by landing in aircraft carrier territory here.”
The vaccine shortage has led to stark racial disparities that the administration is now trying to address. Dr. Wafaa El-Sadr, a professor of epidemiology and medicine at Columbia University’s Mailman School of Public Health, said she shared Dr. Daskalakis said the outbreak can be brought under control, but only with intensive efforts to reach underserved populations.
“The risk,” she said, “is that you have these populations that are hard to reach, often poor, and people from racial and ethnic minorities who are less informed, have less access. They tend to sometimes fall behind, as we see, when it comes to vaccination. “