Understanding MPOX: Low Cases in the U.S and the Emphasis on Community-Centric Response

Current State of MPOX in the United States

The United States continues to maintain a relatively low number of MPOX cases without any signs of a major summer wave. This is a significant achievement considering that MPOX was declared a public health emergency of international concern by the World Health Organization (WHO) in 2022. Despite the severity of this disease, which typically manifests in the form of pimple or blister-like lesions and flu-like symptoms, the U.S has managed to keep its case numbers under control.

The Community-Centric Approach to MPOX Response

The key to managing this outbreak lies in a community-centric response. This approach involves closely focusing on the affected communities, adapting the strategies to their unique needs, and persisting in these efforts longer than initially anticipated. This strategy has proven effective so far, particularly in Washington State where a substantial number of residents have been fully vaccinated against MPOX.

Vaccination Efforts in Washington State

The Washington State Department of Health (DOH) has been leading in terms of MPOX vaccination. As of January 3, 2024, the department had administered 35489 MPOX vaccines, with a whopping 99% being the JYNNEOS vaccine. A total of 21481 Washington state residents received an MPOX vaccine, with 13357 of them being fully vaccinated. The focus has been on JYNNEOS distribution, with very few administrations of ACAM2000.

Early Use of Tecovirimat in HIV Individuals

A study published in JAMA Internal Medicine highlighted the importance of early intervention, especially in people with HIV. It found that individuals with HIV who received early Tecovirimat (Tpoxx) after showing MPOX symptoms were less likely to experience a full-blown course of illness. However, the study also cautioned against premature broad recommendation of Tpoxx to all people with HIV, given the limitations of Tecovirimat availability and the potential for creating a resistant virus.

Low Fatality Rate Despite High MPOX Cases

Despite more than 30,000 US MPOX cases reported in the past two years, the fatality rate remains remarkably low. Only 55 deaths have been reported, a case-fatality ratio of less than 0.2%. This is largely due to effective measures such as early detection, prompt treatment, and widespread vaccination.

Demographics Most Affected by MPOX

Interestingly, more than 99% of MPOX cases in the US outbreak have been among men who have sex with men, although MPOX is not generally considered a sexually transmitted disease. The outbreak has also disproportionately affected Black Americans and Latinos, who constitute 54% of the cases.

Conclusion

In conclusion, the US has managed to keep MPOX cases low through a community-centric approach that focusses on early detection, vaccination, and treatment. However, the fight is far from over. Continued vigilance, research, and community-focused strategies are essential to keep the numbers low and prevent future outbreaks.