A Northwell Health staff member holds the monkeypox vaccine, at Cherry Grove in Fire Island, New York, where monkeypox vaccines were administered on July 14, 2022.
James Carbon | News | Getty Images
The Biden administration is considering declaring a public health emergency in response to the growing smallpox outbreak, a senior White House health official said Friday.
Dr. Ashish Jha, the White House’s Covid response coordinator, said the administration is considering how a public health emergency declaration could strengthen the U.S. response to the outbreak.
“There is no final decision on this that I am aware of,” Jha said. “It’s an ongoing conversation, but a very active one at HHS.”
The Secretary of Health and Human Services, Xavier Becerra, has the authority to declare a public health emergency in accordance with the Public Health Services Act. A declaration can help mobilize federal financial assistance to respond to a disease outbreak.
According to the Centers for Disease Control and Prevention, the United States has so far reported more than 2,500 cases of smallpox in 44 states, Washington, DC and Puerto Rico. The largest outbreaks are in New York, California, Illinois, Florida, DC and Georgia.
The Biden administration’s response to the outbreak has come under scrutiny from Congress as infections rise. Fifty House Democrats, in a letter to President Joe Biden this week, called on the administration to declare a public health emergency in response to the outbreak.
Senate Health Committee Chairwoman Patty Murray, in a letter to HHS Secretary Becerra, said she is concerned about the U.S. response to the outbreak. Murray said some patients and health care providers lack the information and resources to test for monkeypox and respond to the outbreak.
CDC Director Rochelle Walensky said last week that the demand for vaccines is outstripping the available supply. Many people are struggling to get vaccinated amid long queues outside clinics.
The United States has so far sent more than 300,000 doses of the monkeypox vaccine, called Jynneos, to city and state health departments, Jha told reporters Friday. The Food and Drug Administration is in the process of authorizing an additional 786,000 doses stored at manufacturer Bavarian Nordic’s facility in Denmark for distribution in the U.S.
Jha said some of these shots have started shipping and will arrive in the US this week and next week. The doses can be delivered to city and state health departments once FDA clearance is complete, Jha said. The U.S. has also ordered 5 million more doses to be delivered through mid-2023, according to HHS.
Monkey pox is spread primarily through skin-to-skin contact during sex. Right now, men who have sex with men are at the highest risk of infection, but anyone can get the virus through close physical contact. People usually recover within two to four weeks, but the virus causes lesions that can be very painful. No deaths have been reported in the US
The CDC confirmed the first two cases of smallpox in children on Friday. One case is a toddler in California and the other is a non-US resident infant. According to the CDC, the cases are unrelated and the children likely caught the virus through transmission within their home.
The children are in good health and are receiving the antiviral treatment tecovirimate, according to the CDC. CDC official Dr. Jennifer McQuiston told reporters Friday that the health agency is working to make it easier for doctors to prescribe tecovirimate to patients.
Prescribing tecovirimat for monkeypox comes with an extra layer of red tape right now because it’s only FDA-approved for smallpox. Monkeypox belongs to the same family of viruses as smallpox, but causes a milder illness.
McQuiston said more than 97 percent of monkeypox patients who provide demographic information are gay, bisexual or other men who have sex with men.
“While this outbreak is spreading on a particular social network at this time, I think we sent a message early on that there could be cases that occur outside of those networks and that we need to be vigilant and prepared to respond and send messages to it,” McQuiston told reporters.
According to the CDC, the United States has the capacity to conduct 80,000 smallpox tests a week after bringing in several commercial laboratories this month. But the tests pick up lesions caused by the virus, which can take weeks to develop from initial exposure. That means the U.S. likely doesn’t have an accurate picture of how many people are infected because patients can only be tested once symptoms develop.
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