Monkeypox Outbreak: Weekly Update (September 19, 2022)

While health officials have “cautious optimism” about the monkeypox outbreak slowing down, the first US death due to the infection was confirmed.

As of September 14, there were 23,499 confirmed cases of monkeypox in the US. One fifth of them (4,656) were reported in California, 3,738 in New York, and 2,352 in Florida.

First death due to monkeypox

The Los Angeles Department of Public Health and the Centers for Disease Control and Prevention (CDC) confirmed the first US death due to monkeypox last week. Officials say the patient was severely immunocompromised and had been hospitalized. No additional information will be made public to protect the patient's confidentiality.

Earlier in September, another person with monkeypox died in Texas. However, it remains unclear what role monkeypox played in the death of a patient who also was severely immunocompromised.

The CDC has "cautious optimism"

The CDC director, Dr. Rochelle Walensky, said that over the last several weeks, there had been a decline in the growth of new cases in the US and abroad.

"Though there are areas in the United States where the rate of rise in new cases is still increasing. We approach this news with cautious optimism, recognizing that we must continue to aggressively respond using our entire toolkit, including vaccination, testing, and education about risk, to inform behavior change," she said while testifying before the Senate Committee on Health, Education, Labor and Pensions on Wednesday.

The World Health Organization (WHO) Director-General Dr. Tedros Adhanom Ghebreyesus also said last week that the downward trend in the monkeypox outbreak is continuing but warned that "this is not the time to relax or let down our guard."

NY state expands vaccine eligibility

On Thursday, the New York State Department of Health (NYSDOH) announced plans to distribute more than 15,000 doses of the monkeypox vaccine and expand vaccine eligibility.

In New York, the monkeypox vaccine is available for individuals with recent exposure to a suspected or confirmed monkeypox case within the past 14 days.

Those at high risk of recent exposure to monkeypox, including members of the LGBTQ community and other men who have sex with men and have engaged in intimate or skin-to-skin contact while living or visiting areas where monkeypox is spreading, are eligible for the vaccine.

According to the NYSDOH, any individual who may be at risk of future exposure to infection with monkeypox can also get vaccinated.

ACAM2000 effective against monkeypox

A new study published in the peer-reviewed journal Viruses looked at whether the genetic mutations in the monkeypox virus observed in the current outbreak (MPXV-2022) may affect immune responses induced by vaccinia virus (VACV)-based vaccines. In the US, the VACV-based vaccine ACAM2000 is licensed for immunization against smallpox disease.

Using genomic and immunological data, researchers evaluated the genetic similarities and differences between VACV and MPXV-2022, specifically within the protein regions that are targeted by vaccine-induced neutralizing antibodies or T cells.

"While we identified a small number of distinct mutations in MPXV-2022, our study more broadly demonstrates that VACV and MPXV-2022 are highly genetically similar in the regions targeted by the immune system through vaccination," said Prof. Matthew Mckay from the University of Melbourne, one of the study authors.

Authors say the study suggests vaccines should be used to combat the monkeypox outbreak globally; however, experimental studies are required to confirm their findings.