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“I can report that there has been a request for release of the Jynneos vaccine from the National Stockpile for some of the high-risk contacts of some of the early patients, so this is actively happening now,” Dr. Jennifer McQuiston, deputy director of the division of pathogens and pathology with serious consequences within the CDC’s National Center for Emerging and Zoonotic Infectious Diseases, said Monday.
McQuiston said the United States has a “good stockpile” of vaccines because it has been preparing for the possibility of having to use smallpox doses.
In the United States, the two-dose vaccine Jynneos is approved for the prevention of smallpox, specifically monkeypox.
“Right now we have over 1,000 cans of this available and we expect that level to increase very quickly in the coming weeks as the company makes more cans available to us,” McQuiston said.
There’s another US-approved smallpox vaccine, ACAM2000, that could be used to prevent monkeypox, she said, and the country has more than 100 million doses.
“ACAM2000 is an older generation smallpox vaccine that has some potential significant side effects. Therefore, a decision for such wide application would have to be backed by serious discussions,” said McQuiston.
Overall, “we hope to maximize distribution of the vaccine to those we know would benefit,” she said. “These are people who have been in contact with a known monkeypox patient, healthcare workers, very close personal contacts and especially those who may be at high risk of serious illness.”
The confirmed U.S. case of monkeypox involves a man in Massachusetts, and the four cases of orthopox involve men in New York, Florida and Utah, according to the CDC. Orthopox generally refers to smallpox viruses.
McQuiston said healthcare providers should assume these orthopox cases are monkeypox.
“It’s likely that more cases will be reported in the United States,” she said.
McQuiston said the CDC expects to receive samples from the four suspected cases “today or tomorrow” for further analysis. Laboratories within the CDC’s Laboratory Response Network can test for an orthopoxvirus, and then confirmation of monkeypox is done specifically at the agency through PCR testing, which takes “a couple of hours” to run, she said.
“From the time CDC receives a sample, we could probably do our monkeypox confirmatory PCR testing the same day. We’ve really seen a turnaround of a few days from when a suspected patient could bring a doctor to the attention of them and they can get those first LRN lab results,” McQuiston said.
CDC sequencing of the sample from the confirmed Massachusetts case was “very quick,” and within 48 hours the researchers were able to determine that it was very similar to that of a case in Portugal.
“This process used to take up to two weeks, but we were able to release it in two days because we believe this type of public sharing of data from early sequences will be important for all countries so that we can all better understand.” how the virus is spreading around the world,” McQuiston said.
Monkeypox isn’t transmitted through sex itself, but it can be transmitted through contact during sex, said Dr. John Brooks, CDC’s Chief Medical Officer for HIV Prevention.
“Monkeypox is not a sexually transmitted infection in the typical sense, but it can be transmitted through sexual and intimate content, as well as through personal contact and shared bedding and clothing,” Brooks said Monday.
“Some groups may currently have a greater chance of exposure to monkeypox, but the current risk of exposure to monkeypox is by no means exclusive to the gay and bisexual community in the United States,” Brooks said. “Everyone, everyone can develop [and] spread monkeypox, but…many of those affected in the current global outbreak identified as gay and bisexual men.”
Brooks said the CDC decided to hold a press briefing about the outbreak now because LGBTQ pride month typically begins around Memorial Day weekend and officials wanted to make sure the community was aware of the situation. He also urged doctors to be on the lookout for the disease, as it can look like other types of STDs.
He said the rash “shows up on different parts of the body than we would normally expect.”
“In some cases it has resulted in anal or genital lesions that look like other diseases like herpes, chickenpox or syphilis. So anyone who has a rash or lesion around or on their genitals, their anus, or anywhere else they have never seen before should be fully evaluated, both for that rash, but especially for sexually transmitted infections and other diseases , which can cause skin rashes,” he said.
“What we’re trying to do in drawing attention to the fact that some of these cases had genital and perianal presentation is just to remind people that people can come to an assessment of what they think of as a sexual communicable disease, but we’d like the vendor to think, “Could it also be monkeypox?” if the circumstances fit the story.”
