‘Absolutely be concerned.’ Monkeypox cases are increasing in South Florida

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Less than eight weeks ago, the Florida Department of Health reported the first suspected case of monkeypox — a viral disease once rare in the United States.

Now, as the number of new cases of monkeypox has risen rapidly in the United States and more than 50 other countries, Florida’s case count is also rising to 73 as of Thursday, the third most common of any state, after California and New York, according to the Centers for Control and disease prevention. There were 700 confirmed U.S. cases as of Thursday, according to the CDC.

And South Florida is the epicenter of the state’s outbreak, with Miami-Dade and Broward counties accounting for more than 70% of all reported cases in Florida. Broward leads the state with 40 cases, while Miami-Dade is second with 14 cases, according to the Florida Department of Health.

“Anyone working in healthcare right now should be absolutely concerned, and we should be very aware that this is happening,” says Dr. Aileen Marty, professor of infectious diseases in the medical department at FIU Herbert Wertheim College of Medicine.

Most Floridians diagnosed with monkeypox are middle-aged, with more than 70% of cases occurring in people between the ages of 35 and 54, according to the Florida Department of Health. They typically contracted the disease in Florida, rather than coming here with the virus from elsewhere, according to the department’s disease archive.

Monkeypox can spread from person to person through contact with an infectious rash, scabs, or bodily fluids of a person infected with the virus, and the disease can also be transmitted through “respiratory secretions from prolonged, personal contact or during intimate physical contact” with a symptomatic person, according to recent CDC guidance.

Although anyone can get monkeypox, the “major population we’ve seen so far in the United States has been among men who have sex with men,” the FIU’s Marty said. “Not because it’s an STD, but because they had the kind of interactions they had with each other at big parties. This is basically a super spreader.”

More than 6,000 cases worldwide

Epidemiologists around the world are seeing the same trends. Of the more than 6,000 monkeypox cases reported in 58 countries as of Wednesday, 99 percent of the cases involved men — with the majority in men who have sex with men, the World Health Organization’s Europe chief told The Associated Press on Friday reported.

But others are also increasingly at risk: children, pregnant women, the immunocompromised and the elderly must remain particularly careful, Marty said.

Symptoms include a rash, fever, muscle pain, vomiting, and chills. No deaths were reported.

The Florida Department of Health and the CDC are urging at-risk individuals to get vaccinated and are widely distributing the CDC’s monkeypox test through commercial laboratories. To get this test, people must first see their doctor, who will collect samples and start the testing process.

READ MORE: What are the signs and symptoms of monkeypox?

Why is monkeypox dangerous?

According to the CDC, monkeypox was first noticed in 1958 in a monkey colony used for medical research. The first human case was recorded in the Democratic Republic of the Congo in 1970.

The virus belongs to a group called orthopoxviruses, which includes a number of species that can infect animals and humans, such as: B. the viruses that cause smallpox, horsepox, camelpox and cowpox.

“There are different types of people: tall, short, fat and thin […] Also, sprouts come in different flavors and different styles,” says Marty. Although more than one type of monkeypox virus circulates in the world, the predominant group is 3B.1.

Public health experts were “more than a little surprised,” Marty said, when they analyzed the “Book of Life,” or genetic sequencing, of the monkeypox strain currently spreading around the world and found that it differed greatly from previous ones Variants differ. In particular, experts found an alteration in a particular enzyme called APOBEC3 that allows the virus to mutate more quickly.

The APOBEC3 enzyme is also found in the hepatitis B virus and herpes virus, and in the HIV virus that causes AIDS.

Although scientists don’t yet fully understand how this enzyme affects the current variant of monkeypox, mutations in general allow viruses to enter human cells more easily, spread from person to person, replicate within a host, and the immune system to escape.

How is it spreading?

The monkeypox virus spreads from person to person through direct contact with infected areas, respiratory droplets and genital secretions, and even by touching objects used by infected people. Humans can also contract the virus by being bitten or scratched by an infected animal, especially rodents.

Marty said there are documented cases of healthcare workers in Europe who have contracted monkeypox after handling the sheets and towels of infected patients.

But the disease is rarely, if ever, fatal.

Luckily, “most of the cases that we’ve seen haven’t been very serious, other than the blisters it causes,” Marty said, although there have been rare cases of blindness, severe breathing problems and sepsis.

Vaccines, Tests and Treatment

There are two vaccines approved by the Food and Drug Administration to prevent monkeypox infection: JYNNEOS and ACAM2000. The former vaccine is a “very safe” vaccine that contains a virus that cannot replicate effectively in our bodies. However, the latter has a replication competent virus.

In addition to vaccines, testing protocols are being ramped up. As of yesterday, Labcorp, a company that operates one of the largest clinical laboratory networks in the world, began testing for monkeypox using the CDC’s orthopoxvirus test. This will double the current testing capacity of the CDC’s Laboratory Response Network.

“The ability of commercial laboratories to test for monkeypox is an important pillar in our overall strategy to combat this disease,” said CDC Director Dr. Rochelle Walensky in a press statement on Wednesday. “Not only will this increase testing capacity, but it will make it more convenient for providers and patients to access tests using existing provider-to-laboratory relationships.”

Although there are no treatments specifically approved for monkeypox, many antivirals developed for smallpox can also work for monkeypox. The CDC’s interim clinical guidelines for treating monkeypox suggest four different antivirals that physicians can use.

Prioritizing vaccines for the LGBTQ community

The Florida Department of Health is working with the South Florida CDC to raise awareness among the community and medical providers, said Olga Connor, director of communications and legislative affairs for the Miami-Dade office of the state Department of Health.

“It is imperative that medical providers are aware of the clinical manifestations in order to detect and treat them early. In addition, DOH-Miami-Dade has distributed educational materials to various community organizations to raise awareness,” Connor said.

The health department has also “distributed treatment and vaccines from the National Strategic Stockpile to individuals who meet criteria for treatment and vaccination, and followed CDC guidelines for monitoring individuals who have identified themselves as close contacts.”

Due to a shortage of JYNNEOS vaccine and the prevalence of monkeypox in the LGBTQ community, public health officials are prioritizing vaccinations for gay, bisexual and other men over the age of 18 who have sex with men or are transgender, nonconforming, or gender nonbinary Individuals over the age of 18 with multiple or anonymous sex partners in the past two weeks.

Nina Levine, public information officer at the Broward County office of the Department of Health, said people concerned about contracting monkeypox should contact a medical provider, adding that DOH epidemiologists are also available around the clock available for consultations with healthcare providers.

If public health authorities cannot quickly contain the monkeypox outbreak, the disease could become a long-term risk.

“We are very concerned that with so much human-to-human transmission, rodents that people have in their homes can become infected and wild rodents such as squirrels can become infected. Then it becomes endemic in our country and other countries. And then it becomes an ongoing problem that we will all face for a long time,” she said.

But the tide is rising fast against those trying to stem the spread of the monkeypox virus.

“There were 917 cases throughout the 20th century,” Marty said. “In two months we had over 7,000 confirmed cases [globally].”

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