Nicolle Baird, a fellow at the federal Centers for Disease Control and Prevention, is conducting real-time polymerase chain reaction analysis in a Ghana laboratory in 2022 to gain a better understanding of mpox. With an increase in mpox cases in several states compared to last year, U.S. public health officials are strongly recommending vaccination for those at risk. The number of mpox cases in the United States has more than doubled compared to last year, prompting the CDC to urge clinicians across states to encourage vaccinations for high-risk individuals. According to the CDC, as of May 25, there has been a roughly 150% increase in mpox cases, rising from 434 cases at the same time last year to 1,089 cases this year. Approximately one-third of these cases are in New York state, New York City (which the CDC reports separately), New Jersey, and Pennsylvania.
During the 2022 U.S. outbreak, the viral disease mpox primarily affected men in gay and bisexual communities, although anyone can contract it. Mpox can cause a rash, severe pain that may require hospitalization, and in rare cases, death, particularly in patients with other complications. It is important to note that mpox is not a sexually transmitted infection, but it can be transmitted through skin-to-skin contact, respiratory droplets, or contact with bodily fluids.
As June is Pride Month, public health experts are expressing concerns about a potential increase in mpox cases this summer due to large celebrations and gatherings. To address this, experts are emphasizing the importance of vaccination outreach, especially targeting Black and Hispanic LGBTQ+ individuals. These communities are less likely to be vaccinated and may face additional barriers to accessing healthcare.
The Jynneos vaccine is recommended for those at highest risk for mpox, such as men who have sex with men and individuals with advanced HIV. It is administered in two doses, with a four-week interval, to prevent infection. The CDC has emphasized the importance of vaccinating these high-risk groups to avoid a resurgence of the disease. Dr. Richard Silvera, an infectious diseases expert, has expressed concern about the rising mpox rates, although they are currently lower than in 2022. He predicts an increase in cases, especially during Pride Month.
In New York City, the number of cases has increased significantly compared to last year. Experts believe that one possible reason for this surge is that some patients have not received their second vaccine doses. This could mean that their immunity is decreasing or that they did not complete their vaccination. The New York City Department of Health and Mental Hygiene released an advisory stating that out of the 256 diagnoses between October 2023 and April 15, 73% were among unvaccinated individuals or those who had only received one dose. Additionally, there is a significant overlap between these cases and individuals from BIPOC communities, those living with HIV, and those identifying as LGBTQ+.
We have increased our regular outreach efforts in the past few months, recognizing the importance of the upcoming summer period. Our goal is to ensure that the necessary messaging and services reach the communities in need.
The World Health Organization decided to rename mpox in 2022 due to the association of racist language with its former name. Additionally, public health experts were worried that the previous name was contributing to stigma surrounding the disease, potentially discouraging people from getting tested and vaccinated.
Despite the rising number of tuberculosis cases, public health agencies are facing resource limitations that hinder their ability to adequately respond.
According to recent reports, the CDC has issued a warning about a more dangerous strain of mpox that is causing devastation in the Democratic Republic of Congo. While this particular strain has not been detected in the United States, the CDC and healthcare professionals are remaining vigilant for any potential cases in travelers from the affected country.
Dr. Anu Hazra, an infectious disease physician, emphasized the importance of monitoring this strain closely. He believes that the key to eradicating mpox is ensuring that vaccines are accessible to all affected areas worldwide. Dr. Hazra works at Howard Brown Health, which operates multiple clinics in the Chicago area that specialize in LGBTQ+ care.
It is worth noting that individuals with HIV are at a higher risk of contracting mpox, and these individuals are often disproportionately Black and Hispanic. Factors such as racism, homophobia, poverty, and limited access to healthcare and transportation further complicate efforts to prevent and treat the illness.
Hazra, a medical expert, highlighted the correlation between communicable diseases and racial and economic disparities. This pattern has been observed with diseases like HIV, COVID, and certain STIs, as well as mpox.
Silvera, a medical professional from the Icahn School of Medicine, emphasized the importance of acknowledging the historical distrust of medicine among Black and Hispanic communities. Undoing this deep-rooted mistrust requires significant time and effort, as it involves undoing decades and even centuries of damage.
In addition to distrust and vaccine skepticism, the fear of being exposed as gay poses a significant barrier in some Black communities. Ryan Payne, a prevention specialist at the Alliance of AIDS Services-Carolina, noted that this fear hinders access to healthcare and prevention services in these communities, which the organization serves across six counties in North Carolina.
“That is an undeniable truth. It is a very difficult situation. My co-workers and I discuss this issue frequently,” Payne stated.
According to the North Carolina Department of Health and Human Services, out of the 51 cases reported in the past six months, 30 were among Black individuals. However, only 27% of the vaccinated patients in the state this year were Black.
In Pennsylvania, there have been 64 reported cases of mpox, compared to only two cases at the same time last year, as reported by the CDC. The state’s health department plans to prioritize the importance of vaccinations throughout 2024. They will launch an awareness campaign targeting at-risk populations through social media and dating apps.
Cory Haag, a registered nurse at the Central Outreach Wellness Center in Pittsburgh, emphasized that addressing barriers, educating patients, and alleviating fears within the LGBTQ+ community are crucial in containing the spread of the disease.
The center offers care to patients who travel for long hours, sometimes up to two, to reach there. To ensure their convenience in returning for a second vaccine dose, the center provides bus passes. Haag expressed their satisfaction in being a secure place for patients to rely on.