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Monkeypox

CDC echoes World Health Organization: Monkeypox? Limit sex partners

“Folks should consider reducing multiple partners and anonymous new partners as one strategy to prevent exposure to monkeypox”

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Deputy director, White House task force on monkeypox Dr. Demetre Daskalakis (Screenshot/YouTube CDC)

ATLANTA – The newly named Deputy director of the White House task force on monkeypox outlined the updated guidance CDC issued Friday regarding the need for men who have sex with men to limit their sexual partners.

Demetre Daskalakis told the Washington Blade’s Chris Johnson during a press call answering the Blade’s question about the World Health Organization’s guidance issued a week ago calling for men who have sex with men to limit sexual partners:

“It mentions that folks should consider reducing multiple partners and anonymous new partners as one strategy to prevent exposure to monkeypox,” Daskalakis said.

“So I think really, there’s a broad range, and I think one of the things that’s really important about the CDC guidance is it’s designed to really meet people where they are and see what we can do to have individuals to create their own prevention plans, understanding that there’s not one answer for preventing monkeypox, that it requires a lot of domains to really achieve the goal of preventing new infections.”

Vaccinations for monkeypox are a key component of the CDC guidance, even though the limited availability has not kept up with the growing demand for the shots as the outbreak continues. Daskalakis conceded on the call there is “supply and demand mismatch” for vaccines, but maintained the Department of Health & Human Services announcement declaring monkeypox a public health crisis would be a tool to address the shortage.

A key concern among reporters on the call was the Biden administration not emphasizing the disease is almost exclusively at this point affecting gay and bisexual men, as well as concerns about stigma and misinformation about monkeypox.

Daskalakis, drawing on his experience as a medical expert during the HIV/AIDS crisis, emphasized stigma should play no part in messaging.

“I know from my own experience in public health and personally that stigma is actually what drives so much of infection and really creates false starts and false information that really gets people to go down paths that end up really vilifying people’s lives and behavior,” Daskalakis said. “And so, coming from the experience, both professionally and personally, it is my mission, to not allow stigma to be a part of this or any response that I work on.”

The Biden Administration on Thursday officially declared monkeypox a public health emergency, a move that’s aimed at freeing up emergency funding and improving distribution of vaccines and treatments.

“We are prepared to take our response to the next level in addressing this virus, and we urge every American to take monkeypox seriously and to take responsibility to help us tackle this virus,” U.S. Health and Human Services Secretary Xavier Becerra told reporters during a Thursday news call conference briefing.

With the vaccination roll-out hampered by supply-chain issues, the CDC and other health experts are offering advice to keep the risk of exposure minimal. ABC News reported that as the number of cases continue to rise, “the most important thing you can do is know your risk level. Monkeypox is still rare and most people have a low risk. But if you are in a city where monkeypox is spreading, and in a community where it’s spreading, you are at higher risk in this current phase of the outbreak.”

Experts interviewed by ABC News provided the latest on how to stay safe. Alongside these suggestions, the experts reiterated that at this time, the risk of transmission to the general population is low. But they agreed everyone should be aware of current outbreak and take steps to reduce risk.

Be alert: Avoid close or skin-to-skin contact with those who may have the virus

Direct, close, skin-to-skin contact “is considered to be the main route of transmission, which can occur in a variety of ways. It can occur just by day-to-day contact with a case of monkeypox, in close proximity, or can occur through intimate contact, as well as during sexual contact,” said Dr. Wafaa El-Sadr, a professor of epidemiology and medicine at Columbia University.

Don’t share: Avoid sharing towels, clothing and bed linens

The virus can spread through contaminated objects including “clothing, bed sheets, towels, and other porous materials,” says Dr. Anne Rimoin, professor of epidemiology at the University of California, Los Angeles.

While this form of transmission is not nearly as common as skin-to-skin contact, it is something to keep in mind when sharing items with others.

General hygiene: Wash hands with soap and water or use an alcohol-based hand sanitizer

“Hand hygiene is the most important thing, not just for monkeypox but for any infectious disease,” says ABC News chief medical correspondent Dr. Jennifer Ashton.

Cover up: Being fully clothed may be safer, especially when encountering large crowds

To reduce the likelihood of skin-to-skin contact with someone who may be infected with the virus, wear clothing that covers your body.

The CDC says “festivals, events, and concerts where attendees are fully clothed and unlikely to share skin-to-skin contact are safer,” when compared to similar events with minimal clothing and close contact says Dr. John Brownstein, an ABC News contributor and chief innovation officer at Boston Children’s Hospital.

Disinfect: Wipe down surfaces that may be contaminated

Monkeypox is considered an orthopoxvirus, which are sensitive to many disinfectants, according to the CDC. They recommend disinfecting areas where someone with monkeypox has spent time, and for objects they may have used.

If eligible, get vaccinated: Reach out to a local health department

The CDC currently recommends that vaccines should be administered to those at risk of developing monkeypox. This includes those that have been exposed to monkeypox as well as people who are aware that one of their sexual partners in the past two weeks has been diagnosed or people with multiple sexual partners in the past two weeks living in an area with known monkeypox. People should stay up-to-date with their local health department to determine eligibility requirements.

Stay current: Be on the lookout for new information as it comes

As of Friday, August 5, The total confirmed monkeypox/orthopoxvirus cases in the United States was 7,510. The majority of cases were located:

New York1,862
California826
Florida633
Texas606
Illinois602
Georgia596
District Of Columbia283

Los Angeles County reported that its total of Monkeypox / Orthopox confirmed cases as of August 5, 2022 was 496.

Los Angeles County Public Health- Monkeypox Vaccine Eligibility Criteria for Los Angeles County:

Monkeypox vaccine is available to gay or bisexual men and transgender persons 18 years of age and older who:

  • Had multiple or anonymous sex partners in the last 14 days including engaging in survival and/or transactional sex (e.g., sex in exchange for shelter, food and other goods and needs)

Note: If you are immunocompromised (including if you have advanced or uncontrolled HIV), you may be at high risk for severe disease and will be prioritized for vaccination.

If you met the prior eligibility criteria you are still eligible for vaccination (i.e., you are a gay or bisexual man or a transgender person and you had gonorrhea or early syphilis in the past 12 months; or you are on HIV PrEP; or you had anonymous sex or sex with multiple partners within the past 21 days in a commercial sex venue or other venue).

Due to the limited number of vaccines, the pre-registration link for monkeypox vaccine has reached capacity and is currently paused. Please subscribe to our monkeypox newsletter on our monkeypox website to be notified when pre-registration may reopen. Those already registered will receive a text message from Public Health inviting them to be vaccinated over the next 1-2 days. Please do not call or show up at monkeypox vaccination clinics or public walk-up sites without a personal text message invitation from Public Health as this is required proof of verification.

If you have monkeypox symptoms or are currently under isolation for monkeypox, please do not attend the vaccination clinics or walk-up sites. If you think you have monkeypox please speak with a provider and get tested. If you do not have a provider, call 2-1-1 for assistance.

5 Things to Know about Monkeypox:

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Monkeypox

LA County Public Health expands Monkeypox vaccination eligibility

Eligible residents can go to a Public vaccinating site or visit Myturn.ca.gov to find other vaccinating sites near you

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Photo Credit: County of Los Angeles

LOS ANGELES – The Los Angeles County Department of Public Health has expanded eligibility to the monkeypox vaccine to closely align with the Centers for Disease Control and Prevention’s recent expansion, which includes persons in select occupational groups whose jobs may expose them to orthopoxviruses (such as monkeypox).

Monkeypox vaccine will be available to residents who self-attest to being in the following groups:

  • Gay, bisexual or other men who have sex with men or transgender people who have sex with men or other transgender people
  • Persons of any gender or sexual orientation who engage in commercial and/or transactional sex
  • Persons living with HIV, especially persons with uncontrolled or advanced HIV disease
  • Persons who had skin-to-skin or intimate contact with someone with suspected or confirmed monkeypox, including those who have not yet been confirmed by Public Health
  • (NEW) Sexual partners of people in any of the above groups
  • (NEW) People who anticipate being in any of the above groups

Monkeypox vaccine is also available for persons in select occupational groups whose may be exposed to orthopoxviruses including:

  • Research laboratory personnel working with orthopoxviruses
  • Clinical laboratory personnel performing diagnostic testing for orthopoxviruses
  • Designated public health response team members
  • Health care personnel who administer ACAM2000 (Smallpox [Vaccinia] Vaccine)
  • Designated health care workers who care for persons with suspected or confirmed orthopoxvirus infections, including clinicians and environmental services personnel

Note that the risk of monkeypox transmission remains very low for health care workers if appropriate personal protective equipment is worn and other infection control practices are followed.

Eligible residents can go to a Public vaccinating site or visit Myturn.ca.gov to find other vaccinating sites near you.

Residents do not need to show ID in order to get a vaccine at sites run by Public Health. However, because residents may need to show vaccination record and ID if you travel or visit certain venues, it is recommended that when getting a vaccine that residents provide the name that is on their ID.

Residents who met prior eligibility criteria can still get vaccinated (see below for prior criteria).

Gay or bisexual men or transgender people who:

  • Had multiple or anonymous sex partners in the past 14 days
  • Had skin-to-skin or intimate contact with persons at venues or events in the past 14 days
  • Had a history of early syphilis or gonorrhea in the past 12 months
  • Are on HIV pre-exposure prophylaxis (PrEP)
  • Had anonymous sex or sex with multiple partners in the past 21 days in a commercial sex venue or other venue.

Residents who have monkeypox symptoms or are currently under isolation for monkeypox, should not come to the vaccination clinics or walk-up sites. If residents think they have monkeypox, they should speak with a provider and get tested. If residents do not have a provider, residents can call the Public Health Call Center for more information on monkeypox, including general information, testing, treatment, and vaccines at (833) 540-0473 (open 7 days a week 8am – 8:30pm).

For more information, please visit: http://publichealth.lacounty.gov/monkeypox/.   

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Monkeypox

Los Angeles County Supervisors approve sick leave for monkeypox

Both coronavirus and the monkeypox outbreak has disproportionately affected essential workers, who are predominantly Black and Latino

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The Los Angeles County Board of Supervisors meeting room (Photo Credit: County of Los Angeles)

LOS ANGELES – The Los Angeles County Board of Supervisors unanimously passed a motion Tuesday, sponsored by Supervisors Hilda Solis and Sheila Kuehl, which directs County attorneys to report back to the board in three weeks on how the County could implement a paid sick leave policy for people who contract monkeypox, or other new and emerging infectious diseases.

The Board also is urging California Governor Gavin Newsom to extend the state’s coronavirus supplemental paid sick leave by signing the AB-152 COVID-19 relief leave bill.

Supervisor Solis prior to the vote pointed out that both coronavirus pandemic and the monkeypox outbreak has disproportionately affected essential workers, who are predominantly Black and Latino.

Solis further noted that without a form of paid sick leave, are in most cases, unable to take the recommended five to 10 days to isolate for COVID-19 — much less the two to four weeks needed to isolate for the duration of a monkeypox diagnosis as recommended by the Centers for Disease Control and Prevention as well as the County Dept. of Public Health .

During a monkeypox townhall hosted by the Blade in East Los Angeles last week, which was also attended by Supervisor Solis, Sherrill Brown, M.D, AltaMed’s Medical Director of Infection Prevention, in her presentation noted the need for economic relief.

In her practice treating primarily Latino monkeypox cases at AltaMed clinics in Los Angeles and Orange Counties, she told the townhall attendees she was hearing some of her patients were having difficulty with the required isolation protocols because of their economic needs.

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Monkeypox

Unvaccinated 14 times more likely to contract monkeypox

Racial disparities persist in new cases of monkeypox as Black & Latino people are overrepresented in the numbers

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White House Monkeypox Response Team and Public Health Officials (Screenshot/YouTube)

WASHINGTON – U.S. health officials are celebrating preliminary data on the vaccine used in the monkeypox outbreak, which has led them to conclude eligible persons who didn’t get a shot were 14 times more likely to become infected than those who are vaccinated.

The new data, as described by health officials on the White House monkeypox task force during a call with reporters on Wednesday, comes as the overall number of new cases of monkeypox is in sharp decline, although considerable racial disparities persist in the remaining cases as Black and Latino people are overrepresented in the numbers.

Rochelle Walensky, director of the Centers for Disease Control & Prevention, said during the conference call the preliminary data — collected from 32 states between July 2022 and September 2022 — provides an early shapshot of the effectiveness of the vaccine and cause for optimism on the path forward.

“These new data provide us with a level of cautious optimism that the vaccine is working as intended,” Walkensky said. “These early findings and similar results from studies and other countries suggest even one dose of the monkeypox vaccine offers at least some initial protection against infection.”

Walensky during the conference call admitted the data is incomplete in numerous ways. For example, the data is based on information on individuals who have obtained only the first shot as opposed to both shots in the two-shot vaccination process. (The data showing positive results from individuals who have only one shot contradicts previous warnings from the same U.S. health officials that one shot of the monkeypox vaccine was insufficient.)

The data also makes no distinction between individuals who have obtained a shot through subcutaneous injection, a more traditional approach to vaccine administration, as opposed to intradermal injection, which is a newer approach adopted in the U.S. guidance amid the early vaccine shortage. Skeptics of the new approach have said data is limited to support the idea the intradermal injection is effective, particularly among immunocompromised people with HIV who have been at higher risk of contracting monkeypox.

Not enumerated as part of the data were underlying numbers leading health officials to conclude the unvaccinated were 14 times more likely to contract monkeypox as opposed to those with a shot, as well as any limiting principle on the definition of eligible persons. Also unclear from the data is whether individual practices in sexual behavior had any role in the results.

Despite the positive data on the monkeypox vaccine based on one shot, U.S. health officials warned during the conference call the two-shot approach to vaccine administration is consistent with their guidance and more effective.

Demetre Daskalakis, the Biden administration’s face of LGBTQ outreach for monkeypox and deputy coordinator for the White House monkeypox task force, made the case that for individuals at risk obtaining a second dose is “really important.”

“So we see some response after the first [shot] in the laboratory, but the really high responses that we want to really get — that you know, level 10 forcefield as opposed to the level five forcefield — doesn’t happen until the second dose,” Daskalakis said. “So the important message is this just tells us to keep on trucking forward because we need that second dose at arms that people haven’t gotten the first should start their series of two vaccines.”

Also during the call, health officials said they would be expanding opportunities for vaccines as pre exposure prophylaxis, as opposed to practices in certain regions granting vaccines in their limited supply to individuals who meet certain criteria or have had risk of exposure.

The Centers of Disease Control & Prevention, officials said, is also updating its guidance to allow injection of the vaccines in places other than a patient’s arm.

Daskalakis said fear of stigma about getting a noticeable shot in the forearm after obtaining a monkeypox vaccine was a key part of the decision to issue the new guidance on implementation.

“Many jurisdictions and advocates have told us that some people declined vaccine to monkeypox because of the stigma associated with the visible but temporary mark often left on their forearm,” Daskalakis said. “New guidance from CDC allows people who don’t want to risk a visible mark on their forearm to offer a vaccine on their skin by their shoulder or their upper back. Those are areas more frequently covered by clothes.”

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