The monkeypox virus is unlikely to be eliminated from the United States anytime soon, according to a report released this week by the Centers for Disease Control and Prevention.
The CDC said in a technical letter that the outbreak is slowing as vaccine availability has increased, people have become more aware of how to avoid infection, and immunity among gay and bisexual men, the most vulnerable to the virus affected group, has probably increased.
But low-level transmission of the virus among men who have sex with other men could continue indefinitely, according to the report. The CDC said it has no guidance on how many people in total could become infected with the virus.
The Biden administration declared a public health emergency in August to ramp up vaccines, testing, treatments and outreach to eradicate the virus in the United States
The US is trying to contain the world’s largest monkeypox outbreak, with nearly 26,000 cases reported in all 50 states, Washington DC and Puerto Rico, according to CDC data. According to the data, at least two people have died from the disease in the United States.
The worldwide outbreak of monkeypox, the largest in history, is highly unusual given the widespread spread of the virus in countries where it is not normally found. Historically, monkeypox has been common in remote parts of West and Central Africa. In this context, humans usually caught the virus from animals. There was little spread between people.
Monkeypox is now widely spread among humans, mainly through close contact during sex between gay and bisexual men. The disease is rarely fatal, but patients develop blister-like lesions in sensitive areas that are extremely painful. In some cases, the pain is so severe that people have to be hospitalized, and on rare occasions, people with weakened immune systems have died.
The CDC said in its report that the virus still spreads primarily among men who have sex with men. But anyone can contract the virus through close contact with an infected person or with contaminated material. Health authorities have so far confirmed 29 cases of children who have contracted the virus, and 78 cases in children are under investigation at the end of September.
Although 96% of patients are men, 408 women in the US have contracted the virus so far. Four pregnant women and one breastfeeding woman contracted monkeypox.
The CDC said the percentage of patients who identify as gay or bisexual men has declined over time, with 75% of those who gave their sexual history reporting male-to-male contact.
However, sex history data is lacking in a large number of cases, and more than 90% of infections occur in men, according to the CDC. The drop in the percentage of cases reporting male-to-male sexual contact is likely due to a lack of data rather than a change in the spread of the virus, according to the health agency.
The CDC said the outbreak is likely to focus long-term on men who have sex with men, with infections continuing to decline in the coming weeks and expected to decline significantly over the next few months.
More than 684,000 people have received the Jynneos monkeypox vaccine so far. Earlier this week, the CDC reported preliminary data suggesting the vaccine offers at least some protection against infection. The vaccination campaign is primarily aimed at gay and bisexual men.
The outbreak could accelerate again if the virus spreads widely among the US population through heterosexual networks or contacts that do not involve sex, according to the CDC. However, according to the CDC, there is no country in the current global outbreak that has found clear evidence of continued spread of the virus outside of gay and bisexual men’s sexual networks.
The health agency also warned that if the virus establishes itself in an animal population in the United States, it could spread more quickly among humans again. The CDC said it is not known which animals in North America are most susceptible to infection.
In Africa, the virus mostly spread from animals to humans. If monkeypox becomes established in animals in the United States, it would be very difficult to eradicate.