Monkeypox appears to recede, but risks and uncertainties linger

Nearly four months after the first report of monkeypox in the United States, the virus is showing promising signs of retreat, easing fears that it may spill over into populations of older adults, pregnant women and young children.

Supplies of the vaccine have improved, and federal health officials have begun clinical trials to gain a better understanding of who benefits, and how much, from both the vaccine and the drug used to treat those who become infected.

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That’s the good news. But unhappily, case numbers are accelerating in a few states and jurisdictions, including Indiana, Virginia and Massachusetts. Black and Hispanic men make up nearly two-thirds of the infected, but only about one-fourth of those vaccinated so far.

“Our progress is incredibly uneven,” said David Harvey, the executive director of the National Coalition of STD Directors.

“This outbreak is far from finished,” he added.

Recent reports suggest that a single dose of the vaccine, Jynneos, may not be protective enough, raising fresh concerns about the Biden administration’s plan to distribute fractional doses.

And federal health officials have warned that the virus could become resistant to tecovirimat, the only safe treatment for those who are infected.

“When you only have one drug in your armamentarium, that can be somewhat precarious,” said Dr. Anthony Fauci, the Biden administration’s top medical adviser. “But you’ve got to go with what you have at the same time as you try and develop additional drugs.”

As of Friday, there were nearly 25,000 cases of monkeypox in all 50 states, the District of Columbia and Puerto Rico. The United States accounts for nearly 40% of the global tally.

But new cases have been decreasing steadily for weeks, to a daily average of 208 on Sept. 22 from more than 500 in early August.

The Los Angeles Department of Public Health recently confirmed the nation’s first death from monkeypox, in a severely immunocompromised individual. Health officials in Texas are investigating another death that may be related to the infection.

Overall, however, federal health officials are optimistic that the epidemic is waning. While testing and vaccines will continue to be important, officials envision a future in which monkeypox is not gone, but manageable with contact tracing, vaccination and early treatment.

This article originally appeared in The New York Times.

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