Remember mpox, that thing that was formerly known as monkeypox and formerly led to a national public health emergency declaration last Summer? Well, just because political leaders and TV personalities haven’t been talking about mpox nearly as much as they formerly did in 2022, doesn’t mean that the mpox virus has disappeared from the U.S. Nope, quite the contrary. This brick-shaped virus that was formerly not established in the U.S. before 2002 just keeps spreading, just keeps spreading, just keeps spreading in this country. And now the Centers for Disease Control and Prevention (CDC) has just issued a new alert about mpox. That’s after the Chicago Department of Public Health (CDPH) reported what they called a “resurgence of mpox.” From April 17 through May 5, 2023, there’s been a cluster of 12 confirmed mpox cases along with one probable case in the Chicago, Illinois, area.

Although none of the folks in this cluster have been hospitalized so far, all have had accompanying mpox symptoms. The confirmed cases have consisted of nine men identified as non-Hispanic White, two men identified as non-Hispanic Black, and two men identified as of Asian-descent, ranging in age from 24 to 46 years with the median age being 34. Four of these men did report recently travel outside of Illinois to New York City, New Orleans, and Mexico. So what happened in the Chicago-area may not necessarily stay in the Chicago-area.

Before you say, “Oh, I’ve been fully vaccinated against mpox already and thus am invincible,” keep in the mind that the vaccine does not create an impenetrable force field around you against the virus. It’s not like Green Lantern’s ring or the Phoenix force. Nine of the men in this cluster had already received two doses of JYNNEOS mpox vaccine. That doesn’t mean that the mpox vaccine didn’t help them. In addition to significantly reduce your risk of catching the virus, the vaccine can reduce the severity of your symptoms even if you do end up getting infected.

All of this is a reminder that the mpox virus hasn’t gone the way of the shutter shades and wedge sneakers. It hasn’t really disappeared even though you may not hear about the virus as much these days. As Yogi Berra once said, it ain’t over ’til it’s over. And the mpox outbreak ain’t over. No one canceled it. While the number of reported mpox cases has gone down significantly since last Summer, in its alert, the CDC did warn in its alert, “the outbreak is not over.” In fact, they also warned about a possible mpox resurgence this Spring and Summer.

Yep, that’s what happens when don’t keep a virus from becoming newly established in the U.S., which is what happened in 2022. You may continue to see clusters of cases and maybe even bigger surges. Speaking of clusters, the very beginning of the mpox outbreak response last Summer was a bit of a cluster you-know-what. For anyone claiming that the U.S. response to the mpox outbreak was somehow adequate, the phrase, “I know what you didn’t do last Summer” applies here. In a July 14, 2022, Scientific American article entitled, “U.S. Monkeypox Response Has Been Woefully Inadequate, Experts Say,” Tanya Lewis described the U.S. mpox response.

And spoiler alert it wasn’t a positive account. After all, people don’t tend to say, “Your job performance has been woefully inadequate, which is why you are getting a raise,” unless, of course, you happen to know the boss really well. Lewis described the various delays and bottlenecks in mpox testing and vaccine roll-outs that were present last Summer. This left many people not knowing whether they were carrying the virus and many people very vulnerable to catching the virus for way too long.

The U.S. response has never really reached the adequate level. Since the beginning of the mpox outbreak, the U.S. end up administering approximately 1.2 million doses of the JYNNEOS mpox vaccine. That may sound like a lot. But it has meant that only 23% of those considered at risk for mpox have been fully vaccinated, according to CDC data. That’s been “mmmgreat” for the mpox virus, allowing that bricking virus to just keep spreading, just keep spreading. In its new alert, the CDC provided the following estimate, given the current situation: “risk of a resurgent mpox outbreak is greater than 35% in most jurisdictions in the United States.” They added, “Resurgent outbreaks in these communities could be as large or larger than in 2022.”

“As large or larger than in 2022” would clearly not be good. As I covered for Forbes, in 2022, the mpox outbreak led international, national, and state emergency declarations. At the height of the outbreak in August 2022, around 460 people were getting newly infected each day in the U.S. Although the number of cases per day has gradually declined since then, cases and clusters have continued to emerge. To date, the outbreak has resulted in at least 30,395 mpox cases since May 2022 in this country. That’s a whole lot more than the zero cases of mpox in the U.S. in most years prior to 2022.

The mpox virus spreads via close contact. This includes direct contact with mpox lesions or handling materials such as clothes and bedding materials that have touched mpox lesions or have otherwise been contaminated with the virus. You can also catch the mpox virus via respiratory secretions and droplets breathed out or snotted out by someone who is infected. And, yes, even though mpox is not strictly considered sexually transmitted infection, you can catch mpox via sex because close contact often is kind of a requirement for sex. It’s not common to have to yell during sex, “Hey, how’s it going over there?”

It’s not the act of sex itself that’s the only way of catching the mpox virus. You can’t say, “Oh, we just cuddled. Therefore, there’s no way I could have caught mpox from my friend.” Prior to 2022, most reported cases of mpox in various parts of the world did not seem to result from sexual contact. Unlike many humans, the mpox virus doesn’t judge people and demonstrate any biases. The virus doesn’t say, “Hmm, I’m going to infect that person because I don’t approve of that person’s backgrounds or lifestyle.” It will simply try to infect any human that it can physically reach.

Again, the big concern is that the Spring and Summer of 2023 will see resurgences of mpox in the U.S. That’s why the CDC issued this latest Health Alert Network (HAN) Health Update to tell clinicians and public health agencies around the U.S. to remain vigilant. It will be important to recognize mpox infections early, quickly isolate anyone who has been infected, and quickly quarantine anyone who may have been exposed. Practicing safe sex will be important as well. Of course, there probably won’t be a time when the CDC or other public health authorities will say, “OK, everyone go for as risky sex as possible.” And remember there are mpox vaccines for those at higher risk for mpox.

The ongoing mpox outbreak is yet another example of how not responding to an infectious disease outbreak quickly and effectively enough has left the U.S. with a problem that it will continue to pay for potentially year after year after year. It’s also yet another example of how just because political leaders and TV personalities stop talking about something doesn’t mean that it’s actually gone away.


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