The prevalence of monkeypox in the United States is bigger than the CDC report: Shot

On June 23, people lined up outside the New York City Department of Health and Mental Hygiene, as the city probably provides vaccines for residents who come in contact with monkeypox.

Typhoon Kaskun / Anadolu Agency via Getty Images

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Typhoon Kaskun / Anadolu Agency via Getty Images

On June 23, people lined up outside the New York City Department of Health and Mental Hygiene, as the city probably provides vaccines for residents who come in contact with monkeypox.

Typhoon Kaskun / Anadolu Agency via Getty Images

On June 13, a man in New York began to feel sick.

“She began to feel swollen lymph nodes and rectal discomfort,” said Keletso Makofen, an epidemiologist at Harvard University.

The man suspects he may have monkeypox. He is a scientist, and knowledgeable about signs and symptoms, says Macofen. So the guy goes to his doctor and asks him to test the monkeypox. The doctor, instead, decided to test the man for a common sexually transmitted disease. Those all come back negative.

“After a few days, the pain gets worse,” Makofen says. So he went to emergency care and said to test a monkeypox again. This time, the provider prescribes him antibiotics for a bacterial infection.

“The pain gets so bad, and starts to interfere with her sleep,” McAufen says. “So this past Sunday, he went to the emergency room of a large academic hospital in New York.”

At this point there is an increase inside the man’s anus, which is a symptom of monkeypox. At the hospital, he sees both an ER doctor and an infectious disease specialist. Again, the guy asks to test a monkeypox. But the expert declined the request, saying “a monkeypox test is not indicated,” Macoffen said. Instead, the doctor speculates that the man may have colon cancer.

A few days later, he developed a skin lesion – another major symptom of monkeypox.

Counting a confusing case

On the surface, the prevalence of monkeypox in the United States does not look so bad, especially compared to other countries. Since the international pandemic began in May, 201 cases of monkeypox have been recorded in the United States. In contrast, there are around 800 cases in the UK. Both Spain and Germany number more than 500.

In the United States, however, the official case count is misleading, Macofen and other scientists told NPR. The prevalence is bigger – probably much larger – than the case count suggests.

In many cases to be sure, health officials do not know how the person became infected with the virus. Those who became infected did not travel or come in contact with another infected person. This means the virus is secretly spreading to some communities and cities.

Jennifer Nujo, an epidemiologist at Brown University, said: “The fact that we can’t rebuild the transmission chain means we’re probably missing a lot of links in that chain.” “And that means there was no opportunity for these infected people to take medication to help them recover faster and not develop serious symptoms.”

“But that means they’re spreading the virus without even knowing they’re infected,” he added.

In other words: “We have no idea about the extent of the outbreak of monkeypox in the United States,” said Joseph Osmundson, a biologist at New York University. “

Why are so few cases being identified? Experimental. In many ways, the United States dropped the ball in the MonkeyPix test.

Across the country, public health agencies are conducting very few tests – very few, Osmundson said. “State officials are refusing to test people because they are using a narrow definition of monkeypox to determine who will test. They are only testing in a very limited number of cases.”

Take the man you know as Macophane. Eventually, after seeing more than four doctors, the man finally finds a worker who is trying to extend the test. The activist associates the man with a doctor who orders the test through a private company (which works to create a commercial test.) Outcome: He is positive. He has monkeypox.

McAfee says the test situation in the United States at the moment is so “undiscovered” that he started his own research called RESPND-MI in New York City to help find out the prevalence of monkeypox and share information about monkeypox with friends.

The CDC will not disclose to NPR how many tests have been performed across the country, nor will the agency say where community transmission may occur in the United States (NPR has emailed the agency more than once about these questions but the press person declined to comment or provide an interview.)

The CDC said this on Thursday New York Times, It tested 1,058 monkeypox. However, it is not clear how many of these tests are fake for the same person. And multiple sources involved with the MonkeyPix test suspect that the company has tested in many cases. A source told NPR that as of last Friday, the CDC had examined about 300 cases. At the time, about 100 of these tests were positive, giving a positive rate of over 30%.

When the first outbreak began last month, the CDC quickly helped set up tests in about 70 state and local labs across the country. Unlike Covid, the company has already created a test and is ready to send it to the lab.

“We should celebrate that previous investment,” Nujo said. “It simply came to our notice then.

An invalid test system

But as testing requirements increased – and the disease became more common than officials initially predicted – the testing system set up by the CDC stopped working well, as it actually prevented doctors from ordering a monkeypox test.

Providers need to go out of their way to order a test. They need to get permission and guidance from local or state labs, Nujo said. The process is cumbersome and often time consuming. Many times you have to sit with the doctor for hours.

“It’s really the barrier that we’re concerned about,” he says “We need to cast a wider net with our tests to find the missing infections. And it’s really hard to do if we make it harder and harder for healthcare providers to request a test on their busy days.”

Nujo said the CDC and local health departments need to remove testing barriers. “I want to make the test easier and more comprehensive so that all physicians think they can test a patient. Any patient with a suspicious rash.”

And doctors and nurses need to have a better understanding of how monkeypox actually looks to patients. It is different from medical textbooks. It can present like many other diseases including herpes, syphilis and colon cancer.

“Infections are mainly found in men who have sex with men, who can usually take care of a sexual health clinic,” Nujo explains. “These providers may now be particularly well-educated about monkeypox and more willing to send a sample for testing. But we don’t see that level of education and don’t want to test with other healthcare providers who see a variety of diseases. And that means We may miss the infection in different patient groups. “

On Thursday afternoon, the CDC announced that they were working on testing in major labs that health providers typically use. And the agency aims to make testing easier sometime in July.

But Nujo says test changes need to happen now. It needs to be easier now for doctors to submit samples to these already tested labs.

“We don’t have time here,” he says. “Every day we are late, we are losing transmission chain links and letting this outbreak grow out of control.”

And monkeypox, like Covid, could be a long-term – perhaps even permanent – problem here in the United States.

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