2022–2024 mpox outbreakin the United States | |
---|---|
Disease | Mpox |
Virus strain | Monkeypox virus (West African clade) |
Location | United States |
Index case | Boston, Massachusetts [1] |
Arrival date | May 17, 2022 (2 years, 4 months, 3 weeks and 6 days ago) |
Date | as of August 31, 2024 |
Confirmed cases | 33,590 [2] |
Deaths | 60 [2] |
Government website | |
www |
The 2022–2023 mpox outbreak in the United States was part of the larger outbreak of human mpox caused by the West African clade of the monkeypox virus. The United States was the fourth country outside of the African countries with endemic mpox to experience an outbreak in 2022. The first case was documented in Boston, Massachusetts, on May 17, 2022. [3] As of August 2022, mpox had spread to all 50 states in the United States, as well as Washington, D.C., and Puerto Rico. [4] The United States had the highest number of mpox cases in the world during the outbreak. [5] California had the highest number of mpox cases in the United States.
On August 4, 2022, the U.S. Centers for Disease Control and Prevention declared mpox a public health emergency in the United States. [6] Wyoming was the last state in the United States to report at least one mpox case. On August 30, 2022, the first mpox death in the United States was reported. [7]
Mpox ( /ˈɛmpɒks/ , EM-poks; formerly known as monkeypox) [8] is an infectious viral disease that can occur in humans and other animals. Symptoms include a rash that forms blisters and then crusts over, fever, and swollen lymph nodes. The illness is usually mild, and most infected individuals recover within a few weeks without treatment. The time from exposure to the onset of symptoms ranges from three to seventeen days, and symptoms typically last from two to four weeks. However, cases may be severe, especially in children, pregnant women, or people with suppressed immune systems. [9] [10] [11]
The disease is caused by the monkeypox virus, a zoonotic virus in the genus Orthopoxvirus . The variola virus, which causes smallpox, is also in this genus. [12] Human-to-human transmission can occur through direct contact with infected skin or body fluids, including sexual contact. [12] People remain infectious from the onset of symptoms until all the lesions have scabbed and healed. [9] The virus may spread from infected animals through handling infected meat or via bites or scratches. [9] Diagnosis can be confirmed by polymerase chain reaction (PCR) testing a lesion for the virus's DNA. [12]An ongoing outbreak of mpox was confirmed on May 6, 2022, beginning with a British resident who, after travelling to Nigeria (where the disease is endemic), presented symptoms consistent with mpox on April 29, 2022. The resident returned to the United Kingdom on May 4, creating the country's index case of the outbreak. [13] The origin of several of the cases of mpox in the United Kingdom is unknown. Some monitors saw community transmission taking place in the London area as of mid-May, [14] but it has been suggested that cases were already spreading in Europe in the previous months. [15]
A large portion of those infected were believed to have not recently traveled to areas of Africa where mpox is normally found, such as Nigeria, the Democratic Republic of the Congo as well as central and western Africa. It is believed to be transmitted by close contact with sick people, with extra caution for those individuals with lesions on their skin or genitals, along with their bedding and clothing. The CDC has also stated that individuals should avoid contact and consumption of dead animals such as rats, squirrels, monkeys, and apes along with wild game or lotions derived from animals in Africa. [16]
In addition to more common symptoms, such as fever, headache, swollen lymph nodes, and rashes or lesions, some patients have also experienced proctitis, an inflammation of the rectum lining. CDC has also warned clinicians to not rule out mpox in patients with sexually transmitted infections since there have been reports of co-infections with syphilis, gonorrhea, chlamydia, and herpes. [17]
The CDC has stated that, among mpox cases with available data, 99% occurred in men, 94% of whom reported recent male-to-male sexual or close intimate contact. [18]
This section needs to be updated.(September 2022) |
The 2022–2023 mpox outbreak in California. As of July 2022, the virus has infected 4,886 people in the U.S. state of California, with 1 death. The state has the highest number of recorded cases in the country. [19]
Florida currently has 2,444 people infected by the virus, with no deaths. It started on May 23, 2022, in Fort Lauderdale and quickly started spreading across the State. [20] [21]
The 2022–2023 mpox outbreak in New York currently has no deaths. This state has the second highest number of recorded cases in the country with 3,679 cases. [22]
In New York the outbreak began on June 10, 2022, with the first mpox case recorded in Ithaca. [22] On July 29, Governor Kathy Hochul declared a public state disaster emergency in New York State. [23] New York is currently the state with the highest recorded number of cases in the US. [22]
The World Health Organization in New York reports its first mpox case outside New York City on June 7. [24]
On July 13, New York becomes the epicenter of the outbreak. With 489 cases only behind California with 266 cases. [25]
On July 27, New York reaches 1,228 cases, with an increase of 739 cases in only 14 days. [26]
On August 1, Mayor Eric Adams declares a state of emergency over the mpox outbreak. [27]
County | Cases | Change [lower-alpha 1] |
---|---|---|
Albany | 3 | (+0) |
Broome | 1 | (+0) |
Chemung | 1 | (+0) |
Columbia | 1 | (+0) |
Dutchess | 5 | (+0) |
Erie | 5 | (+0) |
Greene | 1 | (+0) |
Monroe | 7 | (+0) |
Nassau | 14 | (+0) |
Niagara | 1 | (+0) |
Orange | 6 | (+0) |
Rockland | 4 | (+0) |
St. Lawrence | 1 | (+0) |
Suffolk | 25 | (+0) |
Sullivan | 2 | (+0) |
Tompkins | 2 | (+0) |
Westchester | 50 | (+0) |
New York City | 1,831 | (+0) |
Total cases | 1,960 | (+0) |
As of August 8,2022 [update] at 2:00 pm Eastern Time |
The first known case was detected on May 18, 2022, in a man from Boston, Massachusetts, who had traveled to Canada, where a case of the virus was reported the following day. [29] [30] The person was hospitalized in Boston. [31] There, he tested positive for mpox, becoming the first case in the United States. [29]
Two days after the man tested positive for the virus, other states began reporting cases, with New York reporting its first case on May 21. [32] On May 22, President Biden gave a speech at Osan Air Base in South Korea during which he indicated the disease was "something that everybody should be concerned about". [33] On May 26, Virginia reported its first case in a woman who had traveled to Africa, [34] followed by California and Hawaii on June 4, 2022. [35] [36] As of June 3, the United States had 21 confirmed cases, [37] a number which had risen to 460 as of July 1. [38]
On May 23, 2022, Florida reported a case of mpox. On the same day, the Tampa Bay Times reported that the Florida Department of Health had announced the case on a man that had been isolated since the day before. [20] WESH later on also confirmed the case, which was in Broward County. [39] The following day, WESH reported another mpox case as being "investigated". [40] The case was then confirmed to be in the same county as the first case, adding up the total in the county to two. Later, a third case was also investigated, this time being reported by CBS Miami to also be in the same county as the first and second case. [41] This case added up the total in the United States to 18. A fourth case was reported by the Sun-Sentinel , although the state of Florida did not disclose the county where it was detected. [42]
In early June 2022, a man in Washington, D.C., was reported to test positive for orthopox, potentially mpox. [43]
On July 26, 2022, the United States had more mpox cases than any other country. [44] At the end of August 2022, there were early signs that the mpox spread in the U.S. may be slowing. [45]
Graphs are unavailable due to technical issues. There is more info on Phabricator and on MediaWiki.org. |
Ref:
Graphs are unavailable due to technical issues. There is more info on Phabricator and on MediaWiki.org. |
Data sourced from the CDC [46]
State | Cases | Change [lower-alpha 2] |
---|---|---|
Alabama | 186 | (+74) |
Alaska | 5 | — |
Arizona | 580 | (+134) |
Arkansas | 72 | (+16) |
California | 5,670 | (+784) |
Colorado | 407 | (+144) |
Connecticut | 144 | (+20) |
Delaware | 43 | (+7) |
District of Columbia | 525 | (+31) |
Florida | 2,855 | (+411) |
Georgia | 1,984 | (+248) |
Hawaii | 35 | (+8) |
Idaho | 16 | (+4) |
Illinois | 1,422 | (+152) |
Indiana | 285 | (+62) |
Iowa | 29 | (+4) |
Kansas | 47 | (+38) |
Kentucky | 97 | (+46) |
Louisiana | 306 | (+63) |
Maine | 13 | (+4) |
Maryland | 739 | (+103) |
Massachusetts | 456 | (+75) |
Michigan | 395 | (+138) |
Minnesota | 234 | (+52) |
Mississippi | 108 | (+35) |
Missouri | 209 | (+101) |
Montana | 7 | (+2) |
Nebraska | 31 | (+3) |
Nevada | 319 | (+101) |
New Hampshire | 33 | (+4) |
New Jersey | 764 | (+81) |
New Mexico | 57 | (+17) |
New York | 4,203 | (+361) |
North Carolina | 728 | (+216) |
North Dakota | 6 | — |
Ohio | 263 | (+128) |
Oklahoma | 68 | (+32) |
Oregon | 270 | (+65) |
Pennsylvania | 864 | (+128) |
Puerto Rico | 198 | (+28) |
Rhode Island | 84 | (+11) |
South Carolina | 226 | (+70) |
South Dakota | 3 | (+1) |
Tennessee | 392 | (+119) |
Texas | 2,882 | (+657) |
Utah | 194 | (+45) |
Vermont | 3 | — |
Virginia | 564 | (+112) |
Washington | 658 | (+75) |
West Virginia | 12 | (+1) |
Wisconsin | 87 | (+18) |
Wyoming | 4 | (+2) |
Total cases | 29782 | (+4,936) |
As of January 4, 2023 at 2:00 pm EDT |
Date | States |
---|---|
May 18, 2022 | Massachusetts [47] |
May 21, 2022 | New York [48] |
May 23, 2022 | Florida [49] |
May 25, 2022 | Utah [50] |
May 26, 2022 | Virginia [51] • Colorado [52] |
May 27, 2022 | Washington [53] • California [54] |
June 2, 2022 | Pennsylvania [55] • Illinois [56] |
June 3, 2022 | Hawaii [57] |
June 5, 2022 | District of Columbia [58] |
June 6, 2022 | Georgia [59] |
June 7, 2022 | Texas [60] |
June 9, 2022 | Rhode Island [61] |
June 14, 2022 | Ohio [62] • Oklahoma [63] |
June 15, 2022 | Nevada [64] |
June 16, 2022 | Maryland [65] • Oregon [66] |
June 18, 2022 | Indiana [67] |
June 20, 2022 | New Jersey [68] |
June 22, 2022 | Missouri [69] |
June 23, 2022 | North Carolina [70] |
June 24, 2022 | Kentucky [71] |
June 17, 2022 | Nebraska [72] • Minnesota [73] |
June 29, 2022 | New Hampshire [74] • Michigan [75] |
June 30, 2022 | Wisconsin [76] |
July 1, 2022 | Iowa [77] |
July 5, 2022 | Connecticut [78] |
July 6, 2022 | Arkansas [79] • Idaho [80] |
July 7, 2022 | Louisiana [81] • Tennessee [82] |
July 8, 2022 | South Carolina [83] • West Virginia [84] |
July 9, 2022 | Kansas [85] |
July 11, 2022 | New Mexico [86] |
July 12, 2022 | Delaware [87] • Arizona [88] |
July 14, 2022 | South Dakota [89] |
July 15, 2022 | Alabama [90] |
July 20, 2022 | North Dakota [91] |
July 22, 2022 | Maine [92] |
July 25, 2022 | Mississippi [93] |
July 29, 2022 | Alaska [94] • Vermont [95] |
August 5, 2022 | Montana [96] |
August 22, 2022 | Wyoming [97] |
As of May 8, 2023 there have been 42 mpox-related deaths reported in the US. [46]
Date | States |
---|---|
August 30, 2022 | Texas [98] |
September 13, 2022 | California [99] |
On May 19, 2022, Bavarian Nordic announced that BARDA, part of the Department of Health and Human Services (HHS), exercised a $119 million option, under a $299 million contract, to supply a freeze-dried version of JYNNEOS vaccine, converting existing bulk vaccine. [100] The United States spent $119 million to purchase doses of the Modified vaccinia Ankara-based two-shot [101] Jynneos vaccine from Bavarian Nordic in May 2022. [102] The contract also allows the United States to purchase an additional $180 million worth of the vaccine at a later date. [103] The vaccine, JYNNEOS (also known by the brand names Imvamune and Imvanex), was approved by FDA in 2019 to prevent both smallpox and mpox. As of June 14, the United States had around 70,000 doses of JYNNEOS in its stockpile, and the federal government placed an order for 500,000 more on June 10, 2022. Dawn O'Connell, assistant secretary for preparedness and response at Department of Health and Human Services (HHS), said around 300,000 doses would be delivered in June–July 2022, and the remainder would be delivered later in that year. [17] [104]
In addition, the Strategic National Stockpile (SNS) holds over 100 million doses of an older smallpox vaccine (ACAM2000). [105]
As of June 28, the Biden administration was allocating tens of thousands of vaccine doses from the Strategic National Stockpile to clinics nation-wide. [106] [107] The rollout of vaccines and testing was criticized as too slow, as well as for having similar problems to the rollout of vaccines and tests during the COVID-19 pandemic in the United States. [108]
The United States government's response is coordinated by the National Security Council Directorate on Global Health Security and Biodefense – more commonly known as the White House Pandemic Office – in collaboration with the Department of Health and Human Services (HHS). The White House Pandemic Office had previously reinstated Dr. Beth Cameron to the executive position. [109] [110] The HHS is overseen by Secretary of Health and Human Services Xavier Becerra.
As of June 29, HHS has received requests from 32 states and jurisdictions, deploying over 9,000 doses of JYNNEOS vaccine and 300 courses of ST-246 (tecovirimat) [111] [112] antiviral smallpox treatments. [113] The United States expanded deployment of JYNNEOS vaccines, allocating 296,000 [114] [115] doses over the coming weeks, 56,000 of which will be allocated immediately. Over the coming months a combined 2.5 million [116] [117] [101] additional doses will become available. [118] As of November 2022, New York state ended its state of emergency, mobile mass vaccination sites set up since summer in New York city closed, but vaccinations were moved to outpatient and sexual health clinics. [119]
Hospitals have begun making their own preparations to help control the current mpox outbreak, including screening patients, increasing decontamination and cleaning procedures, [120] [121] [122] and wearing appropriate safety gear [123] [124] when interacting with infected patients.
Mpox is an infectious viral disease that can occur in humans and other animals. Symptoms include a rash that forms blisters and then crusts over, fever, and swollen lymph nodes. The illness is usually mild, and most infected individuals recover within a few weeks without treatment. The time from exposure to the onset of symptoms ranges from three to seventeen days, and symptoms typically last from two to four weeks. However, cases may be severe, especially in children, pregnant women, or people with suppressed immune systems.
Modified vaccinia Ankara (MVA) is an attenuated (weakened) strain of the vaccinia virus. It is being used as a vaccine against smallpox and mpox, having fewer side effects than smallpox vaccines derived from other poxviruses.
The monkeypox virus is a species of double-stranded DNA virus that causes mpox disease in humans and other mammals. It is a zoonotic virus belonging to the Orthopoxvirus genus, making it closely related to the variola, cowpox, and vaccinia viruses. MPV is oval, with a lipoprotein outer membrane. The genome is approximately 190 kb. Smallpox and monkeypox viruses are both orthopoxviruses, and the smallpox vaccine is effective against mpox if given within 3–5 years before the disease is contracted. Symptoms of mpox in humans include a rash that forms blisters and then crusts over, fever, and swollen lymph nodes. The virus is transmissible between animals and humans by direct contact to the lesions or bodily fluids. The virus was given the name monkeypox virus after being isolated from monkeys, but most of the carriers of this virus are smaller mammals.
In May 2022, the World Health Organization (WHO) made an emergency announcement of the existence of a multi-country outbreak of mpox, a viral disease then commonly known as "monkeypox". The initial cluster of cases was found in the United Kingdom, where the first case was detected in London on 6 May 2022 in a patient with a recent travel history from Nigeria where the disease has been endemic. On 16 May, the UK Health Security Agency (UKHSA) confirmed four new cases with no link to travel to a country where mpox is endemic. Subsequently, cases have been reported from many countries and regions. The outbreak marked the first time mpox had spread widely outside Central and West Africa. The disease had been circulating and evolving in human hosts over several years before the outbreak and was caused by the clade IIb variant of the virus.
The 2022–2023 mpox outbreak in the United Kingdom is part of the larger outbreak of human mpox caused by the West African clade (type) of the monkeypox virus. The United Kingdom was the first country, outside of the endemic African areas, to experience an outbreak. As of 22 July 2022, there were 2,208 confirmed cases in the United Kingdom, with 2,115 in England, 54 in Scotland, 24 in Wales, and 15 in Northern Ireland.
The 2022–2023 mpox outbreak in Canada is a part of the outbreak of human mpox caused by the West African clade of the monkeypox virus. The outbreak started in Canada on May 19, 2022, with the country since then becoming one of the most affected in the Americas.
The 2022–2023 mpox outbreak in Belgium is part of the larger outbreak of human mpox caused by the West African clade of the monkeypox virus. Belgium was the fifth country, outside of the African countries with endemic mpox, to experience an outbreak in 2022. The first case was documented in Antwerp, Belgium, on 19 May 2022. As of 10 August, Belgium has 546 cases and 1 suspected case.
The 2022–2023 mpox outbreak in Australia is a part of the outbreak of human mpox caused by the West African clade of the monkeypox virus. The outbreak reached Australia on 20 May 2022. By 28 October 2022 there were over 140 confirmed cases. The Chief Medical Officer of Australia stood down the country's Communicable Disease Incident of National Significance declaration on 25 November 2022.
The 2022–2023 mpox outbreak in Israel is a part of the ongoing outbreak of human mpox caused by the West African clade of the monkeypox virus. The outbreak was first reported in Israel on 20 May 2022 when the Health Ministry announced a suspected case which was confirmed on 21 May 2022. One month later, on 21 June, the first locally transmitted case was reported.
The 2022–2023 mpox outbreak in Germany is part of an ongoing global outbreak of human mpox caused by the West African clade of the monkeypox virus. At the beginning of September 2022, Spain, France, Germany and the United Kingdom are the countries with most cumulative cases in Europe.
The 2022–2023 mpox outbreak in Switzerland is a part of the outbreak of human mpox caused by the West African clade of the monkeypox virus. The outbreak started in Switzerland on 19 May 2022, with the country since then becoming one of the most affected in Europe.
This article documents the chronology and epidemiology of the 2022–2023 mpox outbreak.
The 2022–2023 mpox outbreak in Brazil is a part of the ongoing outbreak of human mpox caused by the West African clade of the monkeypox virus. The outbreak was first reported in Brazil on 9 June 2022 when a man in São Paulo was registered as the country's index case.
The 2022–2023 mpox outbreak in India is a part of the ongoing outbreak of human mpox caused by the West African clade of the monkeypox virus. The outbreak was first reported in India on 14 July 2022 when Kerala's State Health Minister Veena George announced a suspected imported case which was confirmed hours later by the NIV. India was the tenth country to report a mpox case in Asia and the first in South Asia. Currently, India has reported more than 30 cases of mpox.
The 2022–2023 mpox outbreak in Spain is a part of the outbreak of human mpox caused by the West African clade of the monkeypox virus. Spain was the second country outside the African countries with endemic mpox, to experience an outbreak in 2022. The outbreak was first reported in Spain on 18 May 2022.
The 2022 mpox outbreak in Asia is a part of the ongoing outbreak of human mpox caused by the West African clade of the monkeypox virus. The outbreak was reported in Asia on 20 May 2022 when Israel reported a suspected case of mpox, which was confirmed on 21 May. As of 10 August 2022, seven West Asian, three Southeast Asian, three East Asian and one South Asian country, along with Russia, have reported confirmed cases.
The 2022–2023 mpox outbreak in Taiwan is a part of the larger outbreak of human mpox caused by the West African clade of the monkeypox virus. According to the Centers for Disease Control, Taiwan's first mpox case was reported on 24 June 2022.
The 2022–2023 mpox outbreak in North America is a part of the outbreak of human mpox caused by the West African clade of the monkeypox virus. The outbreak reached North America on 18 May 2022, when the United States reported their first case of mpox. As of 23 August 2022, 20 North American countries and territories have confirmed cases.
An epidemic of a new variant of clade I mpox, called clade 1b, began in Central Africa at least as early as September 2023. As of September 2024, more than 29,000 cases have been reported, with over 800 fatalities, nearly all in the Democratic Republic of the Congo. According to the European CDC: "The size of these outbreaks could be larger than reported due to under-ascertainment and under-reporting."
The 2022–2024 mpox outbreak in New Zealand is a part of the outbreak of human mpox caused by the West African clade of the monkeypox virus. The outbreak reached New Zealand on 9 July 2022. By 15 August 2024, there had been 53 local cases of confirmed mpox in New Zealand since July 2022; with four occurring in Auckland in 2024. In mid-September 2024, a local outbreak linked to the Queenstown Winter Pride festival in late August 2024 had been reported.
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: CS1 maint: bot: original URL status unknown (link)Filling capacity is being expanded with a U.S. based contract manufacturer who will fill the vaccines using existing bulk vaccine from previous orders from BARDA Tech transfer to the contract manufacturer and manufacturing planned for 2022