Mpox Cases Could Surge through the Summer

Clinicians should be on the lookout for new cases of mpox through the summer due to a potential surge in cases, according an article published in JAMA.

With summer festivals in full swing, Pride month during June, and other large events happening as the summer continues, public health officials have warned that there could be a surge of mpox cases, explained Preeti N. Malani, MD, MSJ, the deputy editor of JAMA. Additionally, during summer months there could be a greater risk for skin-to-skin contact.

To illustrate the point, Malani cited a CDC press briefing that noted during a recent 3-week period in Chicago, there was 1 probable case and 12 confirmed cases. By mid-May, the case number had risen to 21. Most of these cases occurred in men who identify as gay or bisexual.

Interestingly, most of these cases also occurred among those who have had one or both vaccine doses.

“Vaccination makes getting and spreading mpox less likely and may decrease the chances of severe illness, hospitalization, and death,” deputy director of the White House national mpox response Demetre Daskalakis, MD, MPH, noted in the press briefing.

Daskalakis added that vaccination modeling demonstrated that higher vaccination rates lead to lower risk for an outbreak. The more immunity the community has, the lower the chance for any outbreaks, too.

“My charge to those in the LGBTQ+ community who have not been fully vaccinated—now is the time,” Daskalakis urged. “And get your second dose if you haven’t. Seek health care and get tested if you have a rash even if you have been previously vaccinated or had mpox. We need to be ready to use all the tools in the mpox prevention toolkit, including vaccine, testing, and information so that people can make informed decisions about their sex lives to halt the spread and protect their health and the health of the community.”

Clinicians are reminded to consider mpox and not only chicken pox or other sexually transmitted diseases when a patient presents with a rash, especially if the patient identifies as gay, bisexual, transgender, or a man who has sex with men. This is true even if the patient has been vaccination or previously infected, Malani added.

Most patients have mild mpox disease and can be treated with supportive care and symptom management, Malani explained, with antivirals generally being reserved for those who are hospitalized or at risk for complications. Some patients, like those with advanced or untreated HIV infection, can develop severe or potentially fatal disease. These patients can receive the antiviral TPOXX through clinical trials or emergency use access.

Mpox is still a global health emergency, despite efforts to prevent outbreaks this summer in the U.S. In African nations, such as the Democratic Republic of Congo and Nigeria, can only access the postexposure vaccine through clinical trials.

Daskalakis stressed that there is no difference in effectiveness between the subcutaneous and intradermal vaccines.

“There’s specifically no indication for folks if they’ve gotten two doses of vaccine at this time to get any additional doses,” she continued in the briefing. “I think we’re really learning more about Chicago and making sure we maximize what we know about vaccines so we can make informed decisions.”