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U.S. monkeypox cases are increasing. How does it spread and how is it treated?


In cities around the country, people are lining up to get vaccinated against monkeypox. But there aren't enough shots to go around. And some wonder, is it truly a threat, or after living with the coronavirus for a couple of years, are we all just a bit jumpy? Joining us now to discuss this is Dr. Ali Khan, who spent much of his career at the CDC and handled monkeypox outbreaks in the Democratic Republic of the Congo and in Indiana. Doctor, how exactly is this virus spreading in the U.S. right now?

ALI KHAN: This new variant of the virus that's spreading in the U.S. is spread by intimate contact, especially sexual contact, and that's essentially PC for skin-to-skin contact of people who are infected, especially their lesions.

MARTINEZ: But are we also talking about handshakes, maybe just cuddling, kissing your kid at bedtime? I mean, is that included as well?

KHAN: Not at all. This isn't transmitted by casual contact. It really is transmitted by intimate contact - very intimate contact.

MARTINEZ: There are concerns and misconceptions that monkeypox is a sexually transmitted infection. Are you worried there's confusion out there?

KHAN: Yes, there is some confusion out there. So we should be clear that sexual contact counts as intimate contact, but we know that people who don't have sexual contact can be infected, including here in the United States, where we recently had two kids who have been infected. But 95% of infections are transmitted by sexual contact.

MARTINEZ: All right. Now, at the same time, the U.S. outbreak is concentrated among men who have sex with men. How focused should the response be, given that this group is by far the most at risk right now?

KHAN: Well, this does provide an opportunity for prevention activities within this group, and they've been very proactive in education and lining up for vaccination. But there is the reminder that people who are not amongst this group are at risk. And we need to be concerned - not panicked, but concerned, and make sure that we do adequately prevent this infection from continuing to spread.

MARTINEZ: You know, yesterday I saw a tweet. You tweeted a quote from the CDC director, who said, it's been a struggle to get states to share demographic information about monkeypox cases. And there's no data on who's been vaccinated against monkeypox. And you added in that tweet, be scared, very scared. Fix this now. Doctor, as it specifically relates to monkeypox, why is this something to be scared about?

KHAN: Well, if you don't know who's infected and where there's infected and how many infections there are and how many people you're finding off of contact list, how many people you are following up on, how do you put this disease under control? So data is the lifeblood of public health, and you need adequate data to be able to have a strong public health response to broadly protect our communities.

MARTINEZ: If this isn't fixed, is this going to make the problem worse?

KHAN: Oh, without a doubt. I mean, we see this not just in monkeypox. We saw this in COVID, and we'll see it in the next pandemic. Unless we have a robust modern data system in the United States to supply public health data, we will always have not as robust of a response and rapid response.

MARTINEZ: I know that monkeypox, at least for us right now, is kind of new, but we've been going through something like this. Why is data seemingly so hard to flow?

KHAN: That would be a question - really important to address this HHS, Department of Health and Human Services, CDC, the administration and state and local health departments. This is a ongoing problem and a significant problem for the United States.

MARTINEZ: Do they not care enough? Do - I mean, do they not think it's as important as other things?

KHAN: It's a hard lift - there's no doubt about it - but it has to be done.

MARTINEZ: Because - you know, I ask that, doctor, because, you know, we mentioned earlier how the outbreak is concentrated among men who have sex with men. So, you know, I'm wondering - I mean, if it's this small group, is there some kind of sense of, like, well, maybe it's not something we need to worry about right now?

KHAN: Well, we need to make sure that there's adequate testing in the United States, so it's been markedly ramped up. We need rapid identification. We need to make sure that these individuals are treated. We need to make sure contacts are vaccinated. So all these pieces need to come together. And that all depends on data and understanding how widespread this is within our communities. And kudos, again, the positive side - the CDC - you know, TPOX, the antiviral, is more readily available these days. Vaccination - testing has been extended to five commercial labs. So things are getting much better, but still we need better data.

MARTINEZ: That's Dr. Ali Khan, who has handled monkeypox outbreaks in the Democratic Republic of the Congo and Indiana. Transcript provided by NPR, Copyright NPR.