University of Virginia Health began weekly COVID-19 briefings to discuss one epidemic, but used Friday’s meeting to discuss the reality of tackling two epidemics at once.
There are now 64 cases of monkeypox across the state — a number that has been steadily rising on a weekly basis — and one case in the Blue Ridge Health District, according to the Virginia Department of Health.
And the situation likely is more dire than the numbers imply. Due to the virus’s varied appearances — for instance, certain rashes are fixed to a single area rather than all over one’s body — some individuals may not be seeking medical attention. In addition, medical providers are still receiving training on recognizing, diagnosing and treating monkeypox.
“It’s clear that at this point we’re diagnosing only a fraction number of cases that are out there,” said Dr. Costi Sifri, director of hospital epidemiology at UVa Health.
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Testing has been available to a limited number of health department networks for public health reasons and use, though these tests are not easily accessible for clinicians outside of this network. As a result, VDH has been encouraging its web users to contact their health providers for testing needs.
“Expansion of testing has occurred in the last few weeks through commercial laboratories, and more are coming on board,” Sifri said. “The amount of testing capacity in the United States is going to increase, hopefully five- or six-fold.”
The Food and Drug Administration has approved two vaccines that are available for preventing monkeypox. JYNNEOS is a two-dose option that ensures full vaccination two weeks after the second shot, but the U.S. has a limited supply of this option, according to the Centers for Disease Control and Prevention. The CDC reports a sufficient supply of the ACAM2000 vaccine, which people in their 50s and 60s may have received as the smallpox vaccine; however, it should not be received by people with certain health conditions like a weakened immune system, certain skin conditions, or pregnancy.
“We’re waiting right now to hear about what the plans will be in terms of distribution and then how to provide that,” Sifri said. “I think it’s safe to say we’re not going to see some of the similar vaccine distribution channels as we saw with COVID. It is almost assuredly not going to be available at a local retail pharmacy.”
Monkeypox has most commonly been identified by sores on a person’s face, mouth, chest, hands, feet or genitals, but can also be identified by muscle aches, swollen lymph nodes, fever, chills and exhaustion. Individuals can contract the infection through sustained close contact with someone with smallpox. This may occur most commonly between partners of any sex as well as households. It can also be contracted by sharing clothing or blankets with someone who has smallpox.
“This is not the same as COVID,” Sifri said.
As a respiratory virus, COVID-19 is more easily transmitted through the air rather than prolonged close contact with an infected individual. To prevent the spread of COVID-19, UVa is currently replacing ventilation systems in all academic and housing buildings.
At Friday’s meeting, Dr. Sifri anticipated that some schools nationwide will push for vulnerable and immune compromised students to wear masks in the classroom at all times.
“We may see different approaches across the state,” said Sifri, “and I think we should expect that.”
Immunity after COVID-19 vaccination or infection does not last as long as the original six months of protection for previous variants like the BA.1 and BA.2 versions of the Omicron variant.
“Our rule of thumb is that if you’re several months out from vaccination or infection, particularly if the dominant variants that are circulating in your locality have changed compared to the one that you may have had, then you’re starting to become susceptible again,” Sifri said.
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