New York City appears to be America’s monkeypox “hot spot” as a global outbreak of the virus continues. The number of confirmed monkeypox cases in the city has more than doubled in the past week, according to the city’s health department.

The New York City Department of Health and Mental Hygiene reported that as of Thursday, 141 cases of orthopox virus — “likely monkeypox” — had been lab-confirmed.

The city reported that most of those infected have had mild illnesses from which they were able to recover on their own. But even with mild illness, the advisory said, “the rash and sores from monkeypox can be itchy and painful.”

While the public health officials noted that anyone can get and spread monkeypox, they said that “current cases are primarily spreading among social networks of gay, bisexual and other men who have sex with men, so this community is currently at greater risk of exposure.”

According to the Centers for Disease Control and Prevention, as of the first week of July, monkeypox had been confirmed in 34 states, Washington, D.C., and Puerto Rico. The CDC count shows nearly 700 U.S. cases.

Internationally, more than 3,400 cases had been confirmed in more than 50 countries or territories between Jan. 1 and June 22, according to the World Health Organization. Most of the cases were reported in Europe, but the numbers have been changing rapidly, the public health agency said.

About monkeypox

As the Deseret News has reported, monkeypox is transmitted by contact with infected animals or humans, or with contaminated materials like bed linens and clothing. It gets in through broken skin, by way of the respiratory tract or through the mucous membranes of the eyes, nose and mouth. Someone can get monkeypox from a bite or scratch, contact with a lesion or respiratory droplets. It’s also possible that eating meat of an infected animal can lead to infection.

Symptoms typically start with a fever, headache, muscle aches and exhaustion — all symptoms that are common in monkeypox’s cousin, smallpox. But monkeypox also includes swelling of the lymph nodes. An infected person develops a rash, which then turns into pus-filled lesions that eventually scab over and fall off. From infection to symptoms usually takes between one and two weeks, though it can range from five to 21 days.

The World Health Organization’s leading monkeypox expert, Dr. Romaund Lewis, has said that ending global efforts to vaccinate against smallpox may have enabled the spread of monkeypox.

The first human case of monkeypox was reported in 1970 in the Democratic Republic of Congo, “during an intensified effort to eliminate smallpox,” according to the CDC. It is now considered endemic in central and western African countries. The international public health agency has said that Congo and Nigeria report about 10,000 cases total in a given year.

While it’s not usually seen in the United States, monkeypox has been here before, including last year when single cases were reported in Texas and Maryland, according to The New York Times.

Efforts to vaccinate

The CDC in late May began releasing some Jynneos smallpox vaccine from the National Strategic Stockpile to help contain the spread of monkeypox. The public health organization said the vaccine was to be made available to close contacts of infected individuals and to certain healthcare workers who might have been exposed to monkeypox.

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At that point, it was believed there were five cases in the United States: one confirmed and four suspected.

Then, in June, the Department of Health and Human Services said that nearly 300,000 doses of the Jynneos vaccine would be made available over the summer, including 56,000 from the national stockpile. Allocation was to be based on a state’s population that was at risk for severe disease and its number of cases.

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The Jynneos vaccine is preferred to an older smallpox vaccine because it has fewer side effects. But health officials have said both are effective against monkeypox, as well as smallpox. However, the older one, ACAM2000, cannot be used for those with compromised immune systems, including people who received solid organ transplants or who have certain other health conditions, according to The New York Times.

In a media call, CDC deputy director Dr. Jennifer McQuiston said that the manufacturer was cranking up production of the Jynneos vaccine and more would be distributed as it became available.

Initial efforts to vaccinate against the virus in New York City were marred by “technical glitches” that made it very hard to book an appointment, Politico reported. The city had received almost 6,000 “hotly anticipated vaccines from the federal government that were supposed to go up for grabs Wednesday.” Instead, some people were able to book appointments before the booking portal was supposed to open — and when it did open, the site crashed, creating frustration.

Even so, the World Health Organization said last week that monkeypox is not yet being considered a “serious threat,” the New York Post reported.

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