The World Health Organization announced Thursday a 21% decline in monkeypox cases globally over the past week, giving hope that the current outbreak might be starting to slow.
As of Thursday 242 infections had been reported in San Diego since June, according to the county's latest data. The county announced that this week it began distributing more doses of the monkeypox vaccines to local healthcare providers.
Dr. Robert Schooley, an infectious disease specialist with UC San Diego Health and professor at UC San Diego School of Medicine, joined Midday Edition Thursday to talk about the current state of monkeypox in San Diego county. The interview below has been lightly edited for clarity.
What do you take away from the WHO announcement of a drop in monkeypox cases worldwide?
Dr. Schooley: There's evidence that things are beginning to quiet down in the Bay Area as well. And I think a lot of this reflects the fact that knowledge has spread about how the virus is being transmitted and behaviors are changing and people are getting vaccinated and many of the same sorts of things that helped slow down the early spread of HIV in the days of the early AIDS pandemic.
What is the current monkeypox situation in San Diego County? Are cases here trending up or following the worldwide decrease?
Dr. Schooley: They're still trending up. But the rate of rise has been declining. And looking at some of the other indicators we have, Dr. Rob Knight's group has been looking at monkeypox DNA in the wastewater in Point Loma that's down a little bit. So we may be seeing a little bit of a decline here, and I think that would be a great thing to see.
What are you particularly concerned about with the spread continuing here locally?
Dr. Schooley: Certainly people who get infected can be very significantly impacted in terms of pain and having to stay out of work, and it's quite disruptive. We haven't had any deaths in San Diego that I'm aware of. We've had about five hospitalizations. But what I really worry about is the impact on people who get it.
There is some concern that the virus would find its way into other populations. There was a concern for a while that it might be finding its way into the homeless population, and so far that's been slow. There are only about five cases that have been reported in the under-housed population.
But over the longer term, people are worried that monkeypox could spread into nonhuman populations with which we interact. In other words, pets, rodents, and other things around us. Monkeypox is not as restricted a virus as smallpox. Smallpox really only infects people. That's why we've been able to eradicate smallpox. Monkeypox can find its way into rodents. That's the natural host in Africa. There has been one report of a pet dog that slept with patients with monkeypox becoming infected.
So we really want to try to keep the virus out of other populations while we work to vaccinate the human population and move it back to a future worry rather than a current concern.
So the county said it's distributing 700 vials of the vaccine to healthcare providers in the area this week. We're told each vial contains about five doses of the vaccine. Is that going to meet demand?
Dr. Schooley: I doubt it. I think we're going to need to ramp it up quite a bit. There is a shortage nationwide, but that's beginning to catch up. I don't think we'll see an excess of vaccine for a couple of more months in terms of who really should be vaccinated.
There is a vaccine trial that will be starting at UCSD looking at the JYNNEOS vaccine, just verifying that the lower doses now being used induces the right amount of immunity. That's rolling through the Food and Drug Administration as we speak. And we'll be opening here probably in September. And we hope that in addition to the trial, that more doses will come through the health department.
If someone has gotten their first dose but are unable to get a second dose because they're on a waiting list or it's just not available, what situation are they in?
Dr. Schooley: First dose will help. It's not as protective as both doses, but the first dose certainly will decrease the likelihood you'll become infected if you've become exposed and will decrease the likelihood you'll have a severe infection if you get infected. People who are kind of halfway through their vaccination series should still be careful about exposures, but they're partially protected and it's a good thing to get whichever dosing you can get to get started.
Who is currently eligible to get a vaccine and how do they make an appointment?
Dr. Schooley: The county health department will provide information about which physicians have access to the vaccine. People who've been exposed to someone with monkeypox closely, intermittently exposed, should be vaccinated.
As we get more access to vaccine, men who have sex with men should consider a vaccination. It will protect them from being exposed. But right now it's mainly for people who've been exposed either through intimate contact or through occupational risk.
The name monkeypox comes because it originated in monkeys?
Dr. Schooley: No, it's really kind of a misnomer. Its natural host is mainly rodents and it had been primarily restricted in two regions of Africa, West Africa and the Congo. The first case that was described happens to be on a monkey that had been transported from Africa to Germany. And so it was deemed monkeypox.
But in fact, this virus is much less restricted than many others and can grow in monkeys and humans and dogs and cats and rodents, but lives mostly in rodents. Monkeypox is clearly not the best descriptor for it.
Any additional steps you would like to tell us we should take perhaps, to stop the spread?
Dr. Schooley: No, I think just be careful sexually right now. Vaccines are coming and after the vaccines are out, it'll be a lot safer. I think restricting numbers of partners is really one of the things that has made a big, big difference and it's something that we should all be extremely happy about and should also commend the community for getting on top of it and taking charge of getting this under control.
