Health officials in Nevada are now working to boost messaging and vaccinations for those most likely to contract monkeypox after the US Department of Health and Human Services declared the virus a public health emergency.
Earlier this month, DHHS Secretary Xavier Bercerra acknowledged the ongoing monkeypox outbreak as a public health emergency, a move that means the federal government can more quickly assist states with distributing vaccines and conducting testing and public health campaigns.
During a town hall meeting at the LGTBQ Center of Southern Nevada last week, local health officials detailed their work to increase vaccines and spread information to the public.
Haley Blake, the communicable disease supervisor for the Southern Nevada Health District, said so far Clark County has reported 100 probable and confirmed cases and that the county has managed to administer nearly 2,850 vaccines.
The US Food and Drug Administration approved an emergency use authorization earlier this month to switch from giving the vaccine subcutaneously, the way most people are used to receiving a vaccine, to intradermally, or just below the skin.
While the method expands the amount of vaccines that can be used from a single vial, Bavarian Nordic—the only company that makes the Jynneos vaccine—has some reservations about the FDA decision to approve the method, due to limited safety data.
Biden administration officials, however, defended their recommendationwhich is expected to provide up to five doses per vial instead of one, as safe and effective.
Despite the emergency use recommendation, Nevada still has a limited supply of the vaccine, a growing concern as more Nevadans have been diagnosed with the virus.
“The vaccines are super important but access to vaccines has been a little challenging so we need to rely on what we know,” said Rob Phoenix, a nurse practitioner for the Huntridge Family Clinic, which is distributing vaccines. “It spreads through prolonged skin contact, so you need to make sure to protect yourself against those who may or may not have symptoms yet. A fair percentage of cases don’t have some of the initial symptoms that we think they are going to have, like fever symptoms.”
Blake said the health district is training additional staff to administer the vaccine subcutaneously which will lead to additional appointment availability. Health officials are contact tracing all known cases of monkeypox using a method much like that used to contact trace COVID over the last two years, said Blake.
The vaccine is administered as two subcutaneous injections weeks apart. Immune response takes 2 weeks after the second dose for maximal development. The vaccine is approved for use in the prevention of smallpox or monkeypox in people aged 18 years and older.
Vaccines and follow-up medication for monkeypox are available for free at the LGTBQ Center of Southern Nevada, the Huntridge Family Clinic, and the Southern Nevada Health District.
Brian Labus, an assistant professor of Epidemiology and Biostatistics in the UNLV School of Public Health, emphasized that while most cases of monkeypox are currently among men who reported recent sexual contact with other men, everyone is vulnerable to monkeypox.
“It got a foothold in a particular population and there is always the potential it will get a foothold somewhere else,” Labus said. “There is nothing different among men who have sex with men in terms of behaviors that would lead to monkeypox transmission over anyone else. It just happened to get a foothold in that network.”
Nevada health officials said monkeypox spreads through prolonged close, physical contact between people. That means anyone in close contact with a person with monkeypox can get it and should take steps to protect themselves.
Prolonged contact can include crowded spaces where skin to skin contact is common like dance clubs or more intimate activities such as sex and kissing. People should also avoid touching personal belongings that may have made contact with sores, like bedding and towels. Health officials said a pregnant person with monkeypox can spread it to their fetus.
“There is nothing different among men who have sex with men in terms of behaviors that would lead to monkeypox transmission over anyone else. It just happened to get a foothold in that network.”
– Brian Labus, UNLV Epidemiology and Biostatistics Department
Health officials assured the public that monkeypox is not a respiratory disease and is not as contagious or fatal as COVID.
“You are not at risk by simply being in the same room as other people, it’s not a respiratory disease like COVID,” Labus said. “Once you get it you are immune, it’s not like you will keep getting it over and over again.”
Vaccinations are available for those who may have already been exposed to monkeypox. The CDC recommends administering the PEP or Post-Exposure Prophylaxis vaccine within four days from the date of exposure for the best chance of preventing infection. The vaccine can also reduce symptoms of the disease if given between four and 14 days from the date of exposure.
Most people who contract monkeypox recover within weeks.
Alireza Farabi, the infectious disease clinical medical director for the University Medical Center of Southern Nevada, said when the first cases of the outbreak occurred he wasn’t alarmed. Looking at past monkeypox events, like the 2003 US outbreak which resulted in 47 human cases in six states, Farabi said he did not expect the current US outbreak to hit more than 13,000 cases nationally.
Farabi said the monkeypox cases he’s seen have presented atypical symptoms from those he’s seen in the past, adding that the unusual symptoms have led to misdiagnoses in his own clinic and are likely being misdiagnosed elsewhere. Monkeypox has also been detected in wastewater from Southern Nevada, warned Farabi, meaning it is possibly more prevalent than currently known.
“Definitely, we need to address this as a priority,” Farabi said. “This is a serious problem but we’ve solved it before. This is very similar to smallpox. We vaccinated everyone during that time and we eradicated smallpox. We can do that right now for monkeypox but we need to be serious and act as soon as possible.”
Symptoms of monkeypox include rashes, bumps or blisters. It can also present as a fever, chills, headaches, body or muscle aches, exhaustion, swollen lymph nodes, coughing, and a sore throat. Symptoms typically appear six to 13 days after exposure, but may take up to three weeks.
Those who think they have been exposed to the virus should isolate themselves and contact a health care provider or a public health clinic.