Global Monkeypox Cases Fall 21%—Though U.S. Still Tops World Case Count

Topline

Worldwide confirmed cases of monkeypox fell 21% last week after climbing for four weeks straight, a potential sign the outbreak is slowing in Europe, the World Health Organization said Thursday, though cases in the U.S. remain the highest in the world.

Health workers sit at a check-in table at a pop-up monkeypox vaccination clinic.

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Key Facts

There were 5,097 new cases reported around the world for the week ending August 22, a decrease from the 7,477 new infections reported the week before, according to the WHO.

Cases continue to rise steeply in North and South America, which reported the most cases out of all regions, the WHO said.

The U.S. had 16,603 confirmed cases of monkeypox or orthopoxvirus, the class of viruses monkeypox belongs to, as of August 24, with 2,362 new cases reported the week ending in August 24, a slight decline from the week before, according to the Centers for Disease Control and Prevention.

The U.S. has now confirmed infections in every state, including Wyoming, previously the only state without a single reported case of monkeypox.

Big Number

45,148. That’s how many cases have been reported in 91 countries that have not historically experienced monkeypox outbreaks, according to the CDC.

Key Background

Monkeypox can result in painful lesions, chills, fever, headaches and other symptoms. The disease is endemic to certain regions of Africa, which have experienced several smaller outbreaks in recent years that have not received much international attention. The ongoing global outbreak began in early May. Facing a shortage of vaccine supplies, the White House declared monkeypox a public health emergency on August 4 to streamline the government’s response, increase vaccine availability and free up funding for drug and vaccine development. The next week, the Food and Drug Administration issued an emergency use authorization allowing healthcare workers to administer one-fifth of a standard Jynneos vaccine dose—the only shot specifically approved by the FDA to protect against monkeypox—intradermally, or into the skin, instead of subcutaneously, or into the fat underneath the skin. They hope the move will effectively quintuple the amount of doses available. Health officials in Fulton County, Georgia, which includes Atlanta, Los Angeles and New York, the center of the U.S. outbreak, have started to make the switch to the new method.

Tangent

Some reports suggest this new vaccine administration strategy, which the White House calls “dose sparing,” is encountering some roadblocks. For one, many health care workers have not been trained on how to administer intradermal vaccines and are having difficulty adapting, according to STAT News. The CDC has said it will provide training to health workers on how to do so. Additionally, some local jurisdictions have not been able to extract five full doses from a one-dose vial, a problem Demetre Daskalakis, deputy coordinator for the White House’s monkeypox response, confirmed to STAT. Some health experts—including the CEO of Bavarian Nordic—have also raised concerns about data supporting the efficacy and safety of the new dosing strategy. The White House has relied on a single 2015 study sponsored by the National Institutes of Health for data on the new method, which didn’t directly examine the shot’s ability to protect against disease and had a sample group of only healthy and mostly white adults, according to the Atlantic. NIH confirmed to Forbes this week it plans to launch a clinical trial soon examining the new dose sparing strategy after it has already been rolled out.

What To Watch For

Whether cases continue to rise with a return to college. Experts say students living in close quarters and coming together to socialize, including through hookups and other close contact, could help fuel the spread. Colleges and universities are speaking with local and federal health officials to help coordinate responses, several told Forbes.