US should assume wider spread of monkeypox, says Dr. Scott Gottlieb: 3 updates

Health experts say the U.S. should cast a wider net with monkeypox testing to contain the outbreak, which has now grown to more than 7,500 cases. 

Federal health officials have said the CDC has capacity to conduct about 80,000 tests per week. The U.S. is currently conducting about 8,000. 

"They can broaden this substantially," Scott Gottlieb, MD, former FDA commissioner, told CBS News Aug. 7. "We're continuing to look for cases in the community of men who have sex with men. It's primarily spreading in that community. But there's no question that it's spread outside that community at this point … we need to start looking for cases in the broader community." 

This would include testing anyone who has an "atypical case of shingles or an atypical case of herpes," Dr. Gottlieb said. "If we want to prevent this from becoming an endemic virus, we need to be looking more widely for it, and the worst case scenario is that we start testing more broadly and we don't find it — that would be reassuring." 

Two more updates: 

1. An Illinois daycare worker has tested positive for monkeypox. State and local health officials in Champaign, Ill., shared the news in an Aug. 5 news release, saying the "patient is doing well and the case poses little risk to [the] general public." Officials are now screening potentially exposed children for symptoms and allowing them to receive the Jynneos monkeypox vaccine, which is only authorized for adults, The Washington Post reports. Between 40 and 50 people were potentially exposed to the daycare worker directly or to the items the person had handled. 

There have been at least five confirmed cases among children so far. Health experts have said the U.S. should expect to see more cases among the broader population if the outbreak is not contained. 

2. Federal health officials weigh 'dose-sparing' strategy to stretch monkeypox vaccine supply. The plans would allow for a single Jynneos vial, which contains one dose, to be split into five different doses. People would essentially receive one-fifth of the current doses via an intradermal injection instead of the full dose that is injected into underlying fat. The FDA could make a decision on whether to issue an emergency use authorization for the dose-sparing strategy as early as this week, Dr. Gottlieb told CBS

Some health experts have expressed concern over the approach, citing a lack of research and risks to patients, according to The New York Times. 

"If you're giving a lower dose and you don't inject it properly into the skin — you might inject it into the wrong place — you may not be giving a protective vaccine," Phil Krause, MD, a retired FDA vaccine regulator who previously worked on the licensing of the Jynnos vaccine. "If you ask this to be done nationwide in millions of doses, it's a lot easier for there to be mistakes made in the administration of the vaccine," he told the Times

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