The Biden administration will declare monkeypox a public health emergency.

The Biden administration is declaring a public health emergency as the U.S. outbreak has become the world’s largest, the country’s top health official said Thursday.

Health and Human Services Secretary Xavier Becerra’s emergency statement will help mobilize more resources to fight the outbreak, which has spread rapidly since Boston health authorities confirmed the first U.S. case in May. The US last declared a public health emergency in response to Covid-19 in January 2020.

More than 6,600 cases of monkeypox have been confirmed in the US as of Thursday in 48 states, Washington, DC, and Puerto Rico, according to the Centers for Disease Control and Prevention. The actual number of infections is likely higher than official figures because patients can only be tested after they develop a rash, which can take a week or more after initial exposure to the virus.

“In light of all these developments and changing circumstances on the ground, I want to announce today that I am declaring a public health emergency,” Becerra told reporters during a call on Thursday.

Monkeypox is rarely fatal, and no deaths have been reported in the US so far, but patients often suffer debilitating pain due to the skin rash caused by the virus. The disease has killed eight people worldwide during the current outbreak, mostly in Africa, where healthcare systems are not as reliable as in the US. Spain and Brazil reported their first confirmed cases. virus deaths outside of Africa on the weekend.

Monkeypox is mainly spread through skin to skin contact during sex Currently. Gay and bisexual men are now at the highest risk of infection, health officials say. About 98% of patients who provided demographic information to clinics identified themselves as men who have sex with men, according to the CDC. But anyone can contract the virus through close physical contact with an infected person or contaminated materials.

Scientists and public health officials are concerned that monkeypox could continue to circulate in the US unless faster action is taken to contain the outbreak.

WHO declared monkeypox a global health emergency last month. More than 26,000 cases of monkeypox have been reported in 87 countries, according to the CDC. The United States accounts for 25% of confirmed infections worldwide. UK health authorities first alerted the world to the outbreak in May after confirming several cases there.

A global outbreak is very unusual because monkeypox is spreading widely for the first time in North America and Europe, where the virus is usually not found. Historically, monkeypox spread in small numbers in remote areas of West and Central Africa, where the virus is carried by rodents and other animals. In the past, human-to-human transmission was relatively rare, with the virus usually being transmitted from animals to humans.

State and local emergencies

Lawmakers in Congress and local communities have criticized the pace of the federal government’s response, but Becerra said last week that HHS has done its best increase resources to fight the outbreak. The health secretary said states need to do more to prevent transmission and Congress needs funding to support the outbreak response.

The largest outbreaks in the US have occurred in New York, California, Illinois, Florida, Georgia, Texas and the District of Columbia. New York, Illinois and California declared a state of emergency before the federal declaration.

Public health officials are concerned that the virus could start spreading more among households among the wider population as infections rise. Although physical contact during sex is currently the main mode of transmission, people can also contract monkeypox through hugging, kissing, and contaminated towels and sheets.

The CDC last month confirmed the first US cases of monkeypox in children, a toddler in California, and an infant whose family was traveling in DC. The infant’s family is not a US resident. The children are symptomatic but healthy and receiving the antiviral treatment tecovirimat, according to the CDC. Young children likely contracted the virus in the family, according to the CDC.

Monkeypox can also be airborne when people have lesions in their mouths, but this requires prolonged face-to-face communication. According to the CDC. Health officials do not believe that monkeypox is spread through small aerosol particles like Covid. Respiratory droplets are heavier so they don’t stay in the air for as long, while Covid is an airborne virus, which is one of the reasons it’s contagious.

Monkeypox usually starts with flu-like symptoms and then progresses to a painful rash that can spread throughout the body. But the symptoms of the current outbreak have been unusual. Some people get a rash first, while others get a rash without any flu symptoms at all. Many people have localized lesions on their genitals or anus, according to public health officials.

Patients usually recover in two to four weeks without additional treatment, according to the CDC. But some people are hospitalized because the rash is very painful.

In 2003, there was a small outbreak of monkeypox in the United States with dozens of confirmed and probable cases in six states. People got sick after contact with domestic prairie dogs. Pets became infected after they were settled next to small mammals imported from Ghana. The 2003 US outbreak was the first case of monkeypox reported outside of Africa, according to the CDC.

Public health authorities are also concerned that if monkeypox spreads in the US, the virus could gain a foothold in animal populations, making it difficult to eradicate the virus from the country.

Vaccines, testing and antivirus supplies

Since May, the federal government has supplied more than 600,000 doses of monkeypox vaccine called Jynneos to state and city health departments. CDC Director Dr. Rochelle Walensky admitted last month that vaccine demand outstrips supplyleading to long queues at clinics and protests in some cities.

hhs made 786,000 doses available for local authorities to start ordering last Friday, which could help resolve supply issues. Dawn O’Connell, who heads the office in charge of the strategic national stockpile, said HHS ships doses within 30 hours of states ordering them.

The US has ordered more than 5 million additional doses, with deliveries scheduled for mid-2023. According to HHS, another 11.1 million doses are in stock in Denmark at manufacturer Bavarian Nordic. But these doses must be filled and completed before they can be administered, which will require additional funding from Congress, according to HHS.

The Food and Drug Administration approved Jynneos in 2019 for adults 18 years of age and older who are at high risk of contracting monkeypox or smallpox. Jynneos is the only monkeypox vaccine approved by the US FDA. It is administered in two doses 28 days apart.

There are also more than 100 million doses of an old-generation smallpox vaccine called ACAM2000 in the US that appears to be effective against monkeypox. But ACAM2000 can have serious side effects and is not recommended for people with weak immune systems such as HIV patients, pregnant women, and people with eczema and similar skin conditions.

There is currently no real data in the US on how effective vaccines are at preventing disease in the current outbreak, according to the CDC. The vaccination campaign targets people with confirmed or suspected exposure and men who have sex because they are at the highest risk of infection.

The US has increased its testing capacity to 80,000 a week after bringing in several commercial labs last month. Becerra said last month that current testing demand is only a fraction of the total capacity the US now has.

The US also has 1.7 million courses of tecovirimat antiviral treatment in a strategic national stockpile. Health care providers use tecovirimat to treat patients with monkeypox, but prescribing the drug comes with an additional layer of bureaucracy because the FDA only approved it for smallpox. Last month, the CDC cut red tape to make it easier for doctors to prescribe tecovirimat.