Statement from ASTHO Chief Medical Officer Marcus Plescia, MD, MPH on Monkeypox Outbreak in U.S.

August 09, 2022

ARLINGTON, VA—“Since the first monkeypox case in the U.S. was confirmed in May, health departments have been at the forefront of the response, employing traditional public health actions including: case identification, contact tracing, treatment and support services, outreach to impacted communities, public education, and vaccinations. Now with over 8,900 cases across 48 states, the District of Columbia, and Puerto Rico, the federal public health emergency declaration provides health departments additional tools to coordinate resources, share information, and accelerate the development and procurement of medical countermeasures.

Responsible for the health of their residents, states and territories have prepared for and responded to the MPV outbreak since the first case was identified in the U.S. Unlike COVID-19, there are already effective vaccines available to prevent MPV and public health leaders are working to vaccinate people who are at high risk of exposure. With the first cases appearing in gay, bisexual, and other men who have sex with men, public health leaders carefully considered how to educate the public on what MPV was and who is at risk for contracting MPV without stigmatizing members of the LGBTQ+ community. Learning from mistakes in the early days of the HIV epidemic, health departments are engaging with community-based organizations serving the LGBTQ+ community to provide accurate information and access to health services.

In addition to using non-judgmental language when discussing MPV, which reduces stigmatization of this population and behaviors, public health leaders have carefully considered how to protect the privacy of the people who contract MPV. This includes working with partners to gather timely information about the MPV outbreak without disclosing potentially identifiable information about the people seeking vaccination. Building on the data sharing framework established during the COVID-19 pandemic, state and territorial health officials are working with the CDC to provide information on the MPV outbreak. The federal emergency declaration will further support this process, with several states only able to share information about MPV with the CDC during a declared public health emergency.

Public health departments have been the leaders in responding to MPV cases throughout the nation. This response has included other challenges, such as limited funding to support MPV response, supply of vaccine not able to meet demand, and an exhausted public health workforce which is still responding to COVID-19 while facing burnout and job-related harassment. In the days preceding the federal declaration, several states issued emergency declarations to access additional state funds and relax some regulations to better respond to a rising MPV case count.

ASTHO continues supporting its members as they respond to yet another public health emergency. Facilitating continuous communication among members, with federal partners like the White House, HHS, CDC, and FDA, as well as other partner organizations, ASTHO serves as a crucial coordination point to effectively respond to the MPV public health emergency. In this role, ASTHO encourages public health leaders to continue:

• To communicate with the public and impacted communities in clear, non-judgmental, non-stigmatizing messaging so that the public will have accurate information about MPV, their individual risk, and where to turn for assistance or more information.
• Engage in meaningful ways with communities most impacted by MPV to center the needs of people living with and at increased risk for infection, reduce potential stigma and misinformation, and effectively respond to any unique prevention, treatment, and support needs.
• Work with local and federal partners to coordinate vaccination and treatment efforts, as well as dispel misinformation.
• Follow epidemiologic data to determine where public health action should be focused.
• Support clinical providers with clear guidelines for assessing risks, evaluating signs and symptoms, accessing testing, vaccination, and treatment services.

With increased federal support for the MPV response, ASTHO and public health leaders will continue to work toward providing access to preventive vaccines, testing, treatment, and support services. As well as expanding research into treatment, vaccination, and cure for MPV and other orthopox viruses.

Effectively responding to and preventing MPV is possible, and the recent public health emergency declaration will greatly help the MPV response. ASTHO will continue supporting and equipping our members as they respond to MPV and work to advance health equity and optimal health for all. To reach this goal, ASTHO encourages everyone to learn more about MPV—how it can be prevented, what to look for if you believe you have been exposed, where to turn for additional information, and how we can support those who are impacted—and support public health.”

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ASTHO is the national nonprofit organization representing the public health agencies of the United States, the U.S. territories and freely associated states, and Washington, D.C., as well as the more than 100,000 public health professionals these agencies employ. ASTHO members, the chief health officials of these jurisdictions, are dedicated to formulating and influencing sound public health policy and to ensuring excellence in public health practice.