Health departments prepare for monkeypox response; no county-level data given

Aug. 3—The Maryland Department of Health is not currently reporting county-level data on monkeypox cases, Frederick County Health Department spokeswoman Rissah Watkins said Tuesday.

As of Tuesday, the state had identified 129 confirmed cases of the virus among Maryland residents, according to a news release from Gov. Larry Hogan's office. That's 2.2% of the 5,811 cases identified nationwide.

Most have been reported in the National Capital Region, according to the release, which provided an update on the state's response to the outbreak. The first monkeypox case in Maryland was announced June 16.

It's up to the state Health Department to decide whether to release case numbers by jurisdiction, Watkins said.

Maryland Department of Health spokesman Chase Cook confirmed that the state is not currently sharing county-level data on monkeypox cases, but did not provide a reason why before deadline.

The state has received enough doses of the two-dose Jynneos monkeypox vaccine to immunize 3,202 people, according to the Health Department's news release on Tuesday.

When the first cases of the virus were identified in the U.S. in mid-May, the federal stockpile of the vaccine had about 2,400 usable doses. Supply remains limited, according to the Health Department's release, and additional doses may not be available until the fall.

Despite the deficit, anyone who might need to be tested or treated for monkeypox should contact their health care provider or local health department immediately, Hogan said in a statement in the release.

"We will keep pressing the federal government to provide more vaccines to the states and do all we can to make resources available to those at risk," he said in the release.

Maryland is prioritizing vaccinations for those who may have been exposed in the previous two weeks, Dr. Jinlene Chan — the state Health Department's deputy secretary for public health services — said in the release.

The state has given the most vaccine doses to jurisdictions reporting the highest incidence of known cases and exposures, according to the release.

"We plan to expand access to the vaccine as more supply becomes available," Chan said in the release.

In Frederick County, Health Department employees are making sure local health care providers are up to date on state guidance on the outbreak and know what to do if a patient thinks they may have been exposed to the virus, Watkins said.

Testing for the virus is being conducted at state and many commercial labs, Watkins said. If a patient tests positive, their health care provider will notify them and report the result to the state. The state will then report the result to the county where the patient lives.

If notified of a monkeypox case in the county, the local Health Department would conduct contact tracing for the diagnosed patient, Watkins said.

When COVID-19 started spreading in the county, the local Health Department quickly set up a public dashboard to share data.

But the novel coronavirus presented a unique situation, Watkins said. Health Department employees had a lot to learn about how to prevent and control its spread.

It also quickly caused community transmission in the county. A person could stand within 6 feet of someone with COVID-19 for 15 minutes and get infected.

Monkeypox is different. Although it's spreading in countries where it rarely spread before, the virus has been around a while, Watkins said. Public health professionals know more about how to respond to outbreaks it causes.

The virus has not been shown to spread through "casual contact," like being in the same area as someone infected or briefly touching shared items, such as doorknobs, according to the state Health Department.

"You are not at risk going to the grocery store," Watkins said.

Instead, monkeypox can be spread to anyone through close, personal or skin-to-skin contact, according to the Health Department's fact sheet.

This includes direct skin-to-skin contact with monkeypox rash, sores or scabs; contact with materials such as clothing, bedding or towels used by someone with the virus; or kissing, hugging or talking closely with someone infected.

The conversations Watkins has had with other Health Department employees remind her of discussions from March two years ago about COVID-19 response.

They're using lessons from the pandemic to respond to the monkeypox outbreak, Watkins said. But they're also using lessons from an earlier outbreak — the AIDs epidemic of the 1980s and early 1990s.

Although most monkeypox cases so far identified have been among men who had sex with men, anyone can be infected, Watkins said. It isn't a sexually transmitted infection.

"We do not want to stigmatize any population here," she said.