- The Washington Times - Thursday, June 12, 2003

The response of public health authorities to the monkeypox outbreak is reason for both hope and concern. Even as health authorities work to control the disease, policy-makers must heed the lessons this outbreak has for the emergence of other pox-like illnesses.

Health and Human Services Secretary Tommy Thompson said the monkeypox outbreak “has the potential to pose a threat to the public health.” However, there are reasons to be optimistic that it can be contained and will soon be controlled. To date, the monkeypox virus has not killed anyone (its fatality rate is between one and ten percent), although it has afflicted nine individuals and may have infected 54 others, primarily in Indiana, Illinois and Wisconsin. While the virus can be transmitted from person to person, it is not nearly as infectious as the SARS virus, and is most commonly passed on through direct contact with an infected animal.

While there is no cure for monkeypox, the smallpox vaccine is 85 percent effective against it. On Wednesday, authorities at the Centers for Disease Control and Prevention recommended that all of those exposed to animals infected with monkeypox receive the smallpox inoculation, including those thought to be at a higher risk of adverse events from such vaccinations (individuals with skin diseases, pregnant women and children).

“In this situation, we feel the risk of the disease is sufficient to make that recommendation,” Deputy CDC Director David Fleming said. He is right. It is completely proper that the small chance of adverse events from smallpox vaccinations be subordinated to the need to protect potentially exposed individuals and to stem the spread of the virus. Federal authorities should also be commended for acting aggressively on other fronts —banning sales of prairie dogs, prohibiting the importation of African rodents and providing up-to-date information once they were aware of the outbreak.

However, there was a troubling lag between the identification of the outbreak and its being reported to the CDC. According to The Washington Post, high-resolution photos revealed the presence of a pox-like virus on May 30, but it was almost a week before the CDC was notified. The final diagnosis was only confirmed June 7. That delay could have been far more costly, and it’s frightening that it took local health authorities — who have supposedly been training to respond to such an emergency, including smallpox outbreaks — so long to notify the CDC. That must change.

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