A man in New York felt sick on June 13.
Keletso Makofane is an epidemiologist at Harvard University. “He begins to experience swelling lymph nodes, rectal discomfort,” Makofane said.
He suspects that he may have monkeypox. Makofane, a scientist who is well-versed in the symptoms and signs, says that the man suspects he might have monkeypox. The man visits his doctor to request a monkeypox test. Instead, the doctor suggests that the man be tested for common sexually transmitted disorders. All of those tests come back negative.
Makofane states that the pain gets worse “a few days later.” He goes back to urgent care and asks for a monkeypox testing. The provider then prescribes antibiotics to treat a bacterial infection.
Makofane states that the pain gets so severe, it interferes with his sleep. He went to New York’s emergency room on Sunday.
The man now has a growth in his rectum which is a sign of monkeypox. He sees an ER doctor as well as an infectious disease specialist at the hospital. The man again asks for a monkeypox testing. Makofane replies that a monkeypox test was not necessary. The doctor suggests that the man may have colon cancer.
He develops skin lesions aEUR a few days later. This is another sign of monkeypox.
The U.S. monkeypox epidemic doesn’t seem to be that severe, especially when compared to other countries. The U.S. has now seen 201 monkeypox cases since May when the international epidemic started. The U.K., however, has almost 800 cases. Both Germany and Spain have more than 500.
Makofane and other scientists told NPR that the U.S. official case count is misleading. The outbreak is larger than the official case count and may be even more severe.
Many of the confirmed cases are not known to be a result of an outbreak. The infected people have not been in contact with others infected or traveled to them. This means that the virus is spreading cryptically in certain cities and communities.
Jennifer Nuzzo, an epidemiologist from Brown University, said that “the fact that it’s impossible to reconstruct the transmission chain means we are likely missing many links in that chain.” “And that means those who have been infected don’t have the chance to get medicines that will help them recover quicker and prevent severe symptoms.
She adds, “But it also signifies that they could be spreading the virus to others without knowing that they are infected.”
Also, Joseph Osmundson from New York University says that “we have no idea of the scale of monkeypox epidemic in the U.S.”
Why is it that so few cases are being detected? Testing. The U.S. has fallen short in many areas of monkeypox testing.
Osmundson states that public health agencies across the country are not running enough tests. “State officials deny people testing because they use a narrow definition for monkeypox to determine who gets a test. They are testing in very few cases.
For example, Makofane is a man Makofane has met. After seeing four doctors, the man eventually finds an activist who wants to expand testing. The activist links the man to a doctor, who orders a test through private company (which is working to produce a commercial version). The test came back positive. He has monkeypox.
Makofane claims that the current testing situation in the U.S. is so bad that he started his own study called RESPNDMI to determine the prevalence of monkeypox and help friends share information on monkepox.
NPR was not allowed to know how many tests were performed in the United States. The agency also refused to disclose where transmissions are likely to occur in the U.S. NPR repeatedly emailed the agency with these questions, but the agency declined to comment or give an interview.
The CDC informed the New York Times on Thursday that it had performed 1,058 monkeypox testing. It’s not known how many of these tests are duplicates for the same person. Several sources involved in monkeypox testing are skeptical that the agency has ever tested so many cases. NPR was told by a source that the CDC had already tested 300 cases as of Friday. About 100 of the tests had been positive at that point, which gives a positive rate of over 30%.
The CDC helped set up testing at about 70 local and state labs in the United States when the outbreak began. The agency had an already developed test and was ready to send it to laboratories, unlike COVID.
Nuzzo states, “We should be proud of that prior investment.” “This is what preparation means.
However, as the demand for testing grew aEUR”, and the disease became more prevalent than originally predicted, the CDC’s testing system stopped working well. It actually discourages doctors from ordering a monkeypox exam.
Providers must go the extra mile to order a test. Nuzzo states that they must be given permission from the state or local labs and receive instructions. This process can be time-consuming and cumbersome. Sometimes, a doctor must be on the phone for several hours.
She says, “That’s the real bottleneck we worry about.” We need to expand our testing capabilities to detect infections we aren’t aware of. It’s very difficult to make it easy for health care providers to request tests in their busy schedules.
Nuzzo believes that the CDC and the local health departments must remove any barriers to testing. “I want testing to be easier and more widely available so that all healthcare professionals feel they can test a patient.” Anyone with a suspicious rash.
Doctors and nurses must have a better understanding about what monkeypox looks like in patients. It is not the same as what you read in medical textbooks. It can be present as other diseases such as herpes and syphilis, or colon cancer.
Nuzzo says that infections are most common in men who have had sex with other men. These men may seek treatment at a sexual clinic. These providers might be better educated about monkeypox, and are more likely to send out a specimen for testing. We may not see the same level of education or willingness to test with other healthcare providers who treat different types of patients. This could mean that we might be overlooking infections in different patient populations.
The CDC announced that they are working to increase testing at the main laboratories used by health care providers on Thursday afternoon. The agency plans to make testing more accessible in July.
Nuzzo believes that changes in testing must be made immediately. Doctors should be able to send samples to the laboratories that are already performing this testing right away.
She says, “Time is not on our team here.” “Everyday we delay, we are missing link in the transmission chain and are allowing an outbreak to grow possible beyond control.”
Monkeypox may be a long-term, or even permanent, aEUR problem in the U.S., much like COVID.
