COVID-19 and monkeypox, case counts and treatment options diverge widely in Alabama

HUNTSVILLE, Ala. (WHNT) – The World Health Organization has announced a second global health emergency due to the monkeypox outbreak, even as COVID-19 continues to infect people in the United States and around the world.

The designation comes after reports of more than 16,000 cases of monkeypox in 70 countries.

Dr. Wes Stubblefield of the Alabama Department of Public Health spoke to News 19 on Monday about the dual emergency.

Stubblefield said the designation is contained in a global treaty involving some 300 countries and its purpose is to spur a global effort to identify and treat cases of monkeypox and monitor the spread of the disease.

But there is a big difference in the status of the two viruses in Alabama. The state averages about 2,200 COVID-19 cases per day, while five cases of monkeypox have been reported.

Health officials say cases of monkeypox have usually occurred following contact with a person’s rash, which is usually from sexual contact, with men who identify as gay or bisexual. But Stubblefield says there have also been instances of household contact.

Health experts point to monkeypox Monkeypox has been around for many years, so why this new concern.

Stubblefield said most of the data suggests it’s a byproduct of globalization. As people travel the world, certain viruses will follow. And it has been endemic – found regularly – in parts of West Central Africa, according to the World Health Organization.

There are clearly different effects of COVID-19 and monkeypox in Alabama.

COVID is still active in the community there are well over 600 patients in the hospital statewide with covid so it’s affecting our hospitals it’s affecting our communities almost all of Alabama is in a state of transmission high community,” Stubblefield said. “Monkeypox has a very particular course, you come into contact with the virus, the virus usually has a 1 to 3 week, what we call, an incubation period.”

Stubblefield said the symptoms of monkeypox start like the flu, including muscle aches and potentially a fever, then a rash appears.

“It can be very serious and uncomfortable in some cases, especially those who are immunocompromised, but for most people it is a mild condition that resolves without treatment.”

And a vaccine? Alabama has the monkeypox vaccine, but its use is currently limited. There are no real limits on covid vaccines.

“Anyone six months and older can get the covid shot, there are very few exceptions, but there are,” Stubblefield said. “With the monkeypox vaccine, it’s not recommended for everyone, it’s only recommended for people who handle lab samples, they can get it as a pre-exposure dose. And, people who have been exposed to a suspected or confirmed case of monkeypox, who have not developed symptoms.

There are fewer treatment options for monkeypox, TPOXX is an experimental drug deployed sparingly at this stage. There are more COVID-19 treatment options, Stubblefield said.

“This drug (TPOXX) has a lot of potential side effects, and it’s not for all patients, it’s only for very limited patients,” Stubblefield said. “With COVID-19, we continue to have the same treatments, with Paxlovid, the oral treatment. There are IV treatments, which are available. And covid, unlike monkeypox, covid vaccination and treatment are widely available.

The exposure risks between the two viruses are significantly different, Stubblefield said.

“Covid spreads very easily from person to person,” he said. “Monkeypox doesn’t. Monkeypox really requires that close intimate physical contact. And so, we’ll see cases, we’ll probably see more, but it won’t be this outbreak of explosion that we’ve seen with covid.


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