U.S. Declares Mpox Outbreak a Public Health Emergency

Mpox (formerly known as monkeypox) is now a national public health emergency, Health and Human Services Secretary Xavier Becerra declared on Thursday. The designation gives officials more power to address the outbreak.

Under a public health emergency, federal agencies gain more flexibility to coordinate a containment strategy. This includes accessing emergency funds to develop tests, vaccines, and drugs, and to hire workers to manage the outbreak.

"We're prepared to take our response to the next level in addressing this virus," Becerra said at a press briefing. "We urge every American to take monkeypox seriously and to take responsibility to help us tackle this virus."

The move comes a week after the World Health Organization declared a global health emergency—a rare designation. New York, San Francisco, and Illinois declared mpox a public health emergency earlier this week.

There are more than 6,600 confirmed cases in the U.S. and some 26,000 cases globally. But given the backlog in testing, this is almost certainly an undercount.

The Biden administration faced mounting pressure from politicians and health groups to declare the emergency in the weeks leading up to Thursday’s announcement.

“For nearly three months, STI clinics have been alone on the front lines of this outbreak… HHS’s declaration of a public health emergency is the right thing to do and we applaud their actions. It’s about time,” David Harvey, MSW, executive director of the National Coalition of STD Directors (NCSD), said in a statement.

Picking Up a Lagging U.S. Response

Access to Jynneos, the primary vaccine authorized by FDA for mpox, has been limited. A second vaccine, ACAM2000, exists, but is associated with side effects in immunocompromised people.

The White House said 1.6 million people are at high risk for contracting mpox. The disease can affect anybody, but the majority of cases in the U.S. are among men who have sex with men (MSM).

To date, 580,000 doses of the two-shot vaccine have been distributed to jurisdictions nationwide. In mid-July, the Department of Health and Human Services announced it had ordered more than 2.5 million additional doses.

Some cities with high case rates are delaying the second shot for those at high risk of the disease, in order to administer as many first doses as possible with their limited supply.  

Many mpox patients have also found it challenging to access tecovirimat (TPOXX), the FDA-authorized drug for treating smallpox. There is a protocol in place to request TPOXX for other orthopox illness like mpox. The new emergency declaration may allow the government to waive some restrictions on distributing tecovirimat to make the drug more widely accessible.

Some states have voluntarily shared data with the Centers for Disease Control and Prevention about the demographics of mpox patients and the number of vaccines and tests administered. But the agency could not require data sharing without an emergency declaration, and information on the true burden of mpox nationwide has been unreliable.   

The formal declaration of a the public health emergency will soon be posted on an HHS webpage, Becerra said.