Health Care

Health Care

THE HILL INTERVIEW

Former CDC official on new mpox cases and current federal resources

Demetre Daskalakis, former executive and principal at the Centers for Disease Control and Prevention (CDC), and the Human Rights Campaign’s Senior Public Policy Advocate Matthew Rose spoke with The Hill about recent mpox cases detected in California and how the drastic changes at the federal level threaten the resources needed to respond.

© Ben Gray, The Associated Press

Three cases of mpox clade I were recently detected in California, with all infected individuals needing to be hospitalized. Clade 1 mpox generally causes more severe illness and differs from the clade II mpox that spread among the social networks of men who have sex with men starting in 2022.

These remarks have been edited for length and clarity.

The Hill: Speaking with public health officials, I know that a chief concern among them is that data sharing and testing might be severely impacted.

Daskalakis: I think the first is, you know, there's a government shutdown. And that is particularly problematic. As California is moving to do enhanced surveillance, CDC is sort of working in the background to be able to support such enhanced surveillance. That means, you know, recommending more testing, and then taking testing a few steps further to see if there is clade Ib that has been circulating in that area.

Without a clade I test readily available, people will do a test for a non-smallpox pox virus. When that's positive in the U.S., that means mpox. Sometimes that goes on to a test that looks for clade II. If that test is negative, historically, what happens is they say, oh, that's maybe clade I, which has not been very common.

The Hill: I reached out to the California Department of Public Health and they said they wouldn't be confirming the gender or the sexuality of the people infected. There were concerns about men who have sex with men, primarily because those are people who were affected two or three years ago. Is that wise to say it's still men who have sex with men who should be worried the most?

Daskalakis: The best defense right now is to continue working with the community that is currently recommended by that [Advisory Committee on Immunization Practices] recommendation and that, remember, doesn't just mean men who have sex with men, but also sex workers — I mean, there's a broad swath of folks who could potentially be involved in this.

If they cannot discern a new at-risk community, what they're doing is enhanced investigation of these cases. And so, they're actually then meeting folks who are exposed to these individuals and then potentially giving them vaccine.

Rose: There is still good reason to just let the community continue to get the message it's getting. We know that there are not enough resources. We know that the vaccine works. And going back and forth on regulations and trying to figure out........

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