The C.D.C. should widely release the details of its monkeypox testing protocols so that more labs around the country can develop and run their own tests for monkeypox. The F.D.A. should also issue guidance to all labs with credentials to perform complex laboratory tests and clarify what regulatory authority, if any, they will exercise over monkeypox tests developed elsewhere.
The C.D.C. says that any state health department that confirms a patient has orthopoxvirus should behave as if the person has monkeypox and immediately begin containment efforts like contact tracing. The agency says it is monitoring its testing kit availability should it need to be expanded.
Thankfully, there are monkeypox vaccines and an F.D.A. approved antiviral at the ready in the Strategic National Stockpile. Prioritizing people at immediate monkeypox risk, such as those with a recent close contact, is essential. Vaccinating those who have been exposed, also called ring vaccination, can prevent further spread. Proactive vaccination of those most at risk should also be considered. These efforts and the effective deployment of antivirals require a rapid diagnosis of cases, which is why testing must be a priority, alongside vaccination.
Even if cases among men who have sex with men continue, we will certainly not be the only ones falling ill. Infectious disease epidemics are shaped by the pattern and frequency of contact among people, the pathogen and population immunity and susceptibility. As we learned from Covid-19, epidemics are unpredictable, and human health is globally connected: Variants and viruses that occur in one country can easily cross borders into another.
Our own community of queer people can increase awareness of a novel disease that may present like many other common infections. In the past, we have often been able to lead our physicians and communities by sharing knowledge about our health and ways to intervene with stigma-free care. When bacterial meningitis outbreaks began spreading among gay communities, health officials provided vaccines at nightlife spots and places where men meet for sex. As summer and pride festivities approach, we need similar approaches to help keep one another safe.
Public health officials must develop and implement a testing and vaccination strategy focusing on all communities that are likely to be impacted. Testing and community education focused only in major cities, for example, could increase health disparities along racial, class and geographical lines. We cannot let monkeypox become a disease of those disconnected from health care access.
As experts provide preventive care to those at higher risk, researchers must also initiate studies to answer essential questions about monkeypox transmission. For example, is the virus in saliva and semen, or is it just on skin lesions? The lack of accurate scientific information is now a global problem, and it’s one that could have been addressed much earlier. The first human case was reported in 1970, and human-to-human transmission has been reported in recent years. This is yet another example of the importance of taking neglected diseases seriously in the scientific community even when they don’t appear to be a threat to white people living in the global north.