Members of the Cook County Health and Hospitals Committee gathered Aug. 8 to hear details from local health officials on the monkeypox virus' (MPV's) impact on both suburban Cook County and Chicago, and their planned responses.
Openly gay Cook County Board Commissioner Kevin Morrison introduced a resolution to hold the meeting, attended by officials from Cook County Health (CCH), Cook County Department of Public Health and Chicago Department of Public Health (CDPH).
MPV was declared a national public health emergency Aug. 4. In its current phase, the infection has been transmitted disproportionately to gay and bisexual men, as well as other men who have sex with men (MSM). Vaccine supplies have been scarce, and across the nation several persons seeking protection have encountered logistical difficulties.
"This resolution [to hold the meeting] is meant to strengthen our response to the monkeypox outbreak through increased collaboration and cooperation between the Chicago and county health departments," Morrison said. "… With no signs of [MPV] stopping anytime soon, collaboration is necessary to generate an effective response that communicates proper guidance and dispels misinformation to the public."
Massimo Pacilli, Deputy Commissioner of CDPH's Disease Control Bureau, said that there were 556 cases of MPV in Chicago as of Aug. 8. Also, as of that date, the virus had appeared in 60 out of the city's 77 neighborhoods.
Chicago had received about 33,000 doses of MPV vaccine as of Aug. 3; health authorities are expecting 20,000 more throughout August, Pacilli said.
"There will be many more additional doses of the vaccine that have been ordered by the federal government but that may take a few months to receive them," he added.
Pacilli said that the scarcity of the primary vaccine, JYNNEOS, is thanks to, among other factors, its needing to be resourced from the federal government's stockpile and is manufactured only by a company, Bavarian Nordic, in Denmark.
He further noted that MPV testing is now robust—public health and commercial labs have the capacity to perform about 80,000 tests weekly, and swabs of lesions can be collected by any medical provider.
Cook County Health (CCH) officials, meanwhile, planned on moving into a second phase of its MPV response as of Aug. 10. That phase entails screening and testing, vaccinations and treatment referrals. Beyond Cook County Health's CORE Center in Chicago (where most MPV cases will be referred), these services would additionally be available at CCH facilities in Arlington Heights, Blue Island and North Riverside.
The first phase of Cook County Health's response—offered to CCH patients and community members at high-risk of transmission—commenced July 9. Phase 3 begins in September; in that phase treatments will likely be offered at the CORE Center and previously mentioned suburban locations, as well as locations in Belmont Cragin, Cottage Grove and CCH's John Sengstacke Health Center.
As of Aug. 4, CCH had treated 10 patients with MPV and vaccinated 340, according to Ratna Kanumary, executive director of CCH's ambulatory operations.
Sharon Welbel, chair of Cook County Health's Infection and Hospital Epidemiology division, noted that, thought gay, bisexual and other men who have sex with men have been disproportionately impacted by MPV in its current phase, the virus can be transmitted to "just about anybody."
Welbell explained that the principal mode of transmission of MPV is through skin-to-skin contact with persons with MPV lesions, as well as handling items such as clothing, towels or bedding that individuals with MPV have been using. She noted that there have been some instances of transmission through air droplets, but those instances have been both rare and usually between persons living in close proximity with one another.
Welbell said that all Cook County Health staff was trained through an online module that is continually updated. The Cook County Health system has diagnosed about 45 people with MPV, she said.
LaMar Hasbrouck, MD, COO for Cook County Department of Public Health (CCDPH), added that his agency had diagnosed another 49 cases. He said that about 60-65% of the cases had been among MSM. He noted that about 25% of the patients—both locally and at global levels—are not comfortable disclosing their sexual orientation.
Nevertheless, Hasbrouck added, "We don't look at this as a typical sexually transmitted disease—the data is still out [about whether it can be transmitted through] vaginal fluid or semen, but it has been transmitted [mainly] through the act of sexual intimacy."
He emphasized that, while MPV is not transmitted through casual contact, every person is at some level of risk.
"If you are in the general population, you should not feel like you are in the clear," he said. "If you are in the queer population, you should not feel like you are just going to get this or that you are at higher risk."
Hasbrouck also said the public should expect guidance to evolve, or that other groups might also be disproportionately impacted.
Hasbrouck further acknowledged the shortage of vaccination supplies. He said that Illinois had received about 7,000 doses, of which CCDPH received about 1,000 and subsequently redistributed about half of those.
