The state’s department of health, the CDPH, said the new case was from the Clade I strain – different from the Clade II strain that has been in circulation in the US since 2022.

The person in question, who is now isolating at home, had recently travelled to Africa and the CDPH said their case was “related to the ongoing outbreak of Clade I mpox in Central and Eastern Africa”.

Mpox was declared a global health emergency by the World Health Organization earlier this year.

The CDPH said that while Clade I cases had tended to cause more severe illness than Clade II in the past, “recent infections from Clade I mpox may not be as clinically severe as in previous outbreaks”.

Mpox is caused by a virus in the same family as smallpox but is usually much less harmful.

It was originally transmitted from animals to humans but now also passes between humans.

Initial symptoms include fever, headaches, swellings, back pain and aching muscles. A rash can then develop, which can be extremely itchy or painful.

The infection can clear up on its own and lasts between 14 and 21 days, but in some cases has been fatal, particularly for vulnerable groups including small children.

Mpox is most common in remote villages in the tropical rainforests of West and Central Africa, in countries such as the Democratic Republic of Congo (DR Congo), where it has been seen for many years.

Hundreds of people died during an initial outbreak in DR Congo earlier this year, and the disease has since spread to areas of Central and East Africa.

Outbreaks can be controlled by preventing infections with vaccines, though these are usually only available for people at risk or those who have been in close contact with an infected person.

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LONDON (AP) — The World Health Organization has renamed monkeypox as mpox, citing concerns the original name of the decades-old animal disease could be construed as discriminatory and racist.

The U.N. health agency said in a statement Monday that mpox was its new preferred name for monkeypox, saying that both monkeypox and mpox would be used for the next year while the old name is phased out.

WHO said it was concerned by the “racist and stigmatizing language” that arose after monkeypox spread to more than 100 countries. It said numerous individuals and countries asked the organization “to propose a way forward to change the name.”

In August, WHO began consulting experts about renaming the disease, shortly after the U.N. agency declared monkeypox’s spread to be a global emergency.

To date, there have been more than 80,000 cases identified in dozens of countries that had not previously reported the smallpox-related disease. Until May, monkeypox, a disease that is thought to originate in animals, was not known to trigger large outbreaks beyond central and west Africa.

Outside of Africa, nearly all cases have been in gay, bisexual or other men who have sex with men. Scientists believe monkeypox triggered outbreaks in Western countries after spreading via sex at two raves in Belgium and Spain. Vaccination efforts in rich countries, along with targeted control interventions, have mostly brought the disease under control after it peaked in the summer.

In Africa, the disease mainly affects people in contact with infected animals such as rodents and squirrels. The majority of monkeypox-related deaths have been in Africa, where there have been almost no vaccines available.

U.S. health officials have warned it may be impossible to eliminate the disease there, warning it could be a continuing threat mainly for gay and bisexual men for years to come.

Mpox was first named monkeypox in 1958 when research monkeys in Denmark were observed to have a “pox-like” disease, although they are not thought to be the disease’s animal reservoir.

Although WHO has named numerous new diseases shortly after they emerged, including Severe Acute Respiratory Syndrome, or SARS and COVID-19, this appears to be the first time the agency has attempted to rechristen a disease decades after it was first named.

Numerous other diseases, including Japanese encephalitis, German measles, Marburg virus and Middle Eastern Respiratory Syndrome have been named after geographic regions, which could now be considered prejudicial. WHO has not suggested changing any of those names.

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NEW YORK (AP) — Health officials are warning people who are infected with monkeypox to stay away from household pets, since the animals could be at risk of catching the virus.

The Centers for Disease Control and Prevention for months has had the advice in place as monkeypox spreads in the U.S. But it gained new attention after a report from France, published last week in the medical journal Lancet, about an Italian greyhound that caught the virus.

The dog belongs to a couple who said they sleep alongside the animal. The two men were infected with monkeypox after having sex with other partners and wound up with lesions and other symptoms. The greyhound later developed lesions and was diagnosed with the virus.

Monkeypox infections have been detected in rodents and other wild animals, which can spread the virus to humans. But the authors called it the first report of monkeypox infection in a domesticated animal like a dog or cat.

Pets that come in close contact with a symptomatic person should be kept at home and away from other animals and people for 21 days after the most recent contact, the CDC advises.

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www.gov.ca.gov | Contributed

As part of the state’s ongoing response to the monkeypox outbreak, Governor Gavin Newsom declared a State of Emergency to bolster the state’s vaccination efforts. The proclamation supports the work underway by the California Department of Public Health and others in the administration to coordinate a whole-of-government response to monkeypox, seek additional vaccines and lead outreach and education efforts on accessing vaccines and treatment.

“California is working urgently across all levels of government to slow the spread of monkeypox, leveraging our robust testing, contact tracing and community partnerships strengthened during the pandemic to ensure that those most at risk are our focus for vaccines, treatment and outreach,” said Governor Newsom. “We’ll continue to work with the federal government to secure more vaccines, raise awareness about reducing risk, and stand with the LGBTQ community fighting stigmatization.”

To expand vaccination efforts, the proclamation enables Emergency Medical Services (EMS) personnel to administer monkeypox vaccines that are approved by the FDA, similar to the statutory authorization recently enacted for pharmacists to administer vaccines. The state’s response to monkeypox builds on the infrastructure developed during the COVID-19 pandemic to deploy vaccine clinics and ensure inclusive and targeted outreach in partnership with local and community-based organizations.

As part of the state’s ongoing response to the monkeypox outbreak, Governor Gavin Newsom declared a State of Emergency to bolster the state’s vaccination efforts. The proclamation supports the work underway by the California Department of Public Health and others in the administration to coordinate a whole-of-government response to monkeypox, seek additional vaccines and lead outreach and education efforts on accessing vaccines and treatment.

“California is working urgently across all levels of government to slow the spread of monkeypox, leveraging our robust testing, contact tracing and community partnerships strengthened during the pandemic to ensure that those most at risk are our focus for vaccines, treatment and outreach,” said Governor Newsom. “We’ll continue to work with the federal government to secure more vaccines, raise awareness about reducing risk, and stand with the LGBTQ community fighting stigmatization.”

To expand vaccination efforts, the proclamation enables Emergency Medical Services (EMS) personnel to administer monkeypox vaccines that are approved by the FDA, similar to the statutory authorization recently enacted for pharmacists to administer vaccines. The state’s response to monkeypox builds on the infrastructure developed during the COVID-19 pandemic to deploy vaccine clinics and ensure inclusive and targeted outreach in partnership with local and community-based organizations.

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LONDON (AP) — Since May, nearly 90 countries have reported more than 31,000 cases of monkeypox.

The World Health Organization classified the escalating outbreak of the once-rare disease as an international emergency in July; the U.S. declared it a national emergency last week.

Outside of Africa, 98% of cases are in men who have sex with men. With only a limited global supply of vaccines, authorities are racing to stop monkeypox before it becomes entrenched as a new disease.

CAN MONKEYPOX BE CONTAINED?

Theoretically, yes. The virus does not spread easily and there is a vaccine. But there are only about 16 million doses available now and only one company makes the shot.

Except for Africa, there is no sign of sustained monkeypox transmission beyond men who have sex with men, meaning that stopping spread among that group could effectively end the outbreak. Last week, British scientists said there were “early signs” the monkeypox cases in the U.K. — which once had the world’s biggest outbreak outside Africa — had peaked.

IS THIS ANOTHER PANDEMIC?

No. A pandemic means that a disease outbreak has spread to the entire world. Monkeypox does not transmit as quickly as the coronavirus and stopping it will not require dramatic interventions like the COVID-19 lockdowns.

WHO’s Director-General Tedros Adhanom Ghebreyesus said he declared monkeypox an emergency in part to prompt countries to take the epidemic seriously, saying there is still an opportunity to contain the disease before it becomes a global problem.

HOW DOES IT SPREAD?

Monkeypox spread typically requires skin-to-skin or skin-to-mouth contact with an infected patient’s lesions. People can also be infected through contact with the clothing or bedsheets of someone who has monkeypox lesions.

It also can be spread through contact with respiratory droplets, but scientists are still trying to figure out how often that happens. British health officials say they haven’t confirmed any instances of airborne transmission.

WHO IS GETTING INFECTED?

A large percentage of cases have been in gay and bisexual men. The initial outbreaks in Europe and North America were likely triggered by sex at two raves in Spain and Belgium.

According to the U.S. Centers for Disease Control and Prevention, 99% of monkeypox cases in the U.S. are men. Of those, 94% reported sexual contact with other men in the three weeks before they developed symptoms.

Still, anyone can catch the virus if they are in close contact with an infected person or fabrics that touched an infected person.

WHO IS GETTING VACCINATED?

With supplies limited, health officials are not recommending mass vaccination. They are suggesting the shots for health workers, people who have been in close contact with an infected person, and men at high risk of catching monkeypox.

Officials are also trying to stretch supplies of the vaccine, Jynneos. It requires two doses, but many places are only giving one dose.

U.S. health officials on Tuesday authorized a new strategy that would allow health professionals to vaccinate up to five people — instead of one — with each vial. The approach uses just a fraction of the typical amount of vaccine and administers it with an injection just under the skin rather than into deeper tissue. Recipients would still get two shots a month apart.

WHAT ELSE CAN I DO TO LOWER MY RISK?

WHO’s Tedros recommended that men at risk of catching monkeypox consider making “safe choices” and reducing their sexual partners “for the moment.”

Britain’s Health Security Agency has advised people to check themselves for monkeypox lesions before they have sex or go to a social event, noting that most of the country’s cases are believed to have originated at festivals, saunas and other venues where sex has taken place. Anyone with monkeypox lesions should isolate until they are completely healed, which can take up to three weeks.

WHAT’S THE CONNECTION TO AFRICA?

Monkeypox has been endemic for decades in parts of central and west Africa, where people have mostly been sickened after contact with infected wild animals like rodents and squirrels. The acting director of Africa’s top public health agency said last week that sex among gay and bisexual men was “not relevant” to the continent’s outbreak, with about 40% of cases among women.

Scientists think the monkeypox outbreaks in Europe and North America originated in Africa long before the disease started spreading. Samples from cases in Europe show dozens of mutations, suggesting the initial virus was silently spreading for months or years before the current epidemics were detected.

The version of monkeypox spreading in Europe and North America has a lower fatality rate than the one circulating in Africa. Countries that didn’t see many monkeypox cases before this outbreak have reported a handful of deaths, while Africa has had at least 100 suspected deaths this year.

WHO IS AT HIGHER RISK FOR SERIOUS ILLNESS?

Most people infected with monkeypox recover without treatment, but it can cause more severe symptoms like brain inflammation and in rare cases, death.

Monkeypox can be serious in children, pregnant women and people with underlying health conditions, like cancer, tuberculosis or HIV. In the U.S., the CDC says about 40% of people with monkeypox also have HIV.

The longer the current outbreaks continue, the greater the chances the virus could spread in other communities, similar to how HIV was first spotted in gay men before becoming established more widely.

“There is some crossover between the sexual networks of gay and bisexual men and networks of heterosexual people with high sexual activity, so it is possible we could see monkeypox more widely,” said Dr. Paul Hunter, a professor of medicine at Britain’s University of East Anglia. “If that happens, we may have a much bigger problem.”

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WASHINGTON (AP) — U.S. health officials on Tuesday authorized a plan to stretch the nation’s limited supply of monkeypox vaccine by giving people just one-fifth the usual dose, citing research suggesting that the reduced amount is about as effective.

The so-called dose-sparing approach also calls for administering the Jynneos vaccine with an injection just under the skin rather than into deeper tissue — a practice that may rev up the immune system better. Recipients would still get two shots spaced four weeks apart.

The highly unusual step is a stark acknowledgment that the U.S. currently lacks the supplies needed to vaccinate everyone seeking protection from the rapidly spreading virus.

That includes 1.6 million to 1.7 million Americans considered by federal officials to be at highest risk from the disease, primarily men with HIV or men who have a higher risk of contracting it. Vaccinating that group would require more than 3.2 million shots.

White House officials said the new policy would immediately multiply the 440,000 currently available as full doses into more than 2 million smaller doses.

“It’s safe, it’s effective, and it will significantly scale the volume of vaccine doses available for communities across the country,” Robert Fenton, the White House’s monkeypox response coordinator, told reporters.

The Biden administration declared monkeypox a public health emergency last week in an effort to slow the outbreak that has infected more than 8,900 Americans. Officials announced a separate determination Tuesday that allows the Food and Drug Administration to expedite its review of medical products or new uses for them, such as the dose-sparing technique for Jynneos.

The FDA authorized the approach for adults 18 and older who are at high risk of monkeypox infection. Younger people can also get the vaccine if they are deemed high risk, though they should receive the traditional injection, the agency said.

FDA officials stressed that the second dose is critical to ensuring protection.

“We feel pretty strongly that the two doses are necessary because, in part, we don’t have any evidence that three, six, eight months later people will be adequately protected by a single dose,” said Dr. Peter Marks, the FDA’s vaccine chief.

Regulators pointed to a 2015 study showing that inoculation with one-fifth of the traditional two-dose vaccine generated a robust immune-system response comparable to that of the full dose. About 94% of people receiving the smaller dose had adequate levels of virus-fighting antibodies, compared with 98% of those receiving the full dose, according to the study funded by the National Institutes of Health.

The NIH is planning an additional trial of the technique. And Centers for Disease Control and Prevention Director Dr. Rochelle Walensky said her agency is already starting to track real-world vaccine effectiveness in U.S. communities, though initial estimates will take time to generate.

But some experts and advocates worried that with little data to support the policy, it could backfire if it reduces vaccine effectiveness.

“We have grave concerns about the limited amount of research that has been done on this dose and administration method, and we fear it will give people a false sense of confidence that they are protected,” said David Harvey of the National Coalition of STD Directors, in a statement.

The smaller doses also require a different type of injection that penetrates only the top layer of skin, rather than the lower layer between the skin and muscle. That’s a less common technique that may require extra training for some health practitioners. But infectious disease specialists said it shouldn’t be a major obstacle.

“Intradermal administration is certainly something that has been used for other vaccines, including the smallpox vaccine, which was administered to hundreds of millions of people during the 20th century,” said Anne Rimoin, director of UCLA’s Center for Global and Immigrant Health.

The shallower injection is thought to help stimulate the immune system because the skin contains numerous immunity cells that target outside invaders.

The CDC said it will provide educational materials on the technique along with a broader awareness campaign for U.S. health departments.

Rationing vaccine doses is common in Africa and other parts of the world with limited health resources. In recent years the World Health Organization has endorsed the strategy to address outbreaks of yellow fever, polio and other diseases.

“This is not an uncommon situation” said Dr. William Moss of Johns Hopkins’ Vaccine Access Center. “It comes down to the public health decision-making: In the midst of an outbreak where you have insufficient supply, do you make this tradeoff?”

Both the U.K. and Canada have adopted a single-dose vaccine strategy prioritizing people who face the highest risk from monkeypox. And health departments in several large U.S. cities adopted a similar strategy amid limited supplies, including New York, San Francisco and Washington.

Officials said Tuesday that anyone who previously received a full first dose can get the smaller amount for their second dose.

U.S. officials have shipped more than 625,000 full vaccine doses to state and local health departments. So far the shots have been recommended for people who have already been exposed to monkeypox or are likely to get it due to recent sexual contacts in areas where the virus is spreading.

The Biden administration has come under fire for not quickly marshaling millions more doses from the strategic national stockpile. Officials have ordered 5 million shots since July, but most aren’t expected to be delivered until 2023. Under the new dosing strategy that would represent 25 million doses.

The U.S. owns bulk vaccine ingredients equivalent to 16.1 million doses under contracts with Danish manufacturer Bavarian Nordic. But the material needs to be sealed in vials, a process that’s expected to take months.

The FDA approved the Jynneos vaccine in 2019 to prevent smallpox and monkeypox based, in part, on studies in monkeys. Animals that received the two-dose vaccination were more than twice as likely to survive than those who didn’t after being infected with monkeypox, according to FDA labeling.

Additional human studies showed people who received Jynneos had an immune response similar to those who received an older smallpox vaccine. But Jynneos hasn’t been tested in humans with either monkeypox or its relative smallpox, which was eradicated decades ago.

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GOV.CA.GOV | Contributed

As part of the state’s ongoing response to the monkeypox outbreak, Governor Gavin Newsom today declared a State of Emergency to bolster the state’s vaccination efforts. The proclamation supports the work underway by the California Department of Public Health and others in the administration to coordinate a whole-of-government response to monkeypox, seek additional vaccines and lead outreach and education efforts on accessing vaccines and treatment.

“California is working urgently across all levels of government to slow the spread of monkeypox, leveraging our robust testing, contact tracing and community partnerships strengthened during the pandemic to ensure that those most at risk are our focus for vaccines, treatment and outreach,” said Governor Newsom. “We’ll continue to work with the federal government to secure more vaccines, raise awareness about reducing risk, and stand with the LGBTQ community fighting stigmatization.”

To expand vaccination efforts, the proclamation enables Emergency Medical Services (EMS) personnel to administer monkeypox vaccines that are approved by the FDA, similar to the statutory authorization recently enacted for pharmacists to administer vaccines. The state’s response to monkeypox builds on the infrastructure developed during the COVID-19 pandemic to deploy vaccine clinics and ensure inclusive and targeted outreach in partnership with local and community-based organizations.

Last month, California public health leaders urged federal partners to make more vaccine doses available to the state as quickly as possible so that the state can expand eligibility to both confirmed and probable exposures, as well as to individuals who are at high-risk of contracting the virus. To date, the state has distributed more than 25,000 vaccine doses and will make additional allocations in the coming days and weeks. Los Angeles County has received a separate allocation of vaccine. In all, the state has received more than 61,000 doses. The state is also supporting overall vaccination efforts in collaboration with locals, including helping provide staffing and mobile clinics. The state allocates doses to local health departments based on a number of factors, including the number of reported monkeypox cases in an area and estimate of at-risk populations.

As of July 28, the state had expanded its testing capacity to process more than 1,000 tests a week. The state’s public health laboratory leaders have been working with local public health, academic, and commercial laboratories to ensure testing capacity is increasingly available and coordinated with the public health response. CDPH is also expanding treatment options. Access to the antiviral prescription drug tecovirimat (TPOXX) used to treat monkeypox is limited, but the treatment can now be administered at more than 30 facilities and providers across the state.

The state continues outreach and education efforts to inform Californians about monkeypox and ways to limit its spread. The state has hosted multiple webinars for local health departments, community-based organizations, and other health care providers and has attended various town halls and community meetings to speak with and hear from the public and local leaders. CDPH is also scheduling listening sessions with the LGBTQ community. CDPH is currently running paid ad campaigns on various digital media platforms to promote awareness and engage communities at higher risk of contracting monkeypox.

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SACRAMENTO, Calif. (AP) — California’s governor on Monday declared a state of emergency to speed efforts to combat the monkeypox outbreak, becoming the second state in three days to take the step.

Gov. Gavin Newsom said the declaration will help California coordinate a government-wide response, seek more vaccines and lead outreach and education efforts on where people can get treatment and vaccination.

“We’ll continue to work with the federal government to secure more vaccines, raise awareness about reducing risk, and stand with the LGBTQ community fighting stigmatization,” Newsom said in a statement announcing his declaration.

Nearly 800 cases of monkeypox have been reported in California, according to state public health officials.

The monkeypox virus spreads through prolonged and close skin-to-skin contact, which can include hugging, cuddling and kissing, as well as through the sharing of bedding, towels and clothing. People getting sick so far have mainly been men who have sex with men, though health officials note that the virus can infect anyone.

“Public health officials are clear: stigma is unacceptable and counterproductive in public health response,” Michelle Gibbons, executive director of the County Health Executives Association of California said in a statement. “The fact is that monkeypox is primarily spread by skin to skin contact and sharing objects like bedding or towels, without regard to sexual orientation or gender identity.”

The type of monkeypox virus identified in this outbreak is rarely fatal, and people usually recover within weeks. But the lesions and blisters caused by the virus are painful, and they can prevent swallowing or bowel movements if in the throat or anus.

The declaration in California came after a similar one in New York state on Saturday, and in San Francisco on Thursday. Newsom’s administration had said as recently as Friday that it was too soon for such a declaration.

After pressing for Newsom to make such a declaration, Democratic state Sen. Scott Wiener of San Francisco hailed the governor’s decision.

“The monkeypox outbreak is an emergency, and we need to use every tool we have to control it,” Wiener said.

Newsom’s proclamation allows emergency medical personnel to administer monkeypox vaccines that are approved by the federal government.

That’s similar to a recent law that allows pharmacists to administer vaccines, Newsom’s administration said. It said the state’s response is building on the steps developed during the coronavirus pandemic to set up vaccination clinics and make sure there is outreach to vulnerable populations in cooperation with local and community-based organizations.

California has received more than 61,000 vaccine doses and has distributed more than 25,000 doses.

“We don’t have any time to waste,” Los Angeles County Supervisor Kathryn Barger said in a statement. She said the nation’s most-populous county must use all available resources to speed the distribution of vaccines and help to those who have been infected.

Newsom’s office said Los Angeles County has received a separate allocation of vaccine.

As of last week, the state had expanded its testing capacity to process more than 1,000 tests a week. Critics have said the long wait for test results delayed treatment options.

In San Francisco, Peter Tran was among hundreds who lined up sometimes for hours to receive the monkeypox vaccine at the Zuckerberg San Francisco General Hospital on Monday after the clinic was forced to close last week because it did not receive enough doses.

“It’s horrible. Like this is a vaccine that’s been out for such a long time. And like, it’s not even a deadly disease. It’s harder to be transmitted than COVID. But the rollout of the vaccines throughout this nation is absolutely horrible,” Tran said.

“I think the science shows that protection is greatly improved with the vaccine. So that’s why I’m doing it. And I honestly just don’t want the lesions on my body. I heard the lesions are painful and leave scarring. So I think that’s another motivation to go out and get it.”

Before making their own emergency declaration last week, San Francisco city officials were criticized for not responding rapidly enough to the outbreak. They, in turn, faulted the federal government for failing to deliver enough vaccines. The city received about 4,000 doses on Friday, enabling it to restart vaccinations, and hopes to administer them by mid-week, said Dr. Lukejohn Day, chief medical officer at the Zuckerberg San Francisco General Hospital.

The city had 305 cases as of Monday, he said.

The World Health Organization has declared the monkeypox outbreak in more than 70 countries a global emergency.

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NEW YORK (AP) — For most of the six decades that monkeypox has been known to affect people, it was not known as a disease that spreads through sex. Now that has changed.

The current outbreak is by far the biggest involving the virus, and it’s been designated a global emergency. So far, officials say, all evidence indicates that the disease has spread mainly through networks of men who have sex with men.

“It clearly is spreading as an STI (sexually transmitted infection) at this point,” said Dr. Tom Inglesby, director of the Johns Hopkins Center for Health Security.

To protect the people at highest risk while trying to contain the spread, public health agencies are focusing their attention on those men — and attacking the virus based on how it’s behaving now.

On Wednesday, the head of the World Health Organization advised men at risk for monkeypox to consider reducing their sexual partners “for the moment.”

But this is a complicated outbreak that may shift in how it spreads and which population groups are most affected. There is also debate about whether monkeypox should be called a sexually transmitted disease, with some critics complaining that the term creates a stigma and could be used to vilify gay and bisexual men.

Monkeypox can spread in nonsexual ways too, and it’s not enough to use condoms or other typical measures for stopping STDs, Inglesby and other experts say.

Here’s what we know.

WHAT MAKES SOMETHING AN STD?

A sexually transmitted disease is commonly defined as one that mainly spreads through sexual contact. But some STDs can be spread in other ways, too. HIV can spread through shared needles. Syphilis can spread through kissing. A common, parasite-caused sexual infection called trichomoniasis has been found to spread through the sharing of damp, moist objects like sponges or towels.

Monkeypox has not usually spread easily among people, and experts are still trying to understand exactly how it moves from person to person. In Africa, where small outbreaks have been common for years, people have been infected through bites from rodents or small animals.

But in May, cases began emerging in Europe, the United States and elsewhere that showed a clear pattern of infection through intimate contact with an infected person, like many other sexually transmitted diseases.

The public health workers who respond to outbreaks play a large role how they are framed. Much of the work on monkeypox has been done by professionals who operate sexual health clinics or specialize in STDs.

Indeed, the U.S. government’s response needs to be led by people with that expertise, said David C. Harvey, executive director of the National Coalition of STD Directors.

“The STD field has a wealth of knowledge and expertise in these areas developed over decades fighting various outbreaks and diseases affecting the very communities … we’re seeing monkeypox taking a toll on today,” Harvey said in a statement.

WHO IS GETTING MONKEYPOX?

WHO officials said last week that 99% of all the monkeypox cases beyond Africa were in men and that of those, 98% involved men who have sex with men. Experts suspect that monkeypox outbreaks in Europe and North America were ignited by sex at two raves in Belgium and Spain.

The statistics are the same for cases reported in the United States, according to the Centers for Disease Control and Prevention. As in Europe, cases have emerged in other groups too, including at least 13 people who were female at birth and at least two children.

Last week, the New England Journal of Medicine published a study of hundreds of monkeypox infections in 16 countries. It found that the suspected means of transmission in 95% of the cases was sexual close contact, as reported by doctors. The researchers noted that it was impossible to confirm sexual transmission.

That idea seemed to be further supported by the finding that most of the men had lesions in the genital or anal areas or in the mouth — areas of sexual contact, the researchers said.

WHY IS THERE A DEBATE ABOUT CALLING IT AN STD?

While there is broad agreement among health officials that monkeypox is being transmitted during sexual encounters, some experts debate whether it should be called an STD. They worry that the term unfairly stigmatizes and that it could undermine efforts to identify infections and tame the outbreak.

When a disease is defined as a sexually transmitted infection that mainly affects men who have sex with men, many people may begin to think of it as “a gay disease” that poses no risk to them, said Jason Farley, an epidemiologist at the Johns Hopkins School of Nursing.

That’s what happened in the early days of the AIDS epidemic in the 1980s, which contributed to the spread of HIV to other groups. Farley said.

“We learn nothing from our history,” said Farley, who is gay.

The WHO recommendation that at-risk men limit their sexual partners is sensible public health advice, he said. But it also amplifies “the message that this is a gay disease,” he said.

“This is the fine line between having a public health approach that focuses on the epidemiology of now, compared to the likelihood of the continued emergence of new cases in” the general community, he said.

“Monkeypox is not a sexually transmitted infection,” he said. “It is an infection that can be transmitted with sexual contact.”

WHAT IS KNOWN ABOUT TRANSMISSION?

Some researchers have found evidence of the monkeypox virus in semen. A study in Spain found monkeypox virus DNA in the semen of some infected men, as well as in saliva and other body fluids. But the study didn’t answer whether the virus actually has spread through semen.

Sorting that out could affect the understanding of not only how men spread the infection, but also how long they might be contagious. Evidence of some other viruses — like Ebola and Zika — has been found in the semen of some men months after they were thought to be fully recovered.

Meanwhile, scientists believe the primary route of transmission during the current outbreak has been skin-to-skin contact during sexual encounters with someone who has symptoms. In that respect, it’s similar to herpes, some experts noted.

The virus also may spread through saliva and respiratory droplets during prolonged, face-to-face contact, such as during kissing and cuddling — a kind of spread that can occur outside of sex.

Researchers are exploring how often, and in what situations, that kind of spread might happen, said Christopher Mores, a professor of global health at George Washington University.

“We would do ourselves a disservice to try and exclude anything from the realm of possibility at this point,” he said.

Officials also say people can catch monkeypox from touching items that previously touched an infected person’s rash or body fluids, such as towels or bedsheets. That is thought to explain the infections of the U.S. children.

WHY ARE THESE DETAILS IMPORTANT?

It’s important to understand exactly how monkeypox spreads in order to give people the information they need to protect themselves, health officials say.

That said, health officials believe those who are currently at the highest risk are gay or bisexual men who have sex with multiple partners. That understanding has shaped much of the work to contain the outbreak, including prioritization of the supply of vaccines and treatments.

The government has been shipping a monkeypox vaccine, but the supply is limited. So far it’s only been recommended as a post-exposure treatment or for people who have had multiple sex partners in the past two weeks in a place where monkeypox cases have been reported.

The vaccine is new, and officials are trying to gather data on exactly how well it works.

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WASHINGTON (AP) — After weeks of delays, nearly 800,000 doses of the monkeypox vaccine will soon be available for distribution, U.S. health regulators said Wednesday.

The announcement comes amid growing criticism that authorities have been too slow in deploying the vaccine, potentially missing the window to contain what could soon become an entrenched infectious disease.

Nearly two weeks ago, the Food and Drug Administration said it had finished the necessary inspections at Bavarian Nordic’s facility in Denmark, where the company fills vials of the vaccine. The FDA said via Twitter on Wednesday that the certification had been finalized. The doses are already in the U.S. “so that they would be ready to be distributed once the manufacturing changes were approved,” the agency said.

The U.S. already has sent more than 310,000 doses of the two-shot Jynneos vaccine to state and local health departments. But clinics in San Francisco, New York and other major cities say they still don’t have enough shots to meet demand.

There were more than 4,600 reported monkeypox cases in the U.S. as of late Wednesday, according to the Centers for Disease Control and Prevention. The head of the U.S. Department of Health and Human Services said Wednesday officials would announce more vaccine allocations on Thursday.

Officials at the San Francisco Department of Health welcomed the news, saying they need many thousands more vaccine doses than the 7,800 they have received to date. “Without enough vaccine supply, we would have trouble fulfilling our basic duty of keeping our communities safe,” the agency said in a statement.

Washington, D.C., officials said Wednesday they would join their counterparts in San Francisco, New York City and other cities who have stopped offering appointments for second vaccine doses due to short supplies. They said the single-dose strategy would allow them to “vaccinate more people at risk and slow the spread of monkeypox in the community more quickly.”

The monkeypox virus mainly spreads through skin-on-skin contact, but it can also transmit through touching linens used by someone with the infection. The vast majority of cases reported have been in men who have sex with men, though health officials have stressed that anyone can catch the virus.

People with monkeypox may experience fever, body aches, chills and fatigue. Many in the outbreak have developed zit-like bumps on many parts of the body.

The sluggish federal response has drawn comparisons to the initial days of the COVID-19 outbreak, but experts have pointed out that the U.S. had one huge advantage: more than 1 million doses of vaccine in the strategic national stockpile.

But it turned out U.S. officials had only about 2,000 doses on hand when the outbreak was first identified in May. Shipping and regulatory delays have meant only a portion of the rest were deployed.

“There’s not enough doses,” said Dr. Perry Halkitis, a public health specialist at Rutgers University. “I think with some quicker action on the part of federal government we might not be in the situation we are now.”

The doses previously shipped came from a separate facility in Denmark that already had FDA clearance. Another 786,000 doses made at a newly opened Bavarian Nordic facility were awaiting the U.S. certification announced Wednesday.

The FDA requires inspections of all vaccine manufacturing plants to assure safety, sterility and consistency of production.

U.S. officials announced orders this month for 5 million more doses, though most of those are not expected to arrive until next year

Officials have recommended the shots be given to people who know or suspect they were exposed to monkeypox in the previous two weeks.

The Jynneos vaccine has never been widely used in response to an outbreak like this, and the government will track how well it’s working.

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