Epidemiologic Features of the Monkeypox Outbreak and the Public Health Response - United States, May 17-October 6, 2022

Abstract

On May 17, 2022, the Massachusetts Department of Health announced the first suspected case of monkeypox associated with the global outbreak in a U.S. resident. On May 23, 2022, CDC launched an emergency response (1,2). CDC's emergency response focused on surveillance, laboratory testing, medical countermeasures, and education. Medical countermeasures included rollout of a national JYNNEOS vaccination strategy, Food and Drug Administration (FDA) issuance of an emergency use authorization to allow for intradermal administration of JYNNEOS, and use of tecovirimat for patients with, or at risk for, severe monkeypox. During May 17-October 6, 2022, a total of 26,384 probable and confirmed* U.S. monkeypox cases were reported to CDC. Daily case counts peaked during mid-to-late August. Among 25,001 of 25,569 (98%) cases in adults with information on gender identity,^† 23,683 (95%) occurred in cisgender men. Among 13,997 cisgender men with information on recent sexual or close intimate contact,^§ 10,440 (75%) reported male-to-male sexual contact (MMSC) ≤21 days preceding symptom onset. Among 21,211 (80%) cases in persons with information on race and ethnicity,^¶ 6,879 (32%), 6,628 (31%), and 6,330 (30%) occurred in non-Hispanic Black or African American (Black), Hispanic or Latino (Hispanic), and non-Hispanic White (White) persons, respectively. Among 5,017 (20%) cases in adults with information on HIV infection status, 2,876 (57%) had HIV infection. Prevention efforts, including vaccination, should be prioritized among persons at highest risk within groups most affected by the monkeypox outbreak, including gay, bisexual, and other men who have sex with men (MSM); transgender, nonbinary, and gender-diverse persons; racial and ethnic minority groups; and persons who are immunocompromised, including persons with advanced HIV infection or newly diagnosed HIV infection.

FIGURE 1

Monkeypox cases and public health response, by date^, — United States, May 17–October 6, 2022 Abbreviations: COCA = Clinician Outreach and Communication Activity; FDA = Food and Drug Administration; ID = intradermal; LRN = laboratory and response network. * N = 26,384. Figure excludes one case for which information needed to calculate date is missing. ^† Date is defined as the earliest date available among the following: 1) a positive laboratory test report date, 2) CDC call center reporting date, or 3) case data entry date into CDC’s Data Collation and Integration for Public Health Event Responses platform. ^§ Data since approximately September 25 are incomplete because of delays in reporting.

FIGURE 2

Monkeypox cases in adult men aged ≥18 years, by week of onset, gender identity, and reported recent sexual contact history — United States, May 17–October 6, 2022 Abbreviation: MMSC = male-to-male sexual contact. * Excludes cases in persons aged <18 years and one case with missing information needed to calculate report date. Recent sexual contact is defined as engaging in any sex (e.g., vaginal, oral, or anal) or close intimate contact (e.g., cuddling, kissing, touching partner's genitals or anus, or sharing sex toys) during the 21 days before symptom onset.