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There's a vaccine and decades of research against Monkeypox. So why is it spreading?

ARI SHAPIRO, HOST:

Monkeypox is very different from COVID-19. It's not fatal and generally doesn't lead to hospitalization. It is mostly not spread through the air. People have been getting it from close physical contact. And a monkeypox vaccine was developed long before the current outbreak. So public health experts say the U.S. should have been able to contain this. Instead, the missteps right now look a lot like the start of the coronavirus pandemic. There are not enough tests or vaccines, and experts have an incomplete picture of the spread. Anne Rimoin, is a UCLA epidemiology professor who has studied monkeypox for years. Welcome to ALL THINGS CONSIDERED.

ANNE RIMOIN: Hi. It's nice to be here.

SHAPIRO: Right now, the CDC says there are more than 750 monkeypox cases in the U.S. How accurate do you think that number is?

RIMOIN: Well, I think that the issue here is that we just don't have enough testing. If you don't have widespread testing available, then your situational awareness is limited to just the groups that you're targeting. I'm certain that we have many more cases out there than we're aware of and many people who don't know how to access testing or people who try to access it who just are not able to get it given the limited capacity at this point.

SHAPIRO: But this is a known disease, so why would the public health community have such a hard time monitoring it? It's been on the radar for years.

RIMOIN: Well, monkeypox is a known disease, but it has been something that's really been limited to the Democratic Republic of Congo, Central Africa in general. And then more recently in 2017, we had an outbreak in Nigeria. In West Africa, they just haven't had the resources to be able to do this kind of testing that's needed. And we're running into the same problems globally. Just because we know about a virus and we actually know that there are ways to detect it and vaccines against it doesn't mean that the logistics of deploying those things are going to make it simple for wide access.

SHAPIRO: The vaccines have not been available even to people who are high risk and living in hot spots. Is this something that the public health community could have been more prepared for in this way?

RIMOIN: Absolutely. We have known that monkeypox is a potential problem for decades. In 2010, my colleagues and I published a paper documenting a very large increase in the incidence of monkeypox since the eradication of smallpox and cessation of vaccination against smallpox. And so we no longer have immunity to other orthopox viruses. The good news is we have vaccines. We have therapeutics. We know a fair amount about this virus. The bad news is now we have to get the logistics together to be able to confront it head on.

SHAPIRO: In the U.S., this outbreak has so far mostly affected men who have sex with men. And I have heard lots of gay men ask whether the response would be faster, stronger, better if it were not primarily affecting a marginalized group. Do you think there's anything to that?

RIMOIN: You know, we've seen over and over again marginalized groups more affected than other groups. And sometimes, we see responses slower in that regard. You know, on the other hand, I would say I would guess that we know more about it because the group that it happens to be in happens to be a group that has incredible awareness about infections, has excellent advocacy and are, by and large, a very good group at help-seeking behaviors. You know, this virus has been affecting people, marginalized, vulnerable people, in sub-Saharan Africa for decades and in particular in places like the Democratic Republic of Congo, where I've been working for the last two decades working on monkeypox. Unless we really focus on attacking these disease threats at their source, we will continue to be chasing behind them.

SHAPIRO: At this point, is it too late to contain this outbreak?

RIMOIN: Well, I think that every day that we aren't throwing the kitchen sink at this outbreak is a lost opportunity, a missed opportunity. Whether or not we can contain this virus really depends upon how well we are able to get those vaccines out and, you know, making it as easy as possible for people to access care, to be able to get tested. And we're not there at this point.

SHAPIRO: UCLA epidemiology professor Anne Rimoin, thanks a lot.

RIMOIN: My pleasure. Transcript provided by NPR, Copyright NPR.

Ari Shapiro has been one of the hosts of All Things Considered, NPR's award-winning afternoon newsmagazine, since 2015. During his first two years on the program, listenership to All Things Considered grew at an unprecedented rate, with more people tuning in during a typical quarter-hour than any other program on the radio.