Men wait in Manhattan last summer to register for the vaccine...

Men wait in Manhattan last summer to register for the vaccine against the virus now called Mpox. Credit: AP/Mary Altaffer

Citing "very low" spread of Mpox — formerly known as monkeypox — for two consecutive months, New York City's health department Wednesday declared an end to the outbreak.

The city's daily average number of cases is now near zero — down from almost 75 during the outbreak's summer peak, according to figures posted to the city Department of Health and Mental Hygiene's website. For much of January, the seven-day average was zero, the department said in a news release.

The outbreak's end dovetails with the Biden administration's similar decision last month not to renew August's declared public health emergency over the virus; that declaration expired Tuesday. 

Although the virus has long been endemic to central and West Africa, in May it began to show up in places where it had been typically rare. The outbreak's first known cases were in Europe, among men who have sex with men, the origin believed to be sex at rave parties in Spain and Belgium. But New York City soon became the outbreak's epicenter.

Globally, the 2022 outbreak continued to infect mostly men who have sex with men, especially those who have anonymous or random sex partners. In the city, about 8.3% of cases were detected in heterosexuals, with the balance having an unknown or LGBTQ identity, according to the city figures. About 93.8% of all cases were in men.

As of the most recent statistics available, Suffolk has had 80 cases, Nassau 65 and the city 3,821. The state has had more cases — 4,222, according to the Centers for Disease Control and Prevention — than any other except California, with 5,725. Nationwide, there are have been 30,123.

In New York City, about 100,000 people have been vaccinated against the virus, which is spread primarily by prolonged skin-to-skin contact with lesions and is almost never deadly.

Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security whose work focuses on emerging infectious disease and pandemic preparedness, attributed the virus' decline to several factors, including mass vaccination of the at-risk population as well as that population having sex with fewer people.

“Men who have sex with men, once they were counseled on the risk of monkeypox, they changed their behaviors pretty dramatically, in terms of decreasing the number of sexual partners,” he said.

Another factor: virus-conferred immunity, which with pox viruses like smallpox, typically lasts for a person’s whole life.

“There’s a concept called saturation," Adalja said.  "A lot of the people that were gonna get infected got infected, and because once you get infected you have immunity, you can’t be reinfected. That saturation of the at-risk population left the virus with less people to infect, meaning it got the people that it was gonna get, the people that were most at risk.” He added: “Everybody else had a lower risk, so there was less of the high-risk people in terms of contracting the virus around.”

And while “there are new people making their sexual debut all the time,” he said, “increasingly, people that are at risk are being vaccinated, so I do think that the ability of monkeypox to cause an outbreak like it did in the United States is much more limited now.”

The city also credited "dedicated outreach ... at bars, circuit parties, sex/play parties, and community health fairs and other events."

Late last year, "Mpox" became monkeypox's new name. The change, the CDC said in November, "will enhance the U.S. response to Mpox by using a less stigmatizing term."

Citing "very low" spread of Mpox — formerly known as monkeypox — for two consecutive months, New York City's health department Wednesday declared an end to the outbreak.

The city's daily average number of cases is now near zero — down from almost 75 during the outbreak's summer peak, according to figures posted to the city Department of Health and Mental Hygiene's website. For much of January, the seven-day average was zero, the department said in a news release.

The outbreak's end dovetails with the Biden administration's similar decision last month not to renew August's declared public health emergency over the virus; that declaration expired Tuesday. 

Although the virus has long been endemic to central and West Africa, in May it began to show up in places where it had been typically rare. The outbreak's first known cases were in Europe, among men who have sex with men, the origin believed to be sex at rave parties in Spain and Belgium. But New York City soon became the outbreak's epicenter.

Globally, the 2022 outbreak continued to infect mostly men who have sex with men, especially those who have anonymous or random sex partners. In the city, about 8.3% of cases were detected in heterosexuals, with the balance having an unknown or LGBTQ identity, according to the city figures. About 93.8% of all cases were in men.

As of the most recent statistics available, Suffolk has had 80 cases, Nassau 65 and the city 3,821. The state has had more cases — 4,222, according to the Centers for Disease Control and Prevention — than any other except California, with 5,725. Nationwide, there are have been 30,123.

In New York City, about 100,000 people have been vaccinated against the virus, which is spread primarily by prolonged skin-to-skin contact with lesions and is almost never deadly.

Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security whose work focuses on emerging infectious disease and pandemic preparedness, attributed the virus' decline to several factors, including mass vaccination of the at-risk population as well as that population having sex with fewer people.

“Men who have sex with men, once they were counseled on the risk of monkeypox, they changed their behaviors pretty dramatically, in terms of decreasing the number of sexual partners,” he said.

Another factor: virus-conferred immunity, which with pox viruses like smallpox, typically lasts for a person’s whole life.

“There’s a concept called saturation," Adalja said.  "A lot of the people that were gonna get infected got infected, and because once you get infected you have immunity, you can’t be reinfected. That saturation of the at-risk population left the virus with less people to infect, meaning it got the people that it was gonna get, the people that were most at risk.” He added: “Everybody else had a lower risk, so there was less of the high-risk people in terms of contracting the virus around.”

And while “there are new people making their sexual debut all the time,” he said, “increasingly, people that are at risk are being vaccinated, so I do think that the ability of monkeypox to cause an outbreak like it did in the United States is much more limited now.”

The city also credited "dedicated outreach ... at bars, circuit parties, sex/play parties, and community health fairs and other events."

Late last year, "Mpox" became monkeypox's new name. The change, the CDC said in November, "will enhance the U.S. response to Mpox by using a less stigmatizing term."

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