Prism Health North Texas is reporting a significant increase of monkeypox cases, and there aren’t enough vaccines for those who want them.
Prism Health is North Texas’ largest nonprofit provider of care for HIV/AIDS, sexually transmitted infections, and transgender services. Its chief executive reports an influx of regular and new patients who are arriving with Monkeypox concerns.
“We are seeing a lot of patients that are coming in either with monkeypox infection or worried that they have it,” says Prism CEO Dr. John Carlo. “We are taking care of infected people and trying to learn whether or not they have it.”
According to the health department, there are 175 confirmed cases of monkeypox in Dallas County. As the Dallas Morning News first reported, this accounts for 40 percent of the entire state’s cases. All but three are in men. The fifth case in the county was a man who attended the Daddyland Festival over July 4 weekend, whose website describes it as “four days of dance parties at Dallas’s best venues featuring an amazing international DJ lineup.” Carlo says much of the community spread originated from that festival, but there have since been unconnected cases, meaning community spread is occurring elsewhere.
While monkeypox can be spread during sex, Carlo emphasized that it is not limited to sexual transmission and can be spread with close skin-to-skin contact. Prism is seeing plenty of cases not connected to sex.
“Nobody is unique in terms of a risk for monkeypox infection,” Carlo says. “We’re at the beginning of seeing more cases not connected to one specific group of people.”
As the disease continues to spread, vaccine demand is increasing. Dallas County recently expanded vaccine eligibility to those who have had skin-to-skin contact with someone who has tested positive for monkeypox or who has had multiple or anonymous sex partners in the past two weeks. Prism is working to connect that individual with the county’s health department early in the infection. If a rash has already appeared, the vaccine isn’t effective. In addition to a rash and blisters that form within a few weeks of exposure, monkeypox causes flu-like symptoms and is rarely fatal.
At the moment, demand for the vaccine is exceeding supply, Carlo says.
“There’s simply not enough in our county right now,” he said. “It’s an important step that we need to take as soon as possible. Many people are ready to go come in and get the vaccine.”
The News reported that Dallas County recently received 5,000 doses of the monkeypox vaccine and was waiting on more from the state. That is enough for 2,500 people to receive the two doses, but Dallas County Health Director Dr. Philip Huang told the newspaper that the supply might have to last six weeks. Dallas County Judge Clay Jenkins reported a high call volume for the county’s monkeypox hotline and encouraged residents to keep calling if they couldn’t get through the first time.
In contrast to Dallas, Carlo was in Montreal for the International AIDS Conference when he spoke with D CEO Healthcare. He said he was able to walk into a Canadian clinic without any paperwork and receive the monkeypox vaccine. The vaccine is available for anyone who wants it in Canada. “That was a decision of the Canadian government opening up the stockpile versus the U.S. not having the same stockpile,” he says.
Carlo sees many parallels with the early days of the AIDS crisis and the current news surrounding monkeypox. Misconceptions about who can get the disease, how it is spread, and limited treatment options were present during the AIDS epidemic and are also present today. Thankfully, monkeypox is not close to as deadly as AIDS was.
Though Dallas hasn’t experienced the level of infection seen in New York, San Francisco, and parts of Europe, there has been community spread and an increase in cases. For now, Prism and other organizations are educating the public and trying to stop as many infections as they can through testing and awareness, in addition to administering the limited vaccines. He remains optimistic about the community’s ability to address new infections.
“It looks like we should be getting more vaccines shortly,” he says. “This will open things up quickly, which will be an important step. Many people are ready to stand up and get the vaccine as soon as it’s available.”
Find more information for providers and the public on monkeypox here.