 Dear Colleague,
The Bureau of HIV and STI Programs has been collaborating with others across MDHHS to support communication, vaccination, and testing across the state for mpox. As a reminder, case counts and Michigan specific mpox information can be found online at Michigan.gov/Mpox. Please see the important resource and information below:
There was one new mpox case reported from Wayne County on May 20, 2024. There have been a total of 17 confirmed/probable mpox cases this year since February in the following jurisdictions:
- Genesee County
- Kent County
- Oakland County
- Ottawa County
- Macomb County
- Wayne County
- City of Detroit
There is an additional suspect case in Macomb County with test results currently pending. See below for a summary and some basic demographics for these cases (please note: the most recent suspect case has not yet been lab confirmed, so the numbers below may change to reflect information collected during the interview):
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Sex: 17 male, 0 female
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Age range: 21-43 years old
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Race: 10 Black, 6 White, 1 Other
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Ethnicity: 14 not Hispanic or Latino, 3 Hispanic or Latino
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Hospitalized: 3/17
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Deaths: 0/17
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HIV status: 10/17 HIV positive
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MSM status: 11/17 MSM
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Epi link: 9/17 with known epi link to another mpox case
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Vaccination status: 1/17 vaccinated for mpox
Among the 17 confirmed and probable cases, more than half are people with HIV and only a single person was vaccinated for mpox.
As we move into summer celebrations, it is important to stay apprised of the signs and symptoms of mpox and remind our communities that mpox is still circulating. As a reminder, public-facing mpox campaign materials are expected to be available to order via SHOARS on June 3, 2024. If you are not yet registered for SHOARS, you can learn more about signing up by clicking here.
The majority of pre-positioned Tecovirimat (TPOXX) treatment in Michigan expires today, May 31, 2024, and the FDA has communicated that it is unlikely to be extended. MDHHS Bureau of Emergency Preparedness, EMS, and Systems of Care has 14 bottles remaining with an expiration date of June 30, 2024. These doses of TPOXX will not be pre-positioned but will be available through the standard requesting process for any eligible cases in June.
The JYNNEOS vaccine is still the best protection against mpox for anyone who thinks they have been or could be exposed. Given the upcoming commercialization of JYNNEOS, MDHHS is trying to assure that existing doses that are currently present in Michigan are used before they expire. MDHHS will be working on moving vaccine from areas that have higher quantities and lower demand to higher demand jurisdictions in the coming weeks. This will be done using MCIR inventory data and administration data. If you are a site with low JYNNEOS stock, higher demand and are urgently worried about having vaccine on hand, please contact Katie Macomber at macomberk@michigan.gov and we will try to elevate your request.
As a reminder, the MDHHS Mpox Vaccination, Testing and Treatment guide includes up-to-date information on TPOXX, the STOMP trial, JYNNEOS, MDHHS Bureau of Laboratories testing basics, and additional supportive care and pain control treatment options. The guide can be accessed by clicking here.
On May 16, 2024, CDC released a report on the United States preparedness and response to increasing clade I mpox cases in the Democratic Republic of Congo (DRC). Compared to clade II mpox, which caused the 2022 global mpox outbreak and represents the entirety of cases in the United States, clade I mpox can cause severe illness and higher mortality in more people.
No clade I cases of mpox have been reported in countries without endemic transmission, but the increase in clade I mpox cases in the DRC poses a global threat for potential spread. CDC is supporting the DRC in its response and containment efforts and ensuring preparedness in the United States by increasing awareness and surveillance, expanding clade I diagnostic testing capacity, and communicating guidance.
Clinicians and public health practitioners should be alert for possible cases in travelers from DRC and request clade-specific testing if there is any suspicion of mpox. CDC continues to advocate for anyone who believes they may have a higher chance of exposure to mpox to get vaccinated, as the JYNNEOS vaccine also provides protection against clade I mpox. In the United States, approximately 25% of individuals in the with a higher likelihood of mpox exposure have completed the 2-dose JYNNEOS vaccine series according to CDC estimates.
Last week, CDC issues two new reports on mpox surveillance in the United States from October 2023 through April 2024 and mpox infections after 2 preexposure doses of the JYNNEOS vaccine from May 2022 to present. Since the mpox outbreak began in 2022, mpox cases have continued to occur in the United States although they have sharply declined from the peak of approximately 3,000 cases per week to about 59 cases per week. The majority of new confirmed mpox cases have occurred in unvaccinated individuals.
Mpox infection after completion of the 2-dose JYNNEOS vaccine series is estimated to have occurred in less than 1% of fully vaccinated individuals and comprises a small proportion of national cases. The reports confirm that among those individuals for whom complete data is available, mpox infections have been milder than those among unvaccinated individuals. Disparate time intervals from vaccination to lab-confirmed mpox diagnoses among fully vaccinated individuals suggest that immunity is not waning. CDC and the Advisory Committee on Immunization Practices (ACIP) still do not recommend a booster dose of the JYNNEOS vaccine for anyone that completed the 2-dose JYNNEOS vaccine series. Additionally, CDC and ACIP do not recommend vaccination for anyone that has been diagnosed with mpox regardless of any doses of JYNNEOS vaccine they received. To optimize protection, anyone who believes they would benefit from mpox vaccination should be encouraged to complete the 2-dose JYNNEOS vaccination series.
Our team continues to follow the situation closely and will share updates as they become available.
You are receiving this message as a valued partner of the Michigan Department of Health and Human Services Bureau of HIV and STI Programs. Please feel free to share this message.
Michigan.gov/HIVSTI
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