CDC Media Telebriefing: Update on 2022 U.S. Monkeypox Investigation Transcript

>>> GOOD AFTERNOON.WELCOME, EVERYONE TO TODAY’S CONFERENCE CALL.AT THIS TIME, YOUR LINES HAVE BEEN PLACED ON LISTEN ONLY FOR TODAY’S CONFERENCE UNTIL TODAY’S QUESTION AND ANSWER PART OF OUR CALL.PLEASE ENSURE THAT YOUR LINE IS UNMUTED AND RECORD YOUR NAME TO ASK YOUR QUESTION.YOU WILL BE ALLOWED ONE QUESTION WITH ONE FOLLOWUP.TODAY’S CONFERENCE IS ALSO BEING RECORDED.IF YOU HAVE ANY OBJECTIONS, YOU MAY DISCONNECT AT THIS TIME.I WILL NOW TURN IT OVER TO OUR HOST, MR. BENJAMIN HAYNES.

>> THANK YOU, JILL, AND THANK YOU ALL FOR JOINING US TODAY FOR THE UPDATE ON THE 2022 U.S. MONKEY POX INVESTIGATION.WE’RE JOINED BY THE DEPUTY DIRECTOR FOR CDC’S HIGH CONSEQUENCE OF PATH GENERALS AND PATHOLOGY.THE DIRECTOR OF CDC’S PRESENCE.THE ASSISTANT SECRETARY FOR PREPAREDNESS AND RESPONSE, AND THE WHITE HOUSE’S SENIOR DIRECTOR FOR WHITE HOUSE SECURITY AND GLOBAL BIO DEFENSE.I WILL PROVIDE OPENING REMARKS BEFORE TAKING YOUR QUESTIONS.I WANT TO NOTE THE CONTENTS OF THIS MEETING ARE EMBARGO UNTIL 1:00 P.M.

>> THANKS FOR JOINING US TODAY.AS WAS MENTIONED, MY NAME IS JENNIFER.I AM THE DEPUTY DIRECTOR OF CDC’S HIGH CONSEQUENCE PATHOLOGY AND THE MANAGER FOR CDC’S MONKEY POX RESPONSE.I’M GOING TO TALK TODAY ABOUT NEW INFORMATION THE CDC IS PUBLISHING FROM RESULTS FROM OUR ONGOING INVESTIGATION INTO THE OUTBREAK.WE ARE AWARE OF MORE THAN 700 CASES THAT HAVE BEEN REPORTED GLOBALLY.IN THE UNITED STATES, 20 CASES HAVE BEEN IDENTIFIED IN 11 STATES AS OF TODAY.THERE’S ONE ADDITIONAL CASE IN THE UNITED STATES THAT WAS INFECTED AND TESTED ELSEWHERE.THE STRAIN OF THE MONKEY POX VIRUS INFECTING PATIENTS IS THE WESTERN AFRICAN KIND.MEANING HISTORICAL OUTBREAKS IN AFRICA, IT HAS LED TO FEWER DEATHS.RIGHT NOW, NO DEATHS HAVE BEEN REPORTED AMONG THE U.S. OR OTHER COUNTRIES.THAT BEING SAID, WE DON’T WANT TO MINE ECONOMIZE THIS CONDITION.THE CASH CAUSED BY MONKEY POX VIRUS CAN SPREAD WIDELY ACROSS THE BODY OR PRESENT IN GENTLE AREAS LIKE THE GENITALIA.SOME PATIENTS HAVE REPORTED NEEDING PAIN DESCRIPTIONS TO EASE THE PAIN.CDC IS COLLABORATING WITH LOCAL HEALTH PARTNERS AND THE COMMUNITY TO LEARN MORE ABOUT HOW THIS OUTBREAK BEGAN AND HOW IT’S SPREADING IN THE UNITED STATES AND OTHER COUNTRIES.TODAY, CDC IS PUBLISHING A MORBIDITY AND MORTALITY REPORT WITH SOME OF THE RESULTS FROM THE EARLY RESPONSE.IT INCLUDES DETAILS ABOUT THE FIRST TWO KNOWN CASES AND THE TIMELINE OF THE OUTBREAK AND THE U.S. PUBLIC HEALTH RESPONSE.I’M GOING TO GIVE YOU THE BRIEF TIMELINE AS REPORTED IN THE MMWR.ON MAY 4th, TWO MEN IN THE UNITED STATES PRESENTED WITH SYMPTOMS CONSISTENT WITH MONKEY POX.BOTH HAD RETURNED FROM INTERNATIONAL TRAVEL.IN MASSACHUSETTS, A MAN DEVELOPED A RASH AND SOUTH OUTPATIENT MEDICAL CARE FOUR TIMES.HE WAS HOSPITALIZED MAY 12th FOR PAIN MANAGEMENT OF THAT RASH.ALSO ON MAY 24th, IN NEW YORK CITY, A MAN SOUTH TREATMENT FOR A PAIN IN THE MOUTH AND BLISTER LIKE SORES.ON MAY 7th, THE UK SECURITY AGENCY ANNOUNCED CONFIRMATION OF A CASE OF MONKEY POX AND THEN THE AGENCY ANNOUNCED MORE CASES ON MAY 4th AND 16th UNLINKED TO THAT MAN WHO HAD TRAVELED FROM NIGERIA.ON MAY 17th, PROMPTED BY NEWS COVERAGE OF THE UK CASES, HEALTH PROVIDERS INSTRUCTED THE CDC ABOUT THEIR PATIENT.A STATE LAB CONFIRMED THE PRESENCE OF THE POX VIRUS THAT DAY, AND THE NEXT DAY, CDC CONFIRMED IT TO BE MONKEY POX.CDC, IN CORRELATION WITH STATE AND OTHER JURISDICTIONS ISSUED AN EMERGENCY RESPONSE.CDC CONTINUALLY MONITORS WITH FOR THIS DISEASE.ON MAY 19th, PROMPTED BY THE MASSACHUSETTS CASE, A HEALTH PROVIDER NOTIFIED CDC ABOUT THE POSSIBILITY OF MONKEY POX IN THE PATIENT MENTIONED IN NEW YORK CITY.HE TESTED POSITIVE AS WELL.WITHIN A FEW DAYS, CLINICIANS REPORTED A HANDFUL OF PATIENTS TO THEIR HEALTH CARE DEPARTMENT.ALL PATIENTS IN THE MMWR AND THOSE REPORTED SINCE ARE ADULTS.MOST OF THEM REPORTED INTERNATIONAL TRAVEL IN THE DAYS BEFORE THEIR SYMPTOMS BEGAN, AND MOST PATIENTS IDENTIFIED AS MEN WHO HAVE SEX WITH MEN HAD.IN MANY CASES, THEIR RASH STARTED IN THE GENITAL AREA.THE MAIN RISK FACTOR FOR GETTING MONKEY POX IS CLOSE CONTACT WITH SOMEONE WHO ALREADY HAS IT AND THE SORES.ANYONE CAN GET MONKEY POX, AND WE ARE CAREFULLY MONITORING FOR MONKEY POX THAT MAY BE SPREADING IN ANY POPULATION, INCLUDING THOSE WHO ARE NOT IDENTIFYING AT MEN WHO HAVE SEX WITH MEN.CURRENTLY, THE CASES REPORTED IN THE UNITED STATES, THOUGH, ARE MOSTLY AMONG GUY, BISEXUAL, OR MEN WHO HAVE SEX WITH OTHER MEN.WE’RE ALSO FOCUSSING EFFORTS TO RAISE AWARENESS WITHIN THE LBGTQ COMMUNITY.OUR PRIORITY IS TO HELP EVERYONE MAKE INFORMED DECISIONS TO PROTECT THEIR HEALTH AND THE HEALTH OF THEIR COMMUNITY GUIDED BY SCIENCE.CURRENTLY, ALL PATIENTS ARE IN RECOVERY OR HAVE ALREADY RECOVERED.THOSE WHO HAVE A RASH ARE BEING ADVISE TODAY STAY HOME.THAT MEANS, WHEN ALL THE SORES HAVE SCABBED OVER, THE SCABS FALL OFF, AND NEW HEALTHY SKIN HAS EMERGED.WE ARE WORKING WITH OUR PARTNERS TO REACH OUT TO PEOPLE WHO MAY HAVE HAD CONTACT WITH THE U.S. PATIENTS WHILE THEY HAD MONKEY POX SYMPTOMS BUT BEFORE THEY ISOLATED.MORE THAN 20 ARE HIGH RISK, MORE THAN 100 ARE INTERMEDIATE RISK, AND MORE THAN 220 ARE LOW OR UNCERTAIN RISK CONTACTS.TO DETERMINE HOW WE DETERMINE RISK LEVELS, YOU CAN FIND THAT ON OUR WEBSITE.AS PART OF OUR RESPONSE, CDC DEVELOPED A HEALTH GUIDANCE AND RELEASED IT TO LABORATORIES.CDC HAS DEVELOPED PROTOCOLS TO TREAT AND PREVENT MONKEY POX.THESE ARE JUST A FEW DETAILS ABOUT THIS RESPONSE.YOU CAN FIND MORE IN THE MMWR AND ON CDC’S MONKEY POX RESPONSE WEB PAGES.NOW I’M GOING TO TURN THIS OVER TO DON O’CONNELL FOR HER COMMENTS.

>> GOOD AFTERNOON.I AMENT THE ASSISTANT SECRETARY FOR PREPAREDNESS AND RESPONSE AT THE U.S. DEPARTMENT OF HUMAN RESOURCES.WE LEAD THE NATION’S MEDICAL AND PUBLIC PREPAREDNESS FOR RESPONSE TO AND RECOVERY FROM DISASTERS.WE DO THIS IN CLOSE PARTNERSHIP WITH CDC AND OTHERS ON THE CALL.WE ARE RESPONSIBLE FOR DEVELOPING AND PROVIDING THE VACCINES BEING USED FOR THIS OUTBREAK TODAY.WE CURRENTLY HAVE TWO VACCINES THAT WE ARE PROVIDING TO STATES FOR TREATMENT AND PRESENCE OF MONKEY POCK.WE HAVE BEEN PREPARING FOR MOMENTS LIKE THIS SINCE OUR OFFICE WAS ESTABLISHED IN 2006.OUR BARTA SUPPORTS THE ADVANCED IMPROVEMENT, APPROVAL, AND VACCINES AND OTHER PRODUCTS.SINCE 2007, BARTA HAS PROVIDED SCIENTIFIC AND TECHNICAL SUPPORT TO PROTECT THE NEXT VACCINE, WHICH IS APPROVED BY THE FDA TO PREVENT SMALLPOX AND MONKEY POX.WE HAVE ALSO SECURED ACAM2000, A SECOND VACCINE AVAILABLE WHICH IS APPROVED FOR SMALL BOX BUT CAN BE USED TO TREAT MONKEY POX UNDER AN INVESTIGATIONAL NEW DRUG PROTOCOL.WE HAVE DEPLOYED BOTH VACCINES IN THIS CURRENT OUTBREAK.BARTA HAS ALSO SUPPORTED THE DEVELOPMENT OF TWO ANTIVIRAL PRODUCTS.THESE ARE BOTH FDA APPROVED TO TREAT SMALLPOX WILL BE BUT LIKE THE OTHER VACCINE, CAN BE ADMINISTERED FOR MONKEY POX UNDER A CDC HELD EXPANDED ACCESS INVESTIGATIONAL NEW DRUG PROTOCOL.IT’S CURRENTLY BEING PROVIDED TO STATES TO TREAT THOSE WHO HAVE MONKEY POX.IN PREPARING THE NATION TO RESPOND RAPIDLY, BARTA LOOKS FOR POTENTIAL COUNTERMEASURES THAT CAN BE USED AGAINST MULTIPLE THREATS.WE’RE SEEING THE ADVANTAGE OF THE APPROACH TODAY.YOUR YEARS TO PROTECT AGAINST SMALLPOX HAVE MADE PRODUCTS AVAILABLE IMMEDIATELY TO RESPOND TO THE CASES OF MONKEY POX.ONCE PRODUCTS LIKE THESE ARE DEVELOPED, THEY ARE ADDED TO THE STOCK PILE, OR THE SNS TO ENSURE WE HAVE SUFFICIENT SUPPLY TO PROTECT THE COUNTRY FROM ANY OF THESE POTENTIAL THREATS.THE SNS HAS SMALLPOX VACCINES AT THE READY.WHILE WE DO NOT DISCLOSE THAT DUE TO NATIONAL SECURITY CONSIDERATIONS, I DO WANT TO SAY WE HAVE ENOUGH ON HAND TO MANAGE THE CURRENT OUTBREAK.THIS INCLUDES THE SUFFICIENT SUPPLY OF JYNNEOS TO MEET THE DEMAND IN CONTROLLING MONKEY POX UNDER THE CURRENT SCENARIO.THE SNS IS PART OF THE MEDICAL RESPONSE INFRASTRUCTURE AS MANY OF YOU KNOW AND CAN SUPPLEMENT MEDICAL COUNTERMEASURES NEEDED BY STATES, TRAVEL NATIONS, TERRITORY, AND THE LARGER METROPOLITAN AREAS.THE SNS IS CURRENTLY RESPONDING WITH THESE COUNTERMEASURES TO EIGHT STATES THAT HAVE CONFIRM CASES OF MONKEY POX.EIGHT STATES HAVE REQUESTED THESE.WHILE WE NEED TO REMAIN VIGILANT AND SEEK TO CONTAIN MONKEY POX, THE GOOD NEWS IS WE ALREADY HAVE THE VACCINES AND TREATMENTS READY TO RESPOND.WITH THAT, I’LL PASS IT TO DR. —

>> THANK YOU, DON FOR THE WORK YOU’RE DOING ALONGSIDE YOUR COLLEAGUES AT ASPER AND CDC.I’M A PHYSICIAN AND EPIDEMIOLOGIST, AND I LEAD THE WHITE HOUSE PANDEMIC PREPAREDNESS OFFICE.OUR OFFICE COORDINATES THE GOVERNMENT’S EFFORTS TO PREVENT AND RESPOND TO INFECTIOUS DISEASE OUTBREAKS, INCLUDING MONKEY POX.I THINK YOU ALSO JUST HEARD FROM BOTH THE DOCTORS ABOUT THE VALUE OF INVESTING IN PREPAREDNESS, AND WE HAVE BEEN COORDINATING THE PRESIDENT’S EFFORTS IN INVESTING ON PREPAREDNESS SINCE DAY ONE WHEN HE RESTORED THIS OFFICE AND KEPT HIS PROMISE TO DO SO.I WANT TO COVER WITH YOU BRIEFLY OUR MULTIPRONGED APPROACH TO FIGHTING THIS OUTBREAK.THIS IS DIFFERENT THAN COVID, OF COURSE, AND I WANT TO GIVE YOU A SENSE OF THE APPROACH WE’RE USING.FIRST, WE WANT TO TEST INFECTED INDIVIDUALS TO FIND OUT WHO IS ILL.WE WANT TO ISOLATE AND CARE FOR ANYONE SUFFERING FROM THIS DISEASE.THIRD, WE WANT TO ENSURE THAT WE UNDERSTAND WHO’S AT RISK OF DEVELOPING MONKEY POX THROUGH CONTACT TRACING EFFORTS.AND LASTLY, WE WANT TO OFFER VACCINES TO PEOPLE WHO HAVE HAD HIGH RISK CONTACT WITH INFECTED INDIVIDUALS TO HELP PREVENT MORE ONWARD TRANSMISSION OF THE VIRUS.SO HOW DO WE ASSESS IF WE’RE ON THE RIGHT TRACK IN THIS OUTBREAK?OF COURSE, THERE ARE SEVERAL INDICATORS.THERE ARE THREE PRIMARY INDICATORS AMONGST OTHERS, WHAT I LIKE TO REFER TO AS THE THREE Ts, TESTING, TRACING, AND TIMELY VACCINES AND TREATMENTS.LET ME TELL YOU WHERE WE STAND ON EACH.FIRST ON TESTING, TO DATE, OVER 124 HAVE BEEN PERFORMED ACROSS THE COUNTRY.THIS IS JUST A FRACTION OF WHAT’S AVAILABLE.66 LABS ACROSS 40 STATES ACTUALLY HAVE THE COLLECTIVE ABILITY TO DO OVER 1,000 TESTS PER DAY.WHAT WE’RE WORKING ON NOW IS TO ENSURE THAT TESTING CAPACITY IS USED, AND WE ARE ASKING INDIVIDUALS WITH SYMPTOMS AS THE DOCTOR DESCRIBED TO GO TO THEIR HEALTH CARE PROVIDERS, AND WE’RE ASKING HEALTH CARE PROVIDERS TO SEND MORE TESTS IN IF THERE’S ANY CLINICAL SUSPICION FOR MONKEY POX.THE SECOND T IS TRACING.AS YOU HEARD ALL STATE AND LOCAL HEALTH DEPARTMENTS INVOLVED HAVE BEEN ASKED TO CARRY OUT CONTACT TRACING.YOU HEARD THE NUMBERS ALREADY.AND THAT IS AN EFFORT TO MONITOR THOSE WITH SYMPTOMS, MONITOR FOR SYMPTOMS I SHOULD SAY AMONGST THOSE VICTIMS WHO HAD CONTACT WITH SOMEONE WITH MONKEY POX.THIS W THIS APPROACH TO CONTACT TRACING, HEALTH DEPARTMENTS ARE ABLE TO PROVIDE PROMPT MEDICAL CARE AND ALSO HELPS ENSURE THERE’S NOT ONWARD SPREAD OF THE DISEASE.THE THIRD T IS TIMELY ACCESS TO VACCINES AND TREATMENTS.YOU HEARD FROM DON ABOUT THE WORK THAT ASPER IS DOING.WE WANT TO ENSURE THAT PEOPLE WITH HIGH-RISK EXPOSURES HAVE RAPID ACCESS TO VACCINES, AND IF THEY BECOME SICK, CAN RECEIVE APPROPRIATE TREATMENT.TO DATE, WE HAVE DELIVERED AROUND 1,200 VACCINES THROUGH THE WORK DON AND HER TEAM HAVE DONE AND 100 TREATMENT COURSES TO EIGHT JURISDICTIONS, AND WE HAVE MORE TO OFFER STATES AS YOU ALSO HEARD FROM DON.THANKFULLY, UNTIL NOW, WE HAVE HAD NO MONKEY POX-RELATED DEATHS.THAT’S ON THE HOME FRONT.AS YOU KNOW AND HEARD FROM THE DOCTOR AT THE TOP, INFECTIOUS DISEASES KNOW NO BORDERS.THAT’S WHY THE U.S. EMBRACES THE GOALS OF RESPOND EFFECTIVELY TO THE OUTBREAK AND PARTNERING WITH OTHER COUNTRIES TO RESPOND LOCALLY.THIS MEAN ENDEMIC AND NON-ENDEMIC COUNTRIES.THAT’S WHY FOR YEARS, THE UNITED STATES HAS BEEN WORKING IN COUNTRIES WHERE MONKEY POX IS ENDEMIC TO RESPOND TO MONKEY POX OUTBREAKS AS PART OF OUR OVERALL EFFORTS TO REDUCE COMMUNICABLE DISEASE AND STRENGTHEN HEALTH SYSTEMS.THROUGH THE GLOBAL HEALTH SECURITY PROGRAMS, WE HAVE PARTNERED WITH GOVERNMENTS LIKE NIGERIA AND CONGO TO SUPPORT RESPONSES TO MONKEY POX AND ARE CONDUCTED RESEARCH SO WE CAN LEARN MORE ABOUT THE DISEASE AND HOW TO STOP IT.OF COURSE WITH LOCAL RESEARCHERS IN THOSE AREAS.LET ME JUST SAY PERSONALLY, I HAVE SEEN THE IMPACT FIRSTHAND HAVING WORKED IN WEST AFRICA ON MONKEY POX RESPONSES.IN FACT, WE WERE ABLE TO SEND IN 2016 AND 2018, SAMPLES FROM PATIENTS TO A CDC LAB IN ATLANTA TO GET THEM TESTED FOR MONKEY POX AND ALLOWED LIBERIA TO KNOW THEY HAD POSITIVE CASES AT THE TIME.I WANT TO SAY WE ASPIRE FOR THE FOLLOWING, TO BE EMPATHY BASED, EQUITY BASED, SCIENCE BASED.WITH THAT, LET ME SAY THANK YOU AND TURN BACK TO BEN.

>> THANK YOU, DOCTOR.JILL, WE ARE READY TO OPEN UP FOR QUESTIONS.

>> THANK YOU.AT THIS TIME, IF YOU WOULD LIKE TO ASK A QUESTION, PLEASE PRESS STAR ONE ON YOUR TOUCH TONE PHONE.ONCE AGAIN, IT IS STAR ONE.PLEASE RECORD YOUR NAME WHEN PROMPTED, AND PLEASE LIMIT YOURSELF TO ONE QUESTION WITH ONE FOLLOWUP.OUR FIRST QUESTION IS FROM JULIE WITH REUTER.YOU’RE LINE IS OPEN, MM.

>> WHAT CAN YOU TELL US ABOUT THE GENETIC SEQUENCES THAT YOU HAVE ALREADY DONE ON THE CASES? I WAS READING A REPORT TODAY BY — NEWS SAYING THERE IS SOME EVIDENCE THAT THERE’S MORE THAN ONE — INVOLVED.WHAT DOES THIS INDICATE ABOUT THE SPREAD OF THIS AND IS THIS MONKEY POX OUTBREAK BASED ON YOUR FINDINGS, SOMETHING THAT CAN BE CONTAINED?THANK YOU.

>> HI.THANKS FOR THAT QUESTION.YES.AS THE MONKEY POX OUTBREAK HAS CONTINUED, OUR LABORATORY SCIENTISTS HAVE BEEN WORKING TO BETTER UNDERSTAND HOW CASES IN THE UNITED STATES MIGHT BE LINKED TO EUROPE AND OTHER PLACES.A NEW ANALYSIS BY OUR LAB EXPERTS THAT RESULTED IN SEQUENCE BEING UPLOADED TODAY SHOWS THAT IN THE UNITED STATES AMONG OUR CASES, WE HAVE SEEN AT LEAST TWO GENETICALLY DISTINCT VARIANTS THAT ARE CIRCULATING.BOTH OF THOSE SHARE COMMON ANCESTORS TO STRAINS THAT HAVE BEEN PRESENT IN NIGERIA SINCE 2017.SO THEY USE SEQUENCING TO FIND A UNIQUE FINGERPRINT OF THE VIRUS WITHIN INDIVIDUAL PATIENTS, AND THAT FINGERPRINT CAN HELP US UNDERSTAND HOW VIRUSS MOVE THROUGH POPULATIONS AND CHANGE OVER TIME.WE CAN FIGURE OUT WHICH ONES GROUP TOGETHER.SO RIGHT NOW, MOST OF THE SEQUENCE — WE HAVEN’T SEQUENCED ALL OF — WE HAVEN’T SEQUENCED VIRUSS FROM ALL THE PATIENTS YET.AMONG THOSE WE HAVE BEEN ABLE TO SEQUENCE, THE VARIANT THAT IS FOUND IN THE MAJORITY OF U.S. CASES LINKED TO THE VARIANT THAT HAS BEEN REPORTED OUT OF EUROPE AND MADE PUBLICLY AVAILABLE BY OTHER COUNTRIES THERE.THOSE CASES ARE SIMILAR TO ONE OF THE U.S. IMPORTED CASES THAT CAME IN THROUGH A TRAVELER FROM NIGERIA LAST YEAR THAT CAME INTO MARYLAND IN 2021.WE KNOW IT’S BEEN CIRCULATING SINCE THAT TIME.THE OTHER TWO MONKEY POX CASES WE UPLOADED TODAY, THEY’RE SIMILAR TO THE 2021 IMPORTED CASE TO TEX TEXAS LAST YEAR THAT CAME IN ON A TRAVELER.WHILE THEY’RE SIMILAR TO EACH OTHER, THEIR GENETIC ANALYSIS SHOW THEY’RE NOT LINKED TO EACH OTHER.IN CONTRAST, THE ONES IN EUROPE ARE TIGHTLY LINKED TO ONE ANOTHER.ONE CASE WE UPLOADED TODAY WAS IN A WOMAN WHO TRAVELED TO WEST AFRICA.THE OTHER IS IN A MAN WHO HAD TRAVELED TO THE MIDDLE EAST AND AFRICA.IT’S NOT CLEAR WHAT ALL THIS MEANS, BUT IT’S LIKELY WITHIN THE LAST COUPLE OF YEARS, THERE HAVE BEEN TWO DIFFERENT INSTANCES WHERE MONKEY POX SPILL OVER INTO PEOPLE FROM NIGERIA, AND THAT VIRUS LIKELY BEGAN TO SPREAD PERSON TO PERSON.THAT’S A LONG EXPLANATION, BUT I KNOW A LOT OF PEOPLE PROBABLY HAD THAT QUESTION, SO I WANTED TO COVER IT COMPLETELY.

>> CAN YOU ANSWER THE QUESTION ABOUT THE TERMS OF WHETHER OR NOT THIS OUTBREAK CAN BE CONTAINED?

>> I KNOW THAT THERE ARE SCIENTISTS THAT ARE BEGINNING TO TALK ABOUT WHETHER MONKEY POX COULD POSSIBLY BECOME ENDEMIC OR WHETHER WE CAN CONTAIN IT.I THINK WE’RE WORKING VERY HARD TO CON TAPE IT, AND IN THE UNITED STATES, OUR CONTAINMENT STRATEGY IS FOCUSED ON IDENTIFYING CASES AND THEIR CONTACTS ASK MAKE SURE THEY GET SACK CONVENES OFFERED TO THEM AND CASES ARE BEING ISOLATED TO PREVENT ONWARD SPREAD.I THINK IT’S TOO EARLY TO KNOW WHETHER IT COULD BECOME ENDEMIC, BUT I THINK IT’S IMPORTANT TO NOTE THAT IT HAS BEEN ENDEMIC IN COUNTRIES FOR MANY DECADES.NEXT QUESTION, PLEASE.

>> OUR NEXT QUESTION IS FROM THE NEW YORK TIMES.YOUR LINE IS OPEN.

>> I WAS WONDERING IF YOU COULD SAY HOW MANY OF THE CASES IDENTIFIED SO FAR HAVE BEEN IN MEN WHO HAVE SEX WITH MEN.YOU MENTIONED MOST OF THEM ARE, BUT CAN YOU GIVE A BREAKDOWN OF THE GENDER AND AGE OF THE PATIENTS YOU IDENTIFIED THAT ARE NOT JUST IN THE MMWR ALSO?

>> YES.SO THIS INFORMATION WILL BE REPORTED IN THE MMWR THAT WILL BE COMING OUT AT 1:00, SO OF — CASES THAT WE HAVE THIS INFORMATION FOR, 16 OF 17 SELF IDENTIFY AS MEN WHO HAVE SEX WITH MEN.ONE CASE IS A WOMAN WHO REPORTS NORMAL HETEROSEXUAL INTIMATE CONTACT.

>> EARLIER IN THE CALL, YOU MENTIONED THAT THERE WERE 0 OR 21 CASES IN THE U.S. ALL TOGETHER, RIGHT? SO WHAT ABOUT THE OTHER FOUR?

>> SO THE OTHER CASES ARE NEWLY REPORTED, AND WE’RE STILL WORK ON INTERVIEWING THEM AND COLLECTING THAT INFORMATION.

>> OKAY.THANK YOU.

>> NEXT QUESTION, PLEASE.

>> OUR NEXT QUESTION COMES FROM ALEXANDER WITH CBS.YOUR LINE IS OPEN.

>> THANKS FOR TAKING MY QUESTION.THIS MIGHT BE FOR ASPER OR THE DOCTOR.CAN YOU TELL US WHY WAS ACAM DEPLOYED IF THERE IS ENOUGH SUPPLY OF JYNNEOS?

>> I’LL BE HAPPY TO START IF YOU WANT TO JUMP BEHIND.SO THIS IS DON.THANK YOU FOR THE QUESTION.THE STATE — WE DEPLOYED THE ACAM2000.AGAIN YES IS USED FOR PREEXPOSURE AND POSTEXPOSURE PROPHYLACTIC, AND IT’S THE ONE THE FDA HAS APPROVED FOR SMALLPOX AND MONKEY POX.BUT ONE STATE RECOMMENDED ACAM2000 WHICH IS USED FOR POSTEXPOSURE.SO THAT STATE IN CONSULTATION WITH CDC AND OTHER EXPERTS MUST HAVE MADE THE DETERMINATION THAT WAS THE PREFERRED INDICATION, AND THEY WANTED TO USE IT FOR THAT.BEYOND THAT, I DON’T HAVE ANY INFORMATION.I JUST AM TRACKING WHAT WE HAVE SHARED WITH STATES, AND THERE WAS ONE STATE THAT MADE THAT REQUEST.THEN AS FAR AS NUMBERS, COULD YOU ASK THAT ONE MORE TIME?I APOLOGIZE.I WANT TO MAKE SURE I KNOW EXACTLY WHAT YOUR QUESTION WAS.

>> YOU HAD MENTIONED EARLIER YOU COULDN’T DISCLOSE CERTAIN FIGURES FROM THE STOCK PILE, BUT I WAS WONDERING THE FIGURE ON THE NUMBER OF DOSES DISTRIBUTED? I’M LOOK TO SEE HOW MUCH HAS BEEN OFFERED VERSUS ADMINISTERED.THANK YOU SO MUCH.

>> I DON’T KNOW A CDC WHO IS WORKING WITH THE STATE PUBLIC HEALTH DEPARTMENT KNOWS THE ONE THAT IS WE HAVE DEPLOYED, BUT I DON’T KNOW THAT WE KNOW HOW MANY HAVE BEEN USED.BUT CDC HAS BEEN WORKING CLOSELY WITH THE STATE.CDC, I DON’T KNOW IF YOU GUYS HAVE THAT GRANULARITY? IF NOT, WE CAN FIND IT AND GET BACK TO YOU.

>> YEAH, WE CAN GET BACK ON THAT.DID YOU HAVE ANYTHING YOU WANTED TO ADD?

>> JUST I HAVE BEEN IN FRONT TOUCH WITH SOME OF THE FRONT LINE DOCTORS, AND I MENTIONED THE NUMBER EARLIER OF OVER AROUND 1,200 VACCINES DELIVERED TO EIGHT JURISDICTIONS.ONCE IT GETS THERE BETWEEN STATE, LOCAL CAN BE AND THE HEALTHCARE PROVIDER, THERE’S FURTHER ACTION, INCLUDING OFFERING TO THOSE WHO ARE THOR THE GUIDANCE THAT CDC HAS BEEN GIVEN AND WHATEVER STATE ADAPTATION THERE IS OF THAT TO INDIVIDUALS.PEOPLE ARE BEING OFFERED THE VACCINE, INCLUDING THE HEALTH CARE PROVIDERS THAT HAVE BEEN EXPOSED TO THE PATIENT.AND I WAS JUST IN TOUCH WITH THE DOCTORS THERE TODAY.THAT JUST GIVES YOU A SENSE OF HOW IT’S HAPPENING.YOU MAY WANT THE ALSO THINK ABOUT REACHING OUT TO SOME OF THE LOCAL ACTORS ON THIS AND SEE IF YOU CAN GET MORE INFORMATION.

>> GREAT.NEXT QUESTION.

>> OUR NEXT QUESTION IS FROM THE WASHINGTON POST.YOUR LINE IS OPEN.

>> HI. WHAT DO WE KNOW ABOUT COMMUNITY SPREAD WITHIN THE UNITED STATES?WE HAVE MULTIPLE CASES REPORTED IN NEW YORK CITY AND BROW WARD, FOR EXAMPLE, IS THERE ANY EVIDENCE THAT THERE’S HUMAN TO HUMAN SPREAD PARTICULARLY AMONG MEN WHO HAVE SEX WITH MEN?

>> SO I CAN TAKE THE FIRST PART OF THIS, AND THEN I’M GOING TO TURN IT OVER TO DMITRY TO TALK ABOUT THE FOCUS IN THE SNS COMMUNITY AND WHAT WE’RE TRACKING THERE.SO RIGHT NOW IN THE UNITED STATES, MORE THAN EVER WHEN THE OVERWHELMING MAJORITY OF OUR CASES ARE REPORTING INTERNATIONAL TRAVEL IN A TIMEFRAME IN WHICH IT SUGGESTS THEIR EXPOSURE HAPPENED THERE.THERE HAVE ALSO BEEN SOME CASES IN THE UNITED STATES WE KNOW ARE LINKED TO KNOWN CASES, AND WE ALSO HAVE AT LEAST ONE CASE IN THE UNITED STATES THAT DOES NOT HAVE A TRAVEL LINK OR KNOW HOW THEY ACQUIRED THEIR INFECTION.DO YOU WANT TO ADD ANYTHING TO THAT?

>> I’LL JUST ADD THAT PART OF THE WORK WE’RE DOING IS MAKING SURE THAT THERE ARE GENERAL MESSAGES GOING OUT TO EVERYONE FOR AWARENESS OF HOW MONKEY POX TRANSMITS AND GET THE MESSAGE TO THE SOCIAL NETWORK WHERE YOU CAN HEAR WE’LL ACTUALLY SEE THE INFECTIONS INITIALLY EMERGING.IT’S SOMETHING WE’RE TRACKING REALLY CLOSELY FROM THE EPI PERSPECTIVE, BUT EVEN MORE PREEMPTIVELY FROM THE MESSAGING PERSPECTIVE.

>> WE’RE HEARING SOME OF THE RASHES AND LESIONS LOOK PRETTY SUBTLE COMPARED TO THE USUAL PHOTOS YOU SEE OUT OF AFRICA WHERE IT LOOKS SOMETHING CLOSER TO SMALLPOX AND THE PHOTOS IN THE CASES WE ARE SEEING SO FAR, IT CAN BE HARD TO TELL IT’S SOMETHING ALONG THE LINES OF MONKEY POX.SO WHAT SHOULD PEOPLE BE LOOK OUT FOR BECAUSE THE LANGUAGE YOU GENERALLY USE CAN BE HARD FOR A LAYPERSON TO UNDERSTAND WHEN WE’RE TALKING ABOUT VESTIBULES AND THINGS LIKE THAT.

>> THANKS FOR THAT QUESTION.IT’S A GREAT QUESTION.MONKEY POX DOES HAVE A VERY CHARACTERISTIC RASH.WE USUALLY DESCRIBE IT AS WELL-ROUNDED LESIONS AND THEY PROGRESS AS THEY AGE.THEY START OUT WITH MACK YULES, WHICH ARE JUST SORT OF ROUNDED AREAS AND TURN INTO LIKE A HIGHER-RAISED AREA, ALMOST LIKE A PENCIL ERASER.I KNOW THAT CAN BE VERY CONFUSING.I DO KNOW THAT OUR STI CLINICIANS IN THE COUNTRY ARE USED TO SEEING RASHES THAT ARE ASSOCIATED WITH OTHER INFECTIOUS DISEASES LIKE HERPES OR SYPHILIS AND THINGS LIKE THAT.I DO THINK IN EARLY PRESENTATION, IT CAN BE CONFUSING TO KNOW WHAT THIS MIGHT BE.FOR THAT REASON, CDC DOES HAVE UPDATED CASE DEFINITIONS ON OUR WEBSITE THAT SAYS, A SUSPECT CASE REALLY SHOULD BE ANYONE WITH A NEW CHARACTERISTIC RASH OR WHO MEETS EPIDEMIOLOGIC CRITERIA AND YOU HAVE A HIGH CLINICAL SUSPICION.THE EPI CRITERIA MIGHT BE THE TRAVEL OR KNOWING CONTACT WITH SOMEONE WHO HAD MONKEY POX.THE IMPORTANT THING WE WANT TO EMPHASIZE IS IF A CLINICIAN HAS A CONCERN ABOUT A RASH THEY’RE SEEING, THEY CAN TEST FOR MONKEY POX, AND I ALSO WANT TO EMPHASIZE THAT EVEN IF THEY THINK WHAT THEY’RE LOOKING AT MIGHT BE EXPLAINED BY SOMETHING ELSE LIKE A MORE COMMON SEXUALLY TRANSMITTED INFECTION, THERE ARE CASES PARTICULARLY OUT OF EUROPE THAT HAVE COINFECTIONS WITH OTHER SEXUALLY TRANSMITTED INFECTIONS, SO THEY SHOULD TEST FOR MONKEY POX EVEN IF THEY THINK THEY HAVE A MORE COMMON STI.NEXT QUESTION, PLEASE.

>> OUR NEXT QUESTION IS FROM NPR.

>> SO THE MMWR SAYS THERE’S 14 OF THE 17 CASES HAVE INTERNATIONAL TRAVEL.CAN YOU TELL US ABOUT THOSE THREE OTHER CASES, AND ARE THOSE — AND THEN, YOU SAID ONE CASE IN THE U.S. HAS NO TRAVEL HISTORY, NO CONTACT WITH ANYONE ELSE.WHERE IS THAT CASE HAPPENING AND WHERE DO YOU THINK THE PERSON GOT IT?

>> SO THE OTHER CASES, THEY DO NOT HAVE TRAVEL, AS I MENTIONED.SOME MIGHT HAVE CONTACT WITH A KNOWN CASE, SO WERE IDENTIFIED THROUGH CONTACT TRACING.THERE’S ONE INDIVIDUAL IN THE UNITED STATES WHO ISN’T SURE HOW THEY ACQUIRED THEIR INFECTION.I DON’T KNOW THAT WE ARE DISCUSSING EXACTLY WHICH STATE THAT IS.I WANT TO EMPHASIZE THAT THIS COULD BE HAPPENING IN OTHER PARTS OF THE UNITED STATES.THERE COULD BE COMMUNITY-LEVEL TRANSMISSION THAT IS HAPPENING, AND THAT’S WHY WE REALLY WANT TO INCREASE OUR SURVEILLANCE EFFORTS AND ENCOURAGE PHYSICIAN THAT IS IF THEY SEE A RASH, THEY NEED TO GO AHEAD AND TEST FOR THAT, AND THAT’S ONE OF THE THINGS THAT WE WANT TO EMPHASIZE.SO I HAVE BEEN HEARING FROM THE DOCTORS UP IN MONTREAL THAT THIS RASH CAN BE REALLY SUBTLE AND ONE SMALL LESION THAT DOESN’T LOOK ANYTHING LIKE THE RASH YOU WERE DESCRIBE EARLIER.I’M CURIOUS HOW YOU’RE GETTING THAT INFORMATION OUT TO CLINICIANS.I WAS TALKING TO A DOCTOR HERE IN TEXAS LAST WEEKEND, AND THEY HAD NO CLUE THAT ONE LESION ON THE PENIS COULD BE SUSPICIOUS OF MONKEY POX.HOW ARE THESE DOCTORS GETTING THAT INFORMATION.

>> SO WE KNOW THAT GETTING GOOD UPDATED INFORMATION OUT TO CLINICIANS, INCLUDING PICTURES OF RASH LESIONS IS GOING TO BE REALLY CRITERIA CAL.SO IN ADDITION TO PUTTING THINGS UP ON OUR WEBSITE, WE’RE TRYING TO GET HEALTH ALERT NOTICES BEING HELPFUL IN GETTING THESE CASES OUT.THE INFORMATION ABOUT POSSIBLE COINFECTIONS AND THEN NEEDING TO COVER TESTING FOR MONKEY POX EVEN IF THEY THINK THERE MIGHT BE SOMETHING ELSE AT PLAY.I THINK WE’RE DEFINITELY LEANING INTO HOW WE MORE EFFECTIVELY COMMUNICATE THAT, AND I LOOK FOR YOU TO LOOK FOR MORE INFORMATION COMING OUT IN THE NEXT DAYS.NEXT QUESTION, PLEASE?

>> CNBC.YOUR LINE IS OPEN, SIR.

>> I KNOW YOU SAID YOU’RE NOT DISCLOSING HOW MANY DOSES ARE IN THE NATIONAL STOCK PILE, BUT NUMBERS WERE DISCLOSED LAST WEEK ON A PREVIOUS CDC CALL, AND THOSE NUMBER HAVE BEEN REPORTED.SO CAN YOU CONFIRM THAT THERE ARE 1,000 DOSES OF GENERAL USE AVAILABLE.SO CAN YOU CONFIRM WHETHER THE 1,000 IS ACCURATE OR NOT.AND BEYOND THAT, UNDER WHAT CIRCUMSTANCES COULD ACAM2000 BE A PREFERRED JYNNEOS SINCE ACAM HAS A HIGH RISK OF ADVERSE EVENTS, THANK.

>> I’M GOING TO ASK COME TO TAKE IT, BUT I’M GOING TO STEP IN FIRST BECAUSE I WAS THE ONE WHO PROVIDED THOSE NUMBERS, AND CAN I TELL YOU THE AVAILABILITY IN THE NATIONAL STOCK PILE HAS SHIFTED SINCE WE TALKED ABOUT IT LAST WEEK, SO I WOULD NOT LOOK AT THOSE NUMBERS AS ACCURATE AT THE CURRENT TIME.DON, DO YOU WANT TO ADD ON?

>> ABSOLUTELY.THANK YOU SO MUCH.SO WE CONTINUE TO HAVE MORE THAN ENOUGH VACCINE AVAILABLE.WE DO HAVE THEM PRE-POSITIONED IN SEVERAL FLIGHTS AROUND THE COUNTRY.ALSO AS YOU MENTIONED, A MANUFACTURER THAT WE’RE WORKING WITH, WE CONTINUE TO HAVE DOSES WITH NORDIC THAT WE ARE REQUESTING.THEY CAN HOLD IT AT A NEGATIVE 50 DEGREES WHICH PROVIDES AN ADDITIONAL 50 YEARS OF SELF-LIFE.SO WE’RE WORKING CLOSELY WITH THE IN NORDIC TO MAKE SURE WE’RE PREPOSITIONING THE VACCINES WE THINK WE CURRENTLY NEED IN THE SNS BUT REALIZING WHENEVER WE PULL IT OUT OF STORAGE, WE’RE REDUCING THE SHELF LIFE BY THOSE TWO YEARS.SO JUST TO RE-EMPHASIZE, THE NUMBERS ARE CHANGING.A, WE’RE DEPLOYING THEM TO VARIOUS STATES.AND B, WE’RE MOVING THEM FROM THE NORDIC FACILITY.SO THERE IS A BIT OF A SHIFT, BUT TO SAY THAT WE HAVE MORE THAN ENOUGH VACCINE AVAILABLE IS WHAT WE WILL CONTINUE TO SAY.I CAN GO BACK AND CONFIRM THAT BETWEEN THE TWO STORAGE SITES.

>> JILL, WE HAVE TIME FOR THREE MORE QUESTIONS.

>> ACAM 2000 AND WHAT CIRCUMSTANCES WOULD IT BE RECOMMENDED BECAUSE OF ADVERSE EVENTS?

>> I MEAN, I THINK THAT’S DEFINITELY A DECISIONS THAT’S MADE IN CONSULTATION WITH THE CLINICIAN AND PATIENTS THEY’RE SEEING.I CAN TELL YOU IT’S A SINGLE DOSE VACCINE, AND JYNNEOS IS A TWO-DOSE VACCINE.

>> NEXT QUESTION IS FROM THE HILL.YOUR LINE IS OPEN.

>> THANK YOU FOR TAKING MY QUESTION.I KNOW YOU AREN’T TALKING ABOUT THE STOCK PILE SPECIFICS.BUT ARE THERE PLANS FOR — OR HAVE ORDERS FOR MORE DOSES IN PLACE WITH THE IN NORDIC? I KNOW THE COMPANY HAS RECEIVED THEY RECEIVED VARIOUS ORDERS IN MANY COUNTRY.WONDERING IF YOU COULD GIVE ANY INFORMATION ON THAT.

>> WE CURRENTLY HAVE A RELATIONSHIP WITH NORDIC.SIGNIFICANT NUMBER OF VACCINES WE HAVE AVAILABLE IN BULK DRUG SUBSTANCE, WHICH CAN BE SOLD INTO VACCINES.SO BETWEEN THE VACCINES CURRENTLY AVAILABLE, THE VACCINES IN THE SNS, THE ONES SITTING IN THE NORDIC IN THAT COOLER TEMPERATURE, WE’VE GOT — I’M NOT SURE IF I’M GOING TO — YEAH, I’M TRYING TO BE CAREFULLY NOT TO DISCLOSE THE EXACT NUMBER BUT SAYING WE HAVE MORE THAN ENOUGH FOR THE CURRENT OUTBREAK.

>> CAN I ALSO JUST ADD — THIS IS RAJ FROM THE WHITE HOUSE — WE’RE ALSO MAKING FURTHER PLANS FOR ADDITIONAL ACCESS AND SUPPLIES SHOULD WE NEED IT FOR OTHER SCENARIOS, RIGHT?SO I THINK DON IS ACTUALLY RIGHT.WE’RE FOCUSED ON THE SCALE OF THE CURRENT OUTBREAK AND HAVE CONCURRED WE HAVE SUFFICIENT VACCINES.AND IF — WE’RE NOT IN THE BUSINESS OF PREDICTION, BUT WE’RE IN THE BUSINESS OF PLANNING, AND I THINK OUR FUNCTION IS TO CONTINUE TO PLAN FOR ANY FUTURE SCENARIOS.THAT IS BAG TAKEN INTO ACCOUNT IN THOSE CONVERSATIONS AS WELL.

>> GREAT.NEXT QUESTION, PLEASE.

>> JACQUELINE HOWARD WITH CNN.YOUR LINE IS OPEN.

>> MY QUESTION IS BASED ON THE GENETIC SEQUENCE DATA AND BECAUSE THERE COULD BE COMMUNITY LEVEL TRANSMISSION CURRENTLY, DO WE HAVE ANY REASON TO BELIEVE THAT THERE MIGHT HAVE BEEN MONKEY POX CASES THAT WENT UNDER THE RADAR HERE IN THE U.S. BEFORE THE MASSACHUSETTS CASE WAS FIRST IDENTIFIED.AND DOES WHAT WE’RE LEARNING CHANGE THE PUBLIC HEALTH RISK LEVEL AT ALL FOR THE U.S.?I BELIEVE LAST WEEK, THE RISK FOR THE PUBLIC WAS STILL LOW.THANK YOU.

>> THANKS FOR THAT QUESTION.THE GENETIC SEQUENCE DATA IS CERTAINLY INTERESTING FROM A SCIENTIFIC PERSPECTIVE, AND I THINK SCIENTISTS ARE GOING TO CONTINUE TO TALK ABOUT WHAT WE THINK IT MIGHT MEAN.I THINK TO DETERMINE HOW LONG MONKEY POX VIRUS HAS BEEN CIRCULATING IS GOING TO REQUIRE ANALYSIS OF A LOT MORE SEQUENCES FROM A LOT MORE PATIENTS TO BE ABLE TO PIECE TOGETHER THAT PUZZLE IN A CLEARER WAY.I THINK IT’S CERTAINLY POSSIBLE THERE COULD HAVE BEEN MONKEY POX CASES IN THE UNITED STATES THIS WENT UNDER THE RADAR PREVIOUSLY, BUT NOT TO ANY GREAT DEGREE.WE HAVE HAD IMPORTED CASES IN TRAVELERS, TOO, THAT WERE IDENTIFIED LAST YEAR.I DON’T THINK MONKEY POX HAS BEEN CIRCULATING WIDELY WITHIN THE UNITED STATES.I ACTUALLY THINK THE FINDING OF THESE TWO CASES IS ACTUALLY A POSITIVE SIGN THAT OUR SURVEILLANCE EFFORT THAT WE ARE WORKING TO INCREASE AND MAKING SURE PEOPLE WITH A RASH GET TESTED IS WORKING.NEXT QUESTION, PLEASE.

>> AND THEN, IS THERE ANY CHANGE IN THE PUBLIC HEALTH RISK LEVEL? IS IT STILL LOW?

>> WE STILL BELIEVE THE PUBLIC HEALTH RISK LEVEL IS LOW.FOR THOSE INDIVIDUALS THAT MIGHT BE PART OF COMMUNITIES WHERE IT DOES LOOK LIKE THE VIRUS IS CIRCULATING, WE’RE REALLY WORKING TO ENSURE THEY GET THE MESSAGING THEY NEED TO STOP ONWARD SPREAD.

>> OUR NEXT QUESTION IS FROM KAREN WITH USA TODAY.YOUR LINE IS OPEN.

>> I WAS WONDERING IF YOU COULD TALK A LITTLE BIT ABOUT THE CASES IN NIGERIA AND DRC.AS I UNDERSTAND, THERE HAVE BEEN 1,200 CASES IN DRC SO FAR AND 58 DEATHS.JUST WONDERING DID THE U.S. GET INVOLVED IN THAT AT ALL OR PROVIDE ANYTHING STOP IT SPREADING.

>> IT’S A COUNTRY WHERE MONKEY POX CIRCULATES REGULARLY.WE CONSIDER IT AN ENDEMIC THERE MEANING IT’S NOT INFREQUENTLY REPORTED IN PEOPLE.WE ARE WORKING REALLY CLOSELY WITH THE GOVERNMENT AND THE DEMOCRATIC REPUBLIC OF CONGO AND HAVE FOR MANY YEARS.WE ARE WORKING ON A CLINICAL TRIAL IN THE DRC ON WHETHER IT CAN HELP HEALTH CARE WORKERS.WE WORK WITH MULTIPLE COUNTRIES IN AFRICA WHERE MONKEY POX CIRCULATES TO HELP PROVIDE CONSULTATIONS, TO HELP TRAIN AND DIAGNOSE CASES.AND WHEN THEY DON’T HAVE THE ABILITY, OFFER CONSULTATIONS, SEQUENCE HELP, ALL THOSE THINGS.WE HAVE BEEN WORKING IN THESE COUNTRIES FOR SOME TIME TO HELP THEM TRY TO MANAGE THE ENDEMIC CASES THEY HAVE.I THINK THERE WAS ANOTHER PART OF THE QUESTION I MIGHT NEED YOU TO REPEAT.

>> JUST WONDERING IF THIS COULD HAVE BEEN STOPPED BEFORE IT SPREAD TO EUROPE, IF THERE WERE POSSIBILITIES WITH VACCINATION AND ANTIVIRALS TO STOP IT BEFORE IT SPREADS SINCE WE KNOW EVERY PATH GENERAL IS PLAIN RIGHT AWAY.

>> YOU KNOW, IT IS.AND I THINK THAT NIGERIA REPORTED A PRETTY BIG INCREASE IN MONKEY POX CASES IN 2017, AND THEY HAD AN OUTBREAK AT THAT TIME, AND WE WORKED IN W NIGERIA AT THAT TIME.WE ACTUALLY HAD A TEAM THAT WENT OUT TO THE FIELD IN NIGERIA.WE WORKED WITH THEM, WE HAD FOLKS WORKING THERE, TRAPPING ANIMALS.I THINK THE ISSUE IS THAT AT THAT TIME, IT WASN’T CLEAR THIS VIRUS MIGHT BE SPREADING IN UNUSUAL WAYS.I THINK CERTAINLY IN HINDSIGHT, YOU KNOW, COULD WE HAVE DONE THINGS DIFFERENTLY?I MEAN, I THINK WE’RE ALL GOING TO BE ASKING THOSE QUESTIONS AS SCIENTISTS, BUT THE IMPORTANT THING IS TO FOCUS ON WHAT WE CAN DO RIGHT NOW, AND THAT’S HELP IDENTIFY CASES BOTH IN THE UNITED STATES AND AROUND THE WORLD, MAKE SURE THOSE INDIVIDUALS ARE ISOLATED AND DON’T SPREAD THE VIRUS ONWARD AND MAKING SURE ANY OF THEIR CONTACTS GET THE VACCINES OFFERED TO THEM AND ARE WATCHING FOR SYMPTOMS SO THEY CAN ALSO ISOLATE IF THEY BECOME THE NEXT MONKEY POX CASE.

>> CAN I ADD ONE MORE THING?THIS IS RAJ HERE AT THE WHITE HOUSE.THE GLOBAL HEALTH SECURITY AGENDA THAT WAS LAUNCHED WHEN PRESIDENT OBAMA AND VICE-PRESIDENT BIDEN WERE IN OFFICE IN 2014 AND THE PERIOD FOLLOWING THE EBOLA EPIDEMIC IN WEST AFRICA WAS AN EFFORT TO RAMP UP FURTHER INVESTMENTS IN SUPPORTING COUNTRIES LIKE NIGERIA AND THE DEMOCRATIC REPUBLIC CONGO, SO THE DOCTOR IS ABSOLUTELY RIGHT IN TERMS OF THE EFFORT.I THINK ALSO CORRECT, YOU KNOW, AS WE LOOK FORWARD, ONE OF OUR DEFINED GOALS FOR THE RESPONSE IS TO ENSURE THAT WE ARE TACKLING THIS OUTBREAK HERE AT HOME BUT ALSO FURTHER SUPPORTING ENDEMIC COUNTRIES WHERE MONKEY POX HAS BEEN ENDEMIC I SHOULD SAY LIKE NIGERIA AND THE DRC, AND I THINK YOU HEARD A COUPLE OF EXAMPLES WHERE THAT WORK IS ALREADY ONGOING.

>> THANK YOU.I WOULD LIKE TO THANK ALL OUR SPEAKERS FOR JOINING US TODAY FOR THIS IMPORTANT UPDATE.IF THERE ARE FURTHER QUESTIONS, PLEASE CONTACT CDC’S MAIN MEDIA LINE OR YOU CAN EMAIL MEDIA AT CDC.GOV.

>> THIS DOES CONCLUDE TODAY’S CONFERENCE CALL.WE THANK YOU ALL FOR PARTICIPATING.YOU MAY NOW DISCONNECT AND HAVE A GREAT REST OF YOUR DAY.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

CDC works 24/7 protecting America’s health, safety and security. Whether disease start at home or abroad, are curable or preventable, chronic or acute, or from human activity or deliberate attack, CDC responds to America’s most pressing health threats. CDC is headquartered in Atlanta and has experts located throughout the United States and the world.