197: Preparing for Monkeypox

Dr. Marcus Plescia, ASTHO’s Chief Medical Officer, discusses the three-step approach to combat Monkeypox in the U.S.; Dr. Jinlene Chan, Maryland’s Deputy Secretary for Public Health Services, outlines her department’s response to Monkeypox; and...

Dr. Marcus Plescia, ASTHO’s Chief Medical Officer, discusses the three-step approach to combat Monkeypox in the U.S.; Dr. Jinlene Chan, Maryland’s Deputy Secretary for Public Health Services, outlines her department’s response to Monkeypox; and ASTHO plans a webinar next week to discuss the impact of racism on health equity as part of the organization’s recognition of Juneteenth.

ASTHO Juneteenth Webinar: Commemorating Juneteenth A Journey to Equity

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This is Public Health Review Morning Edition for Friday, June 10th, 2022. I'm Robert Johnson.

Now, today's news from the Association of State and Territorial Health Officials.


As of early this week, the number of confirmed cases of monkeypox in the U.S. remained small, but public health is gearing up with a three-step approach.

ASTHO chief medical officer Dr. Marcus Plescia says the plan includes talking with people who are most at risk, educating providers, and developing a good testing protocol.


We certainly don't want to miss something that could become more and more substantial. But at the same time, you know, we've been going full blast ahead for two and a half years now with COVID and we want to be careful the next time we say we need another all-hands-on-deck because, you know, people have been pushed hard and we want to be respectful of that.


Still, Plescia says:


It's probably time to bring everybody together—from the labs, from the epidemiology staff—and make sure that there's a cohesive plan for how we're going to be aggressive about this, but not overly aggressive.



Public health departments are making plans to deal with monkeypox cases. Maryland's deputy secretary for public health services, Dr. Jinlene Chan, outlines her department's response in today's morning conversation.

How is Maryland responding to this latest public health concern?


Well, right now in Maryland, we have not detected any or confirmed any cases, so we're focused on communications and that's what we've been doing since the initial HAN alert went out from the CDC a few weeks ago. And so, this is about education and outreach, both to providers as well as the public.

So, for providers, we've already reached out to our provider communities a couple of times to amplify the messaging that's coming from the CDC so that those providers are alert to be able to identify some potential patients that might be presenting to them with the characteristic symptoms of monkey pox. And we've also shared information about, if they do have a suspect case or a possible case, what they might do to contact local and state public health officials as well as specimen collection.

The other piece of it, of course, is communication to the public. And so, we want to prepare our public to also identify potential cases because this is not something that we see every day. And so, we have prepared and disseminated public facing messaging to the public so that if they identify characteristic symptoms of fever, swelling of lymph nodes, as well as this rash that's very characteristic of monkeypox, that they can seek medical attention.

And then the last thing that we've been working on, of course, is working with our key partners in the state, including our state public health laboratory, which is part of the public health services division of the department of health. So, they are prepared to test potential samples of suspect cases, even on the weekends. And we have also met together in a partial incident command activation just for planning purposes and coordination purposes—because we know that with a suspect case or a confirmed case, we'll have to coordinate with local health departments, the lab, providers, and the CDC for contact tracing and potentially to be able to request and receive vaccines if that's indicated.


Do you have any advice or counsel for your colleagues around the country regarding this response?


Yeah, I think that those are the key things. It's, you know—I mean, the first and foremost, you know, communication is key. Because again, monkeypox and other emerging infections—and we've experienced this before with other, you know, infections like Zika or Ebola—where we want to make sure that healthcare providers are reminded or, you know, understand what they might be looking for as they see patients. So, that's important. And then what to do about it, you know, who they should contact.

And then, we want to be sure that—on our end—that we're prepared when we received the call to immediately jump into action. And this is sort of the bread and butter of public health, if you will—to coordinate with our healthcare partners, to make sure to test people appropriately, and do appropriate contact tracing. And then in this case, again, for a certain population a vaccine might be recommended to be able to prevent onward propagation of the disease.

The other important piece of course, is, you know, communicating with partners. And so, we talk about communicating with the general public, but we're really are trying to be as broad as we can in terms of our overall outreach and messaging. We want to be careful about stigma—that's something that has been discussed among our group and I know is something that state and local officials are concerned about. We don't want to stigmatize one group of people because the reality is that anyone could be at risk.



Finally this morning, ASTHO plans a webinar next week to discuss the impact of racism on health equity. It's all part of the organization's recognition of Juneteenth coming up next weekend. The panel includes Ms. Opal Lee, a retired teacher who led a movement to make Juneteenth a federal holiday. You can sign up for the online event planned for Thursday, June 16th, using the link in the show notes.


That'll do it for today's newscast. We're back Monday morning with more ASTHO news and information.

I'm Robert Johnson. You're listening to Public Health Review Morning Edition. Have a great weekend.

Marcus Plescia MD MPH

Chief Medical Officer, ASTHO

Jinlene Chan MD MPH FAAP

Deputy Secretary, Public Health Services, Maryland Department of Health