Focus on surging pandemic dims as two other infections grab headlines

monkeypoxcdc-300x184The coronavirus pandemic continues to give Americans a  crash course in global infectious diseases, with experts and regular folks warily watching not only the virus’s continuing summer surge but also seeing with concern increasing incidences of rare hepatitis cases in kids and outbreaks of monkeypox in travelers and among partying gay men.

While the other infections have received their share of  news coverage, the pandemic persists as the nation’s leading public health menace, as the New York Times reported in this summary of the latest overall coronavirus situation:

“The United States is averaging about 110,000 new cases each day, a roughly 30% increase over the last two weeks. Since many cases go uncounted in official reports, the true toll is higher than these figures show. Daily case reports are four times as high as they were in early April, but still a fraction of the numbers seen in January, when the initial Omicron surge was at its worst.

“Hospitalizations are also increasing, though they remain well below the peak levels seen during the winter. About 25,000 people are hospitalized with the virus nationwide, and about 11% of those patients are in intensive care units. In late January, more than 150,000 people were hospitalized with Covid-19 and more than 25,000 of them were in intensive care. The most recent uptick emerged first in the Northeast, where conditions now appear to be stabilizing. Though still high, case rates have started to level off or decline in New JerseyNew York, and Rhode Island … Infections and hospitalizations are increasing quickly across much of the South and Southwest. Average daily case reports have more than doubled in the past two weeks in ArizonaSouth Carolina, and West Virginia.”

With tens of millions of Americans set for travel and gatherings over the Memorial Day holiday, officials are bracing for the pandemic’s latest surge to potentially worsen, especially as the highly infectious Omicron subvariant BA.2.12.1 has become the virus’s dominant stain, the New York Times reported. Experts have detected it in 58% of reported and diagnosed cases, though they have not determined whether it causes a severer infection.

Two more vexing infections

But for health experts, getting the public to pay attention at all to the pandemic — much less to get vaccinated and boosted, to consider wearing face masks again, to distance, and to test and quarantine or isolate — has become a struggle. This is especially true in a summer of soaring gas prices, baby formula shortages, warfare in Europe, horrific mass shootings, and, of course, those pediatric hepatitis and monkeypox cases.

A TV network correspondent on one nightly news broadcast breathlessly declared that worries about monkeypox overshadowed whatever President Biden accomplished in his meetings with Asia’s top leaders. Right, the fate of global security is outweighed by what the New York Times reported as the occurrence of 100 cases of “confirmed or suspected monkeypox that have appeared in countries where the disease does not typically occur, including Australia, Belgium, Canada, France, Germany, Italy, the Netherlands, Portugal, Spain, Sweden, the United Kingdom and the United States”?

Unlike the coronavirus, which was novel, monkeypox is a familiar disease, which has circulated in Africa for some time. (African medical experts are rightly upset that the illness only now is getting attention because of its spread in the industrial world.) Monkeypox is treatable and safe and highly effective vaccines exist to guard against it. The disease, as known now, is not as easy to get infected with as the airborne-spread coronavirus. As the New York Times reported of the disease’s transmission:

“People typically catch monkeypox by coming into close contact with infected animals. That can be through an animal bite, scratch, bodily fluids, feces or by consuming meat that isn’t cooked enough, said Ellen Carlin, a researcher at Georgetown University who studies zoonotic diseases that are transmitted from animals to humans …The virus can also spread by touching or sharing infected items like clothing and bedding, or by the respiratory droplets produced by sneezing or coughing, according to the W.H.O. … The majority of cases this year have been in young men, many of whom self-identified as men who have sex with men, though experts are cautious about suggesting that monkeypox transmission may occur through semen or other bodily fluids exchanged during sex. Instead, contact with infected lesions during sex may be a more plausible route. ‘This is not a gay disease, as some people in social media have attempted to label it,’ Dr. Andy Seale, an adviser with the W.H.O.’s HIV, Hepatitis and STIs Program, said … Anybody can contract monkeypox through close contact.’”

Don’t ignore, don’t panic

Helen Branswell, a sharp medical writer who provided clarion, early warnings about the coronavirus for the science and medical site Stat, has reported that the monkeypox and hepatitis cases — the latter now involving hundreds of kids and six deaths worldwide and, so far, linked not to the coronavirus but to the stomach bug adenovirus 41 — should neither be downplayed nor cause of panic. As she has written as to why the infections deserve attention:

“These viruses are not different than they were before, but we are. For one thing, because of Covid restrictions, we have far less recently acquired immunity; as a group, more of us are vulnerable right now. And that increase in susceptibility, experts suggest, means we may experience some … wonkiness as we work toward a new post-pandemic equilibrium with the bugs that infect us. Larger waves of illness could hit, which in some cases may bring to light problems we didn’t know these bugs triggered. Diseases could circulate at times or in places when they normally would not. ‘I think we can expect some presentations to be out of the ordinary,’ said Petter Brodin, a professor of pediatric immunology at Imperial College London. ‘Not necessarily really severe. I mean it’s not a doomsday projection. But I do think slightly out of the normal.’ Marion Koopmans, head of the department of viroscience at Erasmus Medical Center in Rotterdam, the Netherlands, said she believes we may be facing a period when it will be difficult to know what to expect from the diseases that we thought we understood. ‘I do think that’s possible,’ Koopmans said.

“This phenomenon, the disruption of normal patterns of infections, may be particularly pronounced for diseases where children play an important role in the dissemination of the bugs, she suggested. Little kids are normally germ magnets and germ amplifiers. But their lives were profoundly altered during the pandemic. Most went for stretches of time without attending day care, or in-person school. Many had far less exposure to people outside their households, and when they did encounter others, those people may have been wearing masks. And babies born during the pandemic may have entered the world with few antibodies passed on by their mothers in the womb, because those mothers may have been sheltered …”

Concerned parents can watch out for hepatitis warning signs in sick kids, experts say, with the New York Times reporting this and quoting Dr. Alexander Weymann, director of the Liver Center at Nationwide Children’s Hospital in Columbus, Ohio:

“Hepatitis symptoms are wide-ranging and overlap with many common illnesses. A child with hepatitis may experience fever (low-grade or more significant), fatigue, joint or muscle pain, loss of appetite or nausea, diarrhea, and vomiting. Children may also have abdominal pain or tenderness, particularly in the right upper abdomen, which is where the liver is located, Dr. Weymann said, and it is important to seek urgent medical attention any time a child shows sign of severe pain when their abdomen is touched … Some children may have darker urine, or pale or clay-colored stools. Jaundice, or yellowing of the skin and eyes, is a hallmark sign of hepatitis — although it is possible to have significant liver inflammation and show no signs of jaundice. ‘The first change is in the eyes: The white part begins to look yellow,’ Dr. Weymann said. He noted that it can be more difficult to detect jaundice in children who have darker skin, so parents should take even subtle changes in tone seriously.”

As for monkeypox [virus, as seen, in photo above, from the CDC], experts are issuing cautions and hoping to raise awareness while avoiding stigmatizing gay men. The disease has been discovered in European attendees of rave parties where they participated in sexual activities. It also may have been detected more readily because its hallmark symptoms look like sexually transmitted infections. CNN reported this information from the federal Centers for Disease Control and Prevention:

“Initial symptoms include swollen lymph nodes, headache, fever, muscle aches and fatigue. The disease then progresses into a rash and lesions that blister and scab over. This can happen all over the body. The illness usually lasts two to four weeks. A person can be contagious from one day before the rash appears until up to 21 days after symptoms began. Once the scabs fall off, the person is no longer contagious, the CDC says. The risk to the general public from this outbreak is low, according to the CDC.”

Safeguards as pandemic surges anew

As for the coronavirus, we are not done with the pandemic — and the infection doesn’t care how casual we wish to be about the death and debilitation it can cause. Those with heightened vulnerability to the illness — those who are older, immunocompromised, overweight, and with underlying conditions, or individuals from hard-hit communities of color — still should stay careful, including by keeping on their masks. And, yes, so-called one-way masking has protective benefits.

The savvy will want to build up not discard their supply of masks, nabbing test kits, too (free from the federal government, including a second round of them, and delivered to your door). Just in case.

The vaccines remain life changers and life savers. If you have not gotten your shots, please do so, boosters and all, pronto.

If you haven’t chatted with your doctor for a bit, you should — especially about whether your individual health would benefit from an additional dose of vaccine and when might be the time to get it. Parents should discuss potential shots for their youngest kids and boosters for the older siblings with their pediatricians. (Get the young folks caught up on their shots now if you can, too.) If you have been exposed or think you have gotten infected, please get tested — and quarantine or isolate to protect yourself and others.

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