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ABC - Health News

Monkeypox patient speaks out about what it's like to have the disease

Courtesy Jeffrey Todd

(NEW YORK) -- When the first lesion appeared on Jeffrey Todd's right cheek in mid-July, the 43-year-old didn't pay too much attention to it.

"I noticed I had like a pimple or like a blemish on my cheek and it had this very odd-looking raised white circle around the outside of the blemish and it felt indented a little bit like a crater," Todd, who lives in Hollywood, California, told ABC News.

Being aware of the monkeypox outbreak spreading across the U.S., Todd said he did a Google search of what monkeypox rashes look like and "one of the images looked exactly like my blemish."

He thought, however, the blemish would disappear by morning.

Over the next two days, Todd developed a series of bumps on the back of his right arm and back and a lesion appeared on his neck. He was itchy and had backaches, fatigue and shooting pain down his legs -- all telltale signs of monkeypox.

Being diagnosed

Todd was first tested on July 13 but it took a while to get his results. He didn't know at the time that the first clinic he visited sent the sample to a lab. The sample though was spoiled by the time it got there so it couldn't be tested, he said.

As his condition continued to worsen, he went to the emergency room at Cedars-Sinai Medical Center, where staff performed an in-house test. The next day, Todd got his test results back and found out he was positive for monkeypox.

He is one of the more than 8,900 Americans who have tested positive for the disease across 48 states, the District of Columbia and Puerto Rico as of Tuesday, according to the Centers for Disease Control and Prevention.

Last week, the U.S. Department of Health and Human Services declared the outbreak a public health emergency, 78 days after the first case was detected in the country in mid-May.

The outbreak has mostly affected men who identify as gay, bisexual or other men who have sex with men, although the CDC has warned it is not a sexually transmitted disease and anyone is at risk of infection.

Todd, who identifies as gay, said he was contacted by the Los Angeles County Department of Public Health. The nurse assigned to his case believes he contracted monkeypox at an event during Pride weekend in Los Angeles in late June.

"I was at a dance party," he said. "It was enclosed. It was hot, sweaty. I was shirtless. It was really jam-packed -- a lot of physical touching and close proximity to people. So that seems very much like where it probably happened."

The CDC has said most cases in this outbreak have occurred from skin-to-skin contact or direct contact with a patient's rash, lesions or body fluids.

The disease can also spread from prolonged contact of objects or fabrics used by a monkeypox patient, but it is a lower risk form of transmission, according to the CDC.

'Traumatizing' lesions

There are no treatments specifically for monkeypox. The disease is a cousin of smallpox, so antiviral drugs developed to treat smallpox may be used.

Tecovirimat, known as TPOXX, which is a two-week course of pills, can be considered for people at high risk of severe illness, such as those with weakened immune systems.

Todd said he heard about this treatment from friends of his in New York but it was difficult for him to access it.

After being tested for monkeypox the first time, he asked his physician if he could get on the antiviral medication. He said his physician referred him to an infectious disease specialist.

"He called me immediately and was like, 'You know, I will try to get you on this medication but it's a lot of red tape. Only the county is able to prescribe it but I'll do the paperwork and get this going for you,'" Todd said.

After the county received his positive test from Cedars Sinai, Todd said he was approved for TPOXX two weeks after his symptoms first began.

Although his condition has improved since starting treatment, Todd said his lesions have caused him some pain. In late July, the lesion on his face scabbed over and fell off, leaving behind a small hole.

"My doctor said that the lesion was killing the tissue inside of my face," he said. "It literally was so traumatizing to me."

He continued, "I was expecting that to happen ... I was excited that the scab was falling off and then part of my face was coming out."

Todd said his doctor told him that hole will eventually heal but he will be left with a scar.

Raising awareness about monkeypox

Todd has made several videos showing the progress of his condition, including the "gruesome" nature of his lesions, which he has shared to social media platforms such as Instagram and TikTok.

While he says some of the messages have not been kind, he said the overwhelming majority have been positive. He's also encouraged some of his friends to get vaccinated.

Vaccines are recommended for those who have been exposed to monkeypox and for those who may be more likely to get it.

Data from Africa has shown two doses of vaccination with the smallpox vaccine, JYNNEOS, is at least 85% effective in preventing monkeypox infection.

Todd, who is officially ending his 28-day quarantine on Tuesday, said he wants to raise awareness of what it can be like to have a case of monkeypox.

"Please know that this can happen and I think that's the dialogue that needs to be out there," he said. "When I see people don't take it seriously, they think, 'Oh, it's like Chickenpox.' But no, it's horrible and now I have a hole in my face."

He went on, "I don't want anyone else to go through what I've been going through."

Copyright © 2022, ABC Audio. All rights reserved.

Bug bites begone! Experts break down how to treat itchy skin and stings this summer

Joao Paulo Burini/Getty Images

(NEW YORK) -- It's time to say "bye-bye" to bug bites.

As summer is still in full effect, so are lots of bugs that are ready to bite or sting exposed skin. Whether you are headed on a nature walk or out for a pool dip, everything from mosquitos and ticks to bees and other insects are ready to pounce.

But there are ways to prevent and treat your skin against some of those pesky stings, itches, bumps or marks left behind.

ABC News' Good Morning America consulted with board-certified medical and cosmetic dermatologist Dr. DiAnne Davis, as well as board-certified pediatrician and expert on Bug Bite Thing's medical advisory board Dr. Mona Amin to find out how to prevent and treat bug bites this season.

Are there any key indicators that would let someone know that they have a bug bite versus other skin irritations? How are you able to tell the difference?

Amin: With bug bites, you will usually see a lump or bump of redness and surrounding irritation -- this is generally where the insect bit you and a telltale sign. Some people report seeing or feeling an insect bite them and then noticing the rash develop. Others have seen the rash begin as a hive, where the skin surrounding the bite looks red and puffy -- our bodies create a histamine response to the irritant, which is the saliva of the insect.

What's the first thing you should do when you have identified that you have a bug bite?

Davis: I know this is easier said than done, but the first thing you should try to do is not scratch the bug bite. For bites that itch, apply an ice pack or an over-the-counter anti-itch cream, such as hydrocortisone. Another option is to take an over-the-counter oral antihistamine.

To reduce swelling, apply an ice pack to the bite. If it's a painful bite, take an over-the-counter painkiller, such as acetaminophen or ibuprofen.

What's a top product you recommend when treating a bug bite and why?

Amin: I recommend using Bug Bite Thing immediately after you notice the bite as it will reduce the itching, stinging and swelling within seconds. The product only uses suction and is chemical-free, making it a safe option for people of all ages, including infants and toddlers.

How do you go about getting rid of the sting, itch or pain associated with any bug bites or stings?

Davis: Topical steroids, which also encompass over-the-counter anti-itch creams, can really help to ease the inflammation that occurs with bug bites and reduces the itching.

What are some best practices to help ease inflammation caused by bug bites?

Amin: The best thing is to minimize scratching as soon as you see the bite. When we scratch our skin, this leads to more inflammation. More inflammation leads to more scratching. It's what we call the "itch-scratch" cycle. Using a cool compress can also help ease inflammation after a bite.

Are most bug bites treatable at home? When is it necessary to seek professional help?

Davis: If you experience any serious symptoms after a bug bite, such as a rash, fever, body aches, difficulty breathing, chest pain, swollen lips, tongue, and/or face, dizziness, vomiting, or a headache, contact your doctor or a board-certified dermatologist immediately. Make sure you tell the doctor about your recent bite so that they can examine you for a transmitted disease.

Copyright © 2022, ABC Audio. All rights reserved.

Vaccine for Lyme disease enters final stage of clinical trial

rbkomar/Getty Images

(NEW YORK) -- Researchers are one step closer to developing a vaccine for Lyme disease, which affects nearly half a million people each year in the United States, according to the U.S. Centers for Disease Control and Prevention.

Pfizer, the maker of a COVID-19 vaccine, announced Monday it is starting a phase 3 clinical trial on its Lyme disease vaccine, known as VLA15.

The study will include over 6,000 participants from 50 locations around the world, including the U.S. Children ages 5 and older will also be included in the study, according to Pfizer.

“With increasing global rates of Lyme disease, providing a new option for people to help protect themselves from the disease is more important than ever,” Annaliesa Anderson, Ph.D., senior vice president and head of vaccine research and development at Pfizer, said in a press release announcing the study. “We hope that the data generated from the Phase 3 study will further support the positive evidence for VLA15 to date, and we are looking forward to collaborating with the research sites across the U.S. and Europe on this important trial."

Lyme disease, the most common vector-borne disease in the U.S., is a tick-borne infectious disease that, if left untreated, can affect the joints, heart and nervous system, according to the CDC.

There has not been a vaccine for the disease for the past 20 years. The most recent vaccine for the disease, LYMErix, was discontinued in the U.S. in 2002.

"This one is protein-based vaccine technology," ABC News chief medical correspondent Dr. Jennifer Ashton said of the new Pfizer vaccine. "It’s important to prevent not only short-term signs and symptoms of Lyme disease but long term, so we’re talking about things like short-term fever, headache, fatigue, rash, and then if untreated, it can spread to the joints, heart and central nervous system."

The vaccine is administered through three shots given over a period of several months, followed by a booster dose 12 months later, according to Pfizer, who is developing the vaccine with Valneva, a French biotech firm.

If the trial moves forward as planned, Pfizer said it expects to submit an authorization request to the U.S. Food and Drug Administration in 2025.

Lyme disease, mainly caused by the bacterium Borrelia burgdorferi, is transmitted to humans via tick bites. In most cases, the tick must be attached to the skin for at least 36 hours before the bacterium can be transmitted.

Symptoms generally appear after one week, with approximately 70% to 80% of people experiencing a classic “bull's eye” rash which expands in size at the site of the bite.

Symptoms in the acute phase include fever, headache and fatigue. If left untreated, the infection can spread to joints, the heart and the nervous system. People also may experience lingering symptoms that last months or even years, such as muscle and joint pain, cognitive defects and sleep disturbances, according to the CDC.

Once confirmed with laboratory testing, most cases can be treated for a few weeks with antibiotics. According to the Mayo Clinic, Lyme disease should be treated immediately and may require intravenous antibiotics if the case is severe.

Lyme disease is most commonly found in the Northeast and upper Midwest, with 96% of all cases in 14 states -- Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia and Wisconsin, according to the CDC.

The CDC recommends preventive measures to avoid ticks including avoiding "wooded and brushy areas with high grass and leaf litter" and walking in the center of trails.

When hiking or in wooded areas, you can also treat your clothes and gear with products containing 0.5% permethrin, according to the CDC. They also recommend always doing a "tick check" after being outside and wearing insect repellent with Deet.

Ticks can also come into the home through clothing and pets, so the CDC recommends checking pets for ticks and tumble drying clothes on high heat for 10 minutes after coming indoors to kill ticks.

If you are ever in a situation where you are bitten by a tick, the Cleveland Clinic recommends tugging gently but firmly near the head of the tick until it releases its hold on the skin.

People who are outdoors in areas that may have ticks should also conduct a full body check when they return, including checking under the arms, in and around the ears, inside the belly button, behind the knees, in and around the hair, between the legs and around the waist, the CDC recommends.

Copyright © 2022, ABC Audio. All rights reserved.

From patient to doctor: One woman's resilient fight after six brain surgeries, stroke

ABC News

(NEW YORK) -- A Texas doctor who survived six brain surgeries and a stroke is now treating people at the same hospital where she used to be a patient, bringing a unique perspective to her practice as a physical medicine and rehabilitation (PM&R) physician.

"You learn so many things in medical school but one of the things you don't learn is how to be a patient," Dr. Claudia Martinez told ABC News' Good Morning America. "What they're feeling, what they're thinking, what their families are thinking -- and we went through that for so many years, me and my mom, just navigating the medical system from the other side and seeing all the barriers we had to go over."

"I'm very thankful for that experience and getting to now share what I know with patients and better help them," she added.

Martinez, 31, is a third-year resident physician at TIRR Memorial Hermann hospital, a teaching hospital for Baylor College of Medicine and University of Texas Health Science Center at Houston. But just a few years ago, she was unable to walk or do many everyday tasks by herself. It was at TIRR where Martinez rebuilt her life and where her doctor, Dr. Lisa Wenzel, both treated her and supported her dream of pursuing medicine.

"[Wenzel] was in charge of my entire rehab stay. She's a spinal cord injury specialist. She's been my mentor along the way and my advocate, the one who has helped me get my accommodations for medical school and now residency, and just really given me that hope that I could still be a physician even though she saw me at my lowest point," Martinez said.

Martinez was diagnosed in 2011 with Chiari malformation, an abnormality where portions of the brain "[extend] through the natural opening at the base of the skull," creating pressure on the brain, according to the National Institute of Neurological Disorders and Stroke.

Often, surgery is the only option for patients.

"So my first brain surgery was for Chiari malformation and many of the subsequent [surgeries]," Martinez said of her experience. "The last two were for a complication that developed from my previous surgeries where my brain stem got tethered to the dura -- it's a pretty rare occurrence but it was causing a lot of issues in regards to my brainstem, and so the surgeon had to go in there and kind of de-tether that area."

Overall, Martinez had six brain surgeries in the span of five years with her first surgery in 2012 and her last on Feb. 6, 2017.

"The recoveries from each brain surgery got harder each time," Martinez recalled. "After my first one, it was pretty OK, but then after that second one, the third, the fourth and fifth, every time it was just more and more difficult to bounce back."

It was during her sixth brain surgery when Martinez said she suffered a stroke.

"It was a very risky surgery. Going in, the neurosurgeon told us there were many complications that could happen, [saying], 'Expect these things to happen because of the area that we're going to manipulate; your brain stem controls your breathing, your heart rate, a lot of your autonomic functions,'" Martinez recalled. "...I ended up with a stroke that left me unable to function from the neck down. And of all the things that really could have happened, it was a success in our eyes, but it definitely changed my life for sure."

After her stroke, Martinez said she couldn't walk and was "unable to function from the neck down." She was transferred to TIRR Memorial Hermann where she underwent intensive physical, speech, and occupational therapies for a year.

"There was a point when I was at TIRR that I was like, 'I didn't think that I would make it here.' But I was very persistent, and I wanted to prove not to other people, but just to myself that I could do this. I worked harder than my classmates because I never wanted my disability or my medical illness to define me or have other people let me kind of slide by with doing less, just because I had a disability or was in the hospital so long," Martinez said.

Despite her difficulties and the long odds, Martinez didn't give up. With the support of her family and medical team, she took a year off from medical school to focus on recovery. She then returned to finish her degree program and was matched with TIRR in the spring of 2020 for her residency. Martinez graduated from UTHealth Houston McGovern Medical School that May.

Martinez said her health experiences resulted in at least two unexpected outcomes. The first was the need to shift her initial goal of becoming a surgeon to specializing in PM&R.

"Of all the function I've regained, [the function in my] hands is the one that has been the biggest limiting factor, so I kind of see it as a blessing in disguise," Martinez said. "From there, I got redirected and had to look elsewhere. And when I got to TIRR and saw what they do and how they help after these big life-changing events, I just knew I was meant to be here all along."

The second unexpected outcome from her medical hurdles was meeting her husband Andrew, after local news outlets in Texas, including ABC affiliate KTRK-TV in Houston, shared her journey. The two bonded over their shared experiences undergoing brain surgeries; Andrew had undergone treatment for glioblastoma, a rare type of tumor that can affect the brain or spinal cord.

Today, Martinez wants others to know that "disabilities don't define the capability of a person."

"Never underestimate someone with a disability," she said. "There's so much that they can do and they have so much worth to bring to the world. Sometimes we just need to have a little compassion and patience and now that I'm here being a physician, there [are] so many things that I do differently than my colleagues just because I have a disability, but that doesn't mean that I can't do the things they do."

Copyright © 2022, ABC Audio. All rights reserved.

New monkeypox vaccine strategy underway to increase availability

Chris Kleponis/CNP/Bloomberg via Getty Images, FILE

(WASHINGTON) — The Biden administration is moving forward with a plan to increase the U.S. monkeypox vaccine supply by as much as five times.

In an announcement Tuesday, Health and Human Services Secretary Xavier Becerra said he issued a determination, made possible by the public health emergency declared last week, that will allow the Food and Drug Administration to authorize changing the method of injection for the vaccines.

The new approach would produce up to five more doses from each vial by using an injection method that requires less vaccine per shot.

The vaccine would be injected into the second layer of the skin, just below the first visible layer. Most routine vaccinations are given as intramuscular or subcutaneous shots, which go deeper.

But health experts said the vaccine given intradermally — just under the skin — could be as effective against monkeypox.

Bob Fenton, the White House monkeypox response coordinator, called the new approach a "game changer when it comes to our response and our ability to get ahead of the virus."

"It's safe, it's effective, and it will significantly scale the volume of vaccine doses available for communities across the country," Fenton said in a briefing with reporters on Tuesday.

The U.S. now has over 2.2 million doses of the Jynneos vaccine for distribution, up from 441,000. That's enough to vaccinate 1.1 million more people.

Between 1.6 and 1.7 million people are eligible and at-risk, according to estimates from the Centers for Disease Control and Prevention. So far, around 600,000 doses have already gone out, which could be enough to vaccinate about 300,000 people.

It's difficult to know how many people have been fully vaccinated, however, as data isn't being widely reported and some places have been giving people one shot, instead of the recommended two doses per regimen, in order to stretch doses under such high demand.

Dr. Robert Califf, commissioner for the Food and Drug Administration, said the new method still ensured that the vaccine "meets high standards for safety, effectiveness and manufacturing quality that the American public has come to expect."

"If you have the opportunity to get the Jynneos vaccine, urge you to consider getting your first dose immediately," he said.

The FDA issued an emergency use authorization earlier on Tuesday that allows health care providers to move forward with administering the vaccine immediately. The emergency use authorization also allows children under 18 who are at high-risk of monkeypox to get the vaccine.

As a basis for the new decision to administer the vaccine intradermally, health officials pointed to a 2015 study as well as the history of administering smallpox vaccines the same way.

"It's not at all new," Dr. Peter Marks, the FDA's vaccine chief, said Tuesday.

"We look at the totality of the available scientific evidence and we bring that together to try to do the best by public health," he said.

Dr. Demetre Daskalakis, deputy coordinator for the White House monkeypox response, said the currently affected community already has a high acceptance rate with vaccines and he expected that to continue.

Over 90% of gay, bisexual and men who have sex with men have gotten a COVID vaccine, he said.

"I think that the due diligence done by the FDA, looking into the data, should assure them that the vaccine is immunologically equivalent and safe," Daskalakis said.

"I imagine that just being clear with that and making sure that our local departments of health message this correctly, I think we're going to see that we will likely still run out of vaccines before we run out of arms," he added.

And CDC Director Rochelle Walensky said this newly-proposed method is actually recommended over what some jurisdictions have resorted to, by giving out only one dose in order to stretch doses further.

"There are not data to do so. And in fact, if anything, there are data saying that that is not protective enough," Walensky said.

"So by using this alternative strategy of intradermal dosing ... we have more doses, and in fact, we have the ability to doubly vaccinate people so that they get the protection that they need," she said.

People who got their first dose subcutaneously, or with a full dosage with a deeper injection, are still recommended to get their second dose intradermally, with the shallower skin injection and a fraction of the dose, both Califf and Walensky said.

"The immunologic response should be the same," Califf said.

Dr. Dan Barouch, the director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center, told ABC News the intradermal method "is very effective because there are a lot of immune cells just under the skin, and often lower doses are needed compared with intramuscular vaccination."

The same technique is already used in tuberculin skin tests, also called a PPD test. More recently, the influenza vaccine against the H1N1 strain that caused a pandemic in 2009 was tested intradermally in many research studies and was shown to be just as effective at one-fifth the dose of the intramuscular shot.

The announcement to stretch doses using the intradermal method comes as many state and local officials have been raising the alarm that there are not currently enough monkeypox vaccines to address the emerging crisis.

Without this approach, the U.S. only has enough vaccines to reach around one-third of eligible people over the next two months, or 550,000 people.

This authorization, however, could mean that far more people can be vaccinated with those doses.

It's part of a heightened approach rolled out by the recent declaration of a public health emergency over the monkeypox outbreak, which Becerra announced last week following widespread calls from health officials and activists across the country.

Globally, more than 30,000 cases of monkeypox have now been reported, including nearly 9,000 cases in the U.S. — the most of any country. All but one U.S. state — Wyoming — has now confirmed at least one positive monkeypox case.

The majority of cases in the current monkeypox outbreak have been detected in gay, bisexual or other men who have sex with men. However, health officials have repeatedly stressed that anyone can contract the virus and there is currently no evidence it is a sexually transmitted disease.

Copyright © 2022, ABC Audio. All rights reserved.

Monkeypox and your skin: How to prevent and treat post-infection scarring

Yuki Iwamura/AFP via Getty Images

(NEW YORK) -- Last week monkeypox was declared a public health emergency in the U.S. and now with more than 8,900 confirmed cases of monkeypox, thousands of Americans are struggling with a defining feature of the condition, skin lesions.

The classic skin lesions of monkeypox start with a pimple-like lesion that can look like pus-filled bumps (pustules) with redness around them. After that, the rash goes through phases, including pustules progressing to blisters that eventually scab over.

Unfortunately, the skin lesions can leave an unwanted lasting change on the skin.

Dermatologists say monkeypox lesions should be covered in their active phase, as skin lesions are contagious until the rash has fully healed. The Centers for Disease Control and Prevention said lesions are no longer contagious when the scabs have fallen off and a fresh layer of skin has formed.

Monkeypox lesions inevitably will scab over -- and while that is a step in the right direction in terms of the infection, the sores underneath can scar.

What can monkeypox scarring look like?

Once healed, monkeypox lesions can sometimes result in scarring and discoloration, which may be long-lasting or even permanent.

"In some cases, patients may develop depressed or atrophic scars that may resemble those seen following chickenpox infection or with severe acne," Dr. Trisha Dasgupta, a board-certified dermatologist at Dermatology of Philadelphia, told ABC News.

Monkeypox lesions may also heal with either dark discoloration or lightening of skin color.

"These scars can have varying appearances as well as degrees of severity," Dasgupta said.

Experts said lesions on the face, while concerning, often heal better than lesions on other parts of the body.

Dermatologists caution that some patients develop scars that can be firm, itchy, and even painful.

How can you minimize monkeypox scarring?

One of the best ways to manage a scar is to prevent a scar with good wound care during the healing process.

"The best way to prevent scarring is to take good care of your skin. Nowadays, we believe healing under moist conditions is better than just letting a scab dry out and become hard," Dr. Christine Ko, professor of dermatology at Yale University, told ABC News.

Experts describe wound healing as a cascade of events. Scientists who study wound healing at a cellular level describe skin cells that leapfrog over each other in a wound bed -- and the skin cells have a much easier time doing this if the wound bed is moist compared to a dry, open wound.

Though scarring from healed monkeypox lesions may not be entirely preventable, there are steps you can take to decrease the risk of scarring, including gentle skin care.

Dermatologists said while the spots can be itchy and irritated, it is important to avoid picking, scratching, or scrubbing monkeypox lesions.

"Consider using a gentle, fragrance-free, dye-free soap or cleanser to avoid any additional irritation when cleansing the area daily," Dr. Shoshana Grossman, a board-certified dermatologist at Dermatology of Philadelphia, told ABC News.

Sun protection:

"Sun protection is one of the simplest and most effective ways to maximize the appearance of scars after monkeypox lesions have healed," Grossman said.

Dermatologists recommend a broad-spectrum sunscreen with an SPF of at least 30 to lower the chance of darkening of the skin.

"Sun protection can be important to minimize scarring, especially in patients who have darker skin tones because scars can become quite dark in those patients and using some sun protection might help prevent that," Ko said.

Topical Treatments:

For fully healed areas, using chemical exfoliants such as alpha-hydroxy acids and topical retinoids can be helpful to lower the chance of some types of scarring by increasing skin cell turnover and by stimulating the growth of healthy collagen.

"The limiting factor with these treatments is tolerability in terms of dryness or irritation; they should not be used on active lesions. The key with using these topical treatments is to start slowly — only a couple of times a week to start, building up gradually to nightly use," Grossman said.

How to avoid complications that can increase chance of monkeypox scarring

Monkeypox infections are caused by a virus. Sometimes as these viral lesions heal, other infections, including bacterial infections, can arise on top of the original viral infection.

"Preventing a superimposed bacterial infection in areas of existing or healing monkeypox is also crucial in preventing scarring. A good way to prevent a bacterial infection is by introducing an anti-bacterial wash into your shower routine a few times per week." Grossman said.

Monkeypox scars that are bothersome or symptomatic can be treated with a variety of approaches, including:

Time: Most scars improve on their own with time, especially with good sun protection. It can take six to 12 months for full scar maturation. This is especially true for hyperpigmented scars, which can take many months to fade.

"Ideally, a scar will look closer to the normal skin color around it within four to five weeks, but it can sometimes take longer for scars to remodel and settle, even up to a year," Ko said.

Silicone containing scar gels: Medical-grade silicone scar gels and sheets may be a good option for scars that are thick or at risk of becoming thick.

"Silicone-based products can create a protective barrier over scars which increases hydration and helps stop excess collagen build up in the skin," Dasgupta said.

Steroid injections: For thicker, hypertrophic scars or keloids, a steroid medication can be directly injected into the problem areas.

"The goal of the steroid is to calm down any residual inflammation and flatten any raised areas. While systemic steroids such as pills, intravenous or intramuscular injections can have unwanted internal side effects, intralesional steroids remain localized to the skin and are very well tolerated," Grossman said.

Surgical procedures: Surgically removing a bothersome scar may be the most effective method of treating a scar.

Scars in the skin are sometimes caused by strands of collagen under the skin pulling down on the surface of the skin -- often described as stakes of a tent pulling down on the skin. A specific type of minimally invasive procedure called a subcision can help break apart these band-like scars to allow for a smoother appearance on the skin's surface.

Microneedling is another minimally-invasive procedure in which many tiny needles are used to puncture the affected skin.

"These controlled micro-injuries to the skin help to encourage tissue remodeling by mimicking the skin's natural healing process," Grossman said.

Lasers: Depending on the location of the scar and skin type of the patient, lasers can be used to help improve the appearance of scars that are white or lighter in appearance than the surrounding skin. Lasers have to be carefully used in darker skin types and fractionated lasers are a specific laser approach that decreases downtime after lasers and can be safer in patients with darker skin tones.

Copyright © 2022, ABC Audio. All rights reserved.

Couple speaks out on decision to get abortion after fetus diagnosed with rare genetic conditions

ABC News

(NEW YORK) -- The same month the U.S. Supreme Court issued its landmark ruling overturning Roe v. Wade, a couple in Kansas, thousands of miles away from Washington, D.C., faced their own abortion decision.

Breanna O'Brien said she was 20 weeks pregnant with her first child in June and in the process of decorating the nursery when she and her husband Kyle received a devastating diagnosis.

The O'Briens said doctors told them the fetus had Xeroderma pigmentosum group D (XPD) and Trichothiodystrophy (TTD), two rare and severe genetic conditions that they said can cause significant disability and a shortened life span.

"I thought what is this, like it doesn't make sense," Breanna O'Brien told ABC News' Rachel Scott. "You're talking about one in a million and it just happens to be our baby and it's our first baby, our first pregnancy, an incredibly wanted baby."

The O'Briens said they spoke with genetic counselors and parents of children with TTD and XPD before making the decision to terminate the pregnancy.

"The more we learned about it, I could not put my baby through that," Breanna O'Brien said. "It's a cruel disease and it's really horrible."

"It would not be a normal life and the quality of life would be so low that I wouldn't wish it on my worst enemy," Kyle O'Brien added.

The O'Briens, who described themselves as devout Catholics, said they struggled with their church's teachings on abortion and their own experience.

"Being a Catholic, there's a serious sense of Catholic guilt and that you're going to hell for making this decision," said Breanna O'Brien. "And I would rather go to hell than have my baby live in a prison for three short years."

However, once they made what Breanna O'Brien called the "best decision" for their baby, the couple said they learned they would not be able to access abortion care in their home state of Kansas.

Kansas permits abortions up to 22 weeks of pregnancy, and has additional regulations that include requirements for counseling, parental consent for minors and a waiting period.

Breanna O'Brien said she was not able to access abortion care in Kansas before 22 weeks, so she had to travel two states away, to Illinois, to have an abortion.

"It was preposterous that we had to go to an out-of-state clinic, that's not at a hospital, to get the care we need," she said, adding that the clinic she went to served people from 22 different states.

The Supreme Court's decision to overturn Roe v. Wade, the landmark 1973 ruling on abortion rights, gave power back to states to decide abortion access.

In the weeks since the court's ruling, at least 15 states have ceased nearly all abortion services.

Nearly all of the states surrounding Kansas -- including Oklahoma, Missouri and Arkansas -- have issued near-total abortion bans since the Supreme Court's decision. Kansas has so far kept its law allowing abortion care before 22 weeks of pregnancy.

On Aug. 2, voters in Kansas voted on an abortion-related amendment in the first state-level test on abortion access since the Supreme Court's ruling.

In an election that saw record turnout, voters rejected an amendment to remove the right to abortion from the state's constitution. Had the amendment passed, it would have given the state's GOP-controlled legislature the power to pass new abortion restrictions.

The O'Briens said that while they are still mourning the loss of their unborn child, they wanted to share their story as they see abortion access impacted across the country.

"You have your beliefs and you can make that choice when you have it, but we have the freedom here to make the best choice for our son," said Kyle O'Brien. "You don't think it can happen and you don't think you'd ever exercise the freedom until you need it."

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Ashton Kutcher says he's ‘lucky to be alive’ after developing rare autoimmune disorder

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(NEW YORK) -- Ashton Kutcher says he's "lucky to be alive" after he says he developed vasculitis, a rare condition.

In a first look from Monday night's new episode of National Geographic's Running Wild with Bear Grylls: The Challenge from Access Hollywood, the Punk'd creator opened up to the British adventurer about developing a rare disorder, while the two walked through the jungles of Costa Rica.

"Two years ago, I had this weird, super rare form of vasculitis," Kutcher said. "It knocked out my vision, it knocked out my hearing -- it knocked out all my equilibrium. It took me, like, a year to build it all back up."

While Kutcher did not mention what specific disorder he had, vasculitis is generally defined as swelling that affects the walls of your blood vessels, according to the National Heart, Lung and Blood Institute. Also known as angiitis or arteritis, some cases of vasculitis may be caused by autoimmune disorders that occur "when your immune hurts your blood vessels by mistake," according to the institute.

The National Institutes of Health said it's unknown what happens, but when it does, the blood vessels swell and can close off. Symptoms can vary depending on what kind of vasculitis a person has, but general symptoms include tiredness, fever, aches and pains, loss of appetite and weight loss, according to the NIH.

Vasculitis can also cause ear and nose problems, eye problems, genital ulcers, heart palpitations, joint pain, lung problems, nerve issues, skin rashes or swollen, dry lips or tongue, according to the NIH. Treatment can include prescription medicines or over-the-counter pain medication to relieve symptoms and reduce inflammation, the agency said.

"You don't really appreciate it until it's gone, until you go, 'I don't know if I'm ever gonna be able to see again. I don't know if I'm ever gonna be able to hear again. I don't know if I'm ever gonna be able to walk again,'" Kutcher told Grylls in the clip.

He added, "The minute you start seeing your obstacles as things that are made for you, to give you what you need, then life starts to get fun, right? You start surfing on top of your problems instead of living underneath them."

The new episode of Running Wild with Bear Grylls, premieres Monday at 9 p.m. ET on National Geographic. In clips teasing the new episode on social media, Kutcher is seen pushing himself to the limit as Grylls takes him through the Costa Rican jungle and crossing a ravine. Clips also show Grylls pranking Kutcher about crocodiles in a river as they look for fish to eat.

You can watch Kutcher's adventure on Disney+ starting Aug. 10.

The Walt Disney Company is the parent company of ABC News and Good Morning America.

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CDC sends team to New York to investigate polio case

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(NEW YORK) -- The Centers for Disease Control and Prevention has deployed a federal team to New York to investigate the case of polio detected in Rockland County.

The team will also help administer vaccinations in the county, according to ABC station WABC-TV.

It's unclear how long the CDC will remain in the county or if the findings will be released to the public.

On July 21, the New York State Health Department announced an unvaccinated patient in Rockland County had contracted a case of vaccine-derived polio, the first case in the United States in nearly a decade.

This means the patient was infected by someone who received the oral polio vaccine, which is no longer used in the U.S.

Unlike the polio vaccine given by injection, which uses an inactive virus, the oral vaccine uses a live weakened virus.

In rare cases, the virus spreading through sewage can affect those who are unvaccinated. This is different from wild polio, which infects people by circulating naturally in the environment.

Since then, it's been revealed the patient was a previously healthy 20-year-old man who had traveled to Europe. He was diagnosed after he went to the hospital when he developed paralysis in his legs.

Last week, the state health commissioner said "hundreds" of people in New York could be infected after the virus was found in wastewater samples in multiple counties.

As of Aug. 5, 11 samples were genetically linked to the Rockland County patient including six samples collected in June and July from Rockland County and five samples collected in July from nearby Orange County, health department data shows.

New York State Health Commissioner Dr. Mary Bassett called on anybody who hasn't received the polio vaccine to do so.

The statewide rate of polio vaccination is 78.96% while the Rockland County rate sits at 60.34%, state data shows. In Orange County, the rate is even lower at 58.66%.

"Based on earlier polio outbreaks, New Yorkers should know that for every one case of paralytic polio observed, there may be hundreds of other people infected," Bassett said in a statement Thursday. "Coupled with the latest wastewater findings, the Department is treating the single case of polio as just the tip of the iceberg of much greater potential spread."

The statement continued, "We must meet this moment by ensuring that adults, including pregnant people, and young children by 2 months of age are up to date with their immunization -- the safe protection against this debilitating virus that every New Yorker needs."

Neither the CDC nor the NYSDOH immediately returned ABC News' request for comment.

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Climate change could aggravate over half of known human pathogens, scientists say


(NEW YORK) -- Scientists have made a distressing discovery on how global warming will affect known infectious diseases.

Climate hazards are expected to aggravate 58% of all known human pathogens, according to a study published Monday in Nature Climate Change. That's over half of infectious diseases discovered since the end of the Roman Empire, Camilo Mora, a data analyst and associate professor in the Department of Geography and Environment at the University of Hawaii Manoa, told ABC News.

While the impact that climate change can have on human vulnerability to a range of diseases has been well accepted, the full threat climate change poses to humanity in the context of disease was unknown, according to the researchers. Past studies have primarily focused on specific groups of pathogens, such as bacteria or viruses, the response to certain hazards, such as heatwaves or increased flooding, or transmission types, such as food or water-borne.

Mora's team systematically screened literature that revealed 3,213 empirical cases linking 286 unique, human pathogenic diseases to 10 climate hazards, such as warming, floods or drought. Of these, 277 pathogens were found to be aggravated by at least one climate hazard, with only nine pathogens "exclusively diminished" by climatic hazards, according to the study.

A whopping 58% of an authoritative list of infectious diseases documented to have impacted humanity have already been shown to be aggravated by climatic hazards -- a finding the researchers found "shocking," Mora said.

Examples of hazards include those that bring humans closer to pathogens, such as storms and floods, which then cause displacements associated with cases of Lassa fever or Legionnaires’ disease.

Other examples are events that bring pathogens closer to humans, in which warming increases in areas over which organisms that transmit diseases, such as Lyme disease, dengue and malaria, are active.

There is a broad taxonomic diversity of human pathogenic diseases, such as bacteria, viruses, animals, plants, fungi and protozoa, as well as transmission types -- for example, vector-borne, airborne, direct contact -- that can be affected by warming, heat waves, droughts, wildfires, extreme precipitation, floods and sea level rise, according to the study.

Shifts in the geographical range of species are one of the most common ecological indications of climate change, according to the study. Warming and precipitation changes, for instance, were associated with range expansion of vectors such as mosquitoes, ticks, fleas, birds and several mammals, which then were implicated in outbreaks by viruses, bacteria, animals and protozoans, including dengue, chikungunya, plague, Lyme disease, West Nile virus, Zika, trypanosomiasis, echinococcosis and malaria.

The researchers found 1,006 unique pathways in which climatic hazards, via different transmission types, resulted in cases of pathogenic diseases.

Warming at higher latitudes have allowed vectors and pathogens to survive winter, aggravating outbreaks by several viruses, such as an anthrax outbreak in the Arctic circle that may have stemmed from an ancient bacterial strain that emerged from an unearthed animal corpse as the frozen ground thawed, according to the study.

COVID-19 is an example of how one single disease can create a thematic change in society, Mora said, adding that he does not believe the most recent pandemic -- and the animal-to-human transmission that likely caused it -- could have happened without global warming.

This research reveals more evidence that humans will have difficulty adapting to climate change, especially those in developing countries, Mora said.

"The magnitude of the vulnerability when you think about one or two diseases -- okay, sure, we can deal with that," he said. "But when you're talking about 58% of the diseases, and 58% of those diseases can be affected or triggered in 1,000 different ways. So that, to me, was also revealing of the fact that we're not going to be able to adapt to climate change."

Extreme weather events such as drought and wildfire in the West, flooding in both inland and coastal areas and extreme heat in places that previously did not experience such high temperatures are becoming more common, Mora said.

The findings reveal unique pathways in which climatic hazards can lead to disease, underlining the limited capacity for societal adaptation, and emphasizing the need to reduce greenhouse gas emissions, the authors said.

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New abortion restrictions may push patients to more expensive, complicated care

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(NEW YORK) -- As more states enact near-total bans and restrictions on abortion, providers say many patients are experiencing delayed care which can force them into later stages of pregnancy.

Abortion care options are becoming more limited and complex in some cases, which often means higher costs for patients. For example, medication abortion, which is less costly than other options, is only an option up to 10 weeks into pregnancy.

The most recent data available, from 2017, shows the average cost of an abortion in the first trimester nationwide was about $550, whether it was medication or procedural, according to the Guttmacher Institute, which researches reproductive rights.

Any abortion care for pregnancies further along than 12 weeks costs more than that. The median cost of abortion care for pregnancies at 20 weeks in 2017 was $1,670, Dr. Rachel Jones, a principal research scientist at Guttmacher, told ABC News.

Jones said that access to abortion care for patients in their second trimester has always been limited, and those patients have always had to travel further.

Almost every clinic offers abortions up to nine and 10 weeks into pregnancy and 75% offer abortions until the second trimester, Jones said.

"After that, the percentage of clinics that offer abortion at each week of gestation starts dropping off. And so people are going to have to travel further to get to a facility that can provide care at those gestations. And of course this is all going to be incredibly exacerbated given the overturning of Roe," Jones said.

Dr. Bhavik Kumar, a provider in Texas and the national medical spokesperson for Planned Parenthood, told ABC News that how far along a pregnancy has to be before costs go up varies between clinics and across states.

Whether a patient has insurance coverage is also a main factor in determining cost. In some states, patients may not have to pay anything because abortion is covered by insurance, Kumar said.

Abortions for pregnancies that are further along can cost more because of fewer healthcare professionals that can provide that care and their limited availability, abortion procedures becoming more complicated and requiring medications or abortions needing to happen over two days, Jones said.

Second trimester abortions could also require more surgical preparations like medications or dilators, sometimes an extra procedure to insert dilators, all of which requires more time in the clinic and is factored into higher costs, Kumar said.

When the pandemic first hit, Texas said abortions were not essential health care, forcing patients to travel across state lines or not get care. When abortion care resumed, a study documented that there were more patients coming in at later stages of pregnancy, Jones said.

Other abortion restrictions, like having to make in-person visits or having to return to a clinic before getting care can also delay care by several days and push patients from one trimester into another, Jones said, citing Guttmacher research.

When Texas was one of the only states implementing a ban, wait times were around one to three days. As time progressed, within one to two months, providers saw wait times jump to one to three weeks depending on which clinic you look at, Kumar said.

Kumar said he is seeing a lot of patients who are looking to get care in another state seeing delays of several days or several weeks and some clinics are so overwhelmed, they are not even making appointments.

States with the least restrictions, that do not have mandatory wait times are where Kumar says he is hearing about longer wait times.

"It seems like there's sort of hotspots that are forming for abortion access and the states that come to mind are Illinois, Kansas, Colorado [and] California because of the lack of most restrictions and the ability to get care," Kumar said.

Experts said waiting longer into pregnancy increases costs.

Dr. Katie McHugh, an abortion provider who works at three clinics in Indiana, told ABC News that abortions for pregnancies that are less than 14 weeks cost around $800.

These patients are getting medication abortions or simple procedures, McHugh said.

The cost of abortion for pregnancies further along than 14 weeks range from $900 to $1,200, depending on the stage of pregnancy and need for anesthesia or if the abortion is done over multiple days, McHugh said.

Some states like Indiana had mandated that abortion care be done in a hospital after a certain number of weeks, which costs "many thousands of dollars," McHugh said. The cutoff for when care is required to be in a hospital is regulated by states and varies around the country.

It costs less to get care at a clinic than a hospital because clinics have less overhead costs. Abortions at later gestations cost more largely because they need to be done in a surgical or hospital setting, McHugh said.

Asked whether her clinic has received patients further into pregnancy because of bans or restrictions in their states, McHugh said "absolutely."

"Most of the people that we're seeing from out of state, had to be referred here because of the restrictions in their own states. And then some of them, they tried to be referred to here, but they can't get here in time. And so then we are having to refer them to Illinois," she said.

On Friday, Indiana became the first state to enact near-total abortion ban since the U.S. Supreme Court voted to overturn Roe.

Kumar said that for patients with medically complex pregnancies who need abortion care for health reasons, delaying their care complicates risks.

People likely to have complications like preeclampsia, gestational hypertension, high blood pressure, gestational diabetes or who have had past hemorrhages are also likely to be people who experience other barriers to access. Those people are often uninsured people, people of color and low-income people, Kumar said.

Patients who have to travel to get care also face other costs that vary from patient to patient.

"So much of that depends on where people are traveling from, how much work they have to miss, how much they have to pay in childcare, not to mention gas and lodging and all of those costs," McHugh said.

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How the U.S. struggled to respond rapidly to the monkeypox outbreak: Experts

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(NEW YORK) -- In early May, when the first cases of monkeypox surfaced in the United Kingdom and Europe, health officials in the United States advised Americans not to panic.

There had been outbreaks of the rare disease before that had been controlled with testing and vaccines, and experts were optimistic an outbreak of monkeypox in the U.S. could be contained.

"We're working hard to contain the cases that are happening so they don't spread onward," Jennifer McQuiston, deputy director of the Centers for Disease Control and Prevention's High Consequence Pathogens and Pathology division, said during a media briefing in May.

More than two months later, the situation appears to be much different.

As of Friday, there were more than 7,100 reported cases in the U.S. across 48 states, the District of Columbia and Puerto Rico, according to the CDC, resulting in the Department of Health and Human Services declaring the outbreak a public health emergency Thursday.

That stands in stark contrast to instances of the disease in the recent past -- two travel-associated cases in 2021 and a small outbreak in 2003 linked to contact with pet prairie dogs, which were infected after being kept near small mammals from Ghana.

Currently, about 80,000 specimens per week are being tested and at least 600,000 vaccines have been distributed throughout the nation, health officials said during a media briefing Thursday.

While the federal government has acquired more than 1 million vaccine doses as part of the national stockpile preparedness program and has newly appointed monkeypox crisis coordinators, some public health experts interviewed by ABC News said the first cases in Europe back in May should have been a warning sign for the U.S. to ramp up testing and vaccination because of the possibility of community transmission.

Unlike COVID-19, monkeypox is more difficult to transmit, passing primarily through direct skin-to-skin contact. But there has been criticism leveled that it was a slow start and some mistakes made during the early days of the COVID-19 pandemic were repeated.

"Quite frankly, the inability of the government and inability of federal public health to respond sooner than it did is what cost us here," Dr. Perry Halkitis, dean of Rutgers School of Public Health, told ABC News.

The White House said Thursday President Joe Biden is getting "regularly briefed on monkeypox" and it's an issue that is "top of mind" for him.

Lack of alarm bells

The first case of the current outbreak was reported in the U.K. on May 7. Soon cases began to crop up in countries in mainland Europe, such as in Portugal and Spain.

The U.S. did not see a case of monkeypox confirmed until May 19 in a Massachusetts patient. With only one case, the Massachusetts Department of Public Health cautioned the risk to the public was low.

But like the early days of the COVID-19 outbreak, some public health experts warned that cases were likely more widespread than was publicly known.

Halkitis said the U.S. should have immediately started assembling a task force and increasing the supply of tests and vaccines after the first monkeypox patient was confirmed in Europe, suggesting potential community transmission.

"When the disease first appeared, that should have rung alarm bells for people," he said. "We know perfectly well from COVID how quickly things spread because of global travel. We should have been at that point acting immediately, putting task forces together, getting vaccines and we did not do that."

"Now they're going to put a task force together? It's a little late," Halkitis continued.

Testing criteria not broad enough

It was not until late June that the HHS announced it was expanding testing capacity and accessibility by shipping tests to five commercial laboratories nationwide.

Between mid-May and early June, U.S. laboratories had only tested a little more than 2,000 specimens from patients suspected to have monkeypox, a CDC report found.

However, testing has rapidly increased from 6,000 specimens per week in late June to more than 80,000 per week currently, CDC director Dr. Rochelle Walensky said during a media briefing Thursday.

"As testing has increased, our capacity for testing has increased and far outpaced the demand," she said. "So right now, we're really only testing at about 10% of the capacity we have, and we are encouraging anyone who has a prospective rash that could be monkeypox to present for testing."

The CDC currently recommends that people be tested only if they think they have monkeypox -- including the telltale sign of a rash -- or have had close contact with someone who has monkeypox.

But Dr. Peter Chin-Hong, an infectious diseases specialist at the University of California, San Francisco, said testing recommendations should be expanded to a few more groups because not all rashes look the same and some high-risk people may not know that they were even exposed.

"We should be testing much more than we're testing now and I think we should loosen the criterion or guidance for who we should test," he told ABC News. "I think we should flood the community with testing, just like in COVID."

He also said because monkeypox does not always manifest as a rash on the skin -- with sores sometimes appearing in the mouth, vagina or rectum -- those at high-risk who don't have a traditional rash should have swabs performed in those areas to test for monkeypox.

Delay in making vaccines available

In May, Biden called the level of exposure something "everybody should be concerned about" but that the country has vaccines and that it doesn't rise to the level of concern of COVID.

So far, the U.S. secured 6.9 million doses for delivery by May 2023, according to the HHS, with 1.1 million made available to states for ordering.

Some experts say vaccines could have been distributed a lot more quickly. The U.S. government currently has a contract with Danish firm Bavarian Nordic to "finish and fill" Jynneos, a vaccine approved for both smallpox and monkeypox.

The bulk of the 1.1 million doses initially sat in a plant that needed to be inspected by the U.S. Food and Drug Administration, a typical process for the agency.

Last month, the FDA said it had approved 786,000 doses to be released after it finished inspecting the plant and determined the vaccines being formulated there met its standards. The investigation only took about six weeks, much faster than typical for the FDA.

"Six weeks is pretty fast for that," Dr. Gregory Poland, head of the Mayo Clinic's Vaccine Research Group, told ABC News. "What the argument would be is that the three-year-shelf life is too short."

As soon as vials are filled with the vaccine, a three-year ticking clock to expiration begins. Poland says the FDA may have held off on signing off to try to get the vaccine to as many people as possible before this occurred.

However, demand is far outpacing supply. About 600,000 doses have been delivered and there are 1.1 million people eligible to be vaccinated.

Currently, the U.S. only uses the Jynneos vaccine, not another smallpox vaccine called ACAM2000 -- which the U.S. has in a stockpile -- because the latter can cause side effects in people with certain conditions, such as those who are immunocompromised.

But Poland says the vaccine should be used and people can be screened to make sure they don't have any conditions that put them at risk.

"I understand reluctance to use it but, especially if monkeypox really starts exploding, I don't think you'll have a choice at that point," he said. "I think if your choice is we've got nothing or we've got this, that's easy for me."

To increase the number of doses available, FDA Commissioner Dr. Robert Califf said during a media call on Thursday the agency has "identified a potential solution."

"We're considering an approach ... that would allow health care providers to use an existing one-dose vial of the vaccine to administer a total of up to five separate doses," he said.

The vaccine would be given in a smaller, shallower injection under the skin, a method Califf said would still be safe and effective but would allow up to five doses to be pulled from one vial.

Hesitation to declare a public health emergency

The HHS on Thursday declared monkeypox a public health emergency, 78 days after the first U.S. case was detected in May and about two weeks after the World Health Organization did the same.

It also comes two days after Biden named a national monkeypox team to help combat the outbreak and help increase the availability of tests, treatments and vaccines.

Larry Gostin, a former CDC and WHO consultant who has been advising the White House on monkeypox response, said the announcement could be a "turning point" in the nation's health response after a "lackluster start."

"It's coming very, very late," Gostin, also a professor of medicine at Georgetown University., told ABC News' "Start Here." "It's not a time to panic, but it's absolutely a time to get serious. And I hope that this will be a pivotal turning point for the administration after a lackluster start."

By issuing a declaration, HHS will be able to take a series of actions including accessing funds set aside for such an emergency as well as appointing personnel to positions directly responding to the emergency. It will also help speed up test and vaccine distribution.

"One thing that's been hampered from the beginning is money," Chin-Hong said. "Money means personnel, it means even delivering medications to patients, it means diverting people away from other activities temporarily to try to focus on one outbreak instead of focusing on 10 million other things."

Before the U.S. declared an emergency, New York, Illinois and California all declared their own emergencies. But without a national declaration, it meant states couldn't access federal resources.

"California, Illinois and New York might be able to cobble stuff from their own state funds, but they can't really use federal funds -- unless it's been like some puny money for random emergencies in the future -- because there's no dedicated monkeypox money from a federal level," he said. "You know, a lot of the efforts in each of the parts of the country is hampered by money."

As to why the U.S. took so long to declare a health emergency -- HHS Secretary Xavier Becerra cited "evolving circumstances" for the declaration -- experts say there are a few reasons.

One is to avoid further stigmatization of the LGBTQ community. So far, most cases in the U.S. have been reported among men who have sex with men, a group that includes people who identify as gay, bisexual, transgender and nonbinary.

Even though the CDC has said there is no evidence that monkeypox is a sexually transmitted infection and that anyone can contract the disease, Halkitis said health officials may have been worried about further discrimination of LGBTQ people.

"The other reason I think there's a hesitation is because I think people are exhausted with COVID," he said. "And the last thing people want to hear about is another public health emergency when we don't even have the last one under control."

ABC News' Devin Dwyer, Cheyenne Haslett and Karen Travers contributed to this report.

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Adult at Illinois day care tests positive for monkeypox, children potentially exposed

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(NEW YORK) -- An adult at an Illinois day care center has tested positive for monkeypox, and a number of children may have been exposed to the virus, health officials in Illinois announced on Friday.

At this time, officials did not disclose the number of children that may have been exposed to the virus. Screening of children and staff from the day care, which is located in the Rantoul area of Illinois, near Champaign, is currently underway, and no additional cases have been discovered as of yet.

"All available state, local and federal resources are being deployed to assist families," state officials said during a press conference on Friday afternoon. "Pediatricians are on site, as we speak, to screen children for cases and they're mobile testing and vaccines for their families. Health officials will continue to stay in contact with families and provide information and resources in the coming days."

The day care has been cleaned, and it is still open, officials said.

"The people who have been exposed, potentially, do not need to be in quarantine, so they are being screened and assessed. Anyone with even a tiny little suspicion, we will put them in isolation pending any type of results, but they have the guidance for cleaning and they have done that probably a lot more than is even necessary," officials said.

The individual with monkeypox "also works in a home health care," and health officials have been in contact with the one client who has been impacted.

"The person with monkeypox is in isolation, is being medically monitored, and is doing well," officials added.

The disease is typically spread through prolonged skin-to-skin contact with infected people's lesions or bodily fluids, according to the Centers for Disease Control and Prevention. In addition to lesions, which can appear like pimples or blisters, the most common symptoms associated with monkeypox are swollen lymph nodes, fever, headache, fatigue and muscle aches.

Officials reported that Illinois Gov. J.B. Pritzker had been in touch with the White House, and at the state's request, "the Food and Drug Administration has authorized use of the vaccine for anyone under 18, without jumping through the normal hoops in this process."

"That means that anyone with their guardian's approval will be vaccinated today," officials said.

ABC News has reached out to the FDA and the White House for clarity on whether a formal authorization has been made for children to receive the JYNNEOS vaccine.

On Tuesday, the FDA confirmed to ABC News that "numerous" children have been granted access through a special permission process that operates on a case-by-case basis.

If a doctor decides a person under 18 was exposed to monkeypox and the benefit of the vaccine is greater than any potential risk, they can submit a request to the FDA. In a statement, the FDA said numerous such requests have been granted, but did not say exactly how many.

At this time, the majority of monkeypox cases confirmed domestically and globally in the current outbreak have been detected in gay, bisexual or other men who have sex with men. However, health officials have repeatedly stressed that the virus does not discriminate, and anyone exposed to monkeypox can contract the virus.

At least five children in the U.S. have now positive for monkeypox, according to state and local officials from across the country.

On Thursday, the Biden administration declared the current monkeypox outbreak to be a public health emergency in the U.S.

Globally, more than 28,000 cases of monkeypox have been confirmed across 88 countries, including 7,500 cases reported domestically.

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Novavax's COVID-19 vaccine rollout off to sluggish start with just 7,000 doses in arms

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(NEW YORK) -- Following its emergency authorization last month, just 7,300 doses of Novavax's COVID-19 vaccine have been administered to Americans across the country, newly updated data from the Centers for Disease Control and Prevention (CDC) reveals.

According to John Brownstein, Ph.D., an epidemiologist at Boston Children's Hospital and an ABC News contributor, the sluggish start may be, in part, due to the fact that the vaccines were not immediately made available after authorization, and thus, there could be some reporting delays

The total Novavax doses represent just a fraction of the shots put into arms each day, though the overall number of vaccines administered has plummeted in recent months.

In addition, the vaccine has not been widely available, with just 385 sites initially offering the Novavax vaccine out of the more than 53,000 locations with COVID-19 vaccines, Brownstein said. However, in recent days, that number has jumped to 986 sites, which Brownstein suggested may help boost uptake.

"A mix of lower access, limited promotion and a slowing of the vaccination campaign means that Novavax has not been of high priority for remaining unvaccinated Americans," Brownstein said. "As supply increases, we could see increased access but it’s unlikely to make a real dent."

In July, the Biden administration secured 3.2 million doses of Novavax’s COVID-19 vaccine, in hopes that some unvaccinated Americans would get the shot.

A number of health experts had expressed their hope that some of the individuals, who are still hesitant to be vaccinated, would be more inclined to get the Novavax vaccine, because it is based on a more traditional protein-based technology, one already used for the flu vaccine and other shots, while Pfizer and Moderna vaccine platforms tapped a new genetic technology — with messenger RNA — to produce their vaccines.

"A more traditional delivery route has to be seen as incentive to convince those that have yet to roll up their sleeves," Brownstein explained.

However, early indicators suggest that the authorization has yet to substantially move the needle with the most hesitant Americans.

Even so, health experts previously told ABC News that no matter how widespread the use of Novavax's vaccine is, it will still save lives.

Nationally, there are still more than 26 million American adults who remain completely unvaccinated.

There has not been a significant bump in the number of people receiving a first COVID-19 dose since November 2021. Since then, the average number has steadily fallen to around 50,000 first shots, administered across all eligible age groups, each day.

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Monkeypox vaccine available for kids on case-by-case basis, FDA says

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(NEW YORK) -- With over 6,000 cases of monkeypox confirmed in the United States, including five children, the demand for the monkeypox vaccine is high.

And while the current vaccine, JYNNEOS, is approved only for adults ages 18 and older, it has been administered to children in the U.S. on a case-by-case basis, according to the Food and Drug Administration.

The FDA confirmed to ABC News that "numerous" children have been granted access to the vaccine through a special permission process.

If a doctor decides a person under 18 was exposed to monkeypox and the benefit of the vaccine is greater than any potential risk, they can submit a request to the FDA. Only children with direct exposure are granted access, and even then access is decided on a case-by-case basis

The FDA declined to state exactly how many children have received the vaccine to date through this special permission process.

The JYNNEOS vaccine, delivered in a two-dose regimen, has not been tested through clinical trials in children.

There have been no "adverse events to date" in delivering the vaccine to children in the U.S., and similar vaccines have been tested in children without serious safety concerns, according to the Centers for Disease Control and Prevention.

"JYNNEOS contains a non-replicating Vaccinia virus. While JYNNEOS has not been studied specifically for children or adolescents, the same non-replicating Vaccinia virus in the JYNNEOS vaccine has been used in studies as part of vaccines against other diseases including tuberculosis, measles, and Ebola," the CDC said in a statement. "These studies included children as young as 5 months old, and no serious safety concerns were reported."

Given the case-by-case basis of administering the monkeypox vaccine, there is no availability for mass vaccination of children at this time.

Children under the age of 8 are among those the CDC considers at "increased risk" for developing more severe illness if infected with monkeypox, along with pregnant people, people who are immunocompromised and those who have a history of atopic dermatitis or eczema.

Experts are not sure why children are at increased risk for severe illness, but it may be due to their immune systems and the fact that "younger children are sometimes more susceptible to some viral infections," Dr. Richard Malley, senior physician in pediatrics, division of infectious diseases, at Boston Children's Hospital and a professor of pediatrics at Harvard Medical School, told ABC News.

Monkeypox, also known as MPX, is spread primarily through direct, skin-to-skin contact between someone who has the virus and someone who does not, according to the CDC.

Typically, the disease begins with a fever, headache, fatigue, chills and muscle aches. The disease is similar to smallpox, however, monkeypox also causes swollen lymph nodes.

Within one to three days of initial symptoms, those infected typically develop a rash either on their face or other parts of the body, according to the CDC.

Per the World Health Organization, the lesions -- or rash -- start out as dark spots on the skin before progressing to bumps that fill with fluid.

Antiviral medications such as Tecovirimat, which is available for children, are currently being used for treatment of monkeypox.

Officials in the U.S. and around the world have expressed concern that there are not enough monkeypox vaccines to address the emerging crisis. With demand increasing, U.S. health officials have reported that 1.1 million doses of the JYNNEOS vaccine will be allocated to states and jurisdictions across the country.

Moderna, the maker of a COVID-19 vaccine, said Wednesday they have initiated a research program to consider whether the company could create a monkeypox vaccine with mRNA technology.

Any new vaccine would still need to go through the regulatory authorization process, which can take weeks to months, even in special circumstances.

Now that the Biden administration has declared the current monkeypox outbreak a public health emergency, the FDA could move to issue an emergency use authorization for the JYNNEOS vaccine for children under 18.

The FDA told ABC News it would still need to go through a process to evaluate if it would want to authorize the vaccine for a younger population.

ABC News' Eric Strauss, Arielle Mitropoulos and Ivan Pereira contributed to this report.

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