The Centers for Disease Control and Prevention is cautiously optimistic that the U.S. is slowing the spread of monkeypox as new cases rise in several major cities.

“We’re watching this with cautious optimism, and we’re really hopeful that a lot of our harm reduction messages and our vaccines are getting across and working,” CDC Director Dr. Rochelle Walensky during an update on the monkeypox outbreak.

Although cases of monkeypox are still rising nationwide, the rate of the outbreak appears to be slowing, Walensky said. The U.S. has reported nearly 17,000 monkeypox cases since May, more than any other country in the world, according to the CDC.

In New York, which has reported more infections than any other jurisdiction, the number of new cases of monkeypox dropped from an average of more than 70 a day to nine as of Thursday, according to city health department data.

Dr. Aswhin Vasan, the city’s health commissioner, said earlier this week that the outbreak has slowed due to increased vaccination and community efforts. New York City reported a total of 2,888 cases of monkeypox.

In Chicago, another major epicenter of the outbreak, new cases fell from 141 in the week ending July 30 to 74 in the week ending August 20, according to the city’s health department. Chicago reported a total of 807 cases.

“We’re not seeing the potentially exponential growth that we saw at the beginning, so that’s reassuring,” said Dr. Allison Arwady, Chicago Public Health Commissioner, during a Facebook Live event earlier this week. “It’s too early to say that things are looking really good, but certainly some signs of a slowdown in cases.”

The U.S. is nearing the point where the entire gay and bisexual community, who currently face the greatest health risk from monkeypox, will have access to two doses of the monkeypox vaccine, says Dawn O’Connell, director of the National Stockpile Office at the Department of Health and Human Services services.

The CDC previously estimated that up to 1.7 million gay and bisexual men who are HIV positive or eligible for medication to reduce their chances of contracting HIV face the greatest health risk from monkeypox.

The U.S. has distributed 1.5 million doses of the monkeypox vaccine so far, and O’Connell said more than 3 million doses should be available when the final distribution round is completed.

To date, the epidemic disproportionately affects black and Hispanic men. According to the CDC, about 30% of monkeypox patients are white, 32% are Hispanic, and 23% are black. Whites make up about 59% of the US population, while Hispanics and blacks make up 19% and 13%, respectively.

The monkeypox vaccine, called Jynneos in the US, is given in two doses 28 days apart. According to the CDC, patients will not have full protection from the vaccine until two weeks after receiving the second dose. Data from 19 jurisdictions shows that nearly 97% of injections given so far were first doses, Walensky reports.

About 94% of monkeypox cases are linked to sexual contact, and almost all people who contract the virus are men who have sex with men, according to Demetre Daskalakis, deputy head of the White House monkeypox response team.

A CDC survey of 824 gay and bisexual men found that 48% of respondents reduced the number of sexual partners and 50% reduced the number of single sexual encounters during the current epidemic. A separate CDC study found that a 40% decrease in single sexual encounters would reduce the final percentage of gay and bisexual men infected with monkeypox by as much as 31%.

“We’re actually seeing the vaccine get out there, behavior change, harm reduction messages being heard and implemented,” Walensky said. “And all that together for bending the curve.”

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