Oct. 4, 2022 -- The monkeypox virus is unlikely to be eliminated from the U.S. in the near future and could spread indefinitely at a low level, according to a new technical brief from the CDC.

The report, which was written for scientific audiences, said the outbreak is slowing as vaccine availability has increased and people have become more aware of how to avoid infection. Immunity has also increased among the most at-risk groups, particularly gay and bisexual men.

At the same time, low-level transmission will likely continue among men who have sex with men, the report indicated. The CDC said it doesn’t have a projection of how many people may become infected by the virus, according to CNBC.

The U.S. continues to report the largest monkeypox outbreak in the world, with more than 26,000 cases across all 50 states, according to the latest CDC data. More than 5,000 cases have been reported in California, followed by nearly 4,000 in New York and more than 2,300 in Florida and Texas.

Globally, 69,000 cases and 26 deaths have been reported. Infections have been identified in 100 countries that haven’t historically reported the monkeypox virus.

In the technical report, the CDC said the virus is still primarily spreading among men who have sex with men. But  anyone can catch the virus through close contact with an infected person or contaminated materials such as clothing or bedding. Health authorities have confirmed 29 cases among children, and 78 pediatric cases are under investigation.

What's more, 408 women have contracted the virus in the U.S., including four pregnant women and one who was breastfeeding.

The CDC said the percentage of patients who identify as gay or bisexual men has declined over time during the outbreak, with 75% of people who provided recent sexual history reporting male-to-male contact. More than 90% of infections are among men, but a large number of cases are missing data on sexual history. 

The outbreak will likely remain concentrated among men who have sex with men over the long term, the CDC said, with infections declining in the coming weeks. The CDC expects the case numbers to drop “significantly” during the next several months.

About 685,000 people have received the Jynneos monkeypox vaccine. Last week, the CDC reported preliminary data from July through September that showed the vaccine is providing protection against infection, CNBC reported.

The CDC noted that the outbreak could speed up again if the virus spreads widely among the U.S. population through heterosexual networks or close contact that doesn’t involved sex. So far, other countries haven’t found evidence of sustained spread outside of sexual networks of gay and bisexual men.

Monkeypox virus cases could also spread faster again if the virus becomes established in an animal population in the U.S., the CDC said. Public health officials aren’t sure which animals in North America are most vulnerable to infection, although the virus has infected other mammals such as primates, hedgehogs, and prairie dogs.

The CDC noted several areas for ongoing research, including vaccines, the spread of the virus, and health equity among at-risk groups. 

“Due to the limited availability of detailed data from case reports and contact tracing, we continue to have knowledge and data gaps related to monkeypox transmission dynamics, case ascertainment, clinical characteristics, and other key features of this outbreak,” the CDC said.

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CDC: “Technical Report 3: Multi-National Monkeypox Outbreak, United States, 2022.”

CNBC: “Monkeypox eradication unlikely in the U.S. as virus could spread indefinitely, CDC says.”

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