The rapid summer spread of the once rare monkey pox virus has prompted Chicago health officials and community leaders to act. Fortunately, the incidence of the disease, which had risen rapidly, has declined rapidly.

But even as weekly positive cases in the city plunge to numbers unseen since June, monkey pox responders agree: the spread of the virus is not over yet.

“We must remain vigilant,” said Dr. Sharon Welbel, director of hospital epidemiology and infection control and prevention at Cook County Health.

The Chicago Department of Public Health only reported 23 cases last week, down from a peak of 142 cases in the last week of July. Chicago’s encouraging numbers match national trends, Wellbel said.

He attributes to the decline in the availability of an effective vaccine. According to a recent report from the CDC, unvaccinated at-risk people are 14 times more likely to contract the virus than vaccinated people.

Behavioral changes among men who have s*x with men – who still account for the majority of local and national cases – were another significant positive force, she said.

“Strength really comes from within,” she said.

But Welbel’s calendar is still full of calls related to monkey pox. Even as numbers are falling, she said, “the fight is not over yet.”

The decline in morbidity is evidence that people are becoming more cautious about their s*xual behavior, said Massimo Pacilli, CDPH’s deputy commissioner for disease control. The virus spreads through close physical contact, and while it’s not just s*x, s*xual transmission has played an important role in spreading it, he said.

The increase in vaccine stocks was another important factor in the fight against monkey pox, also referred to as MPV.

“Having more vaccines and putting them where it can do the most good was critical,” said Pacilli.

And yet, despite the incentives, believes that the ability to “really control the epidemic” at the new lower transmission levels could be lost without further action.

“My concern is that as the number of cases may decrease, there may be a false sense of over-calmingness,” said Pacilli. “I think MPV has really been in our communities for a while.”

Pacilli said the priority now is to vaccinate at-risk black and Hispanic men. These two groups account for a disproportionately high proportion of monkey pox and a disproportionately low vaccination rate.

According to CDPH data, black people account for 28% of cases, but only 13% of those who received the first dose of the vaccine. Hispanics account for 30% of cases and only 18% of vaccinations.

Pacilli said the city continued to work with community organizations to carry out vaccination and educational activities targeting blacks and Latinos.

The case declines are not a complete story, said Christopher Balthazar, executive director of TaskForce Prevention and Community Services. The organization works with LGBTQ youth of color and received the first doses of more than 1,000 people, he said.

“There are still many people in our community who are unvaccinated and vulnerable,” said Balthazar.

TaskForce has hosted weekly vaccination clinics during the spread of the virus, supported in part by the CDPH. The collaboration with city, state and local hospitals has been “a huge success,” said Balthazar.

However, funding for TaskForce education and vaccination remains a challenge, he added. The grants that pay for most of the organization’s projects are limited in scope, preventing them from being used in a monkey pox-centered effort, so the response to the urgently spreading virus is largely unfunded.

The vaccine was once rare and offered with very limited availability. Access widened considerably as federal and local authorities provided more doses and introduced a new injection method that allowed five times as many injections per vial.

As official guidelines changed, hard work was required to fight disinformation and confusion among already skeptical communities, Balthazar said. Financing is slowly becoming available, but this has been the biggest barrier so far.

“It slows down the reaction and the strength of the reaction,” he said.

There are clinics at the Puerto Rican Cultural Center that offer monkey pox vaccinations among many other vaccines. The effort allows people who might otherwise face hatred for being gay an unobtrusive way to get protection from the virus, said director of public health initiatives Ricardo Jiménez.

“When you go in, nobody knows what you’re going to get,” said Jiménez.

Cultural Center clinics are established in busy places in various communities. The organizers play music outside to introduce people and convey information.

“It normalizes the situation. They say, “Oh yeah, this is a vaccine.” They get used to it, ”he said.

Nearly 80 people were vaccinated at one of the clinics in mid-August, Jiménez said. The numbers at clinics have dropped, but efforts to reach the still disproportionately infected Hispanic community must continue, he added.

“I don’t think it’s over,” said Jiménez. “I don’t think we’re still stabilized with some population still outnumbering others.”

Every Friday, he meets with CDPH health officials and talks about monkey pox.

Fighting monkey pox would require mass vaccination, said Dr. Daniel Berger, medical director of Northstar Healthcare Medical Center. This means vaccinating more blacks and Latinos, and those who refused the vaccine.

Berger’s LGBT-focused clinic welcomes patients from all over Chicago as the clinic offers TPOXX, an antiviral agent experimentally used to treat severe cases of monkey pox. The number of patients with monkey pox has decreased in recent weeks.

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“There’s a little outcropping, sprinkles,” he said.

Berger attributes the drop in incidents to the news that initially prompted health authorities to respond faster. He hopes the new numbers mean the virus “will end soon.”

It is the subject of much fights against monkey pox, said Welbel of Cook County.

“We need to reach out to people who we know are disproportionately affected by it,” she said.

“The goal, of course, is to eliminate the epidemic.”

jsheridan@chicagotribune.com

Twitter @jakesheridan_

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