What happened to monkeypox in Florida?

Over the summer, Florida faced a growing viral outbreak that was causing thousands of infections and alarming public health experts.

It wasn’t COVID-19 (although the pandemic pathogen was still spreading at the time). It was monkeypox, now known as mpox.

The virus, which is endemic in parts of Africa, started to circulate around the world earlier in the year. The U.S. began to see infections in May, and cases spiked in July as it spread primarily via sexual contact. In August, Florida had the third-highest case count in the U.S.

Mpox later disappeared from the public eye as other illnesses such as flu and respiratory syncytial virus, or RSV, took center stage this fall.

What happened to mpox? Is the virus still a threat in Florida?

Here’s what to know.

Are cases still spiking?

New mpox cases have been dropping for months in Florida, mirroring a national trend. As of Wednesday, the state was averaging only two infections per day. Hillsborough, Pinellas and Pasco counties haven’t reported a case in over a week.

By contrast, Florida was seeing 24 infections per day in mid-September, with local counties accounting for nearly a quarter of those cases, on average.

The U.S. surge peaked in August, according to federal health officials. As of Wednesday, the nation was averaging just six infections per day. That’s down from 462 in early August.

The country has seen 20 deaths and almost 30,000 cases total, according to federal data from Wednesday afternoon. Florida has accounted for just over 2,800 infections. Only California, New York and Texas have recorded more.

The majority of cases in the global outbreak have been among men who have sex with men.

The Florida Department of Health didn’t respond to a request for comment on whether anyone in the state has died from the virus.

Up until recently, mpox was called monkeypox. The World Health Organization recommended late last month that the virus be renamed. Over the next year, the original word will be phased out.

The global health agency cited concerns of racist connotations and stigma.

It was a good decision to change the name, said Luke Johnsen, medical director for Metro Inclusive Health, a Tampa Bay area LGBTQ-focused health and wellness center.

Why are infections declining?

Mpox is a viral disease similar to smallpox but milder. It causes painful lesions and other symptoms including fever, chills, exhaustion and muscle aches.

The federal government fumbled its initial response to the pathogen, failing to order enough of a two-dose vaccine called Jynneos.

But the nation’s vaccine supply eventually improved, including in Florida, thanks to a new injection method that allowed for more shots in arms. Tampa Bay health departments offered doses to those at highest risk of illness: gay and bisexual men with HIV or a history of sexually transmitted diseases, close contacts of infected individuals, and lab workers who handle virus specimens, among others.

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Health officials also launched educational efforts to raise awareness about mpox and its symptoms.

The Florida Department of Health in Pinellas County, for example, held vaccine events at gay bars and gave away coasters labeled with advice on virus prevention, according to spokesperson Maggie Hall.

Nationally, gay and bisexual men took steps to limit transmission, too. Some reduced their number of sexual partners or avoided bars, clubs and parties.

Those behavioral changes, and the vaccination drive, helped slow the virus, said Rochelle Walensky, director of the Centers for Disease Control and Prevention, during a briefing with reporters earlier this year.

“We sort of did better than we were expecting overall with this outbreak,” said Aileen Marty, an infectious disease expert at Florida International University in Miami.

She credited the LGBTQ community for being well organized in sharing information about the virus.

Who is still at high risk?

Even though cases are down and the federal government plans to end its mpox emergency in late January, Marty said Floridians with HIV should stay vigilant.

During a two-month period earlier this year, 82% of 57 people admitted to U.S. hospitals for mpox also had HIV, the Centers for Disease Control and Prevention reported.

It’s unclear if having HIV makes someone more likely to become sick if exposed to mpox. But health officials know that individuals with weakened immune systems, including HIV patients with low CD4 white blood cell counts, are at high risk for severe disease.

The health departments in Hillsborough, Pinellas and Pasco counties still offer Jynneos shots to eligible residents, including gay and bisexual men with HIV.

In 2021, there were more than 120,000 Floridians with HIV, according to state data. It’s highly unlikely that all of them have been vaccinated against mpox.

Fewer than 89,000 Jynneos shots have been administered in the state, according to federal data current as of Wednesday morning.

What happens next?

Mpox is not as transmissible as COVID-19, which means it’s easier to contain the virus and prevent future surges.

But Marty said she’s worried that the virus could infect rodents in the U.S., then mutate and eventually jump back into humans with new, alarming characteristics. Mpox can infect a wide range of mammals.

The U.S. Department of Agriculture and U.S. Department of the Interior could monitor for this, she said.

She noted that a version of SARS-CoV-2, the virus that causes COVID-19, may have spread from humans to mice before evolving and then leaping back into people as the omicron variant. A University of Minnesota study supports this theory.