ABSTRACT
We assessed tecovirimat treatment equity for 3,740 mpox patients in New York, New York, USA, during the 2022 mpox emergency; 32.4% received tecovirimat. Treatment rates by race/ethnicity were 38.8% (White), 31.3% (Black/African American), 31.0% (Hispanic/Latino), and 30.1% (Asian/Pacific Islander/other). Future public health emergency responses must prioritize institutional and structural racism mitigation.
Subject(s)
Antiviral Agents , Mpox (monkeypox) , Humans , Hispanic or Latino/statistics & numerical data , Mpox (monkeypox)/epidemiology , Mpox (monkeypox)/ethnology , Mpox (monkeypox)/therapy , New York/epidemiology , Socioeconomic Factors , Race Factors/statistics & numerical data , White/statistics & numerical data , Black or African American/statistics & numerical data , Asian American Native Hawaiian and Pacific Islander/statistics & numerical data , Antiviral Agents/therapeutic useABSTRACT
Recent outbreaks of infectious diseases have revealed significant health care system vulnerabilities and highlighted the importance of rapid recognition and isolation of patients with potentially severe infectious diseases. During December 2015-May 2016, a series of unannounced "mystery patient drills" was carried out to assess New York City Emergency Departments' (EDs) abilities to identify and respond to patients with communicable diseases of public health concern. Drill scenarios presented a patient reporting signs or symptoms and travel history consistent with possible measles or Middle East Respiratory Syndrome (MERS). Evaluators captured key infection control performance measures, including time to patient masking and isolation. Ninety-five drills (53 measles and 42 MERS) were conducted in 49 EDs with patients masked and isolated in 78% of drills. Median time from entry to masking was 1.5 minutes (range = 0-47 minutes) and from entry to isolation was 8.5 minutes (range = 1-57). Hospitals varied in their ability to identify potentially infectious patients and implement recommended infection control measures in a timely manner. Drill findings were used to inform hospital improvement planning to more rapidly and consistently identify and isolate patients with a potentially highly infectious disease.
Subject(s)
Communicable Disease Control , Communicable Diseases/epidemiology , Disease Outbreaks/prevention & control , Emergency Service, Hospital , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Humans , Masks/statistics & numerical data , Measles/epidemiology , Measles/prevention & control , New York City/epidemiology , Patient Isolation/statistics & numerical data , Patient Simulation , Time Factors , TravelABSTRACT
Severe mpox has been observed in people with advanced human immunodeficiency virus (HIV). We describe clinical outcomes of 13 patients with advanced HIV (CD4 <200â cells/µL), severe mpox, and multiorgan involvement. Despite extended tecovirimat courses and additional agents, including vaccinia immune globulin, cidofovir, and brincidofovir, this group experienced prolonged hospitalizations and high mortality.