"This is something we definitely need to take seriously. We don't know the scope and the potential of it yet, but we have to act like it will have the capability of spreading much more widely than it's spreading right now," Dr. Anthony Fauci told CNN on Saturday.
Former US Food and Drug Administration Commissioner Dr. Scott Gottlieb warned that it may be too late to control and contain the virus.
"I think the window for getting control of this and containing it probably has closed. If it hasn't closed, it's certainly starting to close," Gottlieb told CBS' Margaret Brennan on Sunday on "Face the Nation."
Monkeypox has been detected throughout most of the US, except for a handful of states, according to the US Centers for Disease Control and Prevention. The states with the most cases include New York, California, Illinois and Florida.
The latest data
shows that the CDC has tracked at least 1,814 probable or confirmed cases in the US, as of Friday, and a total of 12,556 confirmed cases in 68 countries.
Fauci, who is director of the National Institute of Allergy and Infectious Diseases and President Joe Biden's chief medical adviser, told CNN's Laura Coates that the numbers are "very likely an undercount."
"Whenever you have the emergence of something like this, you are always probably looking at what might be -- might be, we don't know -- the tip of the iceberg, so that's the reason why we've got to get the testing out there in a much, much more vigorous way," Fauci said.
Gottlieb echoed the need for testing.
"We're probably detecting just a fraction of the actual cases because we had, for a long time, a very narrow case definition on who got tested and by and large, we're looking in the community of men who have sex with men and at STD clinics. So we're looking there, we're finding cases there, but it's a fact that there's cases outside that community right now. We're not picking them up because we are not looking there."
The US Centers for Disease Control and Prevention said Friday that there have been eight cases of monkeypox diagnosed among individuals who were female at birth and that no cases have been reported in children or adolescents.
Gottlieb told Brennan that he believes monkeypox "has spread more broadly in the community" and that he would not be surprised if there are "thousands of cases right now."
"Now this is firmly embedded in the community. And while it's not going to explode because it's harder for this virus to spread, it's probably going to be persistent. You'll have this as a sort of a fact of life, maybe spreading as a sexually transmitted disease but also breaking out of those settings," he said.
The former FDA commissioner compared the response to the monkeypox virus with the start of the Covid-19 pandemic, saying the US is making "a lot of the same mistakes," such as a lack of testing early on and not enough vaccines distributed to the community.
"We could have gotten control of this if we had been more aggressive up front," Gottlieb said.
The CDC is working with five commercial laboratories to expand testing capacity, expanding capacity from an initial 6,000 up to 80,000 specimens per week.
Gottlieb also criticized the CDC for its response to the virus.
"The White House has intervened to take more control of the response away from CDC. This can't be our response every time, that when CDC drops the ball, the White House and the political leadership need to step in," Gottlieb said. "That's what's happened here. It happened in Covid. We need to fundamentally reform how we respond to these crises."
Gottlieb's interview was "misinformed and off base," the CDC said Monday.
"It is true that we have work to do -- here and internationally -- and are likely to see more monkeypox cases in the near term, but it is possible to significantly decrease the number of cases and contain the current monkeypox outbreak through education and increased testing and access to vaccines -- all priorities we've made dramatic progress on," the agency said in a statement.
The CDC said it has expanded the monkeypox case definition to encourage health care providers to test for the virus, and it's ramped up communications on the outbreak. Federal health officials have also "dramatically increased availability of vaccines, with more than 130,000 doses already delivered and thousands more on the way."
"We continue to update the public, partners, and the community about how to protect themselves through daily outreach on our website, media briefings, and partner calls," which involve "90+ partner organizations, including state, tribal, local or territorial partners, public health organizations, clinical, community, LGBTQ+ organizations that forward to their members," the CDC said.
Monkeypox is a poxvirus, related to smallpox and cowpox. The virus generally causes pimple- or blisterlike lesions and flu-like symptoms such as fever, the CDC explained.
The lesions typically concentrate on the arms and legs, but in the latest outbreak, they're showing up more frequently on the genital and perianal area, which has raised some concerns monkeypox lesions may be confused with sexually transmitted disease.
The virus spreads through close contact, including direct physical contact with lesions as well as "respiratory secretions" shared through face-to-face interaction. Touching objects contaminated by monkeypox lesions or fluids may also risk the spread.
And although monkeypox is not an STD, it has mostly been spreading among men who have sex with men.
Fauci said Saturday that he expects up to 700,000 vaccines will be distributed to communities by the end of July.
"Because you want to protect the people at risk, not only the people who might have had an exposure that they know of but also people, by the virtue of the fact that they're in a risk situation, that they need to get vaccinated," h