As the number of U.S. monkeypox cases climbs, one infectious disease expert contends that preventing a nationwide outbreak will depend on whether state and local health departments can contain its spread.

“We are at a tipping point,” says Carl Abraham, M.D., assistant professor of family medicine at New York Institute of Technology College of Osteopathic Medicine (NYITCOM). “This is a make-or-break moment in terms of preventing a widespread monkeypox outbreak, and that will largely be determined by the public health response from state and local agencies.”

As he notes, these agencies must continue to “isolate and vaccinate” infected individuals, as well as those who may have been exposed.

“Right now, there isn’t a need for the general public to be vaccinated against monkeypox, but we shouldn’t underestimate the potential impact of this virus, especially among the immunocompromised. Containing its spread will require an all-hands-on-deck public health response,” he says.

While Abraham notes that it’s unusual for one outbreak to follow on the heels of another, as monkeypox has done with COVID-19, he urges public health officials to view this as an opportunity to prepare for the next “big one.”

“It’s not a matter of if there will be another pandemic, but when,” says Abraham, a faculty member at NYITCOM-Arkansas (located on the campus of Arkansas State University). “The good news is that we’ve learned valuable lessons from the COVID-19 pandemic, including the importance of curbing early disease transmission, as well as the need to prioritize infectious disease research.”

He also notes that, just as federal lawmakers allocated funding for COVID-19 research, they should plan to do the same with monkeypox.