Test tubes labeled “Monkeypox virus positive and negative” are seen in this illustration taken on May 23, 2022.
Looking at Ruvik. Reuters
The Biden administration has distributed 1,200 monkeypox vaccine doses to people who have high-risk exposure to the virus, part of a nationwide public health response to stamp out the disease before it causes a major outbreak.
US health officials, Concerned the virus is spreading faster than previously thought, the global outbreak of monkeypox is by far the largest. The World Health Organization said on Wednesday that there are now more than 550 cases in 30 countries. In the US, there have been at least 20 confirmed or suspected cases in 11 states, including California, Colorado, Florida, Georgia, Illinois, Massachusetts, New York, Pennsylvania, Virginia, Utah and Washington state. According to the Centers for Disease Control and Prevention.
“A monkeypox outbreak of this scale and scope around the world, this has not been seen before,” Dr. Raj Punjabi, who leads the White House Pandemic Preparedness Office, told reporters on a call last week.
However, CDC officials have tried to reassure the public that the arrival of monkeypox in the US is very different from the Covid-19 that blinded the country two years ago. Scientists knew very little about Covid when it first emerged and the US had no vaccine or antiviral treatment to fight the virus in 2020.
Monkeypox, on the other hand, has been known to scientists since 1958, when the virus was first identified during an outbreak in monkeys kept for research purposes, and its transmission to humans has been studied since the 1970s. Global health officials also have extensive experience in successfully fighting smallpox, which was declared by the World Health Organization in 1980 after a successful global vaccination effort. Monkeypox is in the same virus family as smallpox, although it is much milder.
storage vaccine
CDC Director Dr. Rochelle Valensky told reporters last week that the United States has been preparing for an outbreak of viruses like monkeypox for decades. America’s strategic national stockpile holds millions of doses of vaccines that protect against monkeypox and smallpox, as well as antiviral pills to treat diseases.
Don O’Connell, the head of the Office of Health and Human Services responsible for the strategic national stockpile, said Friday that the US has enough vaccines to manage the current monkeypox outbreak. However, O’Connell did not disclose how many shots the US had prepared.
The US has two vaccines but the preferred option is in short supply. Jynneos is a two-dose vaccine approved by the FDA in 2019 to prevent monkeypox in people 18 years of age and older. The CDC generally recommends Genio over the other option, ACAM2000, which is an older-generation smallpox vaccine that can have serious side effects.
Last week, CDC official Dr. Jennifer McQuiston said the US has 1,000 doses of Genios available. However, the Danish biotech company that makes the shots, Bavarian NordicSaid the US actually has a supply of more than 1 million Jynneos frozen supplements stored in the US and Denmark under an order placed in April 2020. The shelf life of the shots is three years.
The spokesperson said the US has ordered about 30 million Ginio supplements since 2010, but 28 million of them have expired. The spokesman said Bavarian Nordic plans to ramp up production this summer and has the capacity to produce 30 million shots annually.
The US government also has a stockpile of over 100 million doses of ACAM2000, made by Emerging Bio Solutions, McQuiston told reporters last week. According to the CDC, the US had released 500 doses of Zynos and 200 doses of ACAM2000 as of Tuesday. Health officials said on Friday that the US has also sent 100 courses of the oral antiviral Tecovirimat to the states.
“We want to make sure that people at high risk have fast access to vaccines and if they do get sick, they can get proper treatment,” Punjabi told reporters on Friday. Jynneos and ACAM2000 can be administered before or after exposure to the virus. However, patients need to receive the vaccine within 4 days of exposure to prevent disease onset.
Mike Slifka, an immunologist at the University of Oregon Health and Science, said that ACAM2000 has demonstrated a high level of protection against monkeypox in animal models and has the potential to provide 85% protection against disease from the virus, similar to older versions of the smallpox vaccine. hopefully. According to people who have studied monkeypox. Slifka said little is known about Genios because the vaccine is new but it has produced reasonable antibody levels in humans and should protect against serious disease.
Side effects
The CDC generally recommends Jynneos over the ACAM2000 because it is considered safer. ACAM2000 can have serious side effects, and distributing the vaccine widely will require serious discussion, McQuiston said in a call with reporters last week. ACAM2000 uses a mild virus strain in the same family as monkeypox and smallpox that can still replicate, meaning there is a risk that the live virus in the vaccine could spread to the human body or to other people.
ACAM2000 is administered with a double-sided needle that is scratched into the upper arm and the virus then turns into a localized infection in the form of a blister. Patients can potentially spread the virus to other people, or to other parts of their body if they scratch the blister and then rub their eye, which can result in vision damage. The FDA warns that it is very important for people vaccinated with ACAM2000 to take proper care of the vaccination site so that they do not spread the virus to other people or other parts of the body.
CDC Alert
CDC has said Women who are pregnant or breast-feeding, people with a weakened immune system, people with skin conditions such as eczema or atopic dermatitis, and people with heart disease should not receive ACAM 2000. In pregnant women, the virus can spread to the fetus and cause stillbirth. People with weakened immune systems face a risk that the virus will grow uncontrollably and cause dangerous infections, Slifka said. People with skin conditions like eczema or atopic dermatitis are also at risk of spreading the virus on their skin, which can turn into a life-threatening infection, he said.
On the other hand, the Genios vaccine is not associated with these risks because it uses a virus strain that is no longer able to replicate in humans, according to Slifka. It is also administered with a normal syringe like other common shots such as the flu vaccine.
Given the potential side effects of ACAM2000, widespread use of the vaccine would only be seen in the context of a major smallpox epidemic because the virus is so deadly, said Dr., an infectious disease and vaccine specialist at Baylor College of Medicine. Peter Hotez. Texas. Monkeypox, on the other hand, is a much milder virus and there have been no deaths in recent cases in Europe and North America.
death count
According to the WHO, the mortality rate from smallpox can be up to 30%. The West African monkeypox that is driving the current outbreak has a mortality rate of around 1%, although data is sparse as the virus has previously spread to remote parts of Africa. According to the CDC, most people recover within two to four weeks without specific medical treatment. Another monkeypox strain, according to the WHO, is the Congo Basin, which is associated with a high mortality rate of 3% to 10%.
Professor of Microbiology and Immunology at East Carolina University, Dr. “We are very fortunate that the outbreak is less virulent than the true West African strain,” he said. Rachel Roper, who has studied monkeypox.
Although the US has far more equipment and more knowledge to fight monkeypox in 2020 than in 2020, there are still many unknowns about the current outbreak. It is not clear why the virus is now spreading to countries outside West and Central Africa where the virus is endemic. Historically, the virus spread in small villages in Africa by jumping from rodents, which carried the virus to humans with very little transmission between people, Slifka said. However, the virus is now spreading better among people, he said.
“Through intimate contact and skin-to-skin transmission, it is transmitted better than other conditions,” Slifka said.
According to McQuiston, most monkeypox patients in the US traveled internationally in the 21 days before symptoms began, which suggests they picked up the virus outside the country. The CDC does not believe that monkeypox is currently widespread in the US, but is monitoring the situation closely. The US has so far conducted 120 tests for orthopoxvirus, the family that includes monkeypox.
community transmission
“There can be community-level transmission, and so we really want to step up our surveillance efforts,” McQuiston told reporters during a call on Friday. “We really want to encourage physicians to go ahead and test for monkeypox if they see a rash and they are concerned it may be monkeypox,” she said.
WHO officials said on Wednesday that the sudden appearance of monkeypox in several countries in North America and Europe is a sign that the virus may be spreading outside West and Central Africa for some time, although it is not clear. Not how long it is. WHO’s technical lead for monkeypox, Dr. Rosamund Lewis said the virus could spread further because immunity in the human population has been reduced since smallpox vaccination was stopped after the disease was eradicated.
Lewis said the WHO is not recommending mass vaccination against monkeypox because the current outbreak can still be controlled. According to the WHO, most cases so far have been reported in men who have had sex with men, developed symptoms and sought care in sexual health clinics. Lewis said it is important to provide gay and bisexual men with the information they need to protect themselves from the virus and prevent it from spreading.
Symptoms
CDC told People with confirmed or suspected infection with monkeypox Unless the local or state health department says otherwise, isolate at home. People with a certain infection should remain in isolation until the skin lesions characteristic of the disease have completely resolved, the scab has fallen off and a new layer of skin has not formed.
Monkeypox usually begins with flu-like symptoms that include fever, headache, muscle aches, chills, fatigue, and swollen lymph nodes. Sores then form on the body, and the virus is mainly spread by skin-to-skin contact with these sores. Monkeypox can be spread through respiratory droplets if a person has sores in the throat or mouth, but it is not easily spread this way.
People exposure to monkeypox According to the CDC, symptoms should be monitored for 21 days. They should check their temperature twice a day and monitor for chills, swollen lymph nodes, and new skin rashes. If a fever or rash develops, the person should self-isolate and contact the local health department immediately.