Test tubes labeled “Monkeypox virus positive and negative” can be seen in this figure taken on May 23, 2022.
Daddle Bitch | Reuters
The Biden administration has distributed 1,200 monkeypox vaccines to people at high risk of the virus. This is part of a national public health response to eradicate the disease before it causes an outbreak.
U.S. health authorities, Worried that the virus might spread faster than previously thought, he said the global outbreak of monkeypox was the largest ever. The World Health Organization said Wednesday that there were more than 550 cases in 30 countries. In the United States, there are at least 20 confirmed or suspicious cases in 11 states, including California, Colorado, Florida, Georgia, Illinois, Massachusetts, New York, Pennsylvania, Virginia, Utah, and Washington. It has been reported. According to the Centers for Disease Control and Prevention.
Dr. Raj Panjabi, head of the White House’s Pandemic Countermeasures Office, told reporters last week that “there has never been a monkeypox of this magnitude and range in the world.”
However, CDC authorities have sought to reassure the public that the arrival of monkeypox in the United States is very different from the Covid-19, which blinded the country two years ago. Scientists knew little when Covid first appeared, and the United States 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 the outbreak of monkeys kept for research purposes, and human infections have been studied since the 1970s. World health authorities also have extensive experience in successfully combating smallpox. Smallpox has been declared eradicated in 1980 by the World Health Organization after a successful global vaccination effort. Monkeypox belongs to the same viral family as smallpox, but is much milder.
Stockpile vaccine
Dr. Rochelle Walensky, director of the CDC, told reporters last week that the United States has been preparing for decades of outbreaks of viruses like monkeypox. In the United States, millions of vaccines have been administered to strategic national stockpiles to protect against monkeypox, smallpox, and even antiviral drugs to treat the disease.
Dawn O’Connell, who heads the Department of Health and Welfare for strategic national stockpiling, said on Friday that the United States has enough vaccines to control the current outbreak of monkeypox. However, O’Connell did not reveal the number of shots the United States was ready for.
There are two vaccines in the United States, but the preferred option is low supply. Jynneos is a double-dose vaccine approved by the FDA in 2019 to prevent monkeypox over the age of 18. The CDC generally recommends Jynneos over the other option, ACAM2000. This is an older generation smallpox vaccine that can cause serious side effects.
Last week, CDC official Dr. Jennifer McQuiston said 1,000 doses of Jynneos are available in the United States. But the Danish biotechnology company that makes shots Bavarian NordicThe United States has said that it is actually supplying the United States and Denmark with more than one million Jynneos frozen doses under orders placed in April 2020. The shelf life of the shot is 3 years.
The United States has ordered nearly 30 million Jynneos doses since 2010, 28 million of which have expired, a spokesman said. Bayern Nordic plans to increase production this summer and is capable of producing 30 million shots a year, a spokesman said.
The US government also has a stockpile of over 100 million doses of ACAM 2000. Emergent BioSolutions, McKistton told reporters last week. According to the CDC, the United States released 500 Jynneos and 200 ACAM 2000s as of Tuesday. The United States has also sent 100 courses of oral antiviral tecovilimat to the state, health officials said Friday.
“We want high-risk people to have quick access to the vaccine and receive appropriate treatment if they get sick,” Punjabi said in a phone call with reporters on Friday. Jynneos and ACAM2000 can be administered before or after exposure to the virus. However, to prevent the onset of the disease, patients should be vaccinated within 4 days of exposure.
According to Mike Slifka, an immunoscientist at the University of Health Sciences at Oregon who studied monkeypox, the ACAM2000 shows a high level of protection against monkeypox in animal models, as well as from the virus in previous versions of the smallpox vaccine. It is expected to provide 85% protection against illness. Little is known about Jynneos, as vaccines are newer, but Slifka said it should produce reasonable antibody levels in humans and protect them from severe illness.
Side effects
The CDC is generally considered to be safer and therefore generally recommends Jynneos over the ACAM2000. ACAM2000 can cause serious side effects, and widespread distribution of the vaccine requires serious debate, McKistton said in a phone call with reporters last week. ACAM2000 uses a mild viral strain of the same family as monkeypox and smallpox and is capable of replication. In other words, there is a risk that the live virus contained in the vaccine will spread to the human body and others.
ACAM2000 is administered with two needles that are scratched on the upper arm, and the virus grows into a local infection in the form of blisters. Patients can spread the virus to other people and other parts of the body, such as by scratching blisters and rubbing their eyes, which can cause vision problems. The FDA warns that it is very important to properly manage the vaccination site so that people vaccinated with ACAM2000 do not spread the virus to other people or other parts of the body. ..
CDC warning
The CDC said Do not take ACAM 2000 for pregnant or lactating women, those with weak immunity, those with skin disorders such as eczema or atopic dermatitis, or those with heart disease. In pregnant women, the virus can spread to the fetus and cause stillbirth. People with weak immunity face the risk of the virus growing out of control and causing dangerous infections, Slifka said. People with skin disorders such as eczema and atopic dermatitis are also at risk of the virus spreading to the skin and can turn into life-threatening infections, he said.
The Jynneos vaccine, on the other hand, is not associated with these risks because it uses a strain of virus that cannot be replicated in humans. It is also given in a regular syringe, just like any other common injection such as the flu vaccine.
Given the potential side effects of ACAM2000, vaccines may be widely used only in smallpox pandemics, according to Dr. Peter Hotez, an infectious disease and vaccine expert at Baylor College of Medicine. Texas. Monkeypox, on the other hand, is a much milder virus, with no deaths reported in recent cases in Europe and North America.
Mortality
According to WHO, the case fatality rate of smallpox can be as high as 30%. The mortality rate of monkeypox strains in West Africa, which appears to be promoting the current outbreak, can be around 1%, but the data are sparse as the virus previously spread primarily to remote areas of Africa. .. According to the CDC, most people recover within 2-4 weeks without receiving specific treatment. According to WHO, there is another monkeypox strain, the Congo Basin, with mortality rates as high as 3% to 10%.
Dr. Rachel Roper, a professor of microbiology and immunology at East Carolina University who studied monkeypox, said:
The United States has far more tools and knowledge to combat monkeypox in 2020, but there are still many unclear points about its current outbreak. It is unknown why the virus is spreading in countries other than West Africa and Central Africa where the virus is endemic. Historically, the virus spread to small villages in Africa by jumping from rodents carrying the virus to humans, with few infections among people, Slifka said. But the virus now seems to spread better among people, he said.
“Through intimate contact and skin-to-skin transmission, it communicates better than under other circumstances,” Slifka said.
According to McQuiston, most monkeypox patients in the United States traveled abroad 21 days before symptoms appeared. This suggests that the virus was picked up abroad. The CDC does not believe that monkeypox is currently widespread in the United States, but it is closely monitoring the situation. To date, the United States has conducted 120 tests against the orthopoxvirus, a family member that includes monkeypox.
Community transmission
“Community-level communications may be happening, which is why we really want to increase our surveillance efforts,” McKistton told reporters on Friday’s phone call. “If you’re worried about seeing a rash, I really want to advise your doctor that monkeypox may be willing to test it,” she said.
WHO officials said Wednesday that the sudden appearance of monkeypox in multiple countries in North America and Europe indicates that the virus has spread outside West Africa and Central Africa. Dr. Rosamund Lewis, WHO’s technical leader in monkeypox, said the virus has spread further as the immunity of the population has declined as smallpox vaccinations have been discontinued after smallpox vaccinations have been eradicated. Said there is a possibility.
Lewis said WHO does not recommend mass vaccination against monkeypox because it can contain the current outbreak. According to WHO, most of the cases so far have been reported among men who have sex with men, develop symptoms and seek care at sexual health clinics. Lewis said it was important to provide gay and bisexual men with the information they needed to protect themselves from the virus and prevent it from spreading.
Symptoms
CDC said Persons with confirmed or suspected monkeypox infection Quarantine at home until the local or state health department says something else. Persons with confirmed infections should remain isolated until the skin lesions that characterize the disease have completely disappeared, the scabs have fallen off, and a new skin layer has formed.
Monkeypox usually begins with flu-like symptoms such as fever, headache, muscle aches, chills, malaise, and swollen lymph nodes. The lesions then form on the body and the virus spreads primarily through skin-to-skin contact with these lesions. Monkeypox can spread through respiratory droplets if there are lesions in the throat or mouth, but it is not so easily transmitted.
people Exposed to monkeypox According to the CDC, symptoms need to be monitored for 21 days. They should check their body temperature twice a day to monitor for chills, swollen lymph nodes, and new skin rashes. If you have a fever or rash, immediately quarantine yourself and contact your local health center.
