Monkeypox is not ready

Monkeypox is here, and it’s spread.Dozens of cases in some countries I talked about last month Currently, there are up to more than 1,000 cases worldwide and 35 have been reported in the United States. But the United States almost certainly has more cases than the statistics suggest, and there is reason to suspect that we are already ruining our epidemic response in some way that makes us uncomfortable. I have.

Not fully tested

During the first months of the COVID pandemic, the test was terribly inadequate when there was an opportunity to contain the virus if all cases and their contacts could be found. Many people infected with the virus have never been tested for the virus, and those who wish to be tested did not necessarily get the virus. The first thing I knew that the virus had spread unnoticed was that there were cases in the United States that were unrelated to each other. The genetics of the various clusters of disease outbreaks may indicate that the virus must have spread undetected for some time.

That’s what’s starting to happen here: TThis is a small cluster of monkeypox cases that are genetically distinct from each other and should be much higher than the 35 US cases reported. Therefore, many cases need to remain undetected.

One of the reasons for underestimation is that people with monkeypox may not be aware that they have monkeypox. Usually, monkeypox lesions are widespread throughout the body. In the current outbreak, a person may have lesions on only one part of the body, or even a single lesion. When that happens, you don’t think, You think, “What a hell, this must be monkeypox.” “HWell, what is that place? And maybe you may or may not see a doctor.

Doctors aren’t always looking for monkeypox, and may not be aware of it at first. This is not a common disease in the United States (or many other areas where it is endemic), and the symptoms of this outbreak do not necessarily follow the order of the textbooks. It is usually expected to have a fever first and then a rash. However, some known cases had a rash before the fever. Some people have lesions only in the area of ​​the anus or genitals and may appear to be confused with sexually transmitted diseases such as herpes and syphilis. (Summary by molecular microbiologist Joseph Osmundson Fact sheet containing pictures of monkeypox lesions of the anus and genitals here.. )

Therefore, the first obstacle to testing is that it has not been fully tested in the first place. The monkeypox test collects secretions and scabs from the lesions and sends them to one of several specific laboratories.Former FDA Commissioner Scott Gottlieb Tweet The current bottleneck is the lack of sampling.

However, as you become more aware, you can quickly run into major problems. Test ability.. Currently, we have a network of 74 laboratories that can run orthopoxvirus tests and can handle an estimated 7,000 tests per week. Monkeypox is the only orthopox virus of concern at this time, as smallpox has been eradicated and other family viruses such as cowpox are rare. If the sample is tested positive for the orthopox virus, the CDC will do further testing to confirm that it is monkeypox.

Persons with monkeypox (or orthopoxvirus suspected of having monkeypox) were quarantined for 21 days, during which time Health authorities perform contact tracing and provide vaccines to affected individuals and their close contacts. There are also antiviral drugs that may help. But vaccines pose another problem.

We have a vaccine but I don’t know how well it works

The good news about vaccines is that we already have them. Multiple, actually: SMalpox vaccination goes back Hundreds of years, Some of the latest vaccines are still available. (Smallpox was declared eradicated worldwide in 1980. It is the only human virus that has that honor.) People are deadly against some of the older smallpox vaccines. Vaccines that use live viruses are not considered because they may react erratically. For monkeypox.

In the United States, there is one vaccine approved for use against monkeypox. Known as MVA (short for Modified Vaccinia Ankara), the brand name here is Jynneos. Although not replicated in humans, it provokes an immune response to smallpox. According to a 1988 study, vaccination is 85% effective against monkeypox infection, but it is a small study and I don’t know if that is the effect we can expect From the current vaccine and the current strain of monkeypox.

I don’t even know if there is enough.US Strategic National Stockpile Say they have 36,000 doses I ordered another 36,000. Vaccine manufacturers have recently received many orders from other countries for obvious reasons and will ship small batches to different countries so that anyone can start vaccination quickly. It’s a schedule.

The current strategy is “ring vaccination”, as it is not enough vaccine to vaccinate everyone, providing vaccines to people in close contact with people known to have monkeypox. To do. (The monkeypox vaccine can also be given to people with monkeypox, because early detection can reduce the severity of the disease.) However, contact tracing is not perfect and is often named recently. And there was no contact information. For all their close contact. Another possible strategy is to provide the vaccine to everyone in the high-risk group, including men who are currently having sex with men. So far, that strategy has only been tried in Canada.

People are already misunderstanding how it is communicated

Many recent cases are found in men who have sex with men. This causes some people to think of it as a sexually transmitted disease, like HIV and other STIs. I have already misunderstood this and have seen social media posts from people who say that they can only catch monkeypox from sex with people who have monkeypox.

Knowing that a virus is sexually transmitted can help you know if sexually transmitted infections are the main transmission route for the virus, such as HIV. However, we find that monkeypox can spread through all types of close contact, including lesions of infected individuals, contact with respiratory droplets (such as coughing and sneezing), and in some cases contact with aerosols. I know.

And about that memo: TThe CDC has briefly issued a recommendation that travelers wear masks to prevent them from catching monkeypox. Withdrew the recommendation “It caused confusion,” he said. Can monkeypox float in the air? perhaps!! However, if you are worried about getting a virus while traveling, you should wear a mask anyway. We already know that masks (especially fit N95 style masks) are effective in protecting us from COVID. Also, cases of COVID are on the rise again and they have never disappeared. So yes, wear a mask. But also be aware of the symptoms of monkeypox. If you have or may have been exposed to monkeypox, don’t be afraid to ask for a test or vaccine.