Moneypox most likely mutated-with increase in spread and cases in the US, UK, EU...and most likely also in Africa. I would not be surprised Latin America/Asia/Australia by now also may have early cases.
Health authorities in Spain have issued an alert over a possible outbreak of monkeypox after 23 people showed symptoms compatible with the viral infection, which has already been detected in the UK and Portugal.
The health ministry cautioned that the suspected cases – all in the Madrid region – had yet to be confirmed, but said a nationwide alert had been issued “to guarantee a swift, coordinated and timely response”.
DJ Some of the TMN links do not open/function inside the EU. But the article mentions also cases in Canada, Portugal, Germany, India...only a few have travellinks with Nigeria.
In May 2022 several cases were identified in London and one in northeast England, according to the UK Health Security Agency. It was emphasised in public announcements that monkeypox did not spread easily between people. https://en.wikipedia.org/wiki/Monkeypox#cite_note-48" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [48] In the same month, both Portugal and Spain reported several cases. https://en.wikipedia.org/wiki/Monkeypox#cite_note-49" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [49]
On 18 May in https://en.wikipedia.org/wiki/Massachusetts" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Massachusetts - Massachusetts , https://en.wikipedia.org/wiki/United_States" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="United States - United States , a case was confirmed after a man traveled to Canada. He was hospitalized, and was known to have been in good condition. https://en.wikipedia.org/wiki/Monkeypox#cite_note-50" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [50]
An ongoing outbreak of monkeypox that started in the https://en.wikipedia.org/wiki/United_Kingdom" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="United Kingdom - United Kingdom began on 29 April 2022 with the presentation of https://en.wikipedia.org/wiki/Monkeypox" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Monkeypox - monkeypox symptoms in a British resident who had travelled to https://en.wikipedia.org/wiki/Nigeria" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Nigeria - Nigeria , where the disease is https://en.wikipedia.org/wiki/Endemic_(epidemiology)" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Endemic (epidemiology) - endemic . The individual subsequently returned to the United Kingdom on 4 May, importing the https://en.wikipedia.org/wiki/Index_case" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Index case - index case of the outbreak into the country. https://en.wikipedia.org/wiki/2022_monkeypox_outbreak#cite_note-WHO1-1" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [1]
The source of several of the cases of monkeypox in the United Kingdom is unknown; however, it appears that https://en.wikipedia.org/wiki/Community_transmission" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Community transmission - community transmission is taking place in the https://en.wikipedia.org/wiki/London" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="London - London area as of mid-May. https://en.wikipedia.org/wiki/2022_monkeypox_outbreak#cite_note-telegraph-2" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [2] Cases of the virus have also been reported in https://en.wikipedia.org/wiki/North_East_England" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="North East England - North East England as well as outside the UK: one in https://en.wikipedia.org/wiki/Portugal" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Portugal - Portugal , two in the https://en.wikipedia.org/wiki/United_States" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="United States - United States and five in https://en.wikipedia.org/wiki/Canada" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Canada - Canada as of 18 May. The outbreak has particularly impacted the https://en.wikipedia.org/wiki/LGBT_rights_in_the_United_Kingdom" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="LGBT rights in the United Kingdom - LGBT community .
Health officials in Portugal said on Wednesday there were five confirmed cases of monkeypox in young men, and authorities in the US state of Massachusetts said a case had been detected there in a man who had recently traveled to Canada.
Another 15 suspected cases in the area around the Portuguese capital, https://www.dw.com/en/lisbon/t-40075833" style="color: rgb(0, 135, 235); text-decoration: none; - Lisbon , were also being investigated, Portugal's General Directorate for Health said.
Britain and Spain have also been looking into suspected cases of the viral infection, marking an unusual outbreak in Europe of a disease typically only found in Africa.
What do we know about monkeypox cases in Europe?
Portuguese authorities said all recorded cases mostly involve young men. Officials did not disclose whether they had been to African countries or had links with recent cases in Britain.
Britain has so far reported seven cases since May 7. Four of those cases apparently identified as https://www.dw.com/en/gay-straight-or-bi-sexuality-is-hard-to-categorize/a-48615683" style="color: rgb(0, 135, 235); text-decoration: none; - gay or bisexual , the UK Health Security Agency said, suggesting that there may be transmission in the community.
On Wednesday, Spanish authorities said they were investigating 23 possible cases, noting they all of them were young men.
There is no scientific evidence suggesting the disease is transmittable through sex. Experts say the infections could have occurred during the close physical contact involved in sex, rather than being a https://www.dw.com/en/who-warns-of-1-million-new-sexually-transmitted-diseases-each-day/a-49094622" style="color: rgb(0, 135, 235); text-decoration: none; - sexually transmittable disease .
What is monkeypox?
The viral infection is similar to smallpox but milder. Its symptoms include fever and a distinctive bumpy rash that normally starts on the face and then moves to other parts of the body.
A pandemic is an https://en.wikipedia.org/wiki/Epidemic" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Epidemic - epidemic occurring on a scale that crosses international boundaries, usually affecting people on a worldwide scale. https://en.wikipedia.org/wiki/Pandemic#cite_note-Porta2008-11" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [11] A disease or condition is not a pandemic merely because it is widespread or kills many people; it must also be infectious. For instance, https://en.wikipedia.org/wiki/Cancer" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Cancer - cancer is responsible for many deaths but is not considered a pandemic because the disease is not https://en.wikipedia.org/wiki/Infection#Contagiousness" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Infection - contagious —i.e. easily transmittable—and not even simply https://en.wikipedia.org/wiki/Infection" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Infection - infectious . https://en.wikipedia.org/wiki/Pandemic#cite_note-12" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [12]
During 2009, the https://en.wikipedia.org/wiki/World_health_organization" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="World health organization - World health organization dropped the words "with enormous numbers of deaths and illness" from their definition. https://en.wikipedia.org/wiki/Pandemic#cite_note-13" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [13] During 2008, they also dropped the requirement of an "influenza pandemic" to be a new sub-type with a simple reassortant virus, meaning that many seasonal flu viruses now could be classified as pandemic influenza. https://en.wikipedia.org/wiki/Pandemic#cite_note-14" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [14]
After the World Health Organization declared in 1980 that smallpox had been eradicated, smallpox vaccination was suspended ( https://wwwnc.cdc.gov/eid/article/21/4/14-0351_article#r1" style="box-sizing: border-box; color: rgb(7, 82, 144); text-decoration: underline; background-color: transparent;" title="1 - Orthopoxvirus, which includes cowpox virus in Europe; monkeypox virus, which occurs naturally in Africa and of which 1 introduction was event reported in the United States; and vaccinia virus (VACV) in Asia and South America ( https://wwwnc.cdc.gov/eid/article/21/4/14-0351_article#r2" style="box-sizing: border-box; color: rgb(7, 82, 144); text-decoration: underline; background-color: transparent;" title="2 - - 5 ).
Especially during the past decade, orthopoxvirus (OPV) infections have increased worldwide, and the immunologic status of the population against OPV is a major risk factor for its reemergence ( https://wwwnc.cdc.gov/eid/article/21/4/14-0351_article#r6" style="box-sizing: border-box; color: rgb(7, 82, 144); text-decoration: underline; background-color: transparent;" title="6 -
In June 2010, an outbreak of exanthematic VACV infection was reported in the rural region of Doresópolis County (20°17′13 ′′S, 45°54′10 ′′ W), Minas Gerais State, Brazil. This region is characterized by small rural properties, where cattle are kept for milk production. Outbreaks of VACV infection had been reported in the neighboring counties in previous dry seasons. In dairy cattle, typical lesions had developed on teats and udders that caused a decrease in milk production; however, the source (index case) was not identified. The reported virulence of the disease in cattle was not atypical and was similar to previously described cases ( https://wwwnc.cdc.gov/eid/article/21/4/14-0351_article#r4" style="box-sizing: border-box; color: rgb(7, 82, 144); text-decoration: underline; background-color: transparent;" title="4 - During our collection of epidemiologic data, we were directed to the local health facility, where 12 rural workers were hospitalized because of high fever; lymphadenopathy; prostration; and painful vesicular–pustular lesions on the hands, arms, faces, and/or knees. All patients were occupationally infected (after milking cows that had lesions on teats). Patients reported that in case of multiple lesions, autoinoculation probably occurred from lesions on hands, the first site of infection; therefore, we have no clinical evidence of “generalized vaccinia.” Three patients also had convulsion, vomiting, diarrhea, and mental confusion.
DJ, It is much to early to "press global alarmbells" - so far it looks like most cases may be mild (???) ...but since it is a new variant of monkeypox we still have to learn a lot...
------------- We cannot solve our problems with the same thinking we used when we created them. ~Albert Einstein
Posted By: Dutch Josh
Date Posted: May 18 2022 at 11:12pm
Well, another one of those days where I keep reading FT every few hours and asking myself how what I'm reading is possible. Monkeypox has now been reported domestically in the UK, Spain, Portugal, Canada, and a case in the US imported from Canada. If this really is a single outbreak due to efficient H2H spread, we're on the verge of something unthinkable. The problem is, if this were the case, I'd have expected more than the few dozen cases reported to this point. If the virus has really mutated to spread more efficiently H2H to cause this outbreak, a pandemic far worse than COVID-19 would be imminent.
So what are the other possible explanations? Could this not be an H2H outbreak at all? Could infected animals or animal products have been distributed throughout North America and Europe? One thing that has been running through my mind repeatedly today is the possibility of contaminated animal skin condoms having been distributed in multiple countries, explaining the possible sexual transmissions.
Could this be a bioterrorist attack, perhaps targeted at the LGBT communities in multiple nations? A group like Boko Haram might certainly be able to obtain this virus from an animal source, but coordinating an attack on multiple nations like this would be difficult? And what would be the method of dispersal? Spraying the virus in gay clubs?
Is it possible that this is a Russian bio-attack on NATO over the war in Ukraine? We know the Soviet Union weaponized the smallpox virus in the 1970s, so it's not too inconceivable there could have been work on monkeypox as well. But sequencing the virus should tell us relatively soon if this is similar to natural strains in West Africa, and if this is not, that would almost certainly trigger a World War. If the virus is indeed fully natural, this scenario seems unlikely simply because of the response it would trigger. My mind shudders at this explanation and its possible consequences almost as badly as it does the thought of the virus naturally going pandemic.
If this virus has indeed gained the ability to transmit more efficiently, whatever the method of mutation, the other question is why it keeps being detected in isolated cases and not large hospital clusters like the original SARS outbreak did. We have a large geographical spread of this outbreak, but not a huge number of cases.
The timing is also suspect here. All these cases have essentially the same onset date, not in generations a couple weeks apart as would be suspected if this were multiple generations of H2H spread from a point source like an importation or release.
Very odd....
One additional thought...if the sexual exposure really represents an H2H transmission, you should be able to contact trace; that is to ask the patients who they had sex with in the past two weeks, and presumably, you'd get only a short list of people who you could check to see if they had previously been ill. This would NOT be the case if an infected condom or something similar had the result of infecting one or both sexual partners during the act. I feel like the former type of contact tracing should have been done already, and the fact that it's not turning up chains of transmission might argue against H2H spread.
This is not HIV with a long incubation period to allow for silent transmission.
Veterinarians should consider all mammals susceptible to monkeypox and be aware of how the disease transmits from animal to animal. Veterinarians who decide to treat animals with suspected monkeypox should use infection control precautions to protect themselves, staff, clients, as well as other animal patients in the clinic.
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In Africa, serologic evidence of monkeypox infection has been observed in a wide variety of mammals, including non-human primates, rodents, and squirrels. Monkeypox virus has been isolated only twice from animals in the wild. Once from a rope squirrel found in the Democratic Republic of the Congo in 1985 and once from a mangabey found in Cote d’Ivoire in 2012.
The role of that or any other particular species as a reservoir has not been established. Several species of primates and rodents are known to be susceptible to infection with monkeypox virus. Because the types of animals that may become ill with monkeypox are currently unknown, all mammals should be considered susceptible as a precaution.
The route of transmission from animal-to-animal may occur through respiratory droplets, inhalation of aerosolized virus or organic matter containing virus particles (e.g., via the disturbance of virus in contaminated bedding), skin abrasions, the eye, or through the ingestion of infected animal tissue.
-
Veterinarians who decide to treat animals with suspected monkeypox should use infection control precautions to protect themselves, staff, clients, as well as other animal patients in the clinic.
Illness presentation may vary amongst animal species. Symptoms that were observed in prairie dogs during the https://www.cdc.gov/poxvirus/monkeypox/outbreak/us-outbreaks.html#outbreak2003" style="box-sizing: border-box; color: rgb(7, 82, 144); text-decoration: underline; background-color: transparent; - 2003 U.S. outbreak included cough, history of fever, conjunctivitis, lack of appetite, respiratory signs, and rash. Similar symptoms have also been observed in non-human primates that have been challenged with monkeypox virus in research studies. Some animals may experience a milder form of illness with fewer symptoms.
Animals suspected of being infected should not be allowed to enter through the waiting area of a veterinarian clinic nor should they be taken to a common treatment room. All treatment and diagnostics should be performed in an examination room. The number of staff allowed in the exam room and that come in contact with the animal should be limited to as few persons as possible.
The most common route for transmission of monkeypox from animals to humans appears to be direct contact with infected animals; however, the possibility of airborne transmission cannot be excluded. When examining animals with suspected monkeypox, veterinarians and staff should use the following precautions:
Hand hygiene: Practice proper https://www.cdc.gov/HandHygiene/index.html" style="box-sizing: border-box; color: rgb(7, 82, 144); text-decoration: underline; background-color: transparent; - hand hygiene after all contact with a sick animal and with contaminated surfaces.
Personal protective equipment: Use gown and gloves for any contact with the sick animal and contaminated surfaces. Use eye protection (e.g., tight-fitting goggles or face shield) if splash or spray of body fluids is likely. Use respiratory protection, including a https://www.cdc.gov/niosh/topics/respirators/" style="box-sizing: border-box; color: rgb(7, 82, 144); text-decoration: underline; background-color: transparent; - NIOSH-certified N95 filtering disposable respirator (or other respirator offering comparable levels of respiratory protection), for entering the exam room or patient care area. If N95 or comparable respirators are not available for veterinary personnel, then surgical masks should be worn to protect against transmission through contact or large droplets. Handle used patient-care equipment in a manner that prevents contamination of skin and clothing.
Waste disposal: Contain and dispose of contaminated waste after consultation with state or local health officials. Do not dispose of waste in landfills or dumps. The animal’s bedding, cage, toys, or food and water bowls should not be disposed of with the clinic trash or at a dump or landfill because this material may be potentially infectious; contact the state or local health department for further instructions. Items that cannot be disposed of should be disinfected as if they were a contaminated surface.
Environmental cleaning: Ensure that procedures are in place for cleaning and disinfecting contaminated environmental surfaces. Any EPA-registered hospital detergent-disinfectant currently used by health-care facilities for environmental sanitation may be used. Manufacturer’s recommendations for dilution (i.e., concentration), contact time, and care in handling should be followed.
Laundry: Wash laundry (e.g., towels, clothing) with hot water and detergent. A standard washing machine may be used. The use of chlorine bleach during hot-water washing can provide an added measure of safety. Care should be used when handling soiled laundry to avoid direct contact with contaminated material. Soiled laundry should not be shaken or otherwise handled in a manner that may disperse infectious particles.
Monkeypox is an https://en.wikipedia.org/wiki/Infectious_disease" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Infectious disease - infectious disease caused by the https://en.wikipedia.org/wiki/Monkeypox_virus" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Monkeypox virus - monkeypox virus that can occur in certain animals, including humans. https://en.wikipedia.org/wiki/Monkeypox#cite_note-CDC2015About-2" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [2] Symptoms begin with https://en.wikipedia.org/wiki/Fever" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Fever - fever , headache, muscle pains, https://en.wikipedia.org/wiki/Swollen_lymph_nodes" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Swollen lymph nodes - swollen lymph nodes , and feeling tired. https://en.wikipedia.org/wiki/Monkeypox#cite_note-CDC2017Sym-1" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [1] This is followed by a rash that forms https://en.wikipedia.org/wiki/Blisters" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Blisters - blisters and crusts over. https://en.wikipedia.org/wiki/Monkeypox#cite_note-CDC2017Sym-1" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [1] The time from exposure to onset of symptoms is around 10 days. https://en.wikipedia.org/wiki/Monkeypox#cite_note-CDC2017Sym-1" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [1] The duration of symptoms is typically two to four weeks. https://en.wikipedia.org/wiki/Monkeypox#cite_note-CDC2017Sym-1" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [1]
Monkeypox may be spread from handling https://en.wikipedia.org/wiki/Bushmeat" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Bushmeat - bushmeat , an animal bite or scratch, body fluids, contaminated objects, or close contact with an infected person. https://en.wikipedia.org/wiki/Monkeypox#cite_note-CDC2015Trans-5" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [5] The virus is believed to normally circulate among certain https://en.wikipedia.org/wiki/Rodent" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Rodent - rodents in Africa. https://en.wikipedia.org/wiki/Monkeypox#cite_note-CDC2015Trans-5" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [5] Diagnosis can be confirmed by testing a lesion for the virus's https://en.wikipedia.org/wiki/DNA" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="DNA - DNA . https://en.wikipedia.org/wiki/Monkeypox#cite_note-CDC2015Out-3" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [3] The disease can appear similar to https://en.wikipedia.org/wiki/Chickenpox" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Chickenpox - chickenpox . https://en.wikipedia.org/wiki/Monkeypox#cite_note-Mc2014-4" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [4]
The https://en.wikipedia.org/wiki/Smallpox_vaccine" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Smallpox vaccine - smallpox vaccine can prevent infection with 85% effectiveness. https://en.wikipedia.org/wiki/Monkeypox#cite_note-CDC2015Out-3" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [3] https://en.wikipedia.org/wiki/Monkeypox#cite_note-6" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [6] In 2019, a monkeypox vaccine was approved in the United States. https://en.wikipedia.org/wiki/Monkeypox#cite_note-7" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [7] There are no monkeypox-specific treatments. https://en.wikipedia.org/wiki/Monkeypox#cite_note-CDC2019Tx-8" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [8] https://en.wikipedia.org/wiki/Cidofovir" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Cidofovir - Cidofovir or https://en.wikipedia.org/wiki/Brincidofovir" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Brincidofovir - brincidofovir may be useful. https://en.wikipedia.org/wiki/Monkeypox#cite_note-Mc2014-4" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [4] https://en.wikipedia.org/wiki/Monkeypox#cite_note-CDC2019Tx-8" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [8] In Africa, reports of the risk of death are as high as 10%. https://en.wikipedia.org/wiki/Monkeypox#cite_note-CDC2017Sym-1" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [1]
The disease mostly occurs in https://en.wikipedia.org/wiki/Central_Africa" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Central Africa - Central and https://en.wikipedia.org/wiki/West_Africa" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="West Africa - West Africa . https://en.wikipedia.org/wiki/Monkeypox#cite_note-Bunge2022-9" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [9] It was first identified in 1958 among laboratory https://en.wikipedia.org/wiki/Monkey" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Monkey - monkeys . https://en.wikipedia.org/wiki/Monkeypox#cite_note-CDC2015Main-10" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [10] The first cases in humans were found in 1970 in the https://en.wikipedia.org/wiki/Democratic_Republic_of_the_Congo" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Democratic Republic of the Congo - Democratic Republic of the Congo . https://en.wikipedia.org/wiki/Monkeypox#cite_note-CDC2015Main-10" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [10] An https://en.wikipedia.org/wiki/2003_Midwest_monkeypox_outbreak" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="2003 Midwest monkeypox outbreak - outbreak that occurred in the United States in 2003 was traced to a pet store where rodents imported from https://en.wikipedia.org/wiki/Ghana" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Ghana - Ghana were sold. https://en.wikipedia.org/wiki/Monkeypox#cite_note-CDC2015Out-3" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [3] The first cases reported to be due to possible https://en.wikipedia.org/wiki/Community_transmission" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Community transmission - community transmission (by sexual contact) of monkeypox outside of Africa occurred in an https://en.wikipedia.org/wiki/2022_monkeypox_outbreak" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="2022 monkeypox outbreak - outbreak in May 2022 . https://en.wikipedia.org/wiki/Monkeypox#cite_note-11" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [11] https://en.wikipedia.org/wiki/Monkeypox#cite_note-12" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [12]
Symptoms begin with https://en.wikipedia.org/wiki/Fever" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Fever - fever , headache, https://en.wikipedia.org/wiki/Myalgia" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Myalgia - muscle pains and feeling https://en.wikipedia.org/wiki/Fatigue" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Fatigue - tired . https://en.wikipedia.org/wiki/Monkeypox#cite_note-CDC2017Sym-1" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [1] Unlike the more severe https://en.wikipedia.org/wiki/Smallpox" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Smallpox - smallpox , there are also https://en.wikipedia.org/wiki/Lymphadenopathy" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Lymphadenopathy - swollen glands . https://en.wikipedia.org/wiki/Monkeypox#cite_note-CDC2017Sym-1" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [1] Within a few days or longer of the high temperature, lesions appear typically on the face first before spreading to other parts of the body. https://en.wikipedia.org/wiki/Monkeypox#cite_note-CDC2017Sym-1" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [1] They begin as https://en.wikipedia.org/wiki/Macule" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Macule - small flat spots , before becoming https://en.wikipedia.org/wiki/Papule" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Papule - small bumps which then fill https://en.wikipedia.org/wiki/Vesicle_(dermatology)" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Vesicle (dermatology) - with at first clear fluid and then https://en.wikipedia.org/wiki/Pustule" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Pustule - pus , which subsequently burst and scab over. https://en.wikipedia.org/wiki/Monkeypox#cite_note-CDC2017Sym-1" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [1] It looks identical to the rash of smallpox. https://en.wikipedia.org/wiki/Monkeypox#cite_note-Kumar2020-13" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [13] An affected person may remain unwell for two to four weeks. https://en.wikipedia.org/wiki/Monkeypox#cite_note-CDC2017Sym-1" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [1]
Limited person-to-person spread of infection has been reported in disease-endemic areas in Africa. https://en.wikipedia.org/wiki/Monkeypox#cite_note-Hut2001-14" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [14]
Monkeypox virus (MPV) also known as the Moneypox virus, is a double-stranded DNA, https://en.wikipedia.org/wiki/Zoonosis" style="text-decoration: none; color: rgb(6, 69, 173); background: none rgb(255, 255, 255); font-family: sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px;" title="Zoonosis - zoonotic virus and a species of the genus https://en.wikipedia.org/wiki/Orthopoxvirus" style="text-decoration: none; color: rgb(6, 69, 173); background: none;" title="Orthopoxvirus - Orthopoxvirus in the family https://en.wikipedia.org/wiki/Poxviridae" style="text-decoration: none; color: rgb(6, 69, 173); background: none rgb(255, 255, 255); font-family: sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px;" title="Poxviridae - Poxviridae . It is one of the human orthopoxviruses that includes https://en.wikipedia.org/wiki/Variola" style="text-decoration: none; color: rgb(6, 69, 173); background: none rgb(255, 255, 255); font-family: sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px;" title="Variola - variola (VARV) , https://en.wikipedia.org/wiki/Cowpox" style="text-decoration: none; color: rgb(6, 69, 173); background: none rgb(255, 255, 255); font-family: sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px;" title="Cowpox - cowpox (CPX) , and https://en.wikipedia.org/wiki/Vaccinia" style="text-decoration: none; color: rgb(6, 69, 173); background: none rgb(255, 255, 255); font-family: sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px;" title="Vaccinia - vaccinia (VACV) viruses. But it is not a direct ancestor to, nor a direct descendant of, the variola virus which causes https://en.wikipedia.org/wiki/Smallpox" style="text-decoration: none; color: rgb(6, 69, 173); background: none rgb(255, 255, 255); font-family: sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px;" title="Smallpox - smallpox . Monkeypox virus causes a disease that is similar to smallpox, but with a milder rash and lower death rate. https://en.wikipedia.org/wiki/Monkeypox_virus#cite_note-Breman_JG_1980-1" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [1] https://en.wikipedia.org/wiki/Monkeypox_virus#cite_note-2" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [2] https://en.wikipedia.org/wiki/Monkeypox_virus#cite_note-3" style="text-decoration: none; color: rgb(6, 69, 173); background: none; - [3] Variation in virulence of the virus has been observed in isolates from Central Africa where strains are mor
DJ however it may be the present monkeypoxvirus may be a bit different/mutated from the known ones. It can be a major risk for both human and non-human hosts. Some of the early symptoms may look like CoViD. People at higher risk for CoViD could ALSO be at higher risk for monkeypox...you can get both !!! Most likely resulting in more severe disease.
------------- We cannot solve our problems with the same thinking we used when we created them. ~Albert Einstein
Posted By: Dutch Josh
Date Posted: May 18 2022 at 11:43pm
And BTW, much knowledge about orthopoxviruses in humans has been lost, and now talk of droplet and contact transmission. However, in the 1700s and 1800s smallpox was accepted a highly airborne. Likely MPX is too.
Two distinct phenomena of airborne transmission of variola virus (smallpox) were described in the pre-eradication era—direct respiratory transmission, and a unique phenomenon of transmission over greater distances, referred to as “aerial convection”. We conducted an analysis of data obtained from a systematic review following the PRISMA criteria, on the long-distance transmission of smallpox. Of 8179 studies screened, 22 studies of 17 outbreaks were identified—12 had conclusive evidence of aerial convection and five had partially conclusive evidence. Aerial convection was first documented in 1881 in England, when smallpox incidence had waned substantially following mass vaccination, making unusual transmissions noticeable. National policy at the time stipulated spatial separation of smallpox hospitals from other buildings and communities. The evidence supports the transmission of smallpox through aerial convection at distances ranging from 0.5 to 1 mile, and one instance of 15 km related to bioweapons testing. Other explanations are also possible, such as missed chains of transmission, fomites or secondary aerosolization from contaminated material such as bedding. The window of observation of aerial convection was within the 100 years prior to eradication. Aerial convection appears unique to the variola virus and is not considered in current hospital infection control protocols. Understanding potential aerial convection of variola should be an important consideration in planning for smallpox treatment facilities and protecting potential contacts and surrounding communities.
DJ-It is to early to say much on the present monkeypox spread...Sewage-sampling maybe would help to see how widespread the virus is. Also it could be an early warningsystem-viralspread before symptoms show up ? There are vaccines-if they protect against the present monkeypox is unclear (as far as I know).
BREAKING—The first confirmed case of #monkeypox in the United States this year just confirmed in a Boston individual who recently travelled to Canada, officials said, as concern rises over the spread of the infectious virus in multiple countries, now US. https://globalnews.ca/news/8846024/canada-us-monkeypox-cases/
DJ Again-as far as I understand; spread may be alarming, severity of disease may be to early to say. Origin/vaccine also still open.
The U.S. has detected a case of #monkeypox in an MA man who recently traveled to Quebec. So add the US and Canada (probably) to the list of countries involved in this growing outbreak. My story:
On Tuesday, the CDC https://www.statnews.com/2022/05/17/cdc-expresses-concern-about-possibility-of-undetected-monkeypox-spread-in-u-k/" style="background-color: transparent; color: rgb(31, 173, 182); - signaled it was worried about the state of the outbreak in the U.K. and the potential that cases would be found in other countries.
“We do have a level of concern that this is very different than what we typically think of from monkeypox,” McQuiston said. “We don’t understand how many other cases could be out there in the U.K., for example, with undefined chains of transmission. We have a sense that there might be some unusual methods of transmission, through intimate contact or some form of close personal contact that we’ve not previously associated with monkeypox.”
The WHO, which previously designated monkeypox as a priority pathogen, has organized a meeting of experts on monkeypox and orthopoxviruses — the wider family of pox viruses — for early next week. Among the issues the experts will likely tackle is an apparent change in the epidemiology of the disease in countries where the virus is endemic that has occurred in recent years.
-
The monkeypox virus is related to the variola virus, which caused smallpox, a once dreaded disease that was declared eradicated in 1980. The symptoms of monkeypox are similar to but milder than smallpox.
Infected people develop flu-like symptoms — fever, body aches, chills — but also swollen lymph nodes. With one to three days of the onset of fever, a distinctive rash appears, often starting on the face. Many conditions can cause rashes but the monkeypox rash has some unusual features, notably the fact that vesicles can form on the palms of the hands.
In countries where it is endemic, the virus is believed to mainly spread to people from infected animals when people kill or prepare bushmeat for consumption.
Once the virus jumps to people, human-to-human transmission can occur via respiratory droplets — virus-laced saliva that can infect the mucosal membranes of the eyes, nose, and throat — or by contact with monkeypox lesions or bodily fluids, with the virus entering through small cuts in the skin. It can also be transmitted by contact with https://wwwnc.cdc.gov/eid/article/26/4/19-1164_article" rel="noopener" style="background-color: transparent; color: rgb(31, 173, 182); - clothing or linens contaminated with material from monkeypox lesions.
-
However, in the past few years there has been small increases in exported monkeypox cases. The U.S. detected https://www.statnews.com/2021/11/17/monkeypox-cdc-maryland-disease/" style="background-color: transparent; color: rgb(31, 173, 182); - two in 2021 , both in travelers who had returned from Nigeria. The U.K. has seen https://www.statnews.com/2018/09/26/monkeypox-cases-united-kingdom/" style="background-color: transparent; color: rgb(31, 173, 182); - multiple importations in the past few years and Israel and Singapore have also detected cases.
McQuiston said the number of exported cases from Nigeria in particular appear to be at odds with the reported number of cases in the country itself.
“I think that we are concerned about the number of exported cases in travelers we’ve seen. And to have so many of them in the last few years is simply a flag to us that there’s a lot more monkeypox transmission happening in Nigeria than perhaps the [official] numbers would suggest,” she said.
“And I think it also is a flag to us that the more traditional routes of transmission that we think of such as hunting wild animals, contact with bushmeat, living at that interface between the jungle and small communities does not seem to be a driver of transmission in terms of what we see happening. And so that makes us cast a wider net about what risk factors might be.”
There is a vaccine that was licensed in the U.S. in 2019 for people 18 years of age and older to protect against smallpox and monkeypox, Bavarian Nordic’s Jynneos. A second vaccine, ACAM2000 made by Emergent Product Development, protects against smallpox and is thought to offer some protection against monkeypox. Both vaccines are licensed only for people considered at high risk of contracting the disease. In the 2003 outbreak in the U.S., smallpox vaccine was used.
DJ...a lot to find out...
------------- We cannot solve our problems with the same thinking we used when we created them. ~Albert Einstein
Posted By: KiwiMum
Date Posted: May 19 2022 at 8:55am
Info I've read about the current vaccine available says it's not something that doctors readily use as it is known to have some fairly severe and unpleasant side effects. I had the standard smallpox vaccine as a tiny baby. I wonder if that is still working?
------------- Those who got it wrong, for whatever reason, may feel defensive and retrench into a position that doesn’t accord with the facts.
Posted By: KiwiMum
Date Posted: May 19 2022 at 9:14am
------------- Those who got it wrong, for whatever reason, may feel defensive and retrench into a position that doesn’t accord with the facts.
Posted By: roni3470
Date Posted: May 19 2022 at 11:34am
I read on line, and no, I didn't save the article, that smallpox vaccines only last for 7 years. Which seems weird that we never got other ones. So I hope that isn't accurate. I have a hard time telling what is true anymore.
I love all these articles posted but curious what peoples thoughts are on this. I realize i am asking everyone to guess and not base anything on real facts, but I am just curious.
My thoughts are that this won't turn out to be anything significant.
------------- NOW is the Season to Know
that Everything you Do
is Sacred
Posted By: Dutch Josh
Date Posted: May 19 2022 at 1:13pm
------------- We cannot solve our problems with the same thinking we used when we created them. ~Albert Einstein
Posted By: A-I
Date Posted: May 19 2022 at 11:25pm
Monkeypox could be used as bioweapon
The Russians worked with monkeypox virus, a close cousin to smallpox, in their bioweapons program and it is possible terrorists could use it in a biological attack against the United States, scientists and former United Nations weapons inspectors told United Press International.
Although some biological weapons experts are concerned with the possibility of terrorists using another smallpox-related virus called camelpox, which Iraq has admitted to researching, Mark Buller, a biologist at Saint Louis University who conducts research on smallpox vaccines, said he is more concerned about monkeypox.
Buller's concern stems from the fact that monkeypox, unlike camelpox, causes mortality in humans and the incidence of human infection is on the rise in central and western Africa.
In addition, the Russian biowarfare experts are known to have worked with the virus in the Soviet Union's biological weapons program.
The Soviets decided they did not want to work with smallpox by the late 1980's "and there was significant discussion of the possible use of monkeypox as a biological weapon instead of smallpox," Ken Alibek, who was former deputy chief of the Soviet biological weapons program and now resides in the U.S., told UPI.
Monkeypox, which causes symptoms similar to smallpox, can be fatal, but only in the minority of cases, said James LeDuc, director of the division of viral and rickettsial diseases at the Centers for Disease Control and Prevention in Atlanta. He said he is "not aware of any cases outside" Africa.
The World Health Organization attributes the increase in monkeypox cases in Africa to the fact that smallpox vaccines, which can protect against monkeypox, are no longer administered.
LeDuc said it is uncertain whether the disease is on the increase, but he noted there appears to have been an outbreak of the disease in Africa about 6 months ago.
The "real fear is that (monkeypox) might be engineered as a bioweapon," said Jonathan Tucker, a former weapons inspector for the United Nations Special Commission who is now with the think tank Monterey Institute in Washington.
Monkeypox is not as contagious as smallpox, but whether it could be or has been modified to be more virulent is unknown. The Soviets were not concerned with contagiousness, Alibek said, because they planned to produce "tons and tons" of the virus -- enough to infect "hundred of thousands of people or even more."
Tucker noted the smallpox vaccine will protect against both monkeypox and camelpox, but Americans do not have access to this vaccine. The CDC, which holds a stockpile of the smallpox vaccine, is currently reconsidering its vaccination strategy and whether to vaccinate everyone or wait until there is an outbreak and try to vaccinate only those exposed.
There are concerns that Russia's smallpox may have been leaked to terrorists, and whether something similar happened with monkeypox is uncertain. Another former U.N. weapons inspector, who requested anonymity, told UPI "There's no confirmation that (monkeypox) leaked out, but the potential exists."
Alibek said he had no idea whether monkeypox had ever been leaked out of the Soviet program. But he noted that from the 1970s until the 1990s, "it was not a problem to get any of the orthopox viruses (smallpox, camelpox and monkeypox)," and many countries had access to them if they wanted them.
Iraq is one of the rogue states that may have obtained access to monkeypox. "We've never ever gotten to the bottom of their involvement with camelpox, whether they were really trying to weaponize it or it was a façade for working with smallpox or monkeypox," said the former U.N. inspector, who was a member of the team that went into Iraq.
There is a lot of suspicion that Iraq had access to smallpox, but "there's no such indirect evidence for monkeypox," the inspector said. Asked if monkeypox was less of a concern than smallpox, the inspector replied, "I wouldn't say it's of less concern ... The fact that we haven't come across evidence from the United Nations doesn't mean it's not there."
No U.N. weapons inspectors have been in Iraq since 1998, so unless the government acknowledges working with a particular biological agent it is difficult to know for certain whether they ever worked with it. No one has any idea what types of agents they have worked with in the past three years, the inspector said.
Iraq is "likely to work with any nasty that comes along" and the government has shown an interest "in all the orthopox viruses," so "it's a strong possibility that they were" working with monkeypox, the inspector said.
The good news is that monkeypox does not appear to be transmissible from person to person and the smallpox vaccine protects against it. Asked whether monkeypox could be modified so that the vaccine is not effective against it, the former weapons inspector said, "I would say that verges on the impossible."
Alibek noted, "There was no such work in getting it resistant to vaccine. I cannot say anything for sure about what they are doing now." Alibek said he left the program more than 10 years ago.
"Making it elusive to the vaccine would be a challenge," CDC's LeDuc said. "The position that we've always held is that it would be very difficult to overcome the vaccine by genetic engineering."
However, Alibek added, "Existent vaccines are not 100 percent effective" against smallpox. They only offer approximately 70 percent protection. "Against monkeypox, the protection could be even lower," he said. "So even if everybody is vaccinated against smallpox, it doesn't mean everybody is protected."
During the first two months of 2022, 704 cases have been reported with 37 deaths (CFR 5.3%) in the DRC.
Since January 2020, DRC has seen more than 10,000 cases and 342 deaths due to monkeypox.
Other African countries most likely must have (lots of) cases.
Some of the explanations do not make much sense; restart of airtravel...Monkeypox is NOT new...the virus may have mutated that much it is able to spread more. "Most" cases in homosexual community...Maybe "more then expected so far in the gaycommunity" would be better...What we did know about monkeypox is most related to the "old" monkeypox. This outbreak looks like dealing with a new form....
It said also in February six new suspected cases were recorded in three states with Bayelsa recording three; Imo, two; and Lagos, one.
DJ, The Nigeria story does not indicate an increase of cases-rare in Nigeria-lately.
One of the questions I have is the relation with CoViD. Did many of the cases test positive for CoViD ? Did CoViD infection open the door-made people more vulnerable-for monkeypox ?
CoViD can do more harm in men-because they have more ACE-2 receptors...Can it-in part-explain why (most) western cases (so far) are also in men ? Does Africa see more monkeypox cases in men ? (And why ?) Animal hosts ?
In recent weeks multiple cases of confirmed and suspected monkeypox infections have been reported in three European countries. https://www.ecdc.europa.eu/en/news-events/monkeypox-cases-reported-uk-and-portugal" style="margin: 0px; padding: 0px; border: 0px; font-size: 13px; font-family: Helvetica, Arial, Verdana, sans-serif; vertical-align: baseline; color: rgb(35, 121, 181); text-decoration: none; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); - The initial cluster of cases which first appeared in the United Kingdom so far includes four men who identify as gay or bisexual or other men who have sex with men (MSM) . The narrative emerging as this outbreak evolves to involve other European countries, Canada and the United States is sadly reminiscent of https://www.cdc.gov/mmwr/preview/mmwrhtml/00043494.htm" style="margin: 0px; padding: 0px; border: 0px; font-size: 13px; font-family: Helvetica, Arial, Verdana, sans-serif; vertical-align: baseline; color: rgb(35, 121, 181); text-decoration: none; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); - initial reporting on pneumocystis pneumonia clusters in gay men with AIDS forty years ago . Monkeypox is not a gay disease and neither are any other infectious diseases. It is unfortunate that this still needs to be said, highlighting how little we have learned from previous outbreaks.
DJ How many cases will be missed/reported late because of "gay-disease madness" ?
This is a twitter thread of a woman in England reporting an unexplained rash illness and states that she has been tested for monkeypox:
https://twitter.com/zenxv/status/1527061731721334784" style="margin: 0px; padding: 0px; border: 0px; font-size: 13px; font-family: Helvetica, Arial, Verdana, sans-serif; vertical-align: baseline; color: rgb(35, 121, 181); text-decoration: none; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); - Sarah Eaglesfield on Twitter: "Didn't really want to make this common knowledge, but it's suspected I've had monkeypox for the last 4 weeks. Swabbed today. At scabbing stage now. Won't share the photos, as instant vomit factor. On a solid 8g of anti-biotics + Aciclovir anti-viral. No idea how I got it." / Twitter
She has also suggested that she was originally diagnosed as shingles, which has not been excluded.
Spain is saying the pathology itself suggests infected fluid exposure to the mucus membranes. If that's correct, that basically rules out terrorism and makes a pandemic incredibly unlikely as it would not be an airborne or aerolized exposure as would be needed to produce a high R0 outbreak. So how is this spreading? This requires a piece of excellent epidemiology.
DJ-Again Monkeypox is NOT new ! Monkeypox may be spread from handling https://en.wikipedia.org/wiki/Bushmeat" style="text-decoration: none; color: rgb(6, 69, 173); background: none rgb(255, 255, 255); font-family: sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px;" title="Bushmeat - bushmeat , an animal bite or scratch, body fluids, contaminated objects, or close contact with an infected person. (wiki)...maybe hosts did become more vulnerable ???? (Due to CoViD)
Monkeypox suspected now in NYC. Boston and New York are almost always our early bell-weathers for epidemics seeded from Europe. Boston had a confirmed #monkeypox yesterday and NYC now has a new suspected case. I’ve seen this pattern before. Hmmm.
2) just look at how fast monkeypox has spread in just a few days. Monkeypox usually is EXTREMELY rare. That’s why the CDC is really worried about this surge because it is so unusual. Yet I see people saying it’s nothing, just like the flu. Do we never learn to follow new data?
3) If the NYC strain came from UK, then it’s probably the 1% CFR mortality West Africa strain instead of the 10% Congo strain. But 1% CFR is higher than COVID’s 0.6% CFR measured in 2020. There is a smallpox vaccine that works, but problem is most under 45 don’t have it. See
DJ You have to compare "new western cases" with recent African ones-both from Nigeria, DRC and other possible sources...It may NOT !!!!! be a west/central-African strain but a new one...!
DJ-Some basic statistics may provide at least some insight !
-gender, age, travelhistory, but also I would like to know CoViD-(vaccination) history...
-Monkeypox may be "endemic" in some parts of Africa-but just as rare in most of Africa as in "western countries". Have there been cases in South(ern) Africa, Tunesia, Egypt ???
-Again-animals being tested ????
DJ-Even if "monkeypox" itself would turn out to be mild-it is very problematic it could explode like this !
------------- We cannot solve our problems with the same thinking we used when we created them. ~Albert Einstein
Posted By: cobber
Date Posted: May 20 2022 at 3:14am
Okay. Does anyone have the abridged version of the Monkey Pox story?
Essentially the basic information needed:
CFR and or IFR
R0
Gestation
Creditable sources too. (not WHO or CDC)
Posted By: cobber
Date Posted: May 20 2022 at 3:18am
Sorry, forgot... is it even transmitting Human to human? or does it need a carrier?
Posted By: cobber
Date Posted: May 20 2022 at 3:43am
Mighty cute in them overalls Chim Chim
Posted By: Dutch Josh
Date Posted: May 20 2022 at 9:17am
You might say “duh…it’s monkeys.” But, it’s not. It’s one of these misleadingly named viruses (e.g. chickenpox isn’t from chickens and isn’t even a poxvirus; the reservoir of cowpox is actually rodents).
The reservoir of monkeypox virus isn’t definitely known but is believed likely one or more small mammals in Africa. It got called ‘monkeypox’ because disease was first reported in monkeys. However, monkeys aren’t the true reservoir, they are just (like us) susceptible to infection.
What animal species are susceptible?
We know that various species are susceptible through natural or experimental studies. This includes:
People, obviously.
Various non-human primates.
Prairie dogs.
Ground squirrels
Various rodents. This would include some pet species, such as rats, although susceptibility of rats seem to vary by species, with some highly susceptible and others resistant.
African hedgehogs
There’s also potentially susceptibility of other species, such as:
Rabbits: there’s some mixed information, with very young rabbits clearly being susceptible and mixed info about older rabbits. It’s possible that older rabbits are not really susceptible to natural exposure, just artificial exposure like intravenous injection of the virus.
Pigs: Pigs on various lists of susceptible species but I haven’t found much detailed info yet.
Other large mammals? Not much is known. There’s https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2536211/pdf/bullwho00094-0031.pdf" style="box-sizing: border-box; color: rgb(6, 58, 177); text-decoration: underline; - one report that suggests potential infection from a gazelle and that gazelles with pox-like lesions were common in one area . However, evidence is pretty limited.
Guinea pigs and golden hamsters seem pretty resistant to infection.
So, the risk of potentially susceptible species includes a few domestic species and could include some wild rodents. Missing from the list are common pets such as dogs and cats, and other livestock such as cattle and horses.
DJ; However it looks like a new form of monkeypox-behaving/spreading in a different way....
------------- We cannot solve our problems with the same thinking we used when we created them. ~Albert Einstein
Posted By: cobber
Date Posted: May 20 2022 at 9:28am
Drilling hard on this one. Nothing yet. Only stuff from the CDC and WHO. For some reason they are into this like a mad woman's breakfast. Weird. When Covid came out they were late to the party, or more accurately sat on the fence. They have heaps of data. Seems monkeypox is common, however its usually isolated.
What we know:
The transmission is human to human. Its via respiratory tract, or the mucous membranes among other things. They aren't saying airborne yet, but...
Incubation period is roughly 7-14 days. I'm also reading up to 20 days. If true, it's long and therefore dangerous.
I've read about a high CFR 3-6%, but I doubt the figures. IFR is more important. Still its high.
And going from the numbers and growth the reproduction rate looks high too. This is what we need to start tracking. Numbers day to day.
This has my attention...
Posted By: KiwiMum
Date Posted: May 20 2022 at 2:56pm
Dutch Josh wrote:
This is a twitter thread of a woman in England reporting an unexplained rash illness and states that she has been tested for monkeypox:
https://twitter.com/zenxv/status/1527061731721334784" style="margin: 0px; padding: 0px; border: 0px; font-size: 13px; font-family: Helvetica, Arial, Verdana, sans-serif; vertical-align: baseline; color: rgb(35, 121, 181); text-decoration: none; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); - Sarah Eaglesfield on Twitter: "Didn't really want to make this common knowledge, but it's suspected I've had monkeypox for the last 4 weeks. Swabbed today. At scabbing stage now. Won't share the photos, as instant vomit factor. On a solid 8g of anti-biotics + Aciclovir anti-viral. No idea how I got it." / Twitter
She has also suggested that she was originally diagnosed as shingles, which has not been excluded.
How many cases are already missed ?????
This is really interesting. One of my cousins in the UK has just told me that a rash she's had under her eye has been diagnosed as shingles even though it doesn't look like shingles. She's been having treatment for it but it hasn't worked and now they've put her on this enormous dosage of anti virals and antibiotics, she has to take a huge dose 5 times a day, four hours apart, starting at 7am and finishing at 11pm. I'm going to contact her today and suggest monkeypox. She's in the Greater London area.
------------- Those who got it wrong, for whatever reason, may feel defensive and retrench into a position that doesn’t accord with the facts.
Posted By: KiwiMum
Date Posted: May 20 2022 at 3:09pm
Here's an all-you-need-to-know article by the Daily Mail on Monkeypox and how it spreads etc.
------------- Those who got it wrong, for whatever reason, may feel defensive and retrench into a position that doesn’t accord with the facts.
Posted By: Dutch Josh
Date Posted: May 20 2022 at 10:16pm
DJ, There must be lots of misdiagnosed and missed monkeypox cases...with weekend limited testing/reporting...however by friday may 27 we will see over 1,000 confirmed cases in 20-30 countries ????
Monkeypox in Nigeria seems to be "very limited", it is more active in the (Democratic Republic of) Congo DRC....but claims are the detected virus has most in common with the west-African virus; there are also some travellinks...However the "New" Monkeypoxvirus does spread much faster...Going for a "gay-virus" is stupid !!!
Stories of a "Russian bio-warfare attack" are very irresponsible...just like calling CoViD the "CCP"virus is not helping....Most likely several countries did study monkeypox in bio-labs...that may help to find out why this new variant is "that active"....
DJ-It has to have a relation with CoViD !!!! Did CoViD weaken immunity in people with monkeypox ? Did monkeypox-infected people get vaccinated against CoViD ? How fast does testing (can) go ? If there are "lots of cases" are there "15-minutes-tests" available ????
Does a combination of (a subtype of) CoViD and monkeypox worsen disease ???? How many cases-by now- do test positive for both CoViD and monkeypox ???
Of course with healthcare allready overstretched by far-in some countries close to breaking point-another pandemic is very unwelcome !
Because-most likely it is not only cases showing up in Africa, Europe, Asia, North America-also spread must be going on in more WHO "regions" ...so YES-be realistic; we are in the early stages of a monkeypox-pandemic !!!
One may "hope" it will "die down"...If we are very lucky the spread will stop. If having sex is the main way of spreading maybe there are "ways to limit spread"...
It will spread in non-human hosts...again-most info is based on older monkeypox variants !!!!
Another CoViD wave is on its way...so monkeypox will find lots of hosts with less immune protection. Healthy people may come in contact with monkeypox but the body may still offer protection. (Long ?) CoviD cases may not be that lucky...
------------- We cannot solve our problems with the same thinking we used when we created them. ~Albert Einstein
Posted By: Dutch Josh
Date Posted: May 20 2022 at 10:58pm
DJ-A virus is just a virus !!! It is not "tropical" or "gay"...it has no color of skin...A virus-so far-most detected in Africa may see a chance to spread in other regions. If it spread via sneezing you would expect a lot of cases in a wide variaty of the population. So far that pattern is not showing up...even missed/misdiagnosed cases do not (yet) indicate "explosive growthrates". So airborne/surface spread most likely will be (very) limited.
However the global number of cases of this form of monkeypox does indicate the virus did change. (So it is NOT !!!! the Nigeria 2018 variant !!! That one was very limited).
DJ; It would be more then welcome to see/look (for) info from Nigeria/(West)Africa to find out if this monkeypox-virus is spreading there. As far as I did notice-with very limited info-and again I just try to catch a glimpse-not an expert at all !- it is so far NOT spreading in West Africa !!!!
Belgium's three confirmed cases of monkeypox have been linked to a large-scale fetish festival in the port city of Antwerp, organisers said Friday.
Several European countries have reported cases in recent days, and the World Health Organisation is investigating whether some outbreaks spread within the gay community.
In Belgium, the Darklands Festival warned patrons who attended four days of parties starting on May 5 that Belgian authorities had linked three cases to the event.
DJ Did an "index/early" case, "patient zero" import the -very rare in Nigeria as well-Monkeypox virus to Europe and is (most of) the spread early stages linked to sex-parties ? Is that also a possible link for earlier (UK ???) cases ?
Then again-it is NOT !!!!!! a "West African virus" !
The virus in the DRC is a different strain of the virus and is unrelated to the cases in North America and Europe. Most of the cases in the DRC are also the result of exposure to infected animals or animal products, and represent minimal if any H2H spread.
The DRC-variant may be more agressive (however killing 10% is related to detected cases...CFR most likely much lower ! DJ-If not treated by a doctor/hospital people may recover. However if there is medical help available seek medical help !!! You do not want to spread it, you do not want to die from it, or end up with complications/long term problems !!!
The U.S. CDC's Morbidity and Mortality Weekly Report published today reviewed the monkeypox virus cases confirmed in a U.S. resident who had returned to Dallas, Texas, from Nigeria in July 2021.
The Dallas County Health and Human Services Laboratory Response Network laboratory-confirmed, by real-time polymerase chain reaction, the presence of nonvariola orthopoxvirus DNA from this Nigerian traveler from lesion swabs, confirming the West African clade Monkeypox virus.
The patient received tecovirimat, an antiviral for treating orthopoxvirus infections and recovered.
...Four months after this case in Texas, an eighth travel-associated monkeypox case in a traveler from Nigeria occurred, also in the U.S., prompting CDC to issue a Level 1 Travel Health Notice for travel to Nigeria.
So monkeypox did show up in isolated cases in western countries. DJ In NL detected monkeypox cases do NOT need to be reported !!! Another question may be did get monkeypox imported from other African countries ? Belgium has a lot of travel with central Africa ??? How much of the "monkeypox in the west story" is known ???
The first 7 confirmed cases in Spain all reported attending "sex parties" and several of them are HIV positive as well.
HIV-link...
Something the media is missing in assuming there are large numbers of missed milder cases worldwide...of the 146 or so cases reported so far, there are NO cases that are both confirmed monkeypox and confirmed female. There are several cases whose gender is not specified, and there is one suspect female case in Spain, but no confirmed female cases.
If you assumed that these cases simply represent the most severe or most unusual cases in a much larger outbreak, you'd suspect equal ratios of males and females. That's totally not what's going on.
The other thing the media is missing is that unless there has been global distribution of infected animals or products, this outbreak will either go pandemic or burn out. This cannot become an endemic situation because there's no reservoir for the virus. The only reason this virus is endemic in Nigeria and the DRC is its presence in animals.
DJ-So again Africa is a different story ! (So far !)
Four pandemic urgent news stories to keep up with:
1. Monkeypox
2. Hepatitis in children
3. Covid cases high and growing rapidly in the US
4. Economic harm of Long Covid
DJ, With the monkeypox outbreak it is important to keep a "wide view". If testing for monkeypox is "very hard" and has a stigma of "gay-parties" we will miss a lot of cases-resulting in much more spread !!! Again-indications may ask for GP/hospitals to "check for symptoms" in ALL patient-groups. Even if most of the spread may be sex-related bisexual men may have infected women...they could both have spread the virus to other age groups. The spread has been going on for SEVERAL WEEKS !!! With a possible incubation of maybe up to three weeks !!! There will be lots more cases...also in women, children, old age....
Monkeypox airport screening to begin in Philippines. “They will do temperature check and procedures for other symptoms of #monkeypox such as headache, malaise or joint and body pains & swollen lymph nodes—among travelers coming from countries with cases”.
This is no monkey business. #monkeypox surge in the past week alone has been astronomical for a traditionally very rare disease. For example, UK cases have doubled overnight form 9 to 20. The
DJ...the longer the incubation period-people having been infected but not yet ill-the more spread. I do not even want to think of a-symptomatic spread...People spreading monkeypox without symptoms themselves over a longer time.
End of part 2...Again I am NOT an expert-just trying to follow the story !
------------- We cannot solve our problems with the same thinking we used when we created them. ~Albert Einstein
Posted By: Dutch Josh
Date Posted: May 21 2022 at 9:59pm
Europe should expect a wave of monkeypox cases in the coming months, according to https://www.rt.com/news/555863-who-monkeypox-transmission-europe/" style="box-sizing: border-box; text-decoration: underline; color: rgb(20, 112, 178); - Hans Kluge, the World Health Organization's top official on the continent.
“As we enter the summer season… with mass gatherings, festivals and parties, I am concerned that transmission [of monkeypox] could accelerate,” Kluge said on Friday.
The number of the infected could rise because “the cases currently being detected are among those engaging in sexual activity,” and many don't recognize the symptoms, he added.
The current spread of the virus in Western Europe is “atypical” as it was previously confined mostly to central and west Africa, the WHO regional director for Europe added.
“All but one of the recent cases have no relevant travel history to areas where monkeypox is endemic,” Kluge said.
Kluge's concerns were shared by UK Health Security Agency's chief medical adviser, Susan Hopkins, who said she expected “this increase to continue in the coming days and for more cases to be identified in the wider community.”
DJ-Maybe again-there may be a link to spread in gay/bi-men-but the virus is not gay ! It will show up in all groups-most likely from 0 to 100 y/o, men and women. Pox vaccination may offer some protection in the older age groups (I did find my scar from the vaccination-decades old-right arm...But not all did get vaccinated !). But vaccine protection of pox-vaccine against monkeypox is expected to be 80/85% if you geet vaccinated recently...It will be waning...
DJ-If you fail to put monkeypox in the bigger story (with a.o. CoViD getting worse again, BA.4/5 Africa links...) you are simply doing a bad job !
The Thailand Medical News mentions cases in India, Singapore...spread has been going on for weeks. Incubation time 1-2 weeks ??? TMN also claims spread of the (same ???) virus is ongoing in "Africa"...
DJ-The ZH (WHO)story is mentioning only ONE (1 !!!!!) travellink to Nigeria as far as cases have been investigated. So most likely this new monkeypox virus is different from the older known variants in Africa.
TMN may have a point in immunity defense getting weaker-opening doors to other diseases...DJ-both in humans and (other) animals. I do not see proof of airborne-spread. If it would be airborne you should expect much higher numbers...Still north part of the globe moving into summer could see more spread.
page to find out the symptoms and what to do if your child shows them
Quote Tweet
UK Health Security Agency
@UKHSA
·
We're continuing to investigate a recent increase in the number of children developing sudden onset hepatitis. Dr Shamez Ladhani explains more about the symptoms & what to do if you're concerned about your child. You can find the latest updates in our news story
In summary: cases continue to rise. Since last update, 34 new UK cases have been diagnosed taking the total to 197 cases • 144 England
• 24 Scotland
• 15 Wales • 12 Northern Ireland 105 are discharged 11 children had liver transplants 0 children have died
Again !!! Reporting "spread is in gay men" is very WRONG !!!!! I would like to know the CoViD-history of the monkeypox cases ! Do thet test positive for CoViD as well, did they get vaccinated ? Did they all get the same sort of vaccine ? Test positive for a same sort of CoViD ???
We are still in the middle of a CoViD pandemic ! What if there is a new CoViD strain resulting in positive tests for monkeypox - because that (sub)variant-virus is "co-spreading" with a new CoViD subvariant ? Again BA.4/5 -African "roots" are spreading around the globe...One should not ignore that !
The monkeypox story -just like the hepatitis in children- has to be related to the CoViD-pandemic !!! It is part of a bigger story-not an isolated "new story"!!!!
(Again I am not an expert-trying to make sense...)
Yaneer Bar-Yam
@yaneerbaryam
·
A Joint Petition urgently requesting an indoor mask requirement to protect the most vulnerable in the U.S. Click here to sign: https://bit.ly/3Lt6wdx?source=twitter&
AIRBORNE PRECAUTION—New @CDCgov update admits to “theoretical risk of airborne transmission” of #monkeypox virus, and thus “airborne precaution should be applied whenever possible”. Don’t take chances. Let’s learn from recent mistakes. Take precaution. https://cdc.gov/poxvirus/monkeypox/clinicians/infection-control-hospital.html
There are few scientific studies pertaining to the transmission of monkeypox virus and most were conducted in Africa. Person-to-person transmission of monkeypox virus is believed to occur by the same mechanisms exploited by variola virus during the smallpox era, namely via respiratory droplets or by direct contact with lesion material.
A combination of https://www.cdc.gov/hicpac/pdf/isolation/Isolation2007.pdf" style="box-sizing: border-box; color: rgb(7, 82, 144); text-decoration: underline; background-color: transparent;" target="new - standard, contact, and droplet precautions - [PDF – 226 pages] should be applied in all healthcare settings when a patient presents with fever and vesicular/pustular rash.
In addition, because of the theoretical risk of airborne transmission of monkeypox virus, airborne precautions should be applied whenever possible.If a patient presenting for care at a hospital or other health care facility is suspected of having monkeypox, infection control personnel should be notified immediately.
DJ respiratory droplets could be seen as "airborne"...It would be wise to mask up against CoViD...also does decrease risks for monkeypox-like-disease.
The Central- and West African forms of monkeypox do not spread via sex. So this new variant I see as "monkeypox like disease"...sequencing indicates lots of similarities with the known West African variant of monkeypox...still so far it did not spread this way...And agian-CoViD is far from over ! Both Delta and Omicron (sub) variants are widespread.
Does a weaker immunity system cause this monkeypox-like-disease outbreak ???? What is the CoViD-link ???
3) Some criticized when I said that aerosol transmission (airborne) was likely. I cited a study that demonstrated it was definitely possible and for the virus to be viable in the air for many many hours. Some said I was fear -mongering. Well, today, CDC admits it’s possible!
DJ, Monkeypox, CoViD far from over, climate collapse, hyperinflation all are bad news...describing it as "fear mongering" is simply ignoring warnings...
(I can not get to scenario's...yet...hope the "error" can be fixed).
------------- We cannot solve our problems with the same thinking we used when we created them. ~Albert Einstein
Posted By: KiwiMum
Date Posted: May 22 2022 at 3:25pm
I keep getting asked the same question again and again; is this outbreak of monkey pox a real threat, or is this another case of overstated and weaponized public health messaging? I am going to save my answer to this question for the end of this article and instead focus on what monkey pox is, the nature and characteristics of the associated disease, what we know and don’t know.
The monkeypox virus, which originates in various regions of Africa, is related to SmallPox (Variola), which are both members of the genus Orthopoxvirus. However, it is important to understand that Variola (major or minor) is the species of virus which is responsible for the worst human disease caused by the Orthopox viruses. For example, Cowpox, Horsepox, and Camelpox are also members of this genus, none of which are a major health threat to humans, and one of which (Cowpox) has even been (historically) used as a Smallpox vaccine. My point is that just because Monkeypox is related to Smallpox, this does not in any way mean that it represents a similar public health threat. Anyone who implies otherwise is basically engaged in or otherwise supporting weaponized public health-related propaganda. In other words, spreading public health fearporn.
Monkeypox was first identified in 1958 in colonies of monkeys, and the first human case of the virus was identified in 1970 in the Democratic Republic of the Congo. Most likely this was just the first case identified, as people living in Africa have been in contact with monkeys and the other Monkeypox animal hosts for millennia. The “West African” monkeypox clade (clade = variant) circulating outside of Africa at this time causes a milder disease compared to the closely related virus found found in other regions of Africa (Congo clade).
The symptoms of monkeypox are somewhat similar to, but much milder than smallpox disease. The general clinical presentation of the disease caused by the West African monkey pox clade virus involves Influenza-like symptoms — fever, body aches, chills — together with swollen lymph nodes. A rash on the palm of the hand is often observed. In the latter stage of the disease, which may last for up to a month or more in some cases, may involve small lesions which develop a crust, and which can result in a small depigmented scar. There is no evidence of asymptomatic transmission. In other words, current medical knowledge indicates that it is only spread by person to person contact between an uninfected individual and someone who already has symptoms of the disease. Therefore, disease spread can be readily controlled by classical public health interventions such as contact tracing, temporary quarantine of those who have had physical contact with someone who is infected, and longer term quarantine of those who develop symptoms. Essentially all of the current cases in the west which we are seeing in the news are among men who have sex with men, and appear to be due to close physical contact. Monkeypox is endemic in many parts of Africa, and is a “zoonotic” virus, meaning it can be transmitted from a variety of animals (not just monkeys) to humans. Initial animal to human transmission followed by limited human to human transmission is probably the cause of the sporadic cases typically observed in Africa. Chicken pox, which is highly transmissible, is not part of the genus Orthopoxvirus, despite that name “pox.” Once again for emphasis, Cowpox and Camelpox are also in the genus Orthopoxvirus, and they are not particularly pathogenic when contracted by humans; just because Monkeypox is a “pox” virus in the genus Orthopoxvirus, does not mean it is particularly deadly.
Monkeypox is a double stranded DNA virus, which means that due to the double stranded nature of DNA each of the two strands act as a “check” on the other during replication. As a consequence of this “error checking”, this and other DNA viruses mutate much more slowly than RNA viruses do. Over time, DNA virus genomes are relatively stable. This means that, unlike SARS-CoV-2 (COVID) or influenza, Monkeypox is unlikely to rapidly evolve to escape either naturally acquired or vaccine induced immunity. For the purposes of making a vaccine, this makes it a much easier target that say, a rapidly evolving RNA Coronavirus such as SARS-CoV-2, the virus which causes COVID-19. Furthermore, from an immunological point of view, the various Orthopox viruses often are cross-protective. In other words, if you have been vaccinated with a smallpox vaccine, or previously infected by Cowpox, Camelpox, or Monkeypox, you are highly likely to be quite resistant to disease caused by the Monkeypox virus which is now being (quite rarely) reported in non-African countries.
Current data indicate that Monkeypox is not very infectious in humans - it has a low Ro (perhaps below 1), which is the term used to describe how efficiency an infectious disease can spread from human to human. Again, this is super good news for containment. An Ro of <1 generally means that (even in the absence of social distancing of other containment measures), for every person already infected, on average less than one other person will become infected. For comparison purposes, the Omicron variants of SARS-CoV-2 have an Ro in the range of 7 to 10. A virus with an Ro of less than one can be easily contained with the standard public health methods discussed above. A virus with an Ro of 7-10 essentially cannot be contained and will rapidly spread throughout the world, as we have seen with the Omicron variants. In the case of a virus with an Ro around 1 or less, traditional infectious disease containment methods such as contact tracing, identification and isolation of infected individuals can be all that is needed to control the virus. Now the fact that Monkeypox is being spread from human to human (rather than only arising from contact between a person and an infected animal) is not such good news, but since this transmission appears to be from very close contact, this means that it can be easily contained without resorting to a general population vaccination campaign. In this type of setting, if there is a significant outbreak, vaccination is often restricted to just the health care and/or first responder personnel most likely to be in contact with an infected person. Using a vaccine to help that containment via either “ring” vaccination or wide-spread vaccination strategies is generally unnecessary, and may even be counterproductive, depending on the safety of the vaccine - keeping in mind that no drug or vaccine is perfectly safe.
Let me take a moment to tell a personal story to illustrate this point. After the 9-11 events including the anthrax letters, I took a job involving clinical development of a wide range of biodefense vaccines under a US Department of Defense (DoD) contract (issued to Dynport Vaccine Company). One of the vaccine indications we worked on was for prevention of Smallpox. The Vice President of the United States at the time, Mr. Dick Cheney, was advocating for widespread vaccination against smallpox because it was thought that there was something like a 1% chance of a bioterror attack involving reintroduction of smallpox into the United States. The existing live attenuated smallpox vaccine began to be deployed throughout the United States to healthcare workers and first responders. Then multiple reports of vaccine-caused damage began to circulate. I was tasked with looking into historic DoD smallpox vaccine campaign records concerning these types of “adverse events”. Adverse events after administration of this live attenuated vaccine were well known, and generally fell into two categories. In some cases, a small subset of young warfighters and recruits had some previously undetected immunologic defect which resulted in them developing an ongoing infection by the live attenuated vaccine virus that was being used at the time. The other group developed more subtle symptoms including what now appears to have been vaccination-associated myo- and pericarditis - typically ascribed to an autoimmune process. These problems were known risks back when smallpox vaccination was common (and smallpox had not been eradicated) and therefore no surprise when the same vaccine was redeployed in the present. But smallpox had been eradicated, and Mr. Cheney’s worst case scenario never happened. Those who were vaccinated and damaged to protect against a non-existent threat provide a great example illustrating a completely upside down risk benefit ratio. All risk, no benefit. And, appropriately, the smallpox vaccination campaign was halted.
Key takeaway: this is not influenza or COVID - this virus mutates slowly, it is not highly infectious, naturally acquired immunity is potent and long lasting, and Orthopox vaccines are usually cross protective. The risk of immunologic escape is very, very low. And the spread of this virus can be readily stopped by simple, inexpensive classical public health measures. If it were otherwise, we would already have experienced a pandemic of Monkeypox decades ago.
Monkeypox disease severity can vary with different clades (found in different regions in Africa, which also suggest the virus has been around for a very long time). Luckily, this particular clade is less severe and appears to be endemic in Africa. Unfortunately, it has rarely been studied and so relatively little is known about the virus and associated human disease, largely because the infectious threat to the general population is so low. STAT news’ journalist Helen Branswell has recently interviewed CDC experts, and published an excellent summary of the clinical presentation:
“With one to three days of the onset of fever, a distinctive rash appears, often starting on the face. Many conditions can cause rashes but the monkeypox rash has some unusual features, notably the fact that vesicles can form on the palms of the hands. In countries where it is endemic, the virus is believed to mainly spread to people from infected animals when people kill or prepare bushmeat for consumption.
Once the virus jumps to people, human-to-human transmission can occur via respiratory droplets — virus-laced saliva that can infect the mucosal membranes of the eyes, nose, and throat — or by contact with monkeypox lesions or bodily fluids, with the virus entering through small cuts in the skin. It can also be transmitted by contact with clothing or linens contaminated with material from monkeypox lesions. ( https://www.statnews.com/2022/05/18/spain-portugal-report-monkeypox-cases-raising-specter-of-wider-outbreak/" rel="" style="--tw-translate-x:0; --tw-translate-y:0; --tw-rotate:0; --tw-skew-x:0; --tw-skew-y:0; --tw-scale-x:1; --tw-scale-y:1; --tw-pan-x: ; --tw-pan-y: ; --tw-pinch-zoom: ; --tw-scroll-snap-strictness:proximity; --tw-ordinal: ; --tw-slashed-zero: ; --tw-numeric-figure: ; --tw-numeric-spacing: ; --tw-numeric-fraction: ; --tw-ring-inset: ; --tw-ring-offset-width:0px; --tw-ring-offset-color:#fff; --tw-ring-color:rgb(59 130 246 / 0.5); --tw-ring-offset-shadow:0 0 #0000; --tw-ring-shadow:0 0 #0000; --tw-shadow:0 0 #0000; --tw-shadow-colored:0 0 #0000; --tw-blur: ; --tw-brightness: ; --tw-contrast: ; --tw-grayscale: ; --tw-hue-rotate: ; --tw-invert: ; --tw-saturate: ; --tw-sepia: ; --tw-drop-shadow: ; --tw-backdrop-blur: ; --tw-backdrop-brightness: ; --tw-backdrop-contrast: ; --tw-backdrop-grayscale: ; --tw-backdrop-hue-rotate: ; --tw-backdrop-invert: ; --tw-backdrop-opacity: ; --tw-backdrop-saturate: ; --tw-backdrop-sepia: ; color: var(--print_on_web_bg_color, #1a1a1a); text-decoration: underline; - STAT News ).
There was a prior outbreak of Monkeypox in the United States during 2003. That particular outbreak, the first reported outside of Africa, was traced back to the importation of small mammals from Ghana. As shown by this outbreak, multiple animals can contract the disease - during that outbreak, giant pouched rats and squirrels tested positive for the virus and eventually spread it to prairie dogs being sold as pets in multiple Midwestern states (per the CDC). Forty-seven people caught the disease from the prairie dogs. This is important and relevant history, because the current outbreak appears to be occurring from human to human transmission, with no single individual traced as as case zero. There have been a few other outbreaks outside of Africa over the years from travelers coming from Nigeria. It is currently thought that the Monkeypox virus is much more common in Nigeria than has previously been reported.
There is a vaccine that was licensed in the U.S. in 2019 for people 18 years of age and older to protect against smallpox and monkeypox; Bavarian Nordic’s Jynneos. A second vaccine, ACAM2000 made by Emergent Product Development, protects against smallpox and is also thought to offer some protection against monkeypox. Both vaccines are licensed only for people considered at high risk of contracting the disease because they are not entirely safe. In the 2003 Monkeypox outbreak in the U.S., smallpox vaccine was deployed to persons considered at high risk.
The U.S. already holds supplies of the vaccines in the Strategic National Stockpile, a hedge against public health emergencies. “To combat a smallpox emergency, the SNS holds enough smallpox vaccine to vaccinate the entire U.S. population. In addition, the SNS has antiviral drugs that can be deployed to treat smallpox infections, if needed,” a spokesperson for the Department of Health and Human Services said via email. In my opinion, the 119 Million dollar smallpox vaccine purchase which was just authorized by the US HHS and Biden administration represents an unnecessary and unwarranted expense, unless there are data showing that the current strain is significantly different from the historic predecessor strains within this clade.
The WHO’s Van Kerkhove noted that some of these products have been licensed using what is known as the animal rule, where animal efficacy data are used as a surrogate because the lack of circulating smallpox means the vaccines or drugs can’t be tested for efficacy in people. As a result, any such product could only be used in the context of a clinical trial, she said.
“There are options. We just have to make sure that they’re used appropriately. One of the things related to vaccines is we want to make sure if the vaccines are needed and used, they’re used among populations that need them the most. There’s not ample supply of anything right now,” she said.
Still, she expressed confidence the outbreak can be controlled.
“What we need to do right now is focus on stopping the spread. And we can do that. We can do that with the appropriate messaging, with the appropriate testing … with supportive isolation and clinical care as necessary, with protecting health workers,” Van Kerkhove said. ( https://www.statnews.com/2022/05/18/spain-portugal-report-monkeypox-cases-raising-specter-of-wider-outbreak/" rel="" style="--tw-translate-x:0; --tw-translate-y:0; --tw-rotate:0; --tw-skew-x:0; --tw-skew-y:0; --tw-scale-x:1; --tw-scale-y:1; --tw-pan-x: ; --tw-pan-y: ; --tw-pinch-zoom: ; --tw-scroll-snap-strictness:proximity; --tw-ordinal: ; --tw-slashed-zero: ; --tw-numeric-figure: ; --tw-numeric-spacing: ; --tw-numeric-fraction: ; --tw-ring-inset: ; --tw-ring-offset-width:0px; --tw-ring-offset-color:#fff; --tw-ring-color:rgb(59 130 246 / 0.5); --tw-ring-offset-shadow:0 0 #0000; --tw-ring-shadow:0 0 #0000; --tw-shadow:0 0 #0000; --tw-shadow-colored:0 0 #0000; --tw-blur: ; --tw-brightness: ; --tw-contrast: ; --tw-grayscale: ; --tw-hue-rotate: ; --tw-invert: ; --tw-saturate: ; --tw-sepia: ; --tw-drop-shadow: ; --tw-backdrop-blur: ; --tw-backdrop-brightness: ; --tw-backdrop-contrast: ; --tw-backdrop-grayscale: ; --tw-backdrop-hue-rotate: ; --tw-backdrop-invert: ; --tw-backdrop-opacity: ; --tw-backdrop-saturate: ; --tw-backdrop-sepia: ; color: var(--print_on_web_bg_color, #1a1a1a); text-decoration: underline; - STAT News ).
The Bill Gates funded organization GAVI has provided their assessment of the medical threat posed by Monkeypox, which can be https://www.gavi.org/vaccineswork/five-things-you-need-know-about-monkeypox" rel="" style="--tw-translate-x:0; --tw-translate-y:0; --tw-rotate:0; --tw-skew-x:0; --tw-skew-y:0; --tw-scale-x:1; --tw-scale-y:1; --tw-pan-x: ; --tw-pan-y: ; --tw-pinch-zoom: ; --tw-scroll-snap-strictness:proximity; --tw-ordinal: ; --tw-slashed-zero: ; --tw-numeric-figure: ; --tw-numeric-spacing: ; --tw-numeric-fraction: ; --tw-ring-inset: ; --tw-ring-offset-width:0px; --tw-ring-offset-color:#fff; --tw-ring-color:rgb(59 130 246 / 0.5); --tw-ring-offset-shadow:0 0 #0000; --tw-ring-shadow:0 0 #0000; --tw-shadow:0 0 #0000; --tw-shadow-colored:0 0 #0000; --tw-blur: ; --tw-brightness: ; --tw-contrast: ; --tw-grayscale: ; --tw-hue-rotate: ; --tw-invert: ; --tw-saturate: ; --tw-sepia: ; --tw-drop-shadow: ; --tw-backdrop-blur: ; --tw-backdrop-brightness: ; --tw-backdrop-contrast: ; --tw-backdrop-grayscale: ; --tw-backdrop-hue-rotate: ; --tw-backdrop-invert: ; --tw-backdrop-opacity: ; --tw-backdrop-saturate: ; --tw-backdrop-sepia: ; color: var(--print_on_web_bg_color, #1a1a1a); text-decoration: underline; - found here . Many readers of this substack will not be surprised by my assessment that this GAVI threat assessment is highly biased towards overstatement. For example, the article seeks to create parallels between Monkeypox and Ebola:
Similar to viruses like Ebola, transmission only happens in close proximity by contact with lesions, body fluids, respiratory droplets or contaminated materials such as bedding or clothes.
The article also states the following pants-on-fire disinformation;
Although symptoms often ease within a month, one in ten cases can be fatal. Children are particularly susceptible.
Factcheck determination by qualified subject matter expert -
This assertion represents a very biased interpretation of a data report from the World Health Organization:
In 2020, the https://www.who.int/csr/don/01-october-2020-monkeypox-drc/en/" rel="" style="--tw-translate-x:0; --tw-translate-y:0; --tw-rotate:0; --tw-skew-x:0; --tw-skew-y:0; --tw-scale-x:1; --tw-scale-y:1; --tw-pan-x: ; --tw-pan-y: ; --tw-pinch-zoom: ; --tw-scroll-snap-strictness:proximity; --tw-ordinal: ; --tw-slashed-zero: ; --tw-numeric-figure: ; --tw-numeric-spacing: ; --tw-numeric-fraction: ; --tw-ring-inset: ; --tw-ring-offset-width:0px; --tw-ring-offset-color:#fff; --tw-ring-color:rgb(59 130 246 / 0.5); --tw-ring-offset-shadow:0 0 #0000; --tw-ring-shadow:0 0 #0000; --tw-shadow:0 0 #0000; --tw-shadow-colored:0 0 #0000; --tw-blur: ; --tw-brightness: ; --tw-contrast: ; --tw-grayscale: ; --tw-hue-rotate: ; --tw-invert: ; --tw-saturate: ; --tw-sepia: ; --tw-drop-shadow: ; --tw-backdrop-blur: ; --tw-backdrop-brightness: ; --tw-backdrop-contrast: ; --tw-backdrop-grayscale: ; --tw-backdrop-hue-rotate: ; --tw-backdrop-invert: ; --tw-backdrop-opacity: ; --tw-backdrop-saturate: ; --tw-backdrop-sepia: ; color: var(--print_on_web_bg_color, #1a1a1a); text-decoration: underline; - World Health Organization (WHO) reported 4,594 suspected cases of monkeypox, including 171 deaths (case fatality ratio 3.7%). They are described as suspected because confirmation requires PCR testing, which is not easily available in endemic areas.
Those readers who have become sensitized to this type of information manipulation and weaponization will immediately notice two key things about this comment. First, the reported mortality of 3.7% (NOT 10%) of cases is from suspected, not confirmed cases. Secondly, this type of sampling is highly biased towards more severe disease- countries rarely will detect and do not report cases of mild disease to the WHO.
So, is the biothreat real? Is is imminent? Does it justify the global media hype? As I was waiting in an airport lounge to travel from USA to the UK two days ago, I saw a newsreel from CNN which was breathlessly reporting on this “threat” while displaying historic images of patients suffering from Smallpox disease. This provides a classical example of public health fearporn, in my opinion, and CNN should be reprimanded for broadcasting irresponsible propaganda - misinformation and disinformation- under the guise of journalism.
In my opinion, based on currently available information, Monkeypox is a virus and disease which is endemic in Africa, emerges sporadically after transmission into humans from animal hosts, and is typically spread by close human contact. It is readily controlled by classical public health measures. It does not have a high mortality rate. Unless there has been some genetic alteration, either through evolution or intentional genetic manipulation, it is not a significant biothreat, and has never been considered a high threat pathogen in the past.
So stop the fear mongering, misinformation and disinformation.
“We conclude that circulation of smallpox, followed by worldwide smallpox vaccination, have previously protected human populations from monkeypox epidemics. We combined historical data on smallpox and monkeypox with mathematical modelling to estimate the basic reproduction number of monkeypox, and found that monkeypox has epidemic potential. This finding may explain the increasing number of monkeypox outbreak reports, resulting in endemic monkeypox in central African countries. Moreover, with declining immunity to orthopoxvirus species, monkeypox can pose an ever-increasing threat for health security.”
Moderna is considering turning its mRNA vaccine platform towards finding a vaccine to defend against Monkeypox, according to a recent tweet by the company.
There are currently two approved vaccines in the U.S. for smallpox which should be effective against Monkeypox. One is made by Acambis (since bought by Sanofi), the other made by https://www.coronaheadsup.com/health/monkeypox/research-the-changing-epidemiology-of-human-monkeypox/" rel="noopener" style="box-sizing: border-box; background-color: transparent; color: rgb(22, 161, 231); text-decoration: none; transition: all 0.3s ease 0s; - Bavarian Nordic .
Moderna’s preclinical trials on a Monkeypox vaccine will add to its work on a host of other products, including vaccines for Covid-19, the flu, the common cold and RSV.
He said there was an increase of 106.6 per cent from the 19th EW (7,526 cases) to 15,548 cases for the 20th EW, which was expected due to the movement of people during the Hari Raya celebration.
Lots of people carry loads of virusses, bacteria, funges etc. that are no problem when immunity offers defense...but may become a major problem when defense collapsed...
So-Monkeypox may have strong relations with CoViD-just one of many diseases that may show up much more ! Some virusses/variants did not have much chance in the past may become killers in the coming months, years...(at least that is the TMN-view...hope they are wrong !)
------------- We cannot solve our problems with the same thinking we used when we created them. ~Albert Einstein
Posted By: roni3470
Date Posted: May 26 2022 at 12:30pm
Well that's not good! I still keep seeing things that say its nothing to worry about and feel that way in general. Is that where we are right now or does anyone think its time to worry?
------------- NOW is the Season to Know
that Everything you Do
is Sacred
Posted By: KiwiMum
Date Posted: May 26 2022 at 1:57pm
This is pure fear mongering. Monkey pox is not going to become a pandemic. As for Moderna offering to tweak it's Rna vaccines to protect us all - god help us is all I can say. We don't need protecting from a skin disease with an RO of less than 1.
Of course the vaccine companies are looking for a new cash cow.
------------- Those who got it wrong, for whatever reason, may feel defensive and retrench into a position that doesn’t accord with the facts.
Posted By: KiwiMum
Date Posted: May 26 2022 at 2:02pm
Do you see that white box blocking out part of the posts? Josh that came from your last post where you've copied in part of a coded tweet and I was able to remove the bulk of it but not all.
------------- Those who got it wrong, for whatever reason, may feel defensive and retrench into a position that doesn’t accord with the facts.
Posted By: KiwiMum
Date Posted: May 26 2022 at 2:02pm
KiwiMum wrote:
This is pure fear mongering. Monkey pox is not going to become a pandemic. As for Moderna offering to tweak it's Rna vaccines to protect us all - god help us is all I can say. We don't need protecting from a skin disease with an RO of less than 1.
Of course the vaccine companies are looking for a new cash cow.
------------- Those who got it wrong, for whatever reason, may feel defensive and retrench into a position that doesn’t accord with the facts.
Posted By: Dutch Josh
Date Posted: May 26 2022 at 9:00pm
KiwiMum, I am sorry !
Copying from twitter seems asking for problems....But a lot of news is on twitter !
I try to copy into the square-somehow it jumps out...ends up below the square...
...lossed on a digital playground.....
------------- We cannot solve our problems with the same thinking we used when we created them. ~Albert Einstein
Posted By: Dutch Josh
Date Posted: May 29 2022 at 11:18pm
Main reason why monkeypox cases do not go up during weekends is lack of testing/reporting during weekends...
Poxviruses have low evolutionary rates of around one mutation per genome per year. The #monkeypox sequences associated with the recent outbreak, however, differ by about 40 mutations from viruses sequenced 4 years ago. [1/5] https://nextstrain.org/monkeypox
-
Since 2017, the lineage leading to the recent samples has a peculiar mutation pattern where almost all mutations are G->A or C->T. Furthermore, they almost all occur in specific sequence contexts as Andrew Rambaut discusses here: https://virological.org/t/discussion-of-on-going-mpxv-genome-sequencing/802…
-
This change in mutation pattern likely marks the jump from the original host to humans or an intermediate host where a host enzyme (maybe APOBEC3) might mutate the genome. The rate of change increased 10-20fold and is now around one change per month. [4/5] https://nextstrain.org/groups/neherla
The mistake they make is they think the monkey pox now is *descended* from the one they sequenced four years ago. Most likely common ancestor and a new zoonosis event.
DJ, Did this monkeypox-variant develop in a human or animal ? Was it "on its way" for years-only not (yet) spreading ? With much higher level of mutations it may become a big problem !
I also wonder Marvin, if the rate of mutation in monkeypox has taken into account the amount of circulation in human populations, which has also been steadily increasing.
DJ-My answer; NO ! When it starts spreading in "new populations/places" it could pick up some mutations that would end the variant....But more likely-statistics-it may see some mutations that offer chance for more spread !
The UK has classified Monkeypox as a high consequence airborne infectious disease In a recently updated document by the UKHSA, along with MERS, Nipah virus, SARS1 and Pneumonic plague.
Travelers should AVOID close contact with sick people, including those with skin lesions or genital lesions.
Travelers should AVOID:
Close contact with sick people, including those with skin lesions or genital lesions.
Contact with dead or live wild animals such as small mammals including rodents (rats, squirrels) and non-human primates (monkeys, apes).
Eating or preparing meat from wild game (bushmeat) or using products derived from wild animals from Africa (creams, lotions, powders).
Contact with contaminated materials used by sick people (such as clothing, bedding, or materials used in healthcare settings) or that came into contact with infected animals.
https://wwwnc.cdc.gov/travel/notices/alert/monkeypox" rel="noopener" style="box-sizing: border-box; background-color: transparent; color: rgb(22, 161, 231); text-decoration: none; transition: all 0.3s ease 0s; - DJ Warning level-3 matter of time...Mutations are a major factor-but no doubt less immunity because of high number of CoViD immunity weakening also will be a factor...
------------- We cannot solve our problems with the same thinking we used when we created them. ~Albert Einstein
Posted By: pheasant
Date Posted: May 30 2022 at 2:33am
I thought that was an interesting catch, excellent post links!
This is the screen shot of the second link from yesterday make of it what you will: Nice bed-fellows
------------- The only thing we have to fear, is fear itself......FDR
Posted By: CRS, DrPH
Date Posted: May 30 2022 at 2:36am
Monkeypox is a pathogen of concern to US law enforcement, as it could potentially be weaponized. This appears to be an interesting "spillover" event, propagated by MSM (public health lingo, "men who have sex with men").
My colleague in the FBI (physician) tells me:
"All found to be west african clade with < 1percent case fatality historically"
From Johns Hopkins Center for Health Security:
To date, all cases confirmed by PCR testing are infected with the https://nam12.safelinks.protection.outlook.com/?url=https%3A%2F%2Fr20.rs6.net%2Ftn.jsp%3Ff%3D001_4Af3rOv7nuXTbIKa2RXh6zsHCWsChkC0OPzA4YXCxf1iBBABtVweOaTI-CVTke2xmmqbxCHdqm0UtMr2IIrvV5hBGwS4bcJPa4_GE2-RZ9GsypCltyT75oxzjyByb50cfmU18hjpDLHzcH7ZTwsYd1YcxRlRtq1WPcOIjn_A0FTXqn16MW9DoT-bp18imJ-HtbIBEn-4KKygTmN_LB_EAW_izx3BGfYE82B4RzZ8iMZpgSeKBzBIg%3D%3D%26c%3DOBYJUd-1AkgPb0JLOSuAe-bu6K8kynrAXrLG3SACgE4xoWa9_mm4GA%3D%3D%26ch%3DSyoDS1Na3W33f_b2y0r43heTvU3-fVerF3P2R6m_mzaM0_GJOwLjJA%3D%3D&data=05%7C01%7C%7C2a017faebbda4d511f9008da3cef1c2a%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637889294916956869%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=AGZv4GgmCMdxrDIb5m4KyB0mP5WVyLHwqZZ9rFwwovs%3D&reserved=0" rel="noopener noreferrer" style="font-family: Verdana, Geneva, sans-serif; font-size: 14px; color: rgb(0, 45, 114); text-decoration: underline; - West African clade of monkeypox, which historically is less virulent than the Congo Basin (Central African) clade. Sequencing results for some cases have been made publicly available, and these data collection efforts are ongoing. Some of the confirmed cases have been hospitalized, but their conditions are unknown. No deaths have been reported.
...I wouldn't be terribly concerned at this point, but I'll be back if I hear anything. Be safe, CRS
------------- CRS, DrPH
Posted By: KiwiMum
Date Posted: May 30 2022 at 3:06am
Thanks for that info Chuck, I'd also read that it was the West African clade and had a very low fatality. I think it's irresponsible of the media to start spouting figures upwards of a 10% fatality. It's a flash in the pan.
------------- Those who got it wrong, for whatever reason, may feel defensive and retrench into a position that doesn’t accord with the facts.
Posted By: Dutch Josh
Date Posted: May 30 2022 at 9:51am
Based on what we know, the primary concern would be infection of rodents, but we don’t know enough to say which species are of “no” concern when it comes to monkeypox.
Best case scenario:
This is a weird outbreak caused by a lot of human-to-human transmission, but it will be contained and die out with the current surveillance and control measures.
Worst case scenario:
Monkeypox is spread from infected people to new animal species outside of Africa, and an animal reservoir is created in countries where the virus has not been present previously. The virus could then be maintained in animals in these countries long term, with periodic spread back to people.
The best case scenario is most likely here, and that’s what we’re hoping for.
DJ I am less optimistic...Part of the monkeypox spread may move into prostitution, addicted people...Medical garbage ending up with other garbage being eaten by rats, mice etc...
The UK has just released their own https://www.gov.uk/government/publications/hairs-risk-assessment-monkeypox/qualitative-assessment-of-the-risk-to-the-uk-human-population-of-monkeypox-infection-in-a-canine-feline-mustelid-lagomorph-or-rodent-uk-pet#about-the-human-animal-infections-and-risk-surveillance-group" style="box-sizing: border-box; color: rgb(6, 58, 177); text-decoration: underline; font-family: Lato, helvetica, arial; font-size: 18px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); - qualitative assessment of the risk to the UK human population of monkeypox infection in a canine, feline, mustelid, lagomorth or rodent UK pet . More concisely, I’d call it their “rapid assessment of the risk of spillback of monkeypox into selected domestic species.”
DJ (also has the link)
The assessment looks at what are likely the highest risk pet animal groups (rodents and rabbits (lagomorphs) and ferrets (mustelids)) and the most common pets (dogs/cats), but it doesn’t cover all species. Of note, it doesn’t address pigs (commercial or pet) and there are questions about susceptibility of that species. However, it’s a pretty logical approach overall, particularly when it needs to be done rapidly. A lot of the assessment and recommnedations are just good, common sense, and use of the precautionary principle in a controlled manner that doesn’t over-react.
Here are some highlights from the https://www.gov.uk/government/publications/hairs-risk-assessment-monkeypox/qualitative-assessment-of-the-risk-to-the-uk-human-population-of-monkeypox-infection-in-a-canine-feline-mustelid-lagomorph-or-rodent-uk-pet#about-the-human-animal-infections-and-risk-surveillance-group" style="box-sizing: border-box; color: rgb(6, 58, 177); text-decoration: underline; - assessment :
As the numbers of affected households in the UK related to the current outbreak are rapidly increasing, this warrants a more thorough assessment of the risk posed by mammalian pets exposed to monkeypox virus to people with whom they may come into contact.
Absolutely. We need to assess this as the outbreak continues and not rely on the somewhat limited data we have from past studies and outbreaks.
For the purposes of the assessment, it is presumed the pet is present in the contaminated household of a confirmed human monkeypox case. The risk posed is therefore to the non-infected human contacts or in-contact peridomestic or wild rodents. It is concluded that the highest risk is posed by the presence of pet rodents, more so than lagomorphs, canids, felids and mustelids.
It is unlikely (but cannot be ruled out) that an infected rodent pet could spread infection to peridomestic or wild rodents. As rodents may not show clinical signs of infection, and the incubation period is unknown, testing to detect the presence of antibodies as well as virus would provide more confidence in ruling out infection.
The evidence of susceptibility for non-rodent pets is poor or incomplete, and therefore a precautionary risk management process should be considered.
This is a really important statement. Too often (and COVID-19 showed us this yet again), the early response by some groups is to say “there’s no evidence of a concern” and therefore no action required. However, with an emerging disease, you sometimes have to act before there’s time to collect the evidence. By the time you know definitely that there can be spread to/from animals, it might be too late to control or prevent it.
Based on current evidence, for pet rodents in households where there are infected people, temporary removal from the household for a limited quarantine period (21 days) and testing to exclude infection is recommended, particularly where there are infected human contacts who have had close direct and prolonged contact with the animal or its bedding and/or litter.
I disagree with this one. It’s good that the risk is being taken seriously. It’s good to consider testing (but we don’t know the sensitivity of testing, so it can’t be used to declare an animal uninfected). But does removing the animal help? It’s great that they clearly said “temporary removal,” so there’s no ambiguity that this might mean people should surrender or euthanize exposed animals. However, I wonder if removal of the pet really helps in a household where there’s been an infected person present, where the animal can be caged and where basic infection control practices aren’t hard to use during a quarantine period.
Furthermore, does moving the animal create risk somewhere else, where there was no risk before? We had the same questions when SARS-CoV-2 emerged and we quickly settled on keeping pets in their infected households as the best solution.
Making sure there’s no potential exposure of pet rodents to wild rodents is important, and if there’s a rodent infestation of the house, I’d be more inclined to want to get pet rodents out, to reduce the risk of human-to-pet-to-wild rodent transmission. But taking care of the rodent infestation itself would also be critical to avoid direct human-to-wild rodent transmission.
Are effective control measures in place to mitigate against these routes of introduction? Outcome: yes – humans; no – rodents and non-rodent mammalian animals.
This gets into the human control approaches that include smallpox vaccination, as well as lack of control measures in the UK for rodents imported from the EU that might introduce the virus. So it’s true, but “no” isn’t necessarily what I’d say, since there’s always something we can to do mitigate risk. We have easy measure to reduce the risk, and those focus on restricting contact between infected people and their pets.
Do environmental conditions in the UK support the natural reservoirs or vectors of disease? Outcome: yes. Quality of evidence: satisfactory.
This is a nice section. It’s long so I won’t copy it here but if you’re interested, check out the link for a good review of species susceptibility info.
I’ve wondered what countries were going to do a rapid risk assessment about spillback (I’ve also asked whether we’re going to do one here in Canada). The good news is that the vast majority of the content from the UK’s report would apply here and elsewhere. We have some differences in the types of wildlife that are present in Canada, but the overall risks, control measures and messages are the same.
Here’s my own assessment:
the likelihood of spillback into an animal somewhere is moderately high if the outbreak continues for a while. Lots of people infected means lots of pets exposed, and transmission to a susceptible species certainly wouldn’t be shocking.
the likelihood of infection of wild animals is low.
the likelihood of establishment of monkeypox virus in a wildlife reservoir in currently non-endemic areas is very low.
But, “very low” isn’t zero, and I’ve definitely been wrong before. So, a bit of basic infection control and common sense can go a long way while we’re collecting more information.
DJ, It may be to early to get a good enough view....How did CoViD end up in US deer ? Eating garbage ? What do we know of monkeypox spread in African animals ? Not that much....
C_Reusken
@c_reusken
·
A huge concern: spill back to animals. Having new reservoirs of increases the probability of it being transmitted to people including in new areas. Monkeypox outbreaks: 4 key questions researchers have
Can a genetic change in the virus explain the latest outbreaks?
Can the outbreaks be contained?
Is the virus spreading differently now compared with previous outbreaks?
I could ask more-the relationship with the major background medical disaster CoViD/SARS-2....BA.4/5...I do expect the outbreak can NOT be contained....Incubationtime and a total lack of restrictions-a total inaction-ensured that...
The problem a disease can bring does not lie in a CFR...When you look at CoViD hundreds of millions of long term healthissues are there-without hospitals crashing....Also the high speed mutations are worrying ! I do see monkeypox already as a very major problem...
------------- We cannot solve our problems with the same thinking we used when we created them. ~Albert Einstein
Posted By: Usk
Date Posted: May 31 2022 at 3:13am
You are creating panic where science does not fit your argument. Monkey pox and covid are like an elephant and a camel try to make a elcam. Not happening !!0
Posted By: Dutch Josh
Date Posted: May 31 2022 at 5:50am
Usk, I do not claim monkeypox and CoVid virusses (very different virusses themselves) are mixing ! I DO however claim the outbreak of monkeypox-acting very different then we did see earlier-may be related to the CoViD pandemic....
How bad it is we still have to learn. However since we are NOT stopping any virus-we simply also are not stopping monkeypox.
A new global Monkeypox tracker cases shows that there are currently 590 suspected and confirmed cases of Monkeypox worldwide in the latest outbreak. The highly contagious disease has already spread to every continent except Antarctica.
The data is available via a dashboard, and as a spreadsheet giving source links to the case information.
The global dashboard can be accessed at https://monkeypox.healthmap.org/" rel="noopener" style="box-sizing: border-box; background-color: transparent; color: rgb(22, 161, 231); text-decoration: none; transition: all 0.3s ease 0s; - https://monkeypox.healthmap.org /
The online Google data Monkeypox spreadsheet can be accessed https://docs.google.com/spreadsheets/d/1CEBhao3rMe-qtCbAgJTn5ZKQMRFWeAeaiXFpBY3gbHE/edit#gid=0" rel="noopener" style="box-sizing: border-box; background-color: transparent; color: rgb(22, 161, 231); text-decoration: none; transition: all 0.3s ease 0s; - here
Again-a coinfection of CoViD AND Monkeypox may increase risks....but we still need to learn a lot more !
------------- We cannot solve our problems with the same thinking we used when we created them. ~Albert Einstein
Posted By: cobber
Date Posted: May 31 2022 at 8:37am
The problem I see with Monkeypox it it will create fear.
The media will stir it up. Stories such as "long pox".
They will show young beautiful girls before and after with scarred faces.
Monkey Pox is super serious. We need to prepare for this one...
Posted By: KiwiMum
Date Posted: May 31 2022 at 1:24pm
It might be the fear and the subsequent controls placed upon us that make monkeypox serious, but that's all. It's a skin disease, it's not going to spread easily.
In my mind there is a definite link between the covid vaccines damaging immune systems and the huge rise in the number of shingles cases in people who've been vaccinated and haven't had covid. Coincidence? I don't think so.
In the British papers earlier this week they said you could tell if you had shingles or monkeypox because if it was on the face it was monkeypox and if it were on the torso then it was shingles. Well my cousin has a strange looking rash on her cheekbone and it's been swabbed at the hospital and it's an "unusual form of shingles".
------------- Those who got it wrong, for whatever reason, may feel defensive and retrench into a position that doesn’t accord with the facts.
Posted By: pheasant
Date Posted: May 31 2022 at 4:54pm
I'm not sure If this should be posted here, I just want to add this, This seems perfect spot to post, given the timing and tenor of the conversation. Please feel free to move if it doesn't fit:
From Doctor John Campbell today...Cannot make this stuff up.
------------- The only thing we have to fear, is fear itself......FDR
Posted By: Dutch Josh
Date Posted: May 31 2022 at 10:33pm
DJ, I think lots of bio-labs did work with monkeypox-virusses. It is their job to study risky virusses...I only hope we did-as humans-not did sink to the level of bio-warfare....There is a chance of accidental spread however....(but not only from Chinese labs).
Rapid, amplified transmission has occurred in the context of the recent lifting of pandemic restrictions on international travel and events.
The potential for further transmission in Europe and elsewhere over the summer is high.
The WHO European Region remains at the epicentre of the largest and most geographically widespread monkeypox outbreak ever reported outside of endemic areas in western and central Africa.
Investigations into past cases show that the outbreak in our region was certainly underway as early as mid-April.
Most people who get monkeypox will have a mild and self-limiting but unpleasant and potentially painful disease that may last up to several weeks.
We do not yet know if we will be able to contain its spread completely.
https://www.euro.who.int/en/media-centre/sections/statements/2022/statement-monkeypox-in-the-european-region-what-we-know-so-far-and-how-we-need-to-respond" rel="noopener" style="box-sizing: border-box; background-color: transparent; color: rgb(22, 161, 231); text-decoration: none; transition: all 0.3s ease 0s; - Most people who get monkeypox will have a mild and self-limiting but unpleasant and potentially painful disease that may last up to several weeks.
A variant in the making. BA.1 with 8 additional spike mutations in a persistently infected individual plus onward spread to the community in New York. Awesome and very important work by my colleagues Harm van Bakel and
Of course ignoring the CoViD-pandemic background is unwise !
Yaneer Bar-Yam
@yaneerbaryam
·
Shanghai just finished a 2 month lockdown. They went all out and stopped the pandemic using a dynamic zero covid strategy, including both lockdown and mass testing. People are out in the street celebrating. They can do so without risk of infection or long covid. 1/
and the discussion on how to deal with large scale infectious disease goes on....
DJ-In my non-expert opinion if you do NOT stop a problem often the problem gets worse....but that fact seems to be unwelcome news more and more....
I am getting fed up with repeating warnings on climate change, hyperinflation, healthcrises etc....people seem to want to find out the hard way....If you can not fix stupid stupid will kill us all....and I hate that !
------------- We cannot solve our problems with the same thinking we used when we created them. ~Albert Einstein
Posted By: cobber
Date Posted: June 01 2022 at 8:35am
Dr. John Campbell is one of the better analysts/reporters
He goes to the edge of what is allowed on Youtube.
Posted By: DanielleFredericksn
Date Posted: June 02 2022 at 1:05am
What are the symptoms of monkeypox?
Posted By: KiwiMum
Date Posted: June 02 2022 at 2:56am
Welcome to the site Danielle,
That's a good question. I'm sure anyone really knows because health authorities have been caught recycling their published photos of Shingles and relabelling them as Monkeypox. But here is an article about how to catch it and what the symptoms are from a UK newspaper last week.
One additional thought...if the sexual exposure really represents an H2H transmission, you should be able to contact trace; that is to ask the patients who they had sex with in the past two weeks, and presumably, you'd get only a short list of people who you could check to see if they had previously been ill. This would NOT be the case if an infected condom or something similar had the result of infecting one or both sexual partners during the act. I feel like the former type of contact tracing should have been done already, and the fact that it's not turning up chains of transmission might argue against H2H spread.
This is not HIV with a long incubation period to allow for silent transmission.
DJ...If monkeypox is a sexual transmitted disease most of the time why there seems to be NO contact tracing ? Even knowing where people with monkeypox have been may be worthwile...to see if surface spread links may show up...
Children infected by monkeypox in WHO report: "Of the 10,141 cases where age was available, there were 72 (0.7%) cases reported aged 0-17, out of which 23 (0.2%) were aged 0-4." Note: Monkeypox in children has been historically more severe with significantly higher fatality.
Important: The percent of child infections will most likely continue growing. The initial stage of the monkeypox pandemic was dominated by MSM community superspreader events. The incubation period can be 5-21 days and multiple periods must pass to show community transmission.
Study: Both surface and air samples tested positive for monkeypox virus "Replication-competent virus was identified in two of four samples selected for viral isolation, including from air samples collected during the bed linen change."
-
Maarten De Cock
@mdc_martinus
·
Yesterday, the @WHO claimed: “FACT: The #monkeypox virus is NOT airborne” Let’s now see what this scientific study shows us. https://medrxiv.org/content/10.1101/2022.07.21.22277864v1… This is evidence that the monkeypox virus is airborne. Please correct @WHO’s misinformation. @PeopleDocGeneva@mvankerkhove
Findings We identified widespread surface contamination (66 positive out of 73 samples) in occupied patient rooms (MPXV DNA Ct values 24·7-38·6), on healthcare worker personal protective equipment after use, and in doffing areas (Ct 26·3-34·3). Five out of fifteen air samples taken were positive. Significantly, three of four air samples collected during a bed linen change in one patient’s room were positive (Ct 32·7-35·8). Replication-competent virus was identified in two of four samples selected for viral isolation, including from air samples collected during the bed linen change.
Interpretation These data demonstrate significant contamination in isolation facilities and potential for aerosolisation of MPXV during specific activities. PPE contamination was observed after clinical contact and changing of bed linen. Additionally, contamination of hard surfaces in doffing areas supports the importance of cleaning protocols, PPE use and doffing procedures.
Current data on growth of the pandemic (daily new cases, 7 day average) showing accelerating growth. Now growing at ~600 cases per day (and increasing).
Outlook for monkeypox-virus=good; free travel, lots of hosts to infect...when will the first non-human monkeypox case be identified ? Outlook for us humans "not good"...
------------- We cannot solve our problems with the same thinking we used when we created them. ~Albert Einstein
Posted By: KiwiMum
Date Posted: July 24 2022 at 1:48pm
I still don't think monkeypox is a problem. I think it's just another thing to try and keep us all in a state of fear. It's ridiculous that the WHO have declared it a global emergency. Just think how many Covid cases there were before that was declared a pandemic.
Here in NZ we're told we should all be concerned about it because we have 2 cases. It's complete madness.
------------- Those who got it wrong, for whatever reason, may feel defensive and retrench into a position that doesn’t accord with the facts.
Posted By: Dutch Josh
Date Posted: July 24 2022 at 9:25pm
Kiwimum, monkeypox may have -so far- been (part of) a cause of death for less then 5 people...As far as I understand maybe a few hundred needed-so far-hospitalcare...from that perspective I have to agree with you...
However the WHO has been critized for running behind the facts with (a.o.) CoViD...There may be 1 million cases+ by november...If most healthissues remain mild in most cases even then maybe calling it an emergency may be overdoing it...
Again-I am not an expert...but I think vaccinations against CoVid without stopping the spread resulted in immunity evading variants...Are we repeating this now in monkeypox ?
With HIV/AIDS a.o. Cuba did "isolate" people testing positive for HIV and still having sex...STOP THE SPREAD should be priority #1 !
Under the monkeypox cases - if I am correct- a lot of people did run above average risk for CoViD...so it is very likely a lot of them may have had CoViD in the past...why not use that info?
I think a smaller group of them did get CoViD vaccinations...I expect a lot of them will not go for monkeypox vaccinations...
Given spread by air/surface a.o. hotel workers seem to get infected...it is no longer a "gay disease"...several children also tested positive...Still sticking to "gay STD" is WRONG !!!
New York, London, Amsterdam a.o. may see increase of spread via aerosol/contact....
Did "they" not learn a thing from earlier mistakes in strategies ? STOP THE SPREAD !!! Vaccines could make matters worse if you are unable to stop the spread !
------------- We cannot solve our problems with the same thinking we used when we created them. ~Albert Einstein
Posted By: Dutch Josh
Date Posted: October 28 2022 at 1:55am
Monkeypox cases are plummeting. Scientists are debating why ... 26 OCT 202211:35 AMBYKAI KUPFERSCHMIDT
When monkeypox cases in Europe began to decline this summer, researchers’ first question was: Is it real? Some worried that people might not be getting tested because of receding fears of the virus, coupled with strict isolation requirements for patients. “They might be reluctant to be confirmed and be told not to go out at all,” says Catherine Smallwood, monkeypox incident manager at the World Health Organization’s (WHO’s) Regional Office for Europe.
But the decline is now unmistakable. WHO Europe, which reported more than 2000 cases per week during the peak in July, is now counting about 100 cases weekly. In the Americas, the other major epicenter of the outbreak, numbers have dropped by more than half (see graphic, right). “We’re seeing a true decline,” Smallwood says.
Vaccines, behavior change among the most affected group—men who have sex with men (MSM)—and immunity after natural infection are all playing a role in that decline, says Erik Volz, an infectious disease modeler at Imperial College London, but how much each factor has contributed is unclear. “This is something we’ve debated a lot internally.” ... In the United Kingdom, at least, vaccination campaigns have played a minor role, according to a model published as a preprint this month by Samuel Brand, an infectious disease modeler at the University of Warwick. Monkeypox’s reproductive number—the average number of new infections triggered by an infected person—began to drop by mid-June, even though campaigns only started in July, Brand notes. Several other European countries saw the same pattern.
That leaves behavior change and immunity from natural infections. A survey conducted by the U.S. Centers for Disease Control and Prevention among MSM in August found about half had reduced their number of sexual contacts. As awareness of the disease increased, people also became more likely to seek diagnosis and treatment early and to avoid sex while they were infectious. The UK Health Security Agency has presented data suggesting syphilis and other sexually transmitted infections declined as well—which would bolster the case for behavior change—although that signal is “suggestive but not conclusive,” Volz says.
Immunity acquired through infections in the most sexually active men may be the biggest factor, however. Monkeypox has been affecting mostly MSM and their sexual networks because parts of those networks are densely connected, with some people having a large number of sexual contacts. Rising immunity in that group could limit the viru’s ability to spread, says Jacco Wallinga, chief epidemic modeler at the Dutch National Institute for Public Health and the Environment. ... https://www.science.org/content/article/monkeypox-cases-are-plummeting-scientists-are-debating-why" style="margin: 0px; padding: 0px; border: 0px; font-size: 13px; font-family: Helvetica, Arial, Verdana, sans-serif; vertical-align: baseline; color: rgb(35, 121, 181); text-decoration: none; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); - https://www.science.org/content/arti...e-debating-why
and ;
Translation Google
Monkey pox: the epidemic is receding but has not yet disappeared
Since mid-July, the contamination curve has fallen very sharply in Western Europe and North America. However, some countries in Central and Latin America are still experiencing an increase in the number of cases.
Article written by franceinfo with AFP France Televisions Postedon 10/21/2022 08:51 Updateon 21/10/2022 09:45
"We're coming to the end, but we're not there yet." The monkey pox epidemic is in full decline, virologist Jean-Claude Manguara told AFP on Friday, October 21. With more than 70,000 cases in a hundred countries since May, "an epidemic of 'monkeypox' so important in such a short time is unheard of" , recalled this head of the environment and infectious risks unit. at the Pasteur Institute.
If since mid-July, the contamination curve has dropped very significantly in Western Europe and North America, certain countries in Central and Latin America are still experiencing an increase. In addition, at present, monkeypox is "endemic" in about ten African countries. In these areas, the epidemic, which is more lethal, stems mainly from contact with wildlife in rural areas.
"The African source remains present and, in a context where there may be population movements, we may have new exported cases and a new epidemic wave at any time" , warns Steve Ahuka Mundeke, head of the virology department at the Biomedical Research Institute of the Democratic Republic of Congo and member of an IRD-Inserm team. In recent months, "we have again seen that global strategies are only deployed when the countries of the North are affected, which does not at all clear the African health authorities ", he notes.
Behavior change and vaccination
Where the epidemic is declining, experts point to the decisive role of changing behavior within communities at risk, in particular thanks to the role "of associations, perhaps more listened to than the authorities and closer to the field" , suggests Jean- Claude Manuguerra. Surveys show that more than half of men who have sex with men have reduced their number of sexual encounters.
As for vaccination, "it has helped, but the number of vaccines available remains low" , reminds AFP Carlos Maluquer de Motes, professor of virology at the British University of Surrey. The vaccine is still recommended for prevention and post-exposure. Its clinical effectiveness is not yet supported by "hard data" , according to the European Center for Disease Prevention and Control, but it is showing positive preliminary results.
In any case, “significant uncertainties remain about the evolution of the epidemic”, underlines the European agency, which draws four scenarios. Heads: rebound of the epidemic, linked in particular to the return of risky behavior, or reduced circulation of the virus with sporadic outbreaks. Tails: persistent decline in the epidemic, even elimination of the disease in Europe.
Monkeypox was diagnosed for the first time in a child in Argentina The boy is 10 years old and lives in the city of Buenos Aires. He had a fever and rashes. How the contagion occurred and what the case implies, according to experts in infectology and dermatology consulted by Infobae By Valeria Roman October 26, 2022
For the first time, monkeypox was diagnosed in a child in Argentina. He is 10 years old and lives in the city of Buenos Aires, according to the epidemiological bulletin of the Ministry of Health of the Nation. Since last May, when the first case of infection caused by the Monkeypox virus was confirmed in the country, most of those affected have been adults, with an average age of 35 years...
... In Argentina, between May and August, smallpox cases increased slowly. From the second half of August they grew "gradually". In the first week of October, a lower number of cases was registered than in the previous week. But in the second week of October, 85 confirmed cases were reported and another 20 were under study at the time of closing of the last epidemiological bulletin.
It was the week with the most confirmed cases reported since the beginning of the outbreak in the country. "In relative terms, the average week-on-week increase registered for the last four weeks was 14%," said the epidemiology experts from the Health portfolio, referring to the evolution of the outbreak between the second half of September and the first half of October.
In total, 627 cases of people with monkeypox have been confirmed in Argentina. Until now, the youngest patient registered was an 18-year-old adolescent. Now there was the case of the 10-year-old boy. As symptoms, the little boy had a fever greater than 38° and rashes on his arms. "As an epidemiological background, it is a close contact of a confirmed case, and the area of contagion would be within the family," the experts clarified. That is, the child had been a close contact of a relative who also had the infection. At the moment, "evolves favorably."...
DJ If MPX would develop into more surface or aerosol spread it could become a bigger problem. Also co-infections may change both the virus as the outcome of disease.
------------- We cannot solve our problems with the same thinking we used when we created them. ~Albert Einstein
Posted By: Dutch Josh
Date Posted: May 27 2023 at 12:30am
Sixteen days ago the https://www.chicagohan.org/alert-detail/-/alert-details/46678186" style="text-decoration: none; color: rgb(63, 63, 127); - city of Chicago issued a HAN (Health Alert Network) alert on a cluster of recent Mpox cases (n=13), a large percentage (69%) which were fully vaccinated with the JYNNEOS vaccine. While https://afludiary.blogspot.com/2022/09/cdc-eid-journal-monkeypox-in-patient.html" style="text-decoration: none; color: rgb(63, 63, 127); - this vaccine was never expected to be 100% protective , this outbreak has raised concerns over a new surge in cases this summer.
Six days later the CDC released a nationwide HAN Update (see https://afludiary.blogspot.com/2023/05/cdc-han-potential-risk-for-new-mpox.html" style="text-decoration: none; color: rgb(63, 63, 127); - CDC HAN: Potential Risk for New Mpox Cases ), and followed up with a live webinar 3 days later (see https://afludiary.blogspot.com/2023/05/coca-call-tomorrow-may-18th-mpox-update.html" style="text-decoration: none; color: rgb(63, 63, 127); - COCA Call : Mpox Update on Testing, Treatment, and Vaccination ).
Over the past week the CDC has also published 5 MMWR reports (3 on May 19th and 2 yesterday) on the potential for additional Mpox outbreaks, and the apparent effectiveness of the vaccine.
-
Although the https://www.who.int/news/item/11-05-2023-fifth-meeting-of-the-international-health-regulations-(2005)-(ihr)-emergency-committee-on-the-multi-country-outbreak-of-monkeypox-(mpox)" style="text-decoration: none; color: rgb(63, 63, 127); - WHO discontinued their PHEIC (Public Health Emergency of International Concern) status for Mpox just over two weeks ago, concerns over the future spread, and evolution, of this virus remain.
Like all viruses, Monkeypox continues to evolve and diversify, as discussed in the 2014 EID Journal article https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3901482/" style="text-decoration: none; color: rgb(0, 0, 127); - Genomic Variability of Monkeypox Virus among Humans, Democratic Republic of the Congo , where the authors cautioned:
Small genetic changes could favor adaptation to a human host, and this potential is greatest for pathogens with moderate transmission rates (such as MPXV) ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3901482/#R40" style="text-decoration: none; color: rgb(0, 0, 127); - 40 ). The ability to spread rapidly and efficiently from human to human could enhance spread by travelers to new regions.
And in a 2020 report, published by the Bulletin of the World Health Organization, researchers warned that our waning immunity to smallpox put society at greater risks of seeing Monkeypox epidemics (see https://afludiary.blogspot.com/2020/08/who-modelling-human-to-human.html" style="text-decoration: none; color: rgb(63, 63, 127); - WHO: Modelling Human-to-Human Transmission of Monkeypox ).
Last September The Lancet published a correspondence also warning of the dangers of failing to contain this virus:
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01789-5/fulltext#%20" style="text-decoration: none; color: rgb(63, 63, 127); - Evolutionary consequences of delaying intervention for monkeypox
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01789-5/fulltext#" style="text-decoration: none; color: rgb(63, 63, 127); - Philip L F Johnson , https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01789-5/fulltext#" style="text-decoration: none; color: rgb(63, 63, 127); - Carl T Bergstrom , https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01789-5/fulltext#" style="text-decoration: none; color: rgb(63, 63, 127); - Roland R Regoes , https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01789-5/fulltext#" style="text-decoration: none; color: rgb(63, 63, 127); - Ira M Longini , https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01789-5/fulltext#" style="text-decoration: none; color: rgb(63, 63, 127); - M Elizabeth Halloran , https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01789-5/fulltext#" style="text-decoration: none; color: rgb(63, 63, 127); - Rustom Antia Published:September 21, 2022 DOI: https://afludiary.blogspot.com/2023/05/mmwr-five-recent-reports-on-mpox.html#" style="text-decoration: none; color: rgb(63, 63, 127); - https://doi.org/10.1016/S0140-6 https://doi.org/10.1016/S0140-6736(22)01789-5" style="text-decoration: none; color: rgb(63, 63, 127); - 736(22)01789-5
While most of the public seems to view mpox as a `niche' or `lifestyle' disease - and unlikely to affect them - the longer the virus circulates, the more opportunities it will have to widen its base and possibly evolve into something worse. We underestimate its potential at our own peril.
DJ, testing/reporting in most countries is "poor"...most infected with M-pox may believe they run "limited risks" so most will NOT seek testing...We only see the tip of the ice-berg....
With CoViD also an immunity disease lots of other diseases get more chances...a higher number of other infectious diseases may result in mutations/new variants with further increased risks...
M-pox can become a disease that one could catch very easily ! Maybe even airborne ??? It is very WRONG to see it as only gay...just like HIV/AIDS is not "just" a gay disease...
------------- We cannot solve our problems with the same thinking we used when we created them. ~Albert Einstein
Posted By: Dutch Josh
Date Posted: December 06 2023 at 1:52am
Just over 10 days ago the https://afludiary.blogspot.com/2023/11/who-reports-1st-confirmed-cluster-of.html" style="text-decoration: none; color: rgb(63, 63, 127); font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; - WHO Reported the 1st Confirmed Cluster Of Sexually Transmitted MPXV Clade 1 in the DRC . Clade 1 Mpox is considered far more dangerous than clade IIb, which is currently spreading outside of Africa.
After presenting the evidence, the WHO warned that `The risk of mpox further spreading to neighbouring countries and worldwide appears to be significant.' and that it poses`. . . an additional risk of mpox outbreaks with potentially more severe consequences than the one which has been affecting the world since 2022.'.
Last week, in https://afludiary.blogspot.com/2023/11/cdc-eid-journal-clade-iassociated-mpox.html" style="text-decoration: none; color: rgb(63, 63, 127); font-stretch: normal; font-variant-east-asian: normal; font-variant-numeric: normal; line-height: normal; - CDC EID Journal: Clade I–Associated Mpox Cases Associated with Sexual Contact, the Democratic Republic of the Congo , we looked at dispatch from the team in the DRC that discovered these clusters. They wrote:
Population movement and previously unreported routes of transmission could exacerbate global distribution of MPXV, which could be compounded by the lack of routine diagnostic testing or inadequate access to rapid point-of-care testing. In view of this investigation, epidemiologic and genomic surveillance for MPXV, in both endemic and nonendemic regions, should be improved and strengthened.
While obviously a concern, so far we've not seen any evidence of clade I transmission outside of the endemic regions of central Africa. To be fair, however, clade IIb was probably circulating internationally long before surveillance first identified it in the UK in May of 2022.
DJ, a total lack !!!! of basic testing for health risks in international travel made SARS-2/CoViD into a pandemic...We do NOT learn a thing even from recent past...
While reassuring, in the summer of 2021 - roughly 1 year before clade IIb Mpox began its world tour - the https://www.ecdc.europa.eu/sites/default/files/documents/Communicable-disease-threats-report-3-july-2021.pdf" style="text-decoration: none; color: rgb(63, 63, 127); - ECDC issued a risk assessment following https://afludiary.blogspot.com/2021/07/ecdc-cdr-3rd-monkeypox-case-in-uk.html" style="text-decoration: none; color: rgb(63, 63, 127); font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 16px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: rgb(235, 237, 236); - a family cluster of Monkeypox cases in the UK (index case imported from Nigeria).
The likelihood for further spread of the virus is very low due to the moderate transmissibility of the virus. However, infections among close contacts cannot be excluded, as demonstrated by the infections described above.
A perfectly reasonable assessment given the facts available at the time. But it does remind us that all risk assessments have a shelf life, and as the virus changes, so do the risks.
The virus is considered to be endemic in https://en.wikipedia.org/wiki/Tropical_rainforest" style="text-decoration: none; color: rgb(51, 102, 204); background: none; overflow-wrap: break-word;" title="Tropical rainforest - tropical rainforest regions of Central and West Africa. https://en.wikipedia.org/wiki/Mpox#cite_note-NIH_mpox-29" style="text-decoration: none; color: rgb(51, 102, 204); background: none; overflow-wrap: break-word; - [27] In addition to monkeys, the virus has been identified in https://en.wikipedia.org/wiki/Gambian_pouched_rat" style="text-decoration: none; color: rgb(51, 102, 204); background: none; overflow-wrap: break-word;" title="Gambian pouched rat - Gambian pouched rats (Cricetomys gambianus), https://en.wikipedia.org/wiki/Dormice" style="text-decoration: none; color: rgb(51, 102, 204); background: none; overflow-wrap: break-word;" title="Dormice - dormice ( https://en.wikipedia.org/wiki/Graphiurus" style="text-decoration: none; color: rgb(51, 102, 204); background: none; overflow-wrap: break-word;" title="Graphiurus - Graphiurus spp.) and African squirrels ( https://en.wikipedia.org/wiki/Heliosciurus" style="text-decoration: none; color: rgb(51, 102, 204); background: none; overflow-wrap: break-word;" title="Heliosciurus - Heliosciurus , and https://en.wikipedia.org/wiki/Funisciurus" style="text-decoration: none; color: rgb(51, 102, 204); background: none; overflow-wrap: break-word;" title="Funisciurus - Funisciurus ). The use of these animals as food may be an important source of transmission to humans. https://en.wikipedia.org/wiki/Mpox#cite_note-WHOfact2023-1" style="text-decoration: none; color: rgb(51, 102, 204); background: none; overflow-wrap: break-word; - [1]
-
Mpox can be transmitted from one person to another through contact with infectious lesion material or fluid on the skin, in the mouth or on the genitals; this includes touching, close contact and during sex. It may also spread by means of respiratory droplets from talking, coughing or sneezing. https://en.wikipedia.org/wiki/Mpox#cite_note-WHOfact2023-1" style="text-decoration: none; color: rgb(51, 102, 204); background: none; overflow-wrap: break-word; - [1] https://en.wikipedia.org/wiki/Mpox#cite_note-CDC_Transmission-30" style="text-decoration: none; color: rgb(51, 102, 204); background: none; overflow-wrap: break-word; - [28] During the 2022–2023 outbreak, transmission between people was almost exclusively via sexual contact. https://en.wikipedia.org/wiki/Mpox#cite_note-31" style="text-decoration: none; color: rgb(51, 102, 204); background: none; overflow-wrap: break-word; - [29] There is a lower risk of infection from https://en.wikipedia.org/wiki/Fomite" style="text-decoration: none; color: rgb(51, 102, 204); background: none; overflow-wrap: break-word;" title="Fomite - fomites (objects which can become infectious after being touched by an infected person) such as clothing or bedding, but precautions should be taken. https://en.wikipedia.org/wiki/Mpox#cite_note-CDC_Transmission-30" style="text-decoration: none; color: rgb(51, 102, 204); background: none; overflow-wrap: break-word; - [28]
The virus then enters the body through broken skin, or mucosal surfaces such as the mouth, respiratory tract, or genitals. https://en.wikipedia.org/wiki/Mpox#cite_note-WHOfact2023-1" style="text-decoration: none; color: rgb(51, 102, 204); background: none; overflow-wrap: break-word; - [1]
The https://en.wikipedia.org/wiki/Natural_reservoir" style="text-decoration: none; color: rgb(51, 102, 204); background: none; overflow-wrap: break-word;" title="Natural reservoir - natural reservoir of monkeypox virus is thought to be small mammals in tropical Africa. https://en.wikipedia.org/wiki/Mpox#cite_note-NIH_mpox-29" style="text-decoration: none; color: rgb(51, 102, 204); background: none; overflow-wrap: break-word; - [27] The virus can be transmitted from animal to human from bites or scratches, or during activities such as hunting, skinning, or cooking infected animals. https://en.wikipedia.org/wiki/Mpox#cite_note-WHOfact2023-1" style="text-decoration: none; color: rgb(51, 102, 204); background: none; overflow-wrap: break-word; - [1]
So eating/contact with infected animals may spread the virus...Also indirect contact (with the infected person leaving behind the virus in a hotel bed etc) could bring further risks...If less immunity after CoViD is (very likely) also a factor we only can expect M-pox to become a major problem soon...
we are simply not stopping/reducing any risk "to save the economy"....
------------- We cannot solve our problems with the same thinking we used when we created them. ~Albert Einstein
Dutch Josh wrote:
Meaghan Kall
Meaghan Kall
Meaghan Kall
• 24 Scotland 
• 15 Wales 
• 12 Northern Ireland 105 are discharged 11 children had liver transplants 0 children have died
Meaghan Kall
