CDC sends monkeys to high-risk races to prevent the spread of smallpox vaccines

The test tubes, labeled “Ape smallpox virus positive and negative,” can be seen in this illustration taken on May 23, 2022.

Ruvic Dice | Reuters

The Biden administration distributed 1,200 doses of the monkey vaccine to people at high risk of the virus as part of a nationwide public health effort to eradicate the disease before it led to a major epidemic.

U.S. Health Care Workers, Concerned that the virus is spreading faster than previously thought, it is said to be the largest global monkey smallpox epidemic. The World Health Organization said Wednesday that more than 550 cases have been reported in 30 countries. At least 20 confirmed or suspected cases have been reported in 11 states in the United States, including California, Colorado, Florida, Georgia, Illinois, Massachusetts, New York, Pennsylvania, Virginia, Utah and Washington, according to the Centers for Disease Control. and prevention.

“There has never been an epidemic of monkey disease on such a scale and scale around the world,” the doctor said. Raj Panjabi, who heads the White House’s pandemic preparedness office, told reporters last week.

However, CDC officials have tried to convince the public that the arrival of the monkey disease in the United States is very different from Coved-19, which blinded the country two years ago. When Covid first appeared, scientists knew little about him, and there was no antiviral vaccine or antiviral treatment in the United States in 2020.

Monkeys have been known to scientists since 1958, when the virus was first identified in monkeys bred for research purposes, and its transmission to humans has been studied since the 1970s. The World Health Organization (WHO) has extensive experience in the fight against smallpox, which the World Health Organization declared to be eradicated in 1980 after a successful global vaccination attempt. Smallpox belongs to the family of smallpox-like viruses, but it is much easier.

vaccine supply

CDC Director Dr. Rochelle Valensky told reporters last week that the United States has been preparing for the outbreak of the monkey-like virus for decades. The U.S. strategic national warehouse contains millions of doses of monkey and smallpox vaccines, as well as antiviral pills to treat the disease.

Down O’Connell, head of the Department of Health and Human Services, which oversees the National Strategic Warehouse, said Friday that the United States has enough vaccine to control the current monkey epidemic. However, O’Connell did not say how many shots the U.S. was ready to shoot.

There are two vaccines in the United States, but the preferred option is less. Jynneos is a two-dose vaccine approved by the FDA in 2019 to prevent smallpox in people over 18 years of age. The CDC generally recommends Ginneos from another variant, ACAM2000, an older-generation smallpox vaccine that can have serious side effects.

Last week, the CDC official Dr. Jennifer McQueiston said there are 1,000 doses of Jynneos in the United States. However, Bavarian Nordic, a Danish biotechnology company that produced the footage, said the U.S. actually has a frozen dose of more than 1 million Jynneos stored in the U.S. and Denmark under an order issued in April 2020. three years.

The U.S. has delivered about 30 million doses of Jynneos since 2010, but 28 million of them have expired, a spokesman said. Bavarian Nordic plans to increase production this summer and has the capacity to produce 30 million rounds a year, a spokesman said.

The U.S. government also has a stockpile of more than 100 million doses of ACAM2000, developed by Emergent BioSolutions, McCuiston told reporters last week. As of Tuesday, the U.S. had released 500 doses of Jynneos and 200 doses of ACAM2000, according to the CDC. Health officials said Friday that the United States also sent 100 courses of oral antiviral tecovirimate to states.

“We want to ensure that people at risk have access to vaccines as soon as possible, and we want them to receive appropriate treatment if they become ill,” Punjabi told reporters on Friday. Jynneos and CAM2000 can be used before or after exposure to the virus. However, to prevent the disease, patients should be vaccinated within 4 days.

Mike Slifka, an immunologist at the University of Oregon Health and Science who studied smallpox, said ACAM2000 showed high levels of protection against smallpox in animal models and is expected to provide 85% protection against the virus, similar to previous versions of smallpox vaccines. . The vaccine is newer because less is known about Jynneos, but it has produced reasonable levels of antibodies in humans and should protect against severe disease, Slifka said.

side effects

The CDC generally recommends Jynneos over ACAM2000 because it is considered safe. ACAM2000 could have serious side effects and the widespread deployment of the vaccine will require serious discussion, McQuiston told reporters last week. The ACAM2000 monkey uses light strains of the virus in a family such as smallpox and smallpox, which can still multiply, which means that the live virus in the vaccine is at risk of spreading to the human body or other people.

The ACAM2000 controls the blister infection with a double-toothed needle drawn into the upper part of the arm, and then the virus becomes localized in the form of a. The virus can spread to other people or other parts of the body, and if they scratch the blister and then wipe their eyes, it can lead to vision loss. The FDA warns people vaccinated with ACAM2000 that it is important to take proper care of the vaccination site to prevent the virus from spreading to other people or other parts of the body.

CDC warning

The CDC said pregnant or breastfeeding women, people with weakened immune systems, people with skin conditions such as eczema or atopic dermatitis, and people with heart disease should not take ACAM2000. In pregnant women, the virus can spread to the fetus and lead to stillbirth. According to Slifka, people with weakened immune systems grow the virus uncontrollably, leading to dangerous infections. People with skin conditions such as eczema or atopic dermatitis are also at risk of the virus spreading to the skin, which can be life-threatening, he said.

The Jynneos vaccine, on the other hand, is not related to these risks because it uses a strain virus that cannot reproduce in humans, Slifka says. It is also given with a conventional syringe, such as a flu shot.

Given the potential adverse effects of ACAM2000, the vaccine could be widely used only in the context of a major smallpox epidemic because the virus is highly lethal, the doctor said. Peter Hotes, an infectious disease and vaccine expert at Baylor College of Medicine in Texas. But monkeys are a much easier virus and there have been no recent deaths in Europe and North America.

mortality rate

According to the World Health Organization, smallpox can be up to 30% fatal. The West African strain of monkeys, which causes the current epidemic, has a mortality rate of about 1%, but data are rare because the virus has previously spread mostly to remote parts of Africa. According to the CDC, most people recover within two to four weeks without special medical treatment. According to the WHO, there is another type of smallpox in the Congo Basin, with a mortality rate of 3% to 10%.

“We are very happy that this epidemic is a West African strain with low virulence,” the doctor said. Rachel Roper is a professor of microbiology and immunology at the University of East Carolina who studied smallpox.

Although the United States has a lot of tools and knowledge to fight monkey smallpox in 2020, there is still a lot of uncertainty about it. It is unclear why the virus is now spreading beyond West and Central Africa. Historically, the virus has spread to small villages in Africa by jumping from rodents that carry the virus to humans, with very little spread among humans, Slifka said. However, the virus is now spreading well among people, he said.

“Through intimate contact and skin-to-skin transmission, it passes better than other conditions,” Slifka said.

McQueeston said most people with smallpox in the United States traveled internationally for 21 days before symptoms began, indicating that they had contracted the virus outside the country. The CDC does not believe monkey disease is widespread in the United States, but is monitoring the situation closely. The United States has already conducted 120 tests for a family with the orthopox virus, which includes smallpox.

giving to the public

“There may be infectious diseases at the community level, so we really want to step up our surveillance efforts,” Mackwiston told reporters Friday. “We really want to encourage doctors to check it out if they see rashes and are worried they might get smallpox,” he said.

The World Health Organization (WHO) said on Wednesday that the sudden appearance of smallpox in several North American and European countries indicates that the virus has been spreading beyond West and Central Africa for some time, but it is unclear how long it will last. Dr. Rosamund Lewis, the World Health Organization’s technical director for smallpox, said the virus may be spreading more now because the human immune system has been weakened since smallpox vaccination was stopped after the disease was eradicated.

Lewis said the WHO does not recommend mass vaccination against smallpox because the current epidemic could still be contained. According to the World Health Organization, most cases have been reported among men who have had sexual intercourse with men, developed symptoms, and sought sexual health care. Lewis said it is important to provide gay and bisexual men with the information they need to protect themselves from the virus and prevent it from spreading.

Symptoms

The CDC has said that people diagnosed or suspected of having a smallpox infection should be isolated from their homes unless local or state health departments say otherwise. People with a confirmed infection should be isolated until the skin lesions that characterize the disease are completely removed, the scabs are removed, and a new layer of skin is formed.

Smallpox usually begins with flu-like symptoms, including fever, headache, muscle aches, chills, fatigue, and swollen lymph nodes. Ulcers then form in the body, and the virus first spreads when it comes in contact with these wounds. If a monkey has sores in its throat or mouth, it can be transmitted through respiratory droplets, but it is not easily transmitted in this way.

According to the CDC, people with smallpox should be monitored for symptoms for 21 days. They should have their temperature checked twice a day for chills, swollen lymph nodes, and new skin rashes. If fever or rash develops, the person should isolate himself and contact the local health department immediately.

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