Monkeypox is here, too spread. There are several dozen cases in several countries We talked about last month There are now more than a thousand cases registered worldwide, 35 of them in the United States. But there are more cases in the United States than there are statistics, and there is reason to suspect that we are somehow uncomfortable with the response to the epidemic.
We are not testing enough
In the first few months of the COVID pandemic, testing was extremely inadequate when it was possible to detect the virus if we could find all the cases and their connections. Many people infected with the virus have never been tested, and those who want to take the test have not always been able to get it. We initially knew that the virus was spreading unnoticed, but there have been unrelated cases in the United States. The genetics of the various clusters of the disease may indicate that the virus has been spreading unnoticed for some time.
Here is what happened:There are small clusters of genetically different monkeys, and we know they must be much larger than the 35 reported cases in the United States. Thus, many cases should go unnoticed.
One of the reasons people who don’t pass the test are that people with smallpox may not understand it. Smallpox in monkeys is common in the body. In the current epidemic, sometimes there may be ulcers in only one part of the body, or even only one ulcer. In that case, you don’t think, You think, “Oh my God, this monkey must be smallpox.” «ХOh, I wonder what that place is like. ”And maybe you don’t see a doctor.
Doctors do not necessarily look for smallpox and may not recognize it at first. It is not a common disease in the United States (or in other areas where it is prevalent) and the symptoms of this epidemic do not always maintain textbook consistency. First the body temperature rises, then rashes appear; but in some specific cases there were rashes up to fever. Some people have sores only in the anal or genital area, which can be confused with STIs, such as herpes or syphilis. (Collected by molecular microbiologist Joseph Osmundson An information sheet containing images of anal and genital monkey smallpox is here.)
Thus, the first obstacle to testing is, first of all, insufficient testing. Examination for smallpox involves collecting secretions or scabs from wounds and sending them to one of several specialized laboratories. Former FDA Commissioner Scott Gottlieb wrote on Twitter The current difficulty is the lack of samples.
But if awareness improves, we may soon face a bigger problem: labs ability to test. There are currently 74 laboratories that test for orthopoxiruses and can process approximately 7,000 tests per week. Smallpox is currently the only orthopoxvirus of concern because smallpox has been eliminated and other viruses such as smallpox are rare in the family. If the sample is positive for orthopoxiruses, the CDC will perform additional tests to confirm that it is smallpox.
People with smallpox (suspected orthopox virus) must be isolated for 21 days and, over time, Health authorities recommend vaccines in contact with the victim and his or her close contacts. There are also antiviruses that can be useful. But the vaccine poses another problem.
We have a vaccine, but we do not know how effective it is
The good news about vaccines is that we already have vaccines. Not one, in fact: SVaccination against smallpox has already begun Hundreds of years, there are still several modern vaccines. (Smallpox was declared extinct worldwide in 1980, the only virus that has such a reputation for humans.) People can sometimes die from old smallpox vaccines, so those who use the live virus are not considered. for monkey smallpox.
There is a licensed smallpox vaccine in the United States. It is known as MVA (Modified Vaccinia for Ankara) and here is its brand name Jynneos. It does not multiply in humans, but still triggers an immune response against smallpox. According to a 1988 study, the vaccine is 85% effective against monkey infections, but this is a small study and We don’t know if this is the effect we would expect from the current vaccine and the current strain of monkey smallpox.
We still don’t know if we can reach it. U.S. Strategic National Reserves says they have 36,000 doses and ordered another 36,000. The vaccine company has more recent orders from other countries for obvious reasons, and they plan to send small batches to different countries so that everyone can start vaccination as soon as possible.
This vaccine is not enough to start vaccinating everyone, so the current strategy is a “ring vaccination” recommended for people who have been in close contact with someone who has a monkey disease. (The monkey smallpox vaccine can also be given to a person with monkey disease because it reduces the severity of the disease if caught early.) However, contact searches are not ideal, and in recent times, people have not had names or contact information. for all their close connections. Another possible strategy is to offer this vaccine to all high-risk groups, including men who are currently having sex with men. So far, this strategy is being tested only in Canada.
People do not understand how it is transmitted
Most of the recent cases have been sexual intercourse with men. This has led some people to think that they are sexually transmitted, like HIV or other STIs; I have already seen reports on social media that this can only be caused by sexual contact with a person who has a monkey disease.
Knowing that a virus is sexually transmitted is useful to know that the main route of transmission of a virus such as HIV is through sexual contact. However, we do know that smallpox can be transmitted through close contact with various types of smallpox, including human wounds or their respiratory droplets (such as coughing or sneezing) and possibly aerosols.
And on this: Tit was then announced by the CDC that short-term travelers should wear masks to prevent monkeys from contracting smallpox rejected this offer “caused chaos,” he said. Can monkeys be in the air? could be! However, if you are worried about getting a virus when you travel, you should still wear a mask. We know that masks (especially good masks in the N95 style) are effective in protecting us from COVID, and COVID cases are on the rise again, and they have never disappeared. So, yes, wear a mask. But also watch for signs of monkey smallpox, and don’t be afraid to ask for a test or vaccine if you think you have or have contracted smallpox.