Monkeypox outbreak

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caltrek
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Re: Monkeypox outbreak

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Monkeypox Background
August 5, 2022
(U.S. Center for Disease Control) Signs and Symptoms: Classically, monkeypox occurs in three stages. After an incubation period of approximately 1–2 weeks, a prodrome, characterized by fever and lymphadenopathy occurs, which is followed by the onset of a deep-seated vesicular or pustular rash that often begins centrally and spreads to the limbs. Transmission of monkeypox can occur through direct contact with the infectious rash, scabs, or body fluids, through respiratory secretions during prolonged face-to-face contact or intimate physical contact, or through touching items, such as clothing or linens, that previously touched a patient’s infectious rash or body fluids.§ Patients are considered contagious until the scabs have crusted over and fallen off and a fresh layer of intact skin has formed underneath.

Reports from the current outbreak suggest transmission patterns and clinical manifestations might not follow the classic presentation of monkeypox. Although any person can acquire monkeypox, epidemiologic data indicate that transmission is currently most intense among interconnected networks of sexually active MSM, with transmission occurring primarily through intimate skin-to-skin contact during sex. Prodrome or systemic symptoms do not always occur or precede the rash. Mucosal involvement occurs in approximately 40% of cases, including genital, perianal, and oropharyngeal lesions. Genital and perianal lesions can be associated with severe and painful proctitis, urethritis, phimosis, and balanitis. Oropharyngeal symptoms, including symptoms resulting from tonsillitis and epiglottitis, can be associated with pain or difficulty swallowing.
Treatment: There are no Food and Drug Administration (FDA)–approved treatments for monkeypox. However, drugs that are approved for treatment of smallpox and cytomegalovirus might have activity against Monkeypox virus. Tecovirimat is an antiviral medication available in oral and intravenous formulations. Animal studies have shown that tecovirimat is effective in treating orthopoxvirus-induced disease. Data are not available on the effectiveness of tecovirimat in treating monkeypox in humans; however, a case report from the United Kingdom suggested that tecovirimat might shorten the duration of illness and of viral shedding (13). Human clinical trials indicate that the drug is safe and tolerable with only minor side effects (14). Randomized controlled trials in humans are underway to further assess safety as well as efficacy in treating monkeypox. Tecovirimat is available from the Strategic National Stockpile (SNS) and is administered under an expanded access (i.e., compassionate use) Investigational New Drug (EA-IND) protocol held by CDC.

Other treatments that can be considered in severe cases include vaccinia immune globulin intravenous (VIGIV), cidofovir, and brincidofovir. Cidofovir and brincidofovir have proven activity against poxviruses in in vitro and animal studies, but only cidofovir is currently available either commercially or from the SNS. VIGIV is available from the SNS and is administered under an EA-IND protocol for monkeypox. At this time, it is unknown whether a person with severe monkeypox will benefit from treatment with VIGIV, cidofovir, or brincidofovir because effectiveness data are not available.
Pre- and Postexposure Prophylaxis: The only form of pre-exposure prophylaxis available or authorized for monkeypox is vaccination, which currently is recommended for persons at risk for occupational exposure to orthopoxviruses, such as laboratory personnel performing diagnostic testing for Monkeypox virus and members of health care worker response teams designated by appropriate public health and antiterror authorities. Routine immunization of all health care workers against smallpox or monkeypox is not currently recommended.**

Postexposure prophylaxis can be considered after exposure to monkeypox.†† Although the use of smallpox vaccines for postexposure prophylaxis has not been studied in the context of monkeypox outbreaks, early administration of vaccines (≤4 days after exposure) might prevent monkeypox, and later use (5–14 days after exposure) might decrease the severity of monkeypox if infection occurs (16,17). Vaccination given after the onset of signs or symptoms of monkeypox is not expected to provide benefit.§§

Two vaccines are licensed by FDA for the prevention of orthopoxvirus infections. JYNNEOS is a live virus vaccine that uses nonreplicating modified vaccinia Ankara (MVA) which is licensed for prevention of smallpox and monkeypox in adults aged ≥18 years (18). Because JYNNEOS contains replication-deficient MVA, it does not present a risk for disseminated infection, autoinoculation, or transmission to others. JYNNEOS vaccine is administered as a series of two doses given 28 days apart. ACAM2000 is a replication-competent live vaccinia virus vaccine licensed for prevention of smallpox that is administered as a single dose (19). ACAM2000 was derived from Dryvax, the vaccine used in the eradication of smallpox.
Read more here (including footnotes not included above): https://www.cdc.gov/mmwr/volumes/71/wr ... 7132e4_w
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Re: Monkeypox outbreak

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Re: Monkeypox outbreak

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caltrek wrote: Sat Aug 06, 2022 12:23 am Remember that fellow Ron DeSantis? The only guy to top Trump in the presidential preference poll among Republican voters?

Well, there is a reason that his lead over Trump in the polls should not be considered a good thing.

'They’re Going to Abuse Those Powers': DeSantis Attacks States for Declaring Emergencies Over Monkeypox Cases
by Meaghan Ellis
August 4, 2022

[...]

The Republican governor went on to share his opinion of states' emergency declarations. “You see some of these states declaring states of emergency. They’re going to abuse those emergency powers to restrict your freedom. I guarantee you that’s what will happen,” DeSantis said.

Read more here: https://www.alternet.org/2022/08/ron-d ... onkeypox/
Ah yes, it's always about freedumb. The absolute highest priority, above literally anything else – even the physical health of the nation.
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caltrek
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Re: Monkeypox outbreak

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Dearth of High Quality Monkeypox Guidelines May be Hampering Care Globally
August 16, 2022

Introduction:
(EurekAlert) A dearth of high quality, up to date clinical guidance on monkeypox may be hampering effective and safe treatment of the infection around the world, concludes a review of what’s available to guide patient care and published in the open access journal BMJ Global Health.

Existing guidance, such as it is, too often lacks sufficient detail, fails to include different groups, and is contradictory, say the researchers
Conclusion:
And they conclude: Our study highlights a need for a rigorous framework for producing guidelines ahead of epidemics and a recognised platform for rapidly reviewing and updating guidance during outbreaks, as new evidence emerges.

“Human [moneypox] is providing a challenge even in high-resource settings with well-resourced healthcare systems. The lack of guidelines may especially impact clinics with limited previous experience in managing patients with [monkeypox].

Given the recent global publicity surrounding monkeypox, this is an opportune moment to harness interest and investment in further research to make sure that everyone is given the best treatment, they say.
Read more here: https://www.eurekalert.org/news-releases/961730
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Re: Monkeypox outbreak

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Monkeypox case reported in man whose 'primary risk factor' was close, nonsexual contact at a crowded outdoor event

Updated 1751 GMT (0151 HKT) August 17, 2022

Most monkeypox cases in the current outbreak have been linked to sexual activity, but research published Wednesday by the US Centers for Disease Control and Prevention offers new insight into other ways it may be spreading.

A man noticed his first lesion and subsequently developed a rash about two weeks after attending a "large, crowded outdoor event at which he had close contact with others, including close dancing, for a few hours," according to researchers from Stanford University School of Medicine. He tested positive for monkeypox after seeking care at an emergency department about a week later.

The patient's "primary risk factor was close, nonsexual contact with numerous unknown persons at a crowded outdoor event," the researchers wrote, and the case "highlights the potential for spread at such gatherings, which may have implications for epidemic control."

https://edition.cnn.com/2022/08/17/heal ... index.html


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Re: Monkeypox outbreak

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wjfox wrote: Thu Aug 11, 2022 10:05 am
caltrek wrote: Sat Aug 06, 2022 12:23 am Remember that fellow Ron DeSantis? The only guy to top Trump in the presidential preference poll among Republican voters?

Well, there is a reason that his lead over Trump in the polls should not be considered a good thing.

'They’re Going to Abuse Those Powers': DeSantis Attacks States for Declaring Emergencies Over Monkeypox Cases
by Meaghan Ellis
August 4, 2022

[...]

The Republican governor went on to share his opinion of states' emergency declarations. “You see some of these states declaring states of emergency. They’re going to abuse those emergency powers to restrict your freedom. I guarantee you that’s what will happen,” DeSantis said.

Read more here: https://www.alternet.org/2022/08/ron-d ... onkeypox/
Ah yes, it's always about freedumb. The absolute highest priority, above literally anything else – even the physical health of the nation.
I guess what he didn't mention to his own supporters is that they also have the freedom to die from their unwise choices.
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Re: Monkeypox outbreak

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caltrek
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Re: Monkeypox outbreak

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U.S. Clinical Trial Evaluating Antiviral for Monkeypox Begins
September 9, 2022

Introduction:
( EurekAlert) A Phase 3 clinical trial evaluating the antiviral tecovirimat, also known as TPOXX, is now enrolling adults and children with monkeypox infection in the United States. Study investigators aim to enroll more than 500 people from clinical research sites nationwide. Interested volunteers can visit the ACTG website (clinical trial A5418) for more information. The trial is sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health. The NIAID-funded AIDS Clinical Trials Group (ACTG) is leading the study, which may later expand to international sites. The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) at NIH is supporting several sites, including through the International Maternal Pediatric Adolescent AIDS Clinical Trials Network (IMPAACT).

Tecovirimat, manufactured by the pharmaceutical company SIGA Technologies, Inc., New York City, is approved by the U.S. Food and Drug Administration for the treatment of smallpox. The drug prevents the virus from spreading in the body by preventing virus particles from exiting human cells by targeting a protein found on both the variola virus, which causes smallpox, and the monkeypox virus. Clinicians currently can access tecovirimat for U.S. patients with monkeypox through an expanded access or “compassionate use” request process.

“Monkeypox can be an extremely painful infection that lasts for weeks,” said NIAID Director Anthony S. Fauci, M.D. “We currently lack efficacy data that would help us understand how well this drug may mitigate painful monkeypox symptoms and prevent serious outcomes. This clinical trial was designed to answer those important questions.”

A global outbreak of human monkeypox virus, first identified in May 2022, prompted public health emergency declarations from both the World Health Organization (WHO) and the U.S. Department of Health and Human Services this past summer. The majority of cases identified thus far have been in men who have sex with men, although other populations, including women and children, can become infected. From Jan. 1, 2022, to Sept. 7, 2022, the WHO has reported 52,996 cases and 18 deaths across 102 countries, territories and areas. The Centers for Disease Control and Prevention has reported 21,274 cases in the U.S.
Read more here: https://www.eurekalert.org/news-releases/964314
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Re: Monkeypox outbreak

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Los Angeles Death May Be The First Confirmed Monkeypox Fatality in The U.S.
by Nicoletta Lanese
September 14, 2022

Introduction:
(Science Alert) A Los Angeles County resident with a severely weakened immune system has died of monkeypox, the Los Angeles Department of Public Health reported Monday (September 12).

The US Centers for Disease Control and Prevention (CDC) also assessed the case and confirmed that the death was due to a monkeypox infection, according to the health department.

"The resident was severely immunocompromised and had been hospitalized," the health department statement reads.

In general, immunocompromised people face a greater risk of developing severe monkeypox infections than the general public, as do children younger than age 8, people with a history of eczema, and people who are pregnant or breastfeeding, Live Science previously reported.

"To protect confidentiality and privacy, additional information on this case will not be made public," the statement continues.
Read more here: https://www.sciencealert.com/los-angel ... in-the-us
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