Monkey pox, a rare zoonotic infection endemic to West Central Africa, can be life-threatening. The first suspected case of the 2022 outbreak was reported in the US on May 17. Do you need to uncover the damage to collect a sample for monkey pox control? Bruce Furness, MD, MPH, an epidemiologist at the CDC’s STD prevention department, said he had cleared more than 10 lesions in different patients and “none of them have been uncovered”. “These are really small, rubbery, deep lesions and unlike HSV [herpes simplex virus] lesions… you can not really say whether you have taken a good sample or not, based on whether there is fluid or not or whether or not there is some bleeding “, he noted. “You just have to rub the swab over the surface of these connected rubber lesions as deeply and aggressively as the patient can tolerate, because most of them are quite tender.” Capt. Brett Petersen, MD, MPH, Deputy Director of the U.S. Department of Public Health, Smallpox and Rabies, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) of the CDC, said that “contain infectious virus”. Therefore, it is important to cover the lesions and the materials of the lesions to prevent transmission. Can samples be collected before they become pustular? Capt. Agam Rao, MD, a physician with the U.S. Department of Public Health at NCEZID, noted that smears can also be obtained during the vesicular phase. In previous cases, some patients had mouth lesions before skin lesions, he explained. “So you can stick bubbles, blisters, [and] “Scabies can also be collected and controlled,” he said, noting that scabies are also a common source of transmission, such as through the bed. Do precursor symptoms always precede the appearance of leprosy in monkeys? The “classic presentation” of monkey pox includes precursor symptoms – fever, nausea, headache and swollen lymph nodes – that precede the onset of lesions, said Leandro A. Mena, MD, MPH, director of the STD prevention department at the National Center. of the CDC on HIV / AIDS, Viral Hepatitis, STDs and TB Prevention. He pointed out that in the current exacerbation patients see lesions without precursor symptoms and in some cases the symptoms develop after the onset of the rash. Does the smallpox or chickenpox vaccine provide any protection against monkeypox? The previous smallpox vaccine is expected to offer “some protection” against monkeypox, Petersen said, as the two viruses are linked. In the outbreak of monkey pox in 2003, six people who had been vaccinated as children acquired monkey pox, but an analysis of the cases in this outbreak showed that “among those who had been vaccinated before, there was a protective effect, even after many decades after receiving the smallpox vaccine, “he added. It is not yet clear how long after vaccination this protection lasts and CDC researchers continue to study this question, he noted. Chickenpox is a herpes virus in a separate family from chickenpox and smallpox, “so the chickenpox vaccine is not expected to provide any protection against chickenpox,” Petersen explained. Can a person be infected more than once by monkey pox? “We have not seen it happen, but that does not mean it could not happen,” Rao said. “In general, smallpox infection has provided lifelong protection; however, it is unclear whether this will also apply to monkey poxvirus infections.” The CDC is aware of a report of a possible smallpox re-infection, but the agency expects this to be a rare scenario, Petersen said. “What we do not know is with this new outbreak and the new epidemiology and route of transmission, if this can affect some of what has previously been observed with monkey pox and other related viruses, such as smallpox. So I think there are “Learn even more there,” he added. Could monkey pox be easily transmitted from person to person, similar to COVID-19? “Monkey pox is definitely not COVID-19,” Rao said. Based on previous cases and the current outbreak, monkey pox appears to be transmitted through “direct close contact. Thus, close contact that may occur during sex, but also any other close contact that may occur – for for example, if you live with someone who has a monkeypox and you sleep in the same bed and use the same towels. “ “It really is not something you just pass on to someone walking down the street,” he said. While the agency’s researchers are “open-minded” about the possibility of the virus spreading more easily, “at the moment, there is no indication that it will spread the way COVID has spread and spread to so many people. [and] “At the moment, the risk to the world population … is low.” In addition to answering clinicians’ questions, Mena presented a case study of a male patient and his evolving symptoms, while Petersen provided an overview of medical countermeasures, including vaccines and biologic drugs that are not commercially available but are stored by the government. of the USA. In November 2021, the Advisory Committee on Immunization Practices voted in favor of a pre-exposure precautionary recommendation with Jynneos, a live non-reproductive smallpox and smallpox vaccine, as an alternative to ACAM2000, a live smallpox vaccine, “for certain individuals at risk of exposure to orthopoxic viruses “. In June, the CDC updated these recommendations. Petersen noted that ACAM2000 carries risks of serious side effects, including myopicarditis. “Myopicarditis has not been reported in relation to Jynneos in the limited number of people who have received the vaccine in clinical trials, so the risk is thought to be lower than for ACAM2000,” he said. As of Wednesday afternoon, there have been 351 confirmed cases of monkey pox / orthopoxides in the United States.
Shannon Firth has been reporting on health policy as a MedPage Today’s Washington correspondent since 2014. She is also a member of the site’s Enterprise & Investigative Reporting team. Follow
