Discussion - Thoughts on a global outbreak of monkeypox

[Pathfinder]

Belgium -

https://flutrackers.com/forum/forum/europe/emerging-diseases-other-health-threats-ad/monkeypox-aa/949192-belgium-2022-monkeypox-cases

Post 3:

"The government decided to consult the RAG, the scientific experts of the Risk Assessment Group.
...
The context is particular, because this virus, endemic in West Africa, but unusual in Europe, seems to have spread here mainly during sexual contact between men and men, and multiple sexual contacts. Monkeypox is transmitted by direct contact during sexual intercourse, regardless of sexual orientation. Transmission also occurs through very close physical contact with an infected person (through bodily fluids, among others) or contact with clothing or linen used by an infected person. Nevertheless, the risk for the general population is low.

The RAG therefore decided that it was necessary to launch an awareness campaign aimed at men who have sex with other men, and people with several sexual partners.

High-risk contacts should self-monitor for any symptoms: fever, body aches, fatigue, rash. A delicate prevention message, because it is as essential as it must be non-stigmatising. On the eve of Pride, which promotes international contacts and male homosexual encounters, the authorities believe it is their duty to pass this recommendation."

[sharon sanders]

Dr. Theresa Tam

@CPHO_Canada
1/4 Emerging confirmed and suspect cases of rare human infection with #Monkeypox (MPX) virus have been reported, including in the UK, Portugal, Spain, US and Canada. MPX virus does not spread efficiently.
5:11 PM · May 19, 2022·Twitter Web App
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Dr. Theresa Tam

@CPHO_Canada
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@CPHO_Canada
2/4 One suspected MPX case that was reported in the US has potential links to suspected case(s) in Canada. The Public Health Agency of Canada (PHAC) is working with partners on the international and provincial investigations.
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Dr. Theresa Tam

@CPHO_Canada
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3/4 Although person-to-person spread of MPX is not common, the virus can be spread by close contact via the respiratory tract and/or through direct exposure to an infected animal/human’s blood, body fluids or lesions, or virus-contaminated objects.
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Dr. Theresa Tam

@CPHO_Canada
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20h
4/4 As laboratory and epidemiological investigations continue in Canada and new information emerges, #PHAC will continue to keep Canadians informed.

[sharon sanders]

FluTrackers.com
@FluTrackers
·
3s

As usual in a disease outbreak there is a lotta **** online.

Please...please!...use at least two sources for your information.

If you have ANY medical questions, please consult your medical practitioner.

Do not take medical advice from the internet! #monkeypox

[sharon sanders]

Thank you to everyone on the site for this effort. I know it is a lot after dealing with COVID-19 for....seems forever...... It continues to be a privledge to work with you.

To our readers, thank you for following.

We remain the same....no corporate $, no government $, no ads, no selling stuff.

We are Independent Media.

[Mary Wilson]

Monkeypox Tracker with Sources

Map

https://flutrackers.com/forum/forum/the-pandemic-discussion-forum/949289-monkeypox-tracker-with-sources-bmo-news

[Pathfinder]

20 May 2022

Monkeypox goes global: why scientists are on alert

...
Max Kozlov
...
“It’s eye-opening to see this kind of spread,” says Anne Rimoin, an epidemiologist at the University of California Los Angeles, who has studied monkeypox in the Democratic Republic of the Congo for more than a decade.
...
The number of cases detected outside of Africa in the past week alone — which is all but certain to increase — has already surpassed the number detected outside the continent since 1970, when the virus was first identified as causing disease in humans. This rapid spread is what has scientists on high alert.
...
‘Deeply concerning’

Still, for monkeypox to be detected in people with no apparent connection to one another suggests that the virus might have been spreading silently — a fact that Andrea McCollum, an epidemiologist who heads the US Centers for Disease Control and Prevention poxvirus team calls “deeply concerning”.

Unlike SARS-CoV-2, which can spread asymptomatically, monkeypox does not usually go unnoticed when it infects a person, in part because of the skin lesions it causes. If monkeypox could spread asymptomatically, it would be especially troubling because it would make the virus harder to track, McCollum says.

Another puzzle is why almost all of the case clusters include men aged 20–50, many of whom are gay, bisexual and have sex with men (GBMSM). Although monkeypox isn’t known to be sexually transmitted, sexual activity certainly constitutes close contact, Rimoin says. The most likely explanation for this unexpected pattern of transmission, MacIntyre says, is that the virus was coincidentally introduced into a GBMSM community, and the virus has continued circulating there.
...

https://www.nature.com/articles/d41586-022-01421-8

[alert]

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.

[alert]

And one more additional thought...might the unusual transmission pattern and unusual location of symptoms be the result of an unusual method of exposure to the virus? In the wild in places like Nigeria, the cases are typically infected through the skin by animal contact or in the digestive tract in the case of eating an infected animal. These cases seem to be having viral exposure in the genitals and on the mucus membranes. Is it possible the unusual epidemiology here is a change in the route of exposure and not a change in the virus itself?

[Emily]

I've been reading up on the history of monkeypox. Very strange, only found in lab monkeys for decades. In this case the pox lesions were seen after the animals were tattooed and only at that site. So maybe with some variants, breaking the skin opens the skin to the virus in the interior.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1965340/pdf/amjpathol00262-0121.pdf

[alert]

Read the entire article:

Monkeypox outbreak questions intensify as cases soar | Science | AAAS

The first 7 confirmed cases in Spain all reported attending "sex parties" and several of them are HIV positive as well.

[Emily]

Very interesting. Nordic is headquartered in the same city where the first monkeypox outbreak occurred in 1958 in lab monkeys.

"In a bizarre coincidence, Bavarian Nordic held a meeting with Heymann and nine other public health leaders from around the world this week, planned 6 months ago, to discuss the need for more countries to stockpile its vaccine, given the increase in monkeypox cases over the past few years. "

[Mary Wilson]

(I came across this from April 2022)

Monkeypox in Texas, What Happened

April 8, 2022 • 5:55 am CDT

(Precision Vaccinations)

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.

https://www.precisionvaccinations.com/2022/04/08/monkeypox-texas-what-happened

[Mary Wilson]

@InfectiousDz


Monkeypox in provinces of the Democratic Republic of the Congo
#Sankuru (468 cases, 36.4 %)
#Tshopo (169 cases, 13.2 %)
#Equateur (168 cases, 13.1 %)
#Tshuapa (108 cases, 8.4 %)
accounted for approximately 3/4 of reported suspected cases (913 cases, i.e. 71.1 %)

10:02 PM · May 20, 2022·Twitter Web App



OMS RDC

@OMSRDCONGO

Les provinces du #Sankuru (468 cas, 36,4%), de la #Tshopo (169 cas, 13,2%), de l’#Equateur (168 cas, 13,1%), de la #Tshuapa (108 cas, 8,4%) ont comptabilisé environ 3/4 de cas suspects rapportés (913 cas, soit 71,1%).

https://twitter.com/InfectiousDz/sta...Cx1cTBgLQqAAAA

[Mary Wilson]

@InfectiousDz



From the beginning of 2022 until May 08, at least 1,284 suspected cases of #monkeypox including 58 deaths (lethality 4.5 %) have been reported in 87 health zones in 18 provinces of the DRR @WHO supports response through in-depth investigations and medical supplies



OMS RDC

@OMSRDCONGO

Depuis le début de 2022 jusqu’au 08 mai dernier, au moins 1 284 cas suspects de #monkeypox dont 58 décès (létalité 4,5%) ont été rapportés dans 87 zones de santé réparties dans 18 provinces de @WHO soutient les investigations approfondies, en plus des fournitures médicales

4:46 AM · May 20, 2022·Twitter Web App

[alert]

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.

[Mary Wilson]

A lot of cases have a history of traveling from Nigeria. Perhaps patients traveled around Africa before boarding at the airport.
No info on what strain is globally spreading, that I've seen.

[Emily]

Alert is correct.

https://www.medpagetoday.com/special-reports/exclusives/98857

Also reporting West African clade here:

https://flutrackers.com/forum/forum/the-pandemic-discussion-forum/949309-global-health-website-has-some-detailed-data-available-on-monkeypox-cases

[Mary Wilson]

First monkeypox genome from latest outbreak shows links to 2018 strain

20 May 2022
Michael LePage

The first draft genome of the virus responsible for the rapidly growing monkeypox outbreak has been released online by a team in Portugal. The DNA sequence shows it is of the mild West African type and most closely related to the monkeypox viruses detected in the UK, Singapore and Israel in 2018 and 2019.

What isn’t yet clear is whether this virus has any changes that make it more transmissible in humans, which would explain why the current outbreak is so widespread and by far the largest seen outside Central and West Africa, where the virus spreads in monkeys. This could take some time to establish, given that monkeypox has a large and complex genome.

At the time of writing, there were 127 confirmed and suspected cases of monkeypox in 10 countries, including the US, UK and Australia, and researchers suspect the true numbers are even higher.

João Paulo Gomes and colleagues at the National Institute of Health in Portugal sequenced a sample taken from a male patient on 4 May. Teams in other countries are also sequencing viral samples from the outbreak, but Gomes’s team is the first to make a sequence public.

Gustavo Palacios at Icahn School of Medicine at Mount Sinai, New York, says the draft sequence from Portugal has too many gaps to draw firm conclusions, but that he has seen a more complete sequence from a team in Belgium. “As far as I can see, it seems to be identical to the one in the UK in 2018,” says Palacios. “That is a little bit odd.”

In 2018, there were three cases in the UK after someone returning from Nigeria infected two other members of their household.

As more samples are sequenced, it should become clear whether, as suspected, a single variant of monkeypox is responsible for all the cases in the latest outbreak.

https://www.newscientist.com/article...o-2018-strain/

[Mary Wilson]

Report of Monkeypox cases in 2018 in the United Kingdom

Published on 14 Feb 2019

Author: Mohana Priya Kunasekaran

DOI: http://doi.org/10.31646/gbio.22

... The first case of monkeypox recorded in the UK and in the European Union (EU) was on 8 September 2018, in a Nigerian resident residing at a naval base in Cornwall, UK (1, 2). The patient was suspected to have been infected in Nigeria before travelling to the UK.

... From previous outbreaks, the CFR has been between 1-10% (18). Two genetic clades of monkeypox virus, the West African Clade and Congo Basic clade, have been defined in the literature. According to available data, the Congo basic clade in more common than the West African clade and is endemic to the DRC (19). The West African Clade is associated with milder disease and fewer deaths and has a CFR <1%, while the Congo Basin clade has CFR up to 11% and previously documented human-human transmission (20).

In September-December 2017, the West African clade was identified in the Nigerian outbreak and, based on NCDC data, had a CFR of 2.9% with 68 confirmed cases from 197 suspected cases across 22 states (14). In 2018, based on NCDC data, the CFR was 2.2% with 45 confirmed cases from 114 suspected cases across 13 states. The same West African clade was reported (15).

https://jglobalbiosecurity.com/artic...31646/gbio.22/

[Emily]

https://www.medpagetoday.com/special-reports/exclusives/98857

Draft Genome Sequence of Latest Monkeypox Virus Unveiled

— No indication latest strain is "substantially different" from those circulating in recent years

by Sophie Putka, Enterprise & Investigative Writer, MedPage Today May 20, 2022
The latest monkeypox virus now popping up in multiple countries appears most closely related to a strain that circulated in 2018-2019, according to a draft genome sequence of a recent case.

Sequencing of a skin lesion sample from an infected male patient in Portugal -- where at least 20 confirmed cases have been reported -- suggests the latest monkeypox virus belongs to the West African clade. It is most closely related to cases that spread from Nigeria to the U.K., Israel, and Singapore in 2018 and 2019, reported João Paulo Gomes, PhD, of the National Health Institute Doutor Ricardo Jorge in Lisbon, and colleagues.

The group, who published their findings on the preprint server virological.org, said the draft genome sequence "will certainly contribute to better understand the epidemiology, sources of infection, and transmission patterns."..

[Emily]

I'm glad this monkeypox virus looks like the SOS. Otherwise, this crazy tabletop exercise from last year might worry me.

https://www.nti.org/wp-content/uploads/2021/11/NTI_Paper_BIO-TTX_Final.pdf

Jaime M. Yassif, Ph.D.
Kevin P. O’Prey, Ph.D.
Christopher R. Isaac, M.Sc.
Strengthening Global Systems
to Prevent and Respond to
High-Consequence Biological Threats
Results from the 2021 Tabletop Exercise Conducted in
Partnership with the Munich Security Conference
SUMMARY
In March 2021, NTI partnered with the Munich Security Conference to
conduct a tabletop exercise on reducing high-consequence biological threats.
The exercise examined gaps in national and international biosecurity and
pandemic preparedness architectures—exploring opportunities to improve
prevention and response capabilities for high-consequence biological
events. This report summarizes the exercise scenario, key findings from
the discussion, and actionable recommendations for the international
community
....

Move 3(May 10, 2023) occurred 12 months after the initial outbreak, with more than 480 million cases and
27 million fatalities globally (Figure 4). At this stage, participants learn that the pandemic was caused by a
regional bio-terror attack that far exceeded the perpetrators’ goals.

Specifically, Brinian intelligence reveals that the engineered monkeypox virus was developed illicitly at
the fictional country of Arnica’s leading institute for virology. Arnica (population 75 million) has a history
of conflict with neighboring Brinia (see map in Figure 5). An independent Arnican terrorist group—the
SPA—had worked with sympathetic laboratory scientists to
engineer a highly contagious, deadly pathogen and disperse
it at crowded train stations in Brinia during the national
holiday, when much of the population was travelling
domestically and internationally.
The SPA had exploited the Arnican government’s weak
oversight of its bioscience research laboratories. SPA
sympathizers working in Arnica’s leading virology institute
used publicly available scientific publications to guide their
work to modify the monkeypox virus to make it more
transmissible and resistant to currently available vaccines.
The discussion in Move 3 focused on governance of dual-
use bioscience research as well as current weaknesses in
biosafety and biosecurity systems that exacerbate biological
risks...