Discussion - Thoughts on a global outbreak of monkeypox

[Zeffy]

In possible relation to the case from Gran Canaria, there was a pride festival (Gay Pride Maspalomas) between 5/5/22 and 15/5/22 on Gran Canaria.

Although it is important not to place any stigma upon these cases, as cautioned by others, this may be relevant as it could possibly explain why so many same generation cases were found in people in different places, if these cases were attained at a shared holiday destination.
Notably, Canary Islands are a popular destination for Spanish, Portugese and British Travellers.
Hopefully Epi interviews would elucidate any shared transmission sites.

[Zeffy]

Thanks Emily (& Sharon). Yes, it seems like the moons aligned in an unfortunate way. BTW, is it known for sure that the index case was from London? UK has seen a few sporadic imported cases over the last few years but there is also the possibility of the index case being in the canaries itself. It is an attractive site for migration from West Africa and it is possible (pure speculation, sorry) that it could be a migrant worker in a hotel, for example. The earliest swab sample data I have seen recorded on the internet was May 4th in Portugal which puts the potential index case at mid April onwards. Fingers crossed that the unfortunate coincidences hypothesis is true....

[Emily]

Zeffy, that's a good point. The London case I'm thinking of had an onset of a rash on 4/29 in Nigeria. I think he got back to London by 5/4 or 5/5 and went straight for treatment, so couldn't have infected anyone going to the GPM. And there is another case of rash onset in Canada on 4/29, too. No travel history but that might be private in Canada. This data from Global Health is handy and you can put it in a spreadsheet.

https://docs.google.com/spreadsheets/d/1CEBhao3rMe-qtCbAgJTn5ZKQMRFWeAeaiXFpBY3gbHE/htmlview#

[Zeffy]

Emily, thanks for the link. Very useful.

[sharon sanders]

Welcome Zeffy!

[JJackson]

The NCBI databank now has a complete sequence (MPXV_USA_2022_MA001 # ON563414) which is aligned with the sequences anticipated as being the problem branch in my original post in this thread ( see phylogenetic tree in post #5 ) note in particular MN648051 (Israel 2018) which is the closest match and I used for my alignment giving a 99.96% homology or about 80 SNPs over the full genome. This is rather more than the ~20 SNPs (estimated from branch length) indicated in the Virological.org partial Portuguese sequence Monkeypox/PT0001/2022.



My speculative working hypothesis at this point is that drift in the WA branch of the genome has allowed pre-symptomatic - or possibly asymptomatic - infection via the anal mucosa which has not come to light in West Africa where homosexuality is largely taboo. Introduction into more liberal areas has allowed spread and, if not contained, will allow further adaption. If this is correct then the vaginal mucosa is also likely to be a target. Endoscopic examination of the anal cavity would seem a logical step looking for lesions.

[alert]

Russia was planning to use monkeypox as bioweapon, claims ex-Soviet scientist - World News (wionews.com)

[alert]

I mean, well sure, the USSR worked on it. But they also worked on a lot of other nasty stuff, including weaponized forms of plague, smallpox, anthrax, etc. The source cited in this article hasn't been in Russia in almost 30 years.

[Emily]

Gee, where'd they get that idea from?

https://www.history.com/news/colonists-native-americans-smallpox-blankets

"What Amherst and Bouquet didn’t know was that somebody at Fort Pitt had already thought of trying to infect the Native Americans with smallpox—and had attempted to do it. "

[kiwibird]

6 days incubation for "direct innoculation" and 8 - 16 days for aerosol..... explains the delay in "non direct" contacts symptoms.... h/t @jmcrookston on twitter. https://twitter.com/jmcrookston/stat...86551753854977 Links to WHO data on monkeys in thread.

[kiwibird]

Data is for smallpox - but extrapolation seems fair.

[JJackson]

The paper I linked to in post #9.1 gives the incubation period as 10-14 days in MPV in humans. The paper is from 2004 and probably relates to the Congo Basin strain so may not be relevant to this phenotype.

[willra1]

There is a now a Nextstrain page on monkeypox.

[JJackson]

Welcome willra1 and thanks for the link.

They have very kindly selected a convenient root and each node gives all the changes since the root and the function of the proteins in which they fall - where the function is know.

[sharon sanders]

Welcome willra1!

[Pathfinder]

Translation Google

Health recommends that pets do not have contact with positives for monkeypox

The Ministry of Health recommends that patients with monkeypox avoid contact with wild or domestic animals

Jorge Jiménez - 05-20-2022 - 14:45 H - 3 min.
...
As the Minister of Health Carolina Darias already advanced , one of the Ministry's recommendations is focused directly on animals. And it is that, Darias pointed out that contact with wild or domestic animals should be avoided, therefore, pets should be excluded from the patient's environment .

Regarding the role of animals in the spread of the monkeypox virus, José Poveda , veterinarian and professor in the Animal Health area of the Veterinary Faculty of the University of Las Palmas de Gran Canaria ( ULPGC ) , explained in statements for this mean that the main reservoir is some rodents .

In fact, the best known of these, the Gambian rat, was responsible for the introduction of the virus in the United States , which ended up affecting native prairie dogs and finally jumping to humans.

However, the expert pointed out that this is unlikely to happen in Spain . "The risk of the virus staying in Spain is very low as long as there is no transmission through possible reservoirs, being only infections between people," he said, noting that humans end up being a cul-de-sac .
...

https://www.animalshealth.es/profesionales/sanidad-recomienda-mascotas-tengan-contacto-positivos-viruela-mono

[sharon sanders]

Connor Bamford
@cggbamford

Given the recent interest in monkeypox, here's a few things that people should know about poxviruses from a virologist point of view (1/14)
10:41 AM · May 22, 2022·Twitter Web App


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Connor Bamford
@cggbamford
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Virologists classify Poxviruses as a kind of large DNA virus in the kingdom "Bamfordvirae" (no known relation) alongside other animal viruses like adeno- and asfari-viruses, all of which have a protein with a "double jelly roll" fold.

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Connor Bamford
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Poxviruses (and some related viruses) are unusual for DNA viruses in that they replicate in the host cell cytoplasm and not the nucleus. Poxvirus particles also have an enigmatic and complex structure.

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Connor Bamford
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Poxviruses are considered fairly generalist with regard to what they infect, in that they don’t use specific receptors, have lots of genes, replicate in the cytoplasm, and are super stable in the environment.
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Connor Bamford
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Although large DNA viruses have a low mutation rate, this isn’t really a hindrance for poxviruses when they encounter a new environment as they already harbour lots of genetic diversity (and genes!), can recombine, and can adapt by amplifying gene numbers.

youtube.com
Poxvirus Gene Accordions
Nels Elde describes how poxviruses utilize gene "accordions" to increase the sampling potential for mutations in a small number of genes, revealing a new mod...
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Connor Bamford
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The most well known poxvirus is the virus that caused the devastatingly lethal, debilitating, and history-changing, smallpox disease in people known as variola virus of which there two types: major and minor

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Connor Bamford
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After killing 500 million people since 1880, variola virus was controlled using an original “Jennerian” vaccine based on inoculation with a related virus (vaccinia) found in animals, providing cross protection against variola virus but was less likely to cause significant disease





Connor Bamford
@cggbamford
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Thankfully the variola virus was eradicated in 1980, leaving humans with only a single endemic poxvirus, the relatively benign molluscum contagiosum virus, which is actually distantly related to the variola-like "orthopox" viruses. Humans don’t have any para- or yata-poxviruses.

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Connor Bamford
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Outside of humans there is a substantial diversity of pox viruses across animals, including arthropods and vertebrates, encompassing significant pathogens of wildlife (e.g. myxoma) and farm (e.g. orf) animals.

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Connor Bamford
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Given their significant diversity and generalist predisposition, poxviruses often jump from one host species to another (likely from rodents). One of the best known examples is monkeypox or cowpox, both of which are actually rodent-borne.

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Connor Bamford
@cggbamford
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Given their less picky nature,poxviruses can infect things through diverse means including touch, droplet,and airborne modes where they can spread from initial inoculation site causing systemic disease over several days.Severe illness is often associated w/ bacterial coinfection

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Connor Bamford
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Poxvirus diseases are known to be vaccine preventable (even as post-exposure) and there's significant cross-protection between different orthopox infections meaning our smallpox vaccine may protect against related viruses. There are even some useful antivirals that could be used.

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Connor Bamford
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Their diversity and their generalist capabilities make poxviruses an obvious threat.The eradication of variola virus has left space for another related infection.Although replaced initially by widespread use of vaccinia,widespread vaccination ceased 50ya and immunity is waning.

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Connor Bamford
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We must be careful w/ orthopox's and not let novel ones adapt further to us.Control of future pox threats should involve limiting global zoonosis, population level surveillance, and shutting down transmission chains. Ensuring we have enough vaccine/antivirals should be paramount.

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[Emily]

That myxoma virus shown in the disturbing photo of the rabbit was used as a horrible biological weapon against rabbits in Australia and in Europe. (In one case a rogue scientist used it to control rabbits on his own property and of course viruses don't abide by property boundaries.) Eventually it jumped into native species in some places.

https://news.asu.edu/20220427-crossing-barriers-how-rabbit-virus-myxoma-leapt-new-species

[Shiloh]

Source: https://www.marketwatch.com/story/mo...MW_latest_news

Monkeypox likely spread by sex at 2 raves in Europe, WHO adviser says
Published: May 23, 2022 at 6:57 a.m. ET

A leading adviser to the World Health Organization described the unprecedented outbreak of the rare disease monkeypox in developed countries as “a random event” that might be explained by risky sexual behavior at two recent mass events in Europe.

In an interview with The Associated Press, Dr. David Heymann, who formerly headed WHO’s emergencies department, said the leading theory to explain the spread of the disease was sexual transmission among gay and bisexual men at two raves held in Spain and Belgium. Monkeypox has not previously triggered widespread outbreaks beyond Africa, where it is endemic in animals.

“We know monkeypox can spread when there is close contact with the lesions of someone who is infected, and it looks like sexual contact has now amplified that transmission,” said Heymann.

That marks a significant departure from the disease’s typical pattern of spread in central and western Africa, where people are mainly infected by animals like wild rodents and primates and outbreaks have not spread across borders.

To date, WHO has recorded more than 90 cases of monkeypox in a dozen countries including Britain, Spain, Israel, France, Switzerland, the U.S. and Australia.

Madrid’s senior health official said on Monday that the Spanish capital has recorded 30 confirmed cases so far. Enrique Ruiz Escudero said authorities are investigating possible links between a recent Gay Pride event in the Canary Islands, which drew some 80,000 people, and cases at a Madrid sauna.

Heymann chaired an urgent meeting of WHO’s advisory group on infectious disease threats on Friday to assess the ongoing epidemic and said there was no evidence to suggest that monkeypox might have mutated into a more infectious form...

[sharon sanders]

I have not started a case list because we normally only add ministry of health confirmed cases to any case list. The governments are lagging greatly behind the media reports. We do not normally add suspected or possible cases.

Also, it is hard to know what the real case numbers are in a disease that can transmit sexually. I feel the detailed lists being kept by a couple of organizations are not even close to the real numbers. There might be some count possible that may be a range but it is hard to estimate at this point in time.

[Pathfinder]

Translation Google

Monkey pox: "This circulation of the disease is completely new"

Published: May 22, 2022 12.37pm EDT Updated: May 23, 2022 2.52am EDT

Authors

Camille Besombes
Infectiologist in epidemiology thesis - Epidemiology of Emerging Diseases Unit, Institut Pasteur

Arnaud Fontanet
Physician, Director of the Epidemiology of Emerging Diseases Unit at the Institut Pasteur in Paris, Professor of Public Health, National Conservatory of Arts and Crafts (CNAM)


Since the beginning of May, more than a hundred suspected cases of monkeypox, a disease originating in Africa, have been detected in several European countries as well as in North America, Australia and Israel. What is this virus? Who is concerned ? Should we be worried about this outbreak? Engaged for 3 years in the Afripox project , which aims to better understand monkey pox in its region of emergence, Camille Besombes, infectious disease doctor and doctoral student in the unit of Arnaud Fontanet, project coordinator, takes stock.

The Conversation: What is monkeypox virus, or monkeypox ?

Camille Besombes: The monkeypox virus (“monkeypox” in English) belongs to the genus of Orthopoxviruses, to which the smallpox virus belongs. It is a large DNA virus that has a particular appetite for skin tissue. However, unlike the smallpox virus, which only infected humans and was thus able to be eradicated following mass vaccination of the world's population, monkeypox has an animal reservoir. And contrary to what one might think, this reservoir is not the monkey.

Indeed, if the monkeypox owes its name to the fact of having been isolated for the first time in captive primates (in 1958 in Denmark), its reservoir would actually be a rodent or a squirrel. The first human case of monkeypox infection , a 9-month-old child, was detected in 1970, in the Democratic Republic of the Congo, as part of the reinforcement of the smallpox eradication campaign.

Two strains of monkeypox virus are currently known . The so-called “West Africa” strain, whose lethality is around 1%, is rampant in Nigeria, Liberia, Sierra Leone and Côte d'Ivoire. It is this strain which is implicated in the cases currently detected in Europe. The second strain, known as "from the Congo Basin", circulates in the Democratic Republic of Congo (DRC), in the Republic of Congo, in the Central African Republic (CAR), in Gabon and also in Cameroon (this country is located at the limit of the distribution of the two strains, and cases from Nigeria have recently been described there). Associated with more severe clinical forms, the “Congo Basin” strain has a lethality of 10%.

It should be remembered, however, that these figures relate to countries where, unfortunately, the medical care of patients is difficult in the most remote regions. Currently, about ten patients are hospitalized, for some in order to better isolate them, but no severe form has been identified in Europe.

TC: What are the symptoms of the disease?

CB: After a relatively long incubation period (from 6 to 13 days, even up to 21 days), the disease begins with two days of "prodromes", early symptoms of the disease: a fever that can be high , headaches, an increase in the volume of the lymph nodes (which is a differential sign with smallpox), muscle pain, fatigue… Patients are considered contagious from this phase.


Skin rashes follow, often on the face first . They gradually spread to the rest of the body. This cutaneous involvement is painful because of the inflammation caused around the lesions, moreover there is significant itching. In the case of the West African strain, these lesions may initially be rare and inconspicuous, and therefore potentially go unnoticed. The disease typically lasts 2 to 4 weeks, and resolves spontaneously in the majority of cases.

The main complications are the occurrence of dehydration, due to the loss of water that occurs when the lesions are numerous and extensive, bacterial superinfection of the said lesions and septicemia, as well as ocular / corneal lesions which can lead to a loss of vision. In addition, encephalitis ( inflammation of the brain, editor's note ) has been described .

Children are more often victims of complications and therefore have a higher mortality rate than adults. It is assumed that immunocompromised people (especially HIV-positive individuals) also have a greater risk of developing severe forms, but data are still lacking to be able to say this with certainty. During the outbreak in Nigeria, 4 of the 7 people who died were HIV positive .

The management of the disease is essentially symptomatic: disinfection of lesions, administration of antibiotic therapy in the event of superinfection, rehydration, etc. Certain antiviral molecules are currently being evaluated for their effectiveness on monkeypox ( tecovirimat in particular), but the results are not yet available.

TC: Is this the first time that this virus has spread beyond the African continent? How many cases have been identified so far, and where?

CB: No, it's not the first time. While the Congo Basin strain has never left Africa, the West African strain has already made inroads into the United States in 2003, following the importation of infected animals. More recently, several imported human cases have also been reported in various countries.

In 2003, American patients had been contaminated following contact with infected prairie dogs, purchased from pet stores where they had rubbed shoulders with Gambian rats ( Cricetomys gambianus ) imported from Ghana and carriers of monkeypox . There were 47 suspected human cases, resulting from animal-to-human transmission (so-called “zoonotic” transmission). No human-to-human transmission had taken place. At the time, US authorities were concerned about the risk of the virus taking hold in an indigenous animal reservoir, but this did not occur.

In 2017, a larger outbreak occurred in Nigeria, a country that had not recorded a monkeypox outbreak for 40 years. This epidemic continues today, fueled by sporadic and regular zoonotic and human-to-human transmissions. Just over 500 suspected cases have been reported to date (including 215 confirmed). Reassuring point: in 5 years, only 8 deaths have been deplored.

This Nigerian epidemic, however, has changed the situation. Indeed, whereas previously the virus was more prevalent in forest regions with little connection to the rest of the country and the world, in 2017 it reached the urban areas of Nigeria, from where it could more easily spread outside the continent. Consequence: in 2018 several cases occurred in Singapore, Israel, and England, among travelers returning from Nigeria .

In the latter country, an indigenous transmission occurred: a British nurse was contaminated while cleaning a patient's bed . The outbreak had not spread, but further cases subsequently emerged in the UK in 2021, again linked to returning travelers from Nigeria, as well as in the US (two cases reported).

TC: How is the current context different?

CB: The situation is very different . Admittedly, the first case of the current outbreak, which occurred on May 7 in the UK, was a traveler returning from Nigeria. But since then, several other cases have been confirmed in the United Kingdom without it being possible to establish a link either with the case of May 7 or between them. No travel abroad compatible with contamination could be demonstrated, and direct chains of transmission could not be established. This situation suggests that there are several chains of transmission and autochthonous circulation of the virus.

Since May 18, cases have also been detected in Spain (7 confirmed cases, 16 suspected cases), Portugal (5 confirmed cases and 15 suspected cases), Sweden (1 confirmed), Italy (1 confirmed, 2 suspected ), Belgium (1 confirmed, 2 suspected), Canada (12 suspected cases in Montreal), Australia (1 confirmed case, 1 suspected case), Germany and Belgium. A case was also confirmed in the United States (this person had recently traveled to Canada). In France, a suspected case was reported by the Directorate General of Health on May 19 .

So far all of these infections have been mild. Of the 80 confirmed cases and the fifty suspected cases, around ten patients are currently hospitalized in Europe, but more from a perspective of isolation than due to clinical severity.

This autochthonous circulation of the disease is completely new. Another novelty: these cases concern almost exclusively young men, declaring themselves, for the majority of them, as having sexual relations with other men. A case in a woman was announced in Spain on May 20, 2022.

TC: How is this new? What are the usual modes of contamination?

CB: Epidemics of monkeypox usually begin with transmission from animals to humans, even if the details are unknown, and the same viral strain has never been isolated in an animal and a human. It could be direct contact with a live animal, during hunting, or during the consumption of bushmeat.

More specifically, in the context of the research we are conducting in the CAR, we have observed a seasonal upsurge in epidemics suggesting a link with certain seasonal activities, such as the collection of edible caterpillars in the forest, suggesting exposure to local fauna during these collections.

Although scientists have been tracking the reservoir of this virus since the 1970s, it has only been isolated from wild animals on 5 occasions to date: in 1985 in the Democratic Republic of Congo in a squirrel, the Funisciure striped-backed monkey ( Funisciurus anerythrus , suspected to be the reservoir for monkeypox ), then in 1992 in a mangabey monkey ( Cercocebus atys ) in the Ivory Coast, and finally, two decades later, in the Gambian rat and another rodent ( Stochomys longicaudatus ), as well as in another Funisciure (Funisciurus bayonii). At present, therefore, the main suspects are rodents, including squirrels.

Interestingly, monkeypox was isolated from chimpanzee faeces , in the Taï National Park in Côte d'Ivoire, during an outbreak among primates, suggesting the possibility of environmental contamination.

Beyond zoonotic transmission, human-to-human transmission occurs following direct and prolonged contact with patients, with their bodily fluids or by touching contaminated surfaces (clothing, bedding, surfaces, etc.), most of the time within fireplace.

Transmission by respiratory droplets is also mentioned, but this point is difficult to establish clearly. Indeed, contaminations generally occur within families, where the proximity is close and the modes of contact numerous and varied. In Africa, nosocomial transmissions have also been documented.
When describing in detail the cases of the 2017 Nigeria epidemic, the high proportion of genital involvement (68%) for the first time raised the suspicion of potential transmission through close contact during sexual intercourse . This proportion is also very high for the cases in CAR for which we have this data.

Intimate and close contacts during sexual intercourse would explain the facilitation of human-to-human transmission of a virus usually known as not very transmissible. This hypothesis seems supported by the fact that – for the moment – the “outside Africa” cases of recent weeks mainly concern young men having sex with other men , or defining themselves as homosexual. Note that this transmission could also occur during heterosexual intercourse.

TC: Should we fear a strong spread of this disease? How to limit it?

CB: For the moment, we can't be certain about what will happen. The problem is these new cases which do not yet correspond to any defined chain of transmission. As the daily evolution shows and due to a relatively long incubation, there is a real risk that new infections will break out in the countries already affected or in other countries in the coming days or weeks. Several cases in Spain and Italy appear in connection with a festive event on the Canary Islands between May 5 and May 15, which brought together 80,000 people, and having been able to play the role of propagating event. Similarly, in Spain, the country with the highest number of cases to date, a sauna in the capital seems to have been a hotbed of contamination .

In order to limit the spread of the virus, it is necessary to raise awareness and inform the communities and people concerned as well as the doctors, in order to quickly identify all cases and trace their contacts. A difficulty for doctors is that the lesions resemble those of chickenpox, and that genital lesions can be confused with the symptoms of certain STDs (syphilis, herpes, etc.). A PCR test and the isolation of the virus can confirm the diagnosis, but only certain specialized laboratories are equipped to carry out this type of analysis.

A rather reassuring point is that epidemics of monkeypox die out quite quickly spontaneously. The longest chain of transmission identified extended over 7 generations, in other words 7 humans pass the disease consecutively before the transmission stops .

The reasons for this spontaneous extinction of the spread are poorly understood. One hypothesis is that these epidemics have hitherto occurred in small villages, within communities of limited size with certain individuals potentially already immunized: the virus only infects people who have never been in contact with it. The 2003 epidemic in the United States had also stopped quickly, without secondary human-to-human contamination.
To be continued this time…

TC: Could the smallpox vaccine be used against this virus?

CB: Natural infection with the smallpox virus is known to confer cross-protection against monkeypox. In the 1980s, it was shown that the smallpox vaccine also conferred cross-protection, estimated at 85%. However, these estimates were made only a few years after mass vaccination campaigns aimed at eradicating smallpox. Currently, it is considered that the efficiency is more around 65% .

In addition, smallpox vaccination was suspended in the 1980s, after the eradication of the disease. Today only certain health personnel are still vaccinated (to be able to respond to a bioterrorist risk – the virus remaining stored under close surveillance in certain laboratories). The first generation of smallpox vaccine is no longer used, due to significant adverse effects.

For the moment, the vaccine most likely to be deployed if necessary is a so-called “3rd generation” vaccine, ^Imvamune (or Imvanex). It is an attenuated vaccine , however, unlike older vaccines, it can be given to immunocompromised people. It has already been used in Israel, Singapore, and the United Kingdom among healthcare workers and contacts of imported cases. Its effectiveness is currently being evaluated in the DRC, among health personnel .
^4th generation vaccines are also under development. These are “subunit” vaccines, which no longer contain attenuated virus, but only fragments. Their effectiveness is also being evaluated.

The vaccine can be used not only in pre-exposure (administration before encountering the virus), but also in post-exposure. In the United States, the recommendation is to administer it preferably within 4 days post-exposure, and up to 14 days.

TC: Is there a risk of seeing other monkeypox variants emerge? Is the genome of the virus currently circulating in Europe strictly the same as that of the West African strain?

CB: Since monkeypox is a DNA virus, it is less likely to mutate than RNA viruses like SARS-CoV-2.

It is quite easy to determine whether we are dealing with the West African strain or that of the Congo Basin: all that is needed is to sequence short specific sequences of its DNA. On the other hand, given the large size of the genome of this virus, it is longer and more tedious to obtain a complete sequence, which is necessary to detect sequence differences more finely, and thus establish chains of transmission and links. between cases. But the experience of SARS-CoV-2 has shown us that general mobilization could greatly speed things up...

The first sequencing carried out in a Portuguese patient and a Belgian patient highlight on the one hand the genetic proximity of this virus with those isolated in Nigeria and during previous exports of 2018 , and the similarity of the two genomes , evoking a community transmission in Europe. Other sequencing is necessary to answer all the persistent questions, and in particular to see if an adaptation of the genome is in progress and this towards a greater transmissibility of the virus. For the moment, there are no elements that go in this direction.

TC: To better understand monkeypox and its circulation dynamics. the Institut Pasteur and its partners in France and CAR set up the Afripox project in 2019 . What does it consist on ?

CB: This transdisciplinary project was set up after Emmanuel Yandoko Nakoune, who heads the laboratory for arboviruses, haemorrhagic fevers, emerging viruses and zoonoses at the Institut Pasteur de Bangui in CAR, reported an increase in the number of epidemics of monkeypox in the country.
More broadly, in recent decades there has been an increase in the number and frequency of monkeypox epidemics in Africa, as well as an expansion into areas where the disease was not endemic. Improved surveillance and waning immunity (smallpox vaccination was stopped in 1980) probably contribute to this increase, however it also seems to reflect increased viral circulation, in a region of the world experiencing disruptions. major environmental issues.
Faced with the large number of unknowns around the epidemiology of monkeypox, the idea of this project was to rely on the national surveillance already in place in the CAR to develop a One Health approach to monkeypox in focusing on its epidemiological, ecological, zoological, anthropological and virological aspects.

In partnership with researchers from the National Museum of Natural History, we are trying, for example, to identify its animal reservoir. With the SESSTIM team in Marseille, we are exploring the ecology of the disease in order to understand, for example, what explains its rather forest-based distribution, to identify the impact of deforestation on epidemics, to determine whether there is a seasonality , etc.

The development of diagnostic PCR tests that can be used in the field, by the team of the Emergency Biological Intervention Unit (Cibu) at the Institut Pasteur in Paris, is also one of the goals of Afripox (currently, the suspect samples are analyzed in Bangui). This would reduce the confirmation time and facilitate the rapid implementation of appropriate measures.

Finally, the epidemiological and anthropological aspects are explored by teams from the Institut Pasteur Paris (Emerging Disease Epidemiology Unit and Anthropology and Ecology of Disease Emergence Unit), in collaboration with local researchers, in order to determine more precisely what are the risk factors for zoonotic or human-to-human transmission, and why monkeypox has been on the rise since the 1980s. Indeed, while understanding the dynamics of this new human-to-human epidemic and its relatively unprecedented, understanding the emergence and circulation of monkeypox on its continent of origin is just as fundamental.

When Afripox was set up 3 years ago, few people imagined that this disease might one day leave the African continent to spread across the planet. The current epidemic once again underlines the importance of investing in scientific research over the long term, in order to prepare for all eventualities...


https://theconversation.com/variole-...ouvelle-183517

[Pathfinder]

ECDC :

"If human-to-animal transmission occurs, and the virus spreads in an animal population, there is a risk that the disease could become endemic in Europe. As such, there needs to be a close intersectoral collaboration between human and veterinary public health authorities to manage exposed pets and prevent the disease from being transmitted to wildlife."

https://flutrackers.com/forum/forum/europe/emerging-diseases-other-health-threats-ad/monkeypox-aa/949597-ecdc-presents-monkeypox-response-options-as-nine-eu-eea-countries-report-cases-may-23-2022

[alert]

She updated her post this morning. She has not received her test results yet, but does not believe she has monkeypox. She uploaded a picture of her rash:

Sarah Eaglesfield on Twitter: "If anyone's following this - the rash is looking a lot more Safe for Work now. Again, * Not Monkeypox * (as far as we know) but this is where we're at on Day 6, and awaiting swab results. Sorry for bad photo, hard to take. This is basically all over my body. https://t.co/a1i3trAU9e" / Twitter

Sarah Eaglesfield (@zenxv) / Twitter

She has now officially tested negative for monkeypox.

[sharon sanders]

There is a CDC presser going on right now:



Helen Branswell

@HelenBranswell

12m
#Monkeypox:
@CDCgov
says there is 1 confirmed monkeypox & 4 confirmed orthopoxvirus infections in the U.S. CDC will do confirmatory testing on the 4 orthopox specimens when it gets them from states today or tomoro, but says the people should be treated as monkeypox cases for now.