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Discussion - Thoughts on a global outbreak of monkeypox
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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....
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Gee, where'd they get that idea from?
There’s evidence that British colonists in 18th-century America gave Native Americans smallpox-infected blankets at least once—but did it work?
"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. "
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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.
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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.
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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.
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