Tweet
Too late to prevent monkeypox, but perfect timing to facilitate recombination between the wild virus and the live vaccine virus?
Vaughan A, Aarons E, Astbury J, et al. Human-to-Human Transmission of Monkeypox Virus, United Kingdom, October 2018. Emerg Infect Dis. 2020;26(4):782-785. doi:10.3201/eid2604.191164
Abstract
In September 2018, monkeypox virus was transmitted from a patient to a healthcare worker in the United Kingdom. Transmission was probably through contact with contaminated bedding. Infection control precautions for contacts (vaccination, daily monitoring, staying home from work) were implemented. Of 134 potential contacts, 4 became ill; all patients survived.
Keywords: Monkeypox, monkeypox virus, orthopoxvirus, transmission, nosocomial, human, viruses, zoonoses, United Kingdom
...
The transmission reported here occurred from a patient with a travel-associated case to an HCW. The only exposure risk identified during assessment of patient 3 was the changing of potentially contaminated bedding, when patient 2 had multiple skin lesions but before a diagnosis of monkeypox had been considered. The use of standard PPE may not have afforded sufficient protection against monkeypox, particularly if skin lesion debris containing virus had been disturbed and inhaled when bedsheets were changed.
Although patient 3 received postexposure vaccination before symptom onset, vaccination was >4 days after the most recent exposure to patient 2. The optimal timing for postexposure vaccination with Imvanex remains unknown, and the postexposure window period chosen for this incident was informed, in part, by that used during the US outbreak in 2003 (6). Patient 3 may have been vaccinated too late to prevent monkeypox...
Vaughan A, Aarons E, Astbury J, et al. Human-to-Human Transmission of Monkeypox Virus, United Kingdom, October 2018. Emerg Infect Dis. 2020;26(4):782-785. doi:10.3201/eid2604.191164
Abstract
In September 2018, monkeypox virus was transmitted from a patient to a healthcare worker in the United Kingdom. Transmission was probably through contact with contaminated bedding. Infection control precautions for contacts (vaccination, daily monitoring, staying home from work) were implemented. Of 134 potential contacts, 4 became ill; all patients survived.
Keywords: Monkeypox, monkeypox virus, orthopoxvirus, transmission, nosocomial, human, viruses, zoonoses, United Kingdom
...
The transmission reported here occurred from a patient with a travel-associated case to an HCW. The only exposure risk identified during assessment of patient 3 was the changing of potentially contaminated bedding, when patient 2 had multiple skin lesions but before a diagnosis of monkeypox had been considered. The use of standard PPE may not have afforded sufficient protection against monkeypox, particularly if skin lesion debris containing virus had been disturbed and inhaled when bedsheets were changed.
Although patient 3 received postexposure vaccination before symptom onset, vaccination was >4 days after the most recent exposure to patient 2. The optimal timing for postexposure vaccination with Imvanex remains unknown, and the postexposure window period chosen for this incident was informed, in part, by that used during the US outbreak in 2003 (6). Patient 3 may have been vaccinated too late to prevent monkeypox...