Discussion - Thoughts on a global outbreak of monkeypox

[sharon sanders]

Former FDA Commissioner: U.S. Can Still 'Catch Up' On Monkeypox


“I think there’s a potential to get this back in the box, but it’s going to be very difficult," Scott Gottlieb said Sunday.
Aug 8, 2022, 12:27 AM EDT


snip

Gottlieb had previously said the U.S. had probably failed to contain monkeypox after stumbling during its initial efforts to address the virus when the first case was reported in the country in May. He said Sunday that while there still remained a low chance a member of the general public would be impacted by the disease, officials should still be testing as many people as possible.

“I think that probably the incidence of this infection in the broader community is still very low,” he said. “But if we want to contain this, if we want to prevent this from becoming an endemic virus, we need to be looking more widely for it. And the worst-case scenario is that we start testing more broadly and we don’t find it. And that would be reassuring. But we should be doing that.”

more...

https://www.huffpost.com/entry/scott-gottlieb-monkeypox-catch-up_n_62f082e7e4b0ecfe3f71bf6d

 

[Pathfinder]

Translation Google

Monkeypox. Primates suspected of having a link to the disease have been attacked in Brazil

The WHO deplored this Tuesday, August 9, 2022 that monkeys, suspected of spreading smallpox of the same name, were attacked in Brazil. The organization recalls that the current epidemic of “monkeypox” is not linked to animals.

Ouest France
with AFP.
Published on 08/09/2022 at 6:02 p.m.

The World Health Organization assured this Tuesday, August 9, 2022 that the monkeypox epidemic raging around the world is not linked to these animals, deploring that primates could have been attacked in Brazil.

"People need to know that the transmission we're seeing now is between humans ," WHO spokeswoman Margaret Harris told a regular press briefing in Geneva.

Poisoned monkeys in Brazil

She was being questioned about reports of attacks on monkeys in Brazil. The Brazilian news site G1 reported that a dozen were poisoned, and some injured, in less than a week in a nature reserve in Rio do Preto, in the state of Sao Paulo.

Others were stoned or chased or poisoned in different Brazilian cities, according to G1, which quotes the association for the fight against illegal wildlife trafficking Renctas.

Brazil has reported more than 1,700 cases and one death, according to WHO statistics. Worldwide, more than 28,100 cases and 12 deaths have been reported.

Monkeypox virus present in many species

The term monkeypox was used when this virus was discovered in 1958 in monkeys in a laboratory in Denmark, but the virus has been demonstrated in different animal species, especially rodents. The first human case was detected in 1970 in the Democratic Republic of Congo (DRC).

This virus can be transmitted from animals to humans, but the recent explosion in cases worldwide is due to transmission between humans during close contact, said Margaret Harris.

People "definitely shouldn't prey on animals," she said, stressing that the best way to curb the spread of the virus was to recognize the symptoms, get help from a doctor and to take "precautions to prevent transmission".

Do not stigmatize infected people

The group most affected by the epidemic are men who have sex with men. The WHO calls not to stigmatize infected people.

Are you planning to get vaccinated against monkeypox?

“Any stigma […] will increase transmission, because if people are afraid to say they are infected, they will not seek treatment and take precautions ,” said Margaret Harris.
...
https://www.ouest-france.fr/sante/v...u-bresil-a8f2a41e-17fa-11ed-b983-aa206fd41485

 

[Shiloh]

Source: https://www.startribune.com/minneso...s-says-she-struggled-to-get-tested/600196968/

Minnesota flight attendant with monkeypox symptoms says she struggled to get tested
Clinicians don't need approval before sending samples for monkeypox testing, but must be careful to collect useable specimens, state advises.
By Jeremy Olson Star Tribune
August 9, 2022 — 3:25pm

Joan Sullivan has cold symptoms and pimple-like rashes on her body, and zero idea yet whether it is all because of monkeypox.

The 29-year-old Minneapolis flight attendant struggled for five days to seek testing from the Minnesota Department of Health and two designated clinics in the Twin Cities. While clinics are urging testing for men who have sex with other men — the risk group making up almost all of the state's 55 known infections — Sullivan said she worries this focus could miss possible cases like hers that fall outside the norm...

...The Red Door Clinic in Minneapolis and Clinic 555 in St. Paul were promoted last week as testing locations to provide easy and familiar access to the primary risk group of men who have sex with other men. However, any clinician can swab rashes on suspect patients and send the samples to the state public health lab or commercial labs such as Mayo Clinic for results.

..After failing since Thursday to reach anyone at Red Door or Clinic 555 to schedule testing, Sullivan went on Monday to her primary care clinic. A provider swabbed lesions and sent the specimens to the state lab, with results expected almost a week after she first sought testing. She received a call from the Red Door Clinic later that day...

...Sullivan said she wonders if she was infected while working on recent flights to England or California, or during long layovers. One person in her close social network has reported symptoms as well, though.

"Everyone in the bubble has kind of locked into their own home until we figure out who are the sick ones," said Sullivan, who first experienced symptoms two weeks ago and took a COVID-19 test, which was negative.

A week into her illness, Sullivan started complaining about the "worst acne flareup in years," she said. A sexual partner, who works as a paramedic, suggested it could be monkeypox. In her isolation, Sullivan has entertained herself and others with TikTok videos, including one on the mittens and other strategies to stop scratching her rashes. One update netted 130,000 views...

 

[sharon sanders]

bump this

 

[sharon sanders]

Please see:

Discussion - Monkeypox vaccine

 

[sharon sanders]

A response I made to someone. This is my opinion and is NOT MEDICAL ADVICE. No slam intended to seniors below - I am one - but as a group seniors are mostly dependant on society (i.e. social security income payments and medicare) and contribute to society less and less as they age.

If you have any medical questions, please contact your medical practitioner.


"Hi!

It appears there is a gov reluctance to use the ACAM2000 stockpile - probably why they want to split the doses of Jynneos. The company wrote a letter not really supporting the split idea because they didn't test it to be administered that way.

As to monkeypox. While having a very low fatality rate in Europe and North America, it could become very disruptive due to societies' reaction. 1) It takes weeks for the scabs to heal over with a new layer of skin. At this time work places are banning people from returning while the scabs are still on the body. This has the potential to really disrupt supply chains. Workers sitting at home for a month. 2) The scabs can look horrendous. People will be afraid to catch this disease. They may act out in all types of bad behaviors to avoid people who are scabby. 3) If this spreads in schools parents of young children will have to take a month leave to sit at home with them. No daycares will take the children either due to the fomite manner of spreading. This could really impact our most vital adult age group. 4) The spread in general society remains to be seen. We will shortly know. If monkeypox is as spreadable as the CDC says we are in for a wild ride.

So while not fatal in the current circulating strain - a potential problem exists for supply chains and the supply of critical workers - people of child bearing age - roughly 20-50.

Large disruptions in supply chains is a threat to public health.

I suspect the vaccine will be made mandatory for school age children as an attempt to keep their parents working. The vaccine was not originally approved for the under 18 group.

In a bizarre way the fatal covid situation could prove less disruptive than a monkeypox outbreak. Covid most adversely hit our non-productive adults - our seniors. Monkeypox is hitting our most productive age group - the fabric of society,

Some random thoughts. Tell your friends to be prepared for supply chain problems if the monkeypox outbreak continues its community spread.

All we can do is make information available so people can decide for themselves.

fondly,

Sharon"

 

[Pathfinder]

• Date 16.08.2022
• Author Clare Roth

Monkeypox in kids is rare but infections can be serious
...

Small number of monkeypox cases in children globally


Countries like the US, France, the Netherlands and Spain have reported cases of the disease in children.

Globally, there had been 103 cases in children aged 17 and younger, according to the World Health Organization (WHO). Of those, 26 cases were reported in children aged 0 to 4. The total number of monkeypox patients whose age was known stood at 19,591 as of August 12.

Overall, more than 34,000 cases of monkeypox have been reported from across the world so far.

How monkeypox affects kids

There is little evidence from countries where monkeypox is non-endemic to understand how the virus could affect kids.

During a 2003 monkeypox outbreak in the US (which officials think could have been caused by human contact with prairie dogs), 28 people were reported to have been infected and only two experienced serious clinical illness — both were children. They recovered.

Aside from that, information about pediatric cases is sparse outside Africa, where monkeypox is endemic in at least eight countries. But studying how the illness affects kids in Africa can offer some potential insight.

Between 2001 and 2021, monkeypox death rates in the Central African Republic were higher in children than in adults: 9.6% of kids versus 5.2% of adults died, according to Paul Hunter, a professor of health protection at the Norwich Medical School in the UK. This information was shared at a WHO conference.

And during a 1985 outbreak in Zaire, death rates were highest among children aged four and under, at a rate of 14.9%, followed by 6.5% in kids aged 5-9 years, according to a study published in The Journal of Infectious Diseases. There were no deaths in kids aged 10 years and up.

"Children, especially children under 5, remain at higher risk of severe disease," said Hunter. "But we are seeing a much lower overall mortality in the current pandemic and I suspect a significant part of that is down to better access to health care."

Overall, Hunter said that although the risk of severe disease and death in very young children is indeed greater than in healthy adults, it will still be "quite a bit lower than we have seen in Africa in recent years."
...
https://www.dw.com/en/monkeypox-in-kids-is-rare-but-infections-can-be-serious/a-62767781

 

[Emily]

https://twitter.com/GYamey/status/1554776266863247361


Prof. Gavin Yamey MD MPH @GYamey

Beware of fake monkeypox stories—these are clickbait, they have nothing to do with science or public health There are lots of them out there, e.g. the one about the guy who says he got MPX from riding a scooter that he bought online. Fake! (H/T @SergioEfe)
5:28 AM · Aug 3, 2022



Dr Iulia Hammond @iuls

Replying to@GYamey
and@SergioEfe

Are you able to signpost to accounts that are keeping on top of monkeypox and are reputable (for myself but also so I can pass along), please.
5:33 AM · Aug 3, 2022




Prof. Gavin Yamey MD MPH @GYamey

Replying to@iuls
and@SergioEfe

Yes, there are many, but some of the excellent folks that I follow to stay on top of MPX information are @reluctantlyjoe
@Boghuma
@klts0
@teozka
@DrWillN

6:11 AM · Aug 3, 2022



https://twitter.com/SergioEfe/status...78864429285376


SergioEfe @SergioEfe

Replying to@GYamey

FYI here you have some info about the scooter story (basically it is a fake account specialising in political propaganda). https://eldiario.es/rastreador/autor-hilo-viruela-mono-tocar-patinete-cuenta-reutilizada-foto-falsa-borrado-mensajes_132_9217199.html

Julián Macías Tovar
@JulianMaciasT
Aug 1

Estimados tuiteros que habéis hecho 25K retuits, y decenas de medios que difundisteis el hilo creando alarma social sanitaria de una cuenta que fue creada en 2013 para luchas internas del PSOE y que usa imágenes de un atleta conocido y de Adidas en su imagen de perfil. STOP
Show this thread




5:39 AM · Aug 3, 2022




Prof. Gavin Yamey MD MPH
@GYamey

Thank you
5:51 AM · Aug 3, 2022

 

[Pathfinder]

Translation google

Monkey pox "is not benign", warns epidemiologist Antoine Flahault

The director of the Institute of Global Health at the University of Geneva warns of the constant increase in the number of cases of monkeypox.

Ouest France
Published on08/17/2022 at 2:45 p.m.

The number of cases of monkey pox worldwide since the beginning of the year could exceed 80,000 by the end of August, epidemiologist Antoine Flahault warned in the Sunday Journal on August 16, 2022. So far, 27,800 positive cases have been recorded.

“The number of cases in the world doubles every two weeks or so and growth has not slowed down in the last month,” said the director of the Institute of Global Health at the University of Geneva.
...

Antoine Flahault, still in the JDD , also warns that Monkeypox "is not benign" . “40% of patients have complications...
...
https://www.ouest-france.fr/sante/vi...5-6d615aeeb143

 

[Pathfinder]

Sex between men, not skin contact, is fueling monkeypox, new research suggests

The claim that skin-to-skin contact during sex between men, not intercourse itself, drives most monkeypox transmission is likely backward, a growing group of experts say.

Aug. 17, 2022, 9:47 AM CST
By Benjamin Ryan

Since the outset of the global monkeypox outbreak in May, public health and infectious disease experts have told the public that the virus is largely transmitting through skin-to-skin contact, in particular during sex between men.

Now, however, an expanding cadre of experts has come to believe that sex between men itself — both anal as well as oral intercourse — is likely the main driver of global monkeypox transmission. The skin contact that comes with sex, these experts say, is probably much less of a risk factor.
...
“A growing body of evidence supports that sexual transmission, particularly through seminal fluids, is occurring with the current MPX outbreak,” said Dr. Aniruddha Hazra, medical director of the University of Chicago Sexual Wellness Clinic, referring to monkeypox and to recent studies that found the virus in semen.
...
“It looks very clear to us that this is an infection that is transmitting sexually the vast majority of the time,” Allan-Blitz said.
...
Dr. Rosamund Lewis, technical lead for monkeypox at the World Health Organization, told NBC News it was “unfortunate but true” that “we don’t know yet” whether the virus is predominantly transmitted through intercourse.
...
“At this point,” said Dr. Paul Adamson, an infectious disease specialist at the UCLA School of Medicine, “I’m not sure we can say it is primarily the sexual transmission and not the skin-to-skin contact that also occurs during sex that is contributing to the most transmission during this current outbreak. However, emerging data seem to suggest that monkeypox might be more efficiently transmitted sexually.”
...
Dr. Oriol Mitjà, an associate professor in infectious disease at the University Hospital Germans Trias i Pujol in Spain and the joint senior co-author of the study in The Lancet, said monkeypox transmits most efficiently when lesions come into contact with mucus membranes in the anorectal area, genitals, mouth and throat.
...
“If we accept that this is how it’s spread, we know how to reduce the spread: by awareness and education and encouraging people for the time being to reduce sex with multiple partners until they get vaccinated,” Klausner said “And if they can’t reduce the behavior, to try to use a condom.”

CDC spokesperson Kristen Nordlund said the agency’s recent analyses “show most diagnosed cases of monkeypox in the United States are associated with sexual and intimate contact, which can involve a range of behaviors. Additional analyses are needed to understand if specific sexual and intimate behaviors that occur during sex are disproportionately contributing to spread.”

Harvard’s Lao-Tzu Allan-Blitz acknowledged the pervasive concern that telling the public that monkeypox transmits sexually among gay men will fuel homophobia. He said there is, however, also a cost to keeping quiet about how the virus apparently transmits: This keeps people at risk from best understanding how to protect themselves.

“In our silence, we can also do harm,” he said.

https://www.nbcnews.com/nbc-out/out-...ests-rcna43484

 

[Emily]

Regarding that woman who is described as the first monkeypox-infected woman in Georgia and who is claiming she thinks she got the virus at work from handling money as she makes thousands of dollars from her self-started Gofundme...this is the public health dept's statement about the likely source of her infection:

https://www.wsbtv.com/news/local/atl...L45OP5AOXKSMA/

Atlanta DPH confirms first case of monkeypox in female in Georgia

The Georgia Department of Public Health says the state has confirmed its first case of monkeypox in a female.

The health department said the woman had close person contact with a man that was previously diagnosed with the virus.

In fact, the same Atlanta outlet that reported the public health information later ignored their own report and did an 'exclusive' interview with the woman without questioning her sensationalistic claim.

https://www.wrdw.com/2022/07/26/heal...-case-georgia/

Health officials announce first female monkeypox case in Georgia
She reported contact with an infected individual

This is CDC's headquarters. You would hope for better journalism there, instead of poorly fact-checked sensationalism that is spreading anxiety-provoking misinformation.

 

[Pathfinder]

LGBTQ+ festival Southern Decadence will test monkeypox precautions in New Orleans

August 20, 20228:03 AM ET
Heard on Weekend Edition Saturday
SSimon
SCOTT SIMON


Scott Simon speaks with New Orleans Health Department Director Dr. Jennifer Avegno about the huge LGBTQ+ gathering Southern Decadence amid the ongoing monkeypox outbreak.

SCOTT SIMON, HOST:

Southern Decadence is sometimes known as Gay Mardi Gras - one of the largest LGBTQ events in the country, drawing in past years massive crowds, mostly men, to New Orleans for Labor Day weekend. But this year, monkeypox casts a shadow over Southern Decadence. We're joined now by the director of the New Orleans Health Department, Dr. Jennifer Avegno.
...

SIMON: A big outdoor concert has been canceled because of concerns about having that many people in close quarters. Is that going to be enough? What's your thought?

AVEGNO: Well, New Orleans is no stranger to understanding the effects of a high-risk event during the early days of a pandemic. We only have to look to Mardi Gras 2020 to understand what happened in the aftermath. And so Southern Decadence brings generally about 250,000 individuals, mainly to the French Quarter, which has very narrow streets. And so it has a lot of close contact. So in our conversations with the venues, they're all really taking stock of what they feel is safe for them, safe for their staff, safe for our community and safe for folks who might be there. And they're making their decisions based on that - you know, understanding we have more tools to fight monkeypox, but that still might not be enough for organizers to want to have the safe event that they planned.

SIMON: So keep your distance.

AVEGNO: Keep your distance. Wear long sleeves. Wear long pants. If you've been to New Orleans in August and September, you know, that's kind of an impossibility. It's pretty hot here.
...
https://www.npr.org/2022/08/20/1118...ill-test-monkeypox-precautions-in-new-orleans

 

[Emily]

https://news.yahoo.com/u-monkeypox-cases-may-peaking-223107451.html
U.S. monkeypox cases may be peaking, experts say

Julie Steenhuysen

Thu, August 25, 2022 at 6:31 PM
CHICAGO (Reuters) - Monkeypox cases in some large U.S. cities appear to be declining, matching trends seen in Europe, and experts are cautiously optimistic the outbreak may have peaked in places hit hardest hit by the virus.

The World Health Organization earlier on Thursday said monkeypox cases reported globally declined 21% last week, after a month-long trend of rising infections, but noted that U.S. cases continued to rise.

Nevertheless, some U.S. experts believe cases are starting to decline based largely on immunity from prior infection and behavior changes as awareness of the disease has grown. That does not mean the disease will be contained, they cautioned...

 

[Emily]

Insightful article but I don't think being inaccurate about risk to make people feel less alone is the best approach. Compassion is needed.

https://www.insider.com/i-had-monkeypox-the-physical-and-emotional-pain-were-excruciating-2022-8
I got monkeypox at my first Pride party in years. The physical pain was excruciating — but the intrusive feelings of self-loathing were worse.

Hilary Brueck
20 hours ago

 

[alert]

Another reminder that monkeypox is NOT strictly a sexually transmitted disease!

I've seen several comments on various articles from around the world suggesting that monkeypox infection in anything other than a gay man was a sign of some kind of foul play. Cases in children have been suggested as a sign of child sexual abuse. Cases in women have been suggested as a sign of closet homosexuality in their spouse. Cases in animals such as dogs have been suggested as evidence of bestiality. Even more alarming, these comments have suggested that the "solution" to this problem is vigilante violence against the supposed predator/adulterer/etc. (who may or may not be another monkeypox case themselves).

Wrong on so many levels that I feel like this is a coordinated disinformation attempt...there are plenty of common non-sexual exposures that can and likely do explain these cases. Doctors in Nigeria have been reporting family clusters of monkeypox for years. Even if a case was determined to be the result of some kind of criminal act, which is unlikely, there is a justice system for handling such issues. Violence as a disease prevention mechanism is literally medieval.

I'm tempted to open up a new thread here to expose the sources of these posts on various articles, but I suspect many of them are just propaganda bots.

 

[Emily]

Please don't start a thread like that, Alert. Some haters are real and dangerous. Any worthwhile site would remove calls for violence if reported. Just leave a site if it is not moderated decently. You only increase a site's future sales price by participating or even viewing it.
I just hope the social media hate and fear doesn't spill over into real life like it did with Ebola. I read about kids being cruelly bullied because of that. And things are still bad for Covid unvaccinated. It's hard to be optimistic about what's ahead. Scapegoating is a real danger in dysfunctional systems.

 

[Emily]

False positives resulting in unnecessary treatment.

https://flutrackers.com/forum/forum...-infant-one-patient-got-unnecessary-treatment

 

[Emily]

https://www.wired.com/story/monkeypox-cases-falling-united-states/

Maryn McKenna

Science
Sep 15, 2022 12:01 PM

Monkeypox Cases in the US Are Falling. There's No One Reason Why



Many people changed their behavior, the vaccines might be helping, and the virus might someday burn itself out—but there’s not enough data to know.

 

[Pathfinder]

https://www.wired.com/story/monkeypox-cases-falling-united-states/

Maryn McKenna

Science
Sep 15, 2022 12:01 PM

Monkeypox Cases in the US Are Falling. There's No One Reason Why



Many people changed their behavior, the vaccines might be helping, and the virus might someday burn itself out—but there’s not enough data to know.

Excerpt from post #43

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

Published: May 22, 2022 12.37pm EDT Updated: May 23, 2022 2.52am EDT
...
Camille Besombes
Infectiologist in epidemiology thesis - Epidemiology of Emerging Diseases Unit, Institut Pasteur
...
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.
...
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…

GO TO POST

 

[Pathfinder]

WHO Director-General's opening remarks at media briefing – 12 October 2022

12 October 2022
...

On monkeypox, more than 70,000 cases have now been reported to WHO, with 26 deaths.

Globally, cases are continuing to decline, but 21 countries in the past week reported an increase in cases, mostly in the Americas, which accounted for almost 90% of all cases reported last week.

Once again, we caution that a declining outbreak can be the most dangerous outbreak, because it can tempt us to think that the crisis is over, and to let down our guard.

That’s not what WHO is doing.

We are continuing to work with countries around the world to increase their testing capacity, and to monitor trends in the outbreak.

We are concerned about reports of cases in Sudan, including in refugee camps near the border with Ethiopia.

Like COVID-19, monkeypox remains a public health emergency of international concern, and WHO will continue to treat it as such.

===
https://www.who.int/news-room/speec...ng-remarks-at-media-briefing---12-october-202