Washington wants to vaccinate contact cases against monkeypox
The United States has two smallpox vaccines approved by the United States Medicines Agency that can be used against monkeypox.
The disease, a less dangerous cousin of smallpox, which was eradicated some forty years ago, begins with a high fever and quickly progresses to a scabbing rash.
AFP
The United States is preparing to vaccinate people who have been in close contact with monkeypox patients as the country, which now has five probable or confirmed cases, expects their numbers to rise.
“We want to maximize vaccine distribution to those we know would benefit,” Centers for Disease Control and Prevention (CDC) manager Jennifer McQuiston said Monday.
“That is, those who have been in contact with a known monkeypox patient, like caregivers, very close personal contacts, especially those who are at risk of developing a severe case of the disease,” he told a news conference.
Five possible cases
One case has been confirmed in Massachusetts and four others are being analyzed but considered highly likely (one in New York, one in Florida, two in Utah). All are men who have traveled outside of the United States.
The disease, a less dangerous cousin of smallpox, which was eradicated some forty years ago, begins with a high fever and quickly progresses to a scabbing rash. It is these lesions that allow transmission of the disease in the event of contact. What fascinates and worries the experts is the co-occurrence of cases in many countries, particularly in Europe, without being linked to returnees from African countries where the disease is endemic.
US authorities confirmed that the sequencing of the virus discovered in Massachusetts matched that identified in a patient in Portugal and that the strain was the one found in West Africa, the less serious of the two in circulation. Most infected people recover spontaneously within two to four weeks without specific treatment.
Two vaccines
But the American authorities are still preparing the answer. Two smallpox vaccines approved by the United States Food and Drug Administration (FDA) can be used. The first, ACAM2000, is a live attenuated vaccine that is not recommended for people with a compromised immune system. The United States has 100 million doses.
Because of “potentially significant” side effects, its widespread adoption would require “a real discussion,” estimated Jennifer McQuiston. The second, Jynneos, is also a live but non-replicating vaccine and is therefore considered safer. The United States has just 1,000 cans, but that number is “expected to increase rapidly in the coming weeks,” according to the official.
She says the data shows that both of these vaccines can help prevent the disease from developing if given quickly after exposure. She also emphasized that the risk of infection for the population as a whole remains low. Among the populations most at risk, according to John Brooks, an epidemiologist, are those with weakened immune systems and those with specific skin conditions such as eczema.
skin rashes
Rashes caused by monkeypox result in lesions that may be centered in specific areas or spread throughout the body. In some cases, the rashes may appear in the genital or perianal areas during the first phase of the disease.
Transmission of the virus occurs through prolonged skin-to-skin contact with someone who has an active lesion, or through respiratory droplets from someone with oral lesions and being in close proximity to another person for some time.
While scientists are concerned that the growing number of cases may point to a new mode of transmission, so far there’s no concrete evidence to support this theory, Jennifer McQuiston said. Thus, the increase in case numbers could be linked to specific propagation events within the gay community, explaining a higher prevalence among gay and bisexual men.
But that “in no way” means, according to John Brooks, that “current risk of exposure to monkeypox is unique to the gay and bisexual community.” The CDC is also developing treatment guidelines to allow the use of the antivirals tecovirimate and brincidofovir, both of which are already approved for the treatment of smallpox.
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