CHAT In response to questions ...
- Thread starter helen
- Start date
Profit of Doom
Dismember
IIRC, many members here have pet fish.Have we all got meds IN HAND should our fishies get an ailment? Meds might get scarce if everyone's fish-tank gets icky at the same time.
Many of our fish have pet humans, they can get medicines for us from alldaychemist, I have heard they work just fine and have more variety.
helen
Panic Sex Lady
All of this is very good info.
I've used doxycycline for birds and lived. I think the dose packs are for larger weights.
I wonder if a fever should be allowed to burn, since that's what the body uses to cook bugs.
Zinc lozenges coat the mouth, throat, and gut. Zinc slows reproduction of bacteria. I've used that to treat colds, flu, and gut bugs. Zinc oxide for baby butts keeps diaper rash from getting infected.
Ok, that's to make you feel better. But the ONLY way to stop spreading monkeypox is quarantine. Isolation. Shelter in place orders. If that happens, obey. It's real.
Jward go to the freaking doctor!
I've used doxycycline for birds and lived. I think the dose packs are for larger weights.
I wonder if a fever should be allowed to burn, since that's what the body uses to cook bugs.
Zinc lozenges coat the mouth, throat, and gut. Zinc slows reproduction of bacteria. I've used that to treat colds, flu, and gut bugs. Zinc oxide for baby butts keeps diaper rash from getting infected.
Ok, that's to make you feel better. But the ONLY way to stop spreading monkeypox is quarantine. Isolation. Shelter in place orders. If that happens, obey. It's real.
Jward go to the freaking doctor!
Profit of Doom
Dismember
I believe you will find that the doses of bird meds is the same as used for humans, for the simple reason that bird and fish meds are made in the same factories as human meds, using the same materials, to the same FDA purity standards. Having separate supply lines and separate processing and packaging lines for what is essentially the same item would just be stupid. I believe that often the pill color and marking is the same, as well.
helen
Panic Sex Lady
Bird meds come in powder form. They sell empty gel caps, but I spill too much. Tried putting it in peanut butter and juice, but it tastes really bad. I gave up and just stirred it into water and gulped fast.
I doubt anyone on this board will get monkeypox. When you hear it's popped up on or near the border, that is a sign that shelter in place orders will follow.
The ten percent kill rate in Africa isn't a good indicator here. We have thousands of people in any geographic area with suppressed immune systems from chronic conditions here.
The outbreak of mumps is interesting because detention center staff is catching it. Mumps vaccination is required for public schools in the U.S. Is this a new strain?
Monkeypox differs from smallpox by causing swollen lymph nodes. Like mumps. Like bubonic plague. It's gonna get hard to tell which disease is presenting. Are you vaccinated against whatever you're looking at?
I don't sleep much. Sorry.
helen
Panic Sex Lady
One path is inevitable.
Everything that is happening is meant to steer us off that path. We have to get off that path.
I'm trying to show you what will happen. When it happens, you remember the other message. Stand down. The good guys can't expend energy fighting you too.
MaureenO
Another Infidel
jward
passin' thru
Thanks, I'm doin' ok. Promise. Will go if that changes.
..How bout you? Doing ok? You promise too?
..for nights the sleepy tea isn't enough..
Epic Emotional Heroic Music: ONE MANS STRENGTH | by Sky Mubs 3:12
Sleepsong ~ Lullaby from a Secret Garden
desertvet2
Veteran Member
Every two??? .yep, on a good night....
Funny, ( not funny). How we got re-wired like that...
HOOAH!!!
Sigh. I'm not one of the bad guys, Helen. I'm not sure what you are trying to say, but I was just wishing you a good night's sleep and a hug.
There are many dangers out there I know nothing about. You've given us warning of one. It's much appreciated.
L.A.B.
Goodness before greatness.
Here is a website I found doing a web-search on a name from the 90’s that was Open Source discussed in press and in radio interviews. ‘Dr. Larry Wayne Harris.’
I broke the link here
http://www.darkbiology.com/plague.
htm
I broke the link here
http://www.darkbiology.com/plague.
htm
It didn't work for me LAB. I got a "404 Page Not Found" message.
Caplock50
I am the Winter Warrior
Pinecone, I don't believe Helen was calling you a 'Black Hat'. I believe what she was saying was that the 'White Hats' need us 'Good Guys' to get out of their way so they can deal with the 'Black Hats' without worrying about 'hitting' us instead.
L.A.B.
Goodness before greatness.
I broke the link by eliminating the htm at the end.
Here you go:
http://www.darkbiology.com/plague.htm
MaureenO
Another Infidel
((((Helen)))))
https://www.nhs.uk/conditions/monke...s a rare disease,on its own without treatment.
Monkeypox
Monkeypox is a rare disease caused by infection with the monkeypox virus.
Most cases have been in Africa. The risk of catching monkeypox in the UK is very low.
It's usually a mild illness that will get better on its own without treatment. Some people can develop more serious symptoms, so patients with monkeypox in the UK are cared for in specialist hospitals.
What is the risk of catching monkeypox in the UK?
There have been 3 cases of monkeypox in the UK in September 2018. The first 2 were in people who had travelled from Africa.
The third person was a healthcare worker who cared for one of the 2 first cases. The healthcare worker was infected before monkeypox was suspected and special precautions were put in place.
Public Health England has already contacted everyone who was known to be in close contact with the 3 infected people.
If you haven't been contacted by Public Health England, be reassured you are extremely unlikely to catch monkeypox.
Symptoms of monkeypox
The illness begins with:
high temperature
headache
muscle aches
backache
swollen glands
chills
exhaustion
A rash usually begins 1 to 5 days after the first symptoms appear. The spots often start on the face before spreading to other parts of the body.
During the illness the rash changes from raised red bumps, to spots filled with fluid. The spots eventually form scabs which later fall off.
How monkeypox is spread
Monkeypox does not spread easily between people, but it's possible to catch it from:
touching items like clothing, bedding or towels used by an infected person
touching monkeypox spots or scabs
a person with a monkeypox rash who coughs or sneezes near you
Diagnosis of monkeypox
It's difficult to know if the infection is monkeypox as it can often be confused with other infections such as chickenpox.
It is diagnosed after an examination by a specialist and testing by Public Health England.
Treating monkeypox
Treatment for monkeypox aims to relieve the symptoms and takes place in specialist hospitals.
Further information
Find more detailed information on monkeypox on GOV.UK.
Page last reviewed: 28 September 2018
https://www.nhs.uk/conditions/monke...s a rare disease,on its own without treatment.
Monkeypox
Monkeypox is a rare disease caused by infection with the monkeypox virus.
Most cases have been in Africa. The risk of catching monkeypox in the UK is very low.
It's usually a mild illness that will get better on its own without treatment. Some people can develop more serious symptoms, so patients with monkeypox in the UK are cared for in specialist hospitals.
What is the risk of catching monkeypox in the UK?
There have been 3 cases of monkeypox in the UK in September 2018. The first 2 were in people who had travelled from Africa.
The third person was a healthcare worker who cared for one of the 2 first cases. The healthcare worker was infected before monkeypox was suspected and special precautions were put in place.
Public Health England has already contacted everyone who was known to be in close contact with the 3 infected people.
If you haven't been contacted by Public Health England, be reassured you are extremely unlikely to catch monkeypox.
Symptoms of monkeypox
The illness begins with:
high temperature
headache
muscle aches
backache
swollen glands
chills
exhaustion
A rash usually begins 1 to 5 days after the first symptoms appear. The spots often start on the face before spreading to other parts of the body.
During the illness the rash changes from raised red bumps, to spots filled with fluid. The spots eventually form scabs which later fall off.
How monkeypox is spread
Monkeypox does not spread easily between people, but it's possible to catch it from:
touching items like clothing, bedding or towels used by an infected person
touching monkeypox spots or scabs
a person with a monkeypox rash who coughs or sneezes near you
Diagnosis of monkeypox
It's difficult to know if the infection is monkeypox as it can often be confused with other infections such as chickenpox.
It is diagnosed after an examination by a specialist and testing by Public Health England.
Treating monkeypox
Treatment for monkeypox aims to relieve the symptoms and takes place in specialist hospitals.
Further information
Find more detailed information on monkeypox on GOV.UK.
Page last reviewed: 28 September 2018
https://www.who.int/csr/don/16-may-2019-monkeypox-singapore/en/
Monkeypox – Singapore
Disease outbreak news
16 May 2019
On 9 May 2019, the Ministry of Health (MOH) in Singapore notified WHO of one laboratory-confirmed case of monkeypox. The case-patient is a 38 year old Nigerian man who arrived in Singapore on 28 April 2019 and attended a workshop from 29-30 April. Prior to his travel to Singapore, he had worked in the Delta state in Nigeria, and had attended a wedding on 21 April 2019 in a village in Ebonyi State, Nigeria.
The patient developed fever, muscle aches, chills and skin rash on 30 April. He reported that he had remained in his hotel room most of the time between 1 and 7 May. He was transferred to a public hospital by ambulance on 7 May and referred to the National Centre for Infectious Diseases (NCID) on the same day, where he was isolated for further management. Skin lesion samples were taken on 8 May and tested positive for monkeypox virus by the National Public Health Laboratory on the same day. He is currently in a stable condition.
Public health response
Based on investigations thus far, authorities in Singapore have traced and contacted a total of 23 close contacts, including 18 participants and trainers who attended the same workshop, one staff at the workshop venue, and four hotel staff who had close contact with the affected individual. Healthcare workers who were in contact with the patient had used personal protection equipment. MOH’s investigation and contact tracing operations are ongoing.
One of the 18 workshop participants had left Singapore before the patient was diagnosed. This contact is a Nigerian national who travelled by air to Nigeria on 5 May. The Nigerian national IHR focal point has been provided with details of the contact for follow up action, as necessary. Potential sources of exposure and possible epidemiological links within Nigeria are currently being investigated.
Close contacts of the affected individual were referred to NCID for further assessment and offered post-exposure prophylaxis with smallpox vaccination, which can prevent disease or reduce the severity of symptoms. As of 15 May 2019, 14 persons were vaccinated. As a precautionary measure, close contacts have been quarantined either at home or designated government quarantine facility and monitored for 21 days from their date of exposure to the confirmed case. If anyone develops symptoms, they will be treated at NCID. All other contacts, who have a low risk of being infected, have been placed under active surveillance, and will be contacted twice daily to monitor their health status.
Singapore MOH released a press statement on 9 May 2019, providing information about the situation, advice for the public, and measures being taken to minimize the risk of any potential onward transmission of the disease.
WHO risk assessment
Monkeypox is a sylvatic zoonosis with incidental human infections that occur sporadically in parts of Central and West Africa. It is caused by the monkeypox virus (MPXV) and belongs to the Orthopoxvirus family. The disease is self-limiting, with symptoms usually resolving spontaneously within 14-21 days. There is currently no vaccine specifically for monkeypox. The animal reservoir remains unknown, although it is likely to include rodents. Direct contact with affected live or dead animals through hunting and consumption of bush meat are presumed drivers of human infection.
This is the first diagnosed case of monkeypox infection in Singapore. The patient was a traveller arriving from Nigeria, where a multistate monkeypox outbreak has been ongoing since September 2017.
Given that authorities in Singapore have promptly initiated appropriate public health measures, including isolation of the primary case, contact tracing and quarantine, surveillance and risk communication, the risk of onward spread in the country is low.
WHO advice
Residents and travelers to endemic areas/countries should avoid contact with sick, dead or live animals that could harbor MPXV (rodents, marsupials, and primates) and should refrain from eating or handling bush meat. Hand hygiene using soap and water, or alcohol-based sanitizer should be emphasized. Any illness during travel or upon return should be reported to a health professional, including information about all recent travel and immunization history. There is no specific treatment or vaccine for the MPXV infection.
Timely contact tracing, surveillance measures and raising awareness of imported emerging diseases among health care providers are essential to prevent secondary cases and effectively manage monkeypox cases and outbreaks.
Health-care workers caring for patients with suspected or confirmed MPXV infection should implement standard, contact and droplet infection control precautions. Samples taken from people and animals with suspected MPXV infection should be handled by trained staff working in suitably equipped laboratories.
WHO does not recommend any restriction for travel to, or trade with, Singapore or Nigeria based on available information at this time.
For more information on Monkeypox:
WHO factsheet on monkeypox, 6 June 2018
WHO disease outbreak news, monkeypox, Nigeria, 21 December
Weekly epidemiological record (WER) no.11, 16 March 2018, Emergence of monkeypox in West Africa and Central Africa 1970-2017
Nigeria CDC, An Update of Monkeypox Outbreak in Nigeria
MOH Singapore press release
Monkeypox – Singapore
Disease outbreak news
16 May 2019
On 9 May 2019, the Ministry of Health (MOH) in Singapore notified WHO of one laboratory-confirmed case of monkeypox. The case-patient is a 38 year old Nigerian man who arrived in Singapore on 28 April 2019 and attended a workshop from 29-30 April. Prior to his travel to Singapore, he had worked in the Delta state in Nigeria, and had attended a wedding on 21 April 2019 in a village in Ebonyi State, Nigeria.
The patient developed fever, muscle aches, chills and skin rash on 30 April. He reported that he had remained in his hotel room most of the time between 1 and 7 May. He was transferred to a public hospital by ambulance on 7 May and referred to the National Centre for Infectious Diseases (NCID) on the same day, where he was isolated for further management. Skin lesion samples were taken on 8 May and tested positive for monkeypox virus by the National Public Health Laboratory on the same day. He is currently in a stable condition.
Public health response
Based on investigations thus far, authorities in Singapore have traced and contacted a total of 23 close contacts, including 18 participants and trainers who attended the same workshop, one staff at the workshop venue, and four hotel staff who had close contact with the affected individual. Healthcare workers who were in contact with the patient had used personal protection equipment. MOH’s investigation and contact tracing operations are ongoing.
One of the 18 workshop participants had left Singapore before the patient was diagnosed. This contact is a Nigerian national who travelled by air to Nigeria on 5 May. The Nigerian national IHR focal point has been provided with details of the contact for follow up action, as necessary. Potential sources of exposure and possible epidemiological links within Nigeria are currently being investigated.
Close contacts of the affected individual were referred to NCID for further assessment and offered post-exposure prophylaxis with smallpox vaccination, which can prevent disease or reduce the severity of symptoms. As of 15 May 2019, 14 persons were vaccinated. As a precautionary measure, close contacts have been quarantined either at home or designated government quarantine facility and monitored for 21 days from their date of exposure to the confirmed case. If anyone develops symptoms, they will be treated at NCID. All other contacts, who have a low risk of being infected, have been placed under active surveillance, and will be contacted twice daily to monitor their health status.
Singapore MOH released a press statement on 9 May 2019, providing information about the situation, advice for the public, and measures being taken to minimize the risk of any potential onward transmission of the disease.
WHO risk assessment
Monkeypox is a sylvatic zoonosis with incidental human infections that occur sporadically in parts of Central and West Africa. It is caused by the monkeypox virus (MPXV) and belongs to the Orthopoxvirus family. The disease is self-limiting, with symptoms usually resolving spontaneously within 14-21 days. There is currently no vaccine specifically for monkeypox. The animal reservoir remains unknown, although it is likely to include rodents. Direct contact with affected live or dead animals through hunting and consumption of bush meat are presumed drivers of human infection.
This is the first diagnosed case of monkeypox infection in Singapore. The patient was a traveller arriving from Nigeria, where a multistate monkeypox outbreak has been ongoing since September 2017.
Given that authorities in Singapore have promptly initiated appropriate public health measures, including isolation of the primary case, contact tracing and quarantine, surveillance and risk communication, the risk of onward spread in the country is low.
WHO advice
Residents and travelers to endemic areas/countries should avoid contact with sick, dead or live animals that could harbor MPXV (rodents, marsupials, and primates) and should refrain from eating or handling bush meat. Hand hygiene using soap and water, or alcohol-based sanitizer should be emphasized. Any illness during travel or upon return should be reported to a health professional, including information about all recent travel and immunization history. There is no specific treatment or vaccine for the MPXV infection.
Timely contact tracing, surveillance measures and raising awareness of imported emerging diseases among health care providers are essential to prevent secondary cases and effectively manage monkeypox cases and outbreaks.
Health-care workers caring for patients with suspected or confirmed MPXV infection should implement standard, contact and droplet infection control precautions. Samples taken from people and animals with suspected MPXV infection should be handled by trained staff working in suitably equipped laboratories.
WHO does not recommend any restriction for travel to, or trade with, Singapore or Nigeria based on available information at this time.
For more information on Monkeypox:
WHO factsheet on monkeypox, 6 June 2018
WHO disease outbreak news, monkeypox, Nigeria, 21 December
Weekly epidemiological record (WER) no.11, 16 March 2018, Emergence of monkeypox in West Africa and Central Africa 1970-2017
Nigeria CDC, An Update of Monkeypox Outbreak in Nigeria
MOH Singapore press release
https://www.healio.com/infectious-d...shows-evidence-of-human-to-human-transmission
Nigeria monkeypox outbreak shows evidence of human-to-human transmission
Rezza G. Lancet Infect Dis. 2019;doi:10.1016/S1473-3099(19)30281-6.
Yinka-Ogunleye A, et al. Lancet Infect Dis. 2019;doi:10.1016/S1473-3099(19)30294-4.
July 11, 2019
Adesola Yinka-Ogunleye, MPH
Adesola Yinka-Ogunleye
Since 2017, Nigeria has been experiencing the largest documented outbreak of human monkeypox caused by the West African clade of the virus, with some evidence of secondary human-to-human transmission, according to a newly published clinical and epidemiological report.
More than 300 cases have been reported in the outbreak as of April 2019, according to the CDC.
Prior to the outbreak, it had been 39 years since Nigeria’s last reported monkeypox case, Adesola Yinka-Ogunleye, MPH, senior epidemiologist at the Nigeria Centre for Disease Control, and colleagues noted in The Lancet Infectious Diseases.
According to Yinka-Ogunleye and colleagues, since smallpox was eradicated almost 4 decades ago, monkeypox has emerged as the most prevalent and important orthopoxvirus in humans.
“[This] study has shown that monkeypox is no longer a 'rare disease' as previously thought as cases of the disease continued to be reported since September 2017 when the resurgence was reported in Nigeria,” Yinka-Ogunleye told Infectious Disease News. “An improvement in the surveillance system in Nigeria is believed to have led to the detection of the outbreak and further improvement in the surveillance capacity will help achieve knowledge of the true burden of the disease.”
According to Yinka-Ogunleye and colleagues, since 1970, outbreaks and sporadic cases of monkeypox in Central and West Africa have been caused by two “distinct” clades of the virus, referred to as the Congo Basin clade and the West African clade. The Congo Basin clade has been associated with more severe disease and higher rates of fatality compared with the West African clade and was the only one documented to have been transmitted between people, they noted.
Because only sporadic cases occurred in West Africa, many experts hypothesized that the “West African clad had little or no propensity for human-to-human transmission,” Giovanni Rezza, MD, PhD, head of infectious diseases at the Italian Ministry of Health, wrote in a related editorial.
Yinka-Ogunleye and colleagues reviewed the epidemiological and clinical characteristics of cases of human monkeypox that occurred between Sept. 22, 2017, and Sept. 16, 2018.
They identified 122 confirmed or probable cases reported from 17 states. There were seven deaths, a 6% case fatality rate, according to the study. Infected individuals were aged between 2 days and 50 years, and 69% were male. All 122 patients had vesiculopustular rash, and it was also common to see fever, pruritus, headache and lymphadenopathy, according to Yinka-Ogunleye and colleagues.
Based on the distribution of cases and contacts, the researchers determined that the outbreak has included both primary zoonotic transmission, as well as secondary human-to-human transmission, including in a prison facility.
“The characteristics of the 2017-2018 outbreak suggest that the strains of monkeypox virus in West Africa could sustain epidemic events,” Rezza wrote.
He called the outbreak “to some extent unexpected,” saying it points to potential changes in the dynamics of monkeypox virus in West Africa.
“The determinants of human monkeypox emergence in Nigeria, including distribution of animal reservoirs and changes in human behavior, need to be identified,” Rezza wrote.
Yinka-Ogunleye and colleagues suggested improved surveillance, especially among animals.
“There are still gaps in the knowledge of the animal reservoir and the mode of transmission of monkeypox as well as lack of known definitive treatment for the disease. The Nigeria Centre for Disease Control is working with our animal sector counterparts to improve this knowledge through rodent trapping and testing,” Yinka-Ogunleye said.
“A preparedness and control strategy for monkeypox is required to contain the increasing incidence of the disease. Developing public health and surveillance capacities in Central and West Africa is important in guiding appropriate response to emerging and re-emerging diseases.” – by Marley Ghizzone
Nigeria monkeypox outbreak shows evidence of human-to-human transmission
Rezza G. Lancet Infect Dis. 2019;doi:10.1016/S1473-3099(19)30281-6.
Yinka-Ogunleye A, et al. Lancet Infect Dis. 2019;doi:10.1016/S1473-3099(19)30294-4.
July 11, 2019
Adesola Yinka-Ogunleye, MPH
Adesola Yinka-Ogunleye
Since 2017, Nigeria has been experiencing the largest documented outbreak of human monkeypox caused by the West African clade of the virus, with some evidence of secondary human-to-human transmission, according to a newly published clinical and epidemiological report.
More than 300 cases have been reported in the outbreak as of April 2019, according to the CDC.
Prior to the outbreak, it had been 39 years since Nigeria’s last reported monkeypox case, Adesola Yinka-Ogunleye, MPH, senior epidemiologist at the Nigeria Centre for Disease Control, and colleagues noted in The Lancet Infectious Diseases.
According to Yinka-Ogunleye and colleagues, since smallpox was eradicated almost 4 decades ago, monkeypox has emerged as the most prevalent and important orthopoxvirus in humans.
“[This] study has shown that monkeypox is no longer a 'rare disease' as previously thought as cases of the disease continued to be reported since September 2017 when the resurgence was reported in Nigeria,” Yinka-Ogunleye told Infectious Disease News. “An improvement in the surveillance system in Nigeria is believed to have led to the detection of the outbreak and further improvement in the surveillance capacity will help achieve knowledge of the true burden of the disease.”
According to Yinka-Ogunleye and colleagues, since 1970, outbreaks and sporadic cases of monkeypox in Central and West Africa have been caused by two “distinct” clades of the virus, referred to as the Congo Basin clade and the West African clade. The Congo Basin clade has been associated with more severe disease and higher rates of fatality compared with the West African clade and was the only one documented to have been transmitted between people, they noted.
Because only sporadic cases occurred in West Africa, many experts hypothesized that the “West African clad had little or no propensity for human-to-human transmission,” Giovanni Rezza, MD, PhD, head of infectious diseases at the Italian Ministry of Health, wrote in a related editorial.
Yinka-Ogunleye and colleagues reviewed the epidemiological and clinical characteristics of cases of human monkeypox that occurred between Sept. 22, 2017, and Sept. 16, 2018.
They identified 122 confirmed or probable cases reported from 17 states. There were seven deaths, a 6% case fatality rate, according to the study. Infected individuals were aged between 2 days and 50 years, and 69% were male. All 122 patients had vesiculopustular rash, and it was also common to see fever, pruritus, headache and lymphadenopathy, according to Yinka-Ogunleye and colleagues.
Based on the distribution of cases and contacts, the researchers determined that the outbreak has included both primary zoonotic transmission, as well as secondary human-to-human transmission, including in a prison facility.
“The characteristics of the 2017-2018 outbreak suggest that the strains of monkeypox virus in West Africa could sustain epidemic events,” Rezza wrote.
He called the outbreak “to some extent unexpected,” saying it points to potential changes in the dynamics of monkeypox virus in West Africa.
“The determinants of human monkeypox emergence in Nigeria, including distribution of animal reservoirs and changes in human behavior, need to be identified,” Rezza wrote.
Yinka-Ogunleye and colleagues suggested improved surveillance, especially among animals.
“There are still gaps in the knowledge of the animal reservoir and the mode of transmission of monkeypox as well as lack of known definitive treatment for the disease. The Nigeria Centre for Disease Control is working with our animal sector counterparts to improve this knowledge through rodent trapping and testing,” Yinka-Ogunleye said.
“A preparedness and control strategy for monkeypox is required to contain the increasing incidence of the disease. Developing public health and surveillance capacities in Central and West Africa is important in guiding appropriate response to emerging and re-emerging diseases.” – by Marley Ghizzone
https://wwwnc.cdc.gov/eid/article/25/5/19-0076_article
ISSN: 1080-6059
Volume 25
Number 5—May 2019
EID JournaledIn Email Syndicate
Volume 25, Number 5—May 2019
Dispatch
Diagnosis of Imported Monkeypox, Israel, 2018
Abstract
We report a case of monkeypox in a man who returned from Nigeria to Israel in 2018. Virus was detected in pustule swabs by transmission electron microscopy and PCR and confirmed by immunofluorescence assay, tissue culture, and ELISA. The West Africa monkeypox outbreak calls for increased awareness by public health authorities worldwide.
Monkeypox is a zoonotic disease caused by monkeypox virus, an orthopoxvirus closely related to variola virus, the causative agent of smallpox. Human cases were first described in 1970; in subsequent decades, sporadic outbreaks were reported in Africa. Mortality rates are 1%–10% (1,2). The 2 clades, Congo-Basin and West African, each cause disease; the West African clade is considered to be less virulent and is associated with a lower mortality rate (3). Nevertheless, this clade is responsible for the largest documented monkeypox outbreak in West Africa (132 confirmed cases in Nigeria) (4). Human infection with monkeypox occurred in the United States in 2003, when imported animals from Africa infected pet prairie dogs (5). In September 2018 in the United Kingdom, 2 imported cases of monkeypox, were detected in persons from Nigeria (6); one of these cases caused nosocomial infection of a healthcare worker (HCW). We report a case of monkeypox in Israel.
The Study
On October 4, 2018, a 38-year-old man sought care for generalized rash and fever at the Department of Emergency Medicine at Shaare-Zedek Medical Center, Jerusalem, Israel. This Israel resident had returned from Port Harcourt, Rivers State, Nigeria, where he had worked a desk job for the previous 10 years. On September 17, during his last trip to Nigeria, he had disposed of 2 rodent carcasses at his residence. He returned to Israel on September 23 and on September 29 noticed 2 itchy lesions on his penis shaft. The next day, he had fever (38.8°C) and chills and started self-medicating with nonsteroidal antiinflammatories and oral penicillin. On October 1, an erythematous rash appeared first on his face and later on his trunk and extremities.
Thumbnail of Dermal manifestations of monkeypox on patient in Israel, 2018. Maculopapular rash was apparent on the face (A) and body on the day of hospital admission. A lesion on the left proximal extremity (B) was suspected to be a rickettsial eschar. After 3 days, the rash changed into vesicles and pustules on the face (C) and body (D). Skin resolution was apparent 13 days after admission; pustules and vesicles crusted and were shed (E, F). G) Timeline of disease progression.
Examination at Shaare-Zedek Medical Center on October 4 revealed that the patient was febrile and had a nonblanching maculopapular rash on his face (Figure 1, panel A), neck, trunk, and lower and upper extremities; several lesions on his palms and soles; 2 ulcers with an erythematous base on his penis shaft; and bilateral enlarged and tender lymph nodes in his groin. Blood test results indicated moderate thrombocytopenia (98,000 platelets/μL) and mild hepatitis. One lesion on the posterior aspect of his left arm (Figure 1, panel B) was suspected to be an eschar, raising the possibility of rickettsialpox. The patient was therefore hospitalized and administered oral doxycycline. His condition improved, and the next day he was discharged with doxycycline and instructions to remain isolated at home.
At a follow-up visit 2 days later (October 7), he was afebrile. The rash was locally synchronous and had progressed from maculopapular to vesicular and pustular; some lesions displayed black umbilication and crusting (Figure 1, panels C, D). Oral examination revealed bilateral tonsillar enlargement and ulcers in the posterior pharynx. Serology results were positive for varicella IgG (past infection) and negative for Coxiella burnetii, Rickettsia conori, Rickettsia typhi, Brucella spp., Treponema pallidum, and antigen/antibody combination for HIV. Pustular samples were negative for herpes simplex virus by PCR. Because of the rash characteristics and the patient’s travel history, monkeypox was suspected.
Samples were sent to the Israel Institute for Biological Research, Ness-Ziona, Israel, and processed in Biosafety Level 3 laboratories. The pustule sample was processed for PCR analysis and transmission electron microscopy. Vero cells were infected for immunofluorescence assay and monitored for cytopathic effect. For transmission electron microscopy, particles were enriched by using a Beckman Airfuge (https://www.beckman.comExternal Link) before negative staining with phosphotungstic acid.
Thumbnail of Transmission electron microscopy and cell culture–based diagnosis of monkeypox in patient in Israel, 2018. Virus particles were detected in lesion samples as either virion aggregates (arrows) (A) or individual virions (B) with a typical brick shape. Infected Vero cells depicted typical cytopathic effect, exhibiting cell detachment and rounding. Scale bar in A indicates 0.2 μm; scale bar in B indicates 100 nm. C) Immunofluorescent staining of infected cells; original magnification ×1
Figure 2. Transmission electron microscopy and cell culture–based diagnosis of monkeypox in patient in Israel, 2018. Virus particles were detected in lesion samples as either virion aggregates (arrows) (A) or individual virions (B)...
The sample exhibited numerous brick-shaped particles, characteristic of orthopoxviruses. Particles were observed to be in clusters (up to 10 virions in each cluster) embedded in skin tissue and as single virions (Figure 2, panels A, B). Viral particle dimensions (± SD) were 281 ± 18 nm × 220 ± 17 nm (n = 24), in accordance with previously reported dimensions for monkeypox virus (5).
PCR diagnosis was based on specific primers to discriminate between the West African (581 bp) and the Congo-Basin (832 bp) clades by product size (7). The PCR product size corresponded to that of the West African clade currently circulating in Nigeria (8). This finding was confirmed by high-throughput sequencing.
Within 24 hours of infection, cytopathic effect was observed in Vero cells, exhibiting typical monolayer separation and cell rounding (Figure 2, panel C). The result of immunofluorescence assay with a specific antibody against orthopoxviruses was positive; some cells exhibited viral factories, typical for orthopoxvirus infection (Figure 2, panel D) (9).
The patient was instructed to remain isolated in his residence until he had fully recovered. Days after he returned home, the pustules turned to scabs (0.3–0.8 mm in diameter) and were shed (Figure 1, panels E, F). Concomitant with recovery, antibodies against orthopoxvirus and a neutralizing antibody titer (50% plaque reduction neutralization test titer = 134) developed, comparable to those of smallpox-vaccinated humans (10). Of note, scabs collected from the patient during recovery, then homogenized and tested for monkeypox virus, contained viable viral loads of 105–107 PFU/scab.
All of the patient’s contacts in Israel (5 household members and 11 HCWs) were offered smallpox vaccination, but only 1 HCW agreed. All contacts were followed up for 21 days; no virus transmission was detected.
Top
Conclusions
Since the first documented case of human monkeypox in 1970, sporadic outbreaks have been reported, especially in the Congo Basin and West Africa. Contributing to the increased frequency of such occurrences were discontinued vaccination against smallpox, increased interaction with wildlife because of deforestation and population movement, consumption of bushmeat, and increased population density (11,12). Although most infections are acquired from wildlife, human-to-human transmission has been reported, as in the 1996–1997 outbreak in the Democratic Republic of the Congo (13) and the current outbreak in West Africa (8). The availability and speed of international transportation combined with the natural progression of the disease (long incubation and prodromal periods, up to 21 days combined) increase the risk for monkeypox spread from rural regions into urban areas and to countries outside Africa. Indeed, during September and October 2018, monkeypox was diagnosed in the United Kingdom and Israel (6,14).
Thus far, all imported cases of monkeypox in humans (United States in 2003, United Kingdom and Israel in 2018) have involved the West African clade of the virus (3,6). After a similar incubation period (12 days), all patients had fever and chills, lymphadenopathy, and skin lesions (5,6). Although the patient in Israel had numerous vesiculopustules on his face and body, the patients involved in the US outbreak had substantially fewer (1–50) and reported a persistent cough, which the patient from Israel did not report. Of note, the first sign noted by the Israel and UK patients was groin lesions (6). Although past reports considered the Congo Basin clade to be more virulent (2,3,12), recent reports show that the West African clade can also cause disseminated disease and can be transmitted from human to human (4,8).
For this study, we used multiple diagnostic approaches. The virus was detected in pustule swab specimens by transmission electron microscopy and PCR within 3 hours of sample arrival and confirmed by immunofluorescence assay, tissue culture, and ELISA for orthopoxvirus antigens.
The very high virus titers contained by pustules and scabs, as demonstrated in this case, increase the risk for human-to-human transmission and environmental spread. To prevent further transmission, HCWs should implement safety practices and local authorities should map contacts and consider use of smallpox vaccines or antiviral drugs (14,15), according to risk assessment.
Top
Drs. Erez and Achdout are researchers at the Department of Infectious Diseases, Israel Institute for Biological Research, Ness-Ziona, Israel. Their research interests include immune response to vaccines and viral infections.
ISSN: 1080-6059
Volume 25
Number 5—May 2019
EID JournaledIn Email Syndicate
Volume 25, Number 5—May 2019
Dispatch
Diagnosis of Imported Monkeypox, Israel, 2018
Abstract
We report a case of monkeypox in a man who returned from Nigeria to Israel in 2018. Virus was detected in pustule swabs by transmission electron microscopy and PCR and confirmed by immunofluorescence assay, tissue culture, and ELISA. The West Africa monkeypox outbreak calls for increased awareness by public health authorities worldwide.
Monkeypox is a zoonotic disease caused by monkeypox virus, an orthopoxvirus closely related to variola virus, the causative agent of smallpox. Human cases were first described in 1970; in subsequent decades, sporadic outbreaks were reported in Africa. Mortality rates are 1%–10% (1,2). The 2 clades, Congo-Basin and West African, each cause disease; the West African clade is considered to be less virulent and is associated with a lower mortality rate (3). Nevertheless, this clade is responsible for the largest documented monkeypox outbreak in West Africa (132 confirmed cases in Nigeria) (4). Human infection with monkeypox occurred in the United States in 2003, when imported animals from Africa infected pet prairie dogs (5). In September 2018 in the United Kingdom, 2 imported cases of monkeypox, were detected in persons from Nigeria (6); one of these cases caused nosocomial infection of a healthcare worker (HCW). We report a case of monkeypox in Israel.
The Study
On October 4, 2018, a 38-year-old man sought care for generalized rash and fever at the Department of Emergency Medicine at Shaare-Zedek Medical Center, Jerusalem, Israel. This Israel resident had returned from Port Harcourt, Rivers State, Nigeria, where he had worked a desk job for the previous 10 years. On September 17, during his last trip to Nigeria, he had disposed of 2 rodent carcasses at his residence. He returned to Israel on September 23 and on September 29 noticed 2 itchy lesions on his penis shaft. The next day, he had fever (38.8°C) and chills and started self-medicating with nonsteroidal antiinflammatories and oral penicillin. On October 1, an erythematous rash appeared first on his face and later on his trunk and extremities.
Thumbnail of Dermal manifestations of monkeypox on patient in Israel, 2018. Maculopapular rash was apparent on the face (A) and body on the day of hospital admission. A lesion on the left proximal extremity (B) was suspected to be a rickettsial eschar. After 3 days, the rash changed into vesicles and pustules on the face (C) and body (D). Skin resolution was apparent 13 days after admission; pustules and vesicles crusted and were shed (E, F). G) Timeline of disease progression.
Examination at Shaare-Zedek Medical Center on October 4 revealed that the patient was febrile and had a nonblanching maculopapular rash on his face (Figure 1, panel A), neck, trunk, and lower and upper extremities; several lesions on his palms and soles; 2 ulcers with an erythematous base on his penis shaft; and bilateral enlarged and tender lymph nodes in his groin. Blood test results indicated moderate thrombocytopenia (98,000 platelets/μL) and mild hepatitis. One lesion on the posterior aspect of his left arm (Figure 1, panel B) was suspected to be an eschar, raising the possibility of rickettsialpox. The patient was therefore hospitalized and administered oral doxycycline. His condition improved, and the next day he was discharged with doxycycline and instructions to remain isolated at home.
At a follow-up visit 2 days later (October 7), he was afebrile. The rash was locally synchronous and had progressed from maculopapular to vesicular and pustular; some lesions displayed black umbilication and crusting (Figure 1, panels C, D). Oral examination revealed bilateral tonsillar enlargement and ulcers in the posterior pharynx. Serology results were positive for varicella IgG (past infection) and negative for Coxiella burnetii, Rickettsia conori, Rickettsia typhi, Brucella spp., Treponema pallidum, and antigen/antibody combination for HIV. Pustular samples were negative for herpes simplex virus by PCR. Because of the rash characteristics and the patient’s travel history, monkeypox was suspected.
Samples were sent to the Israel Institute for Biological Research, Ness-Ziona, Israel, and processed in Biosafety Level 3 laboratories. The pustule sample was processed for PCR analysis and transmission electron microscopy. Vero cells were infected for immunofluorescence assay and monitored for cytopathic effect. For transmission electron microscopy, particles were enriched by using a Beckman Airfuge (https://www.beckman.comExternal Link) before negative staining with phosphotungstic acid.
Thumbnail of Transmission electron microscopy and cell culture–based diagnosis of monkeypox in patient in Israel, 2018. Virus particles were detected in lesion samples as either virion aggregates (arrows) (A) or individual virions (B) with a typical brick shape. Infected Vero cells depicted typical cytopathic effect, exhibiting cell detachment and rounding. Scale bar in A indicates 0.2 μm; scale bar in B indicates 100 nm. C) Immunofluorescent staining of infected cells; original magnification ×1
Figure 2. Transmission electron microscopy and cell culture–based diagnosis of monkeypox in patient in Israel, 2018. Virus particles were detected in lesion samples as either virion aggregates (arrows) (A) or individual virions (B)...
The sample exhibited numerous brick-shaped particles, characteristic of orthopoxviruses. Particles were observed to be in clusters (up to 10 virions in each cluster) embedded in skin tissue and as single virions (Figure 2, panels A, B). Viral particle dimensions (± SD) were 281 ± 18 nm × 220 ± 17 nm (n = 24), in accordance with previously reported dimensions for monkeypox virus (5).
PCR diagnosis was based on specific primers to discriminate between the West African (581 bp) and the Congo-Basin (832 bp) clades by product size (7). The PCR product size corresponded to that of the West African clade currently circulating in Nigeria (8). This finding was confirmed by high-throughput sequencing.
Within 24 hours of infection, cytopathic effect was observed in Vero cells, exhibiting typical monolayer separation and cell rounding (Figure 2, panel C). The result of immunofluorescence assay with a specific antibody against orthopoxviruses was positive; some cells exhibited viral factories, typical for orthopoxvirus infection (Figure 2, panel D) (9).
The patient was instructed to remain isolated in his residence until he had fully recovered. Days after he returned home, the pustules turned to scabs (0.3–0.8 mm in diameter) and were shed (Figure 1, panels E, F). Concomitant with recovery, antibodies against orthopoxvirus and a neutralizing antibody titer (50% plaque reduction neutralization test titer = 134) developed, comparable to those of smallpox-vaccinated humans (10). Of note, scabs collected from the patient during recovery, then homogenized and tested for monkeypox virus, contained viable viral loads of 105–107 PFU/scab.
All of the patient’s contacts in Israel (5 household members and 11 HCWs) were offered smallpox vaccination, but only 1 HCW agreed. All contacts were followed up for 21 days; no virus transmission was detected.
Top
Conclusions
Since the first documented case of human monkeypox in 1970, sporadic outbreaks have been reported, especially in the Congo Basin and West Africa. Contributing to the increased frequency of such occurrences were discontinued vaccination against smallpox, increased interaction with wildlife because of deforestation and population movement, consumption of bushmeat, and increased population density (11,12). Although most infections are acquired from wildlife, human-to-human transmission has been reported, as in the 1996–1997 outbreak in the Democratic Republic of the Congo (13) and the current outbreak in West Africa (8). The availability and speed of international transportation combined with the natural progression of the disease (long incubation and prodromal periods, up to 21 days combined) increase the risk for monkeypox spread from rural regions into urban areas and to countries outside Africa. Indeed, during September and October 2018, monkeypox was diagnosed in the United Kingdom and Israel (6,14).
Thus far, all imported cases of monkeypox in humans (United States in 2003, United Kingdom and Israel in 2018) have involved the West African clade of the virus (3,6). After a similar incubation period (12 days), all patients had fever and chills, lymphadenopathy, and skin lesions (5,6). Although the patient in Israel had numerous vesiculopustules on his face and body, the patients involved in the US outbreak had substantially fewer (1–50) and reported a persistent cough, which the patient from Israel did not report. Of note, the first sign noted by the Israel and UK patients was groin lesions (6). Although past reports considered the Congo Basin clade to be more virulent (2,3,12), recent reports show that the West African clade can also cause disseminated disease and can be transmitted from human to human (4,8).
For this study, we used multiple diagnostic approaches. The virus was detected in pustule swab specimens by transmission electron microscopy and PCR within 3 hours of sample arrival and confirmed by immunofluorescence assay, tissue culture, and ELISA for orthopoxvirus antigens.
The very high virus titers contained by pustules and scabs, as demonstrated in this case, increase the risk for human-to-human transmission and environmental spread. To prevent further transmission, HCWs should implement safety practices and local authorities should map contacts and consider use of smallpox vaccines or antiviral drugs (14,15), according to risk assessment.
Top
Drs. Erez and Achdout are researchers at the Department of Infectious Diseases, Israel Institute for Biological Research, Ness-Ziona, Israel. Their research interests include immune response to vaccines and viral infections.
https://www.dshs.texas.gov/idcu/disease/monkeypox/
Monkeypox
ICD-9 051; ICD-10 B04
In early June 2003 monkeypox infection outside of a laboratory situation occurred for the first time in the western hemisphere. Human monkeypox is a rare zoonotic viral disease that is found primarily in the rain forest countries of central and western Africa. Symptoms of monkeypox infection in humans are similar to those of smallpox, but the monkeypox virus is much less severe.
Human monkeypox infection in the United States happened as a result of contact with animals that were sick with the virus, primarily prairie dogs that were shipped from Texas to Illinois. Information from an ongoing multi-state investigation suggests that the prairie dogs acquired the virus in Illinois after coming in contact with Gambian giant rats from Africa. The prairie dogs transmitted the virus to humans when they handled or provided medical care for the infected animals. Human cases of monkeypox virus have been confirmed in Wisconsin, Illinois, and Indiana. Monkeypox has not been diagnosed in either people or animals in Texas.
NOTICE** On June 11 the Centers for Disease Control and Prevention and the Food and Drug Administration issued a joint order immediately banning the importation of rodents from Africa into the United States. Please note that the order also announces that prairie dogs and certain types of rodents cannot be
transported between states,
sold either between states or within a state,
or let loose in the wild.
Further information on infection control, exposure management, guidance for veterinarians and pet owners, or to see the entire text of the embargo for prairie dogs and rodents.
Last updatedApril 18, 2019
Monkeypox
ICD-9 051; ICD-10 B04
In early June 2003 monkeypox infection outside of a laboratory situation occurred for the first time in the western hemisphere. Human monkeypox is a rare zoonotic viral disease that is found primarily in the rain forest countries of central and western Africa. Symptoms of monkeypox infection in humans are similar to those of smallpox, but the monkeypox virus is much less severe.
Human monkeypox infection in the United States happened as a result of contact with animals that were sick with the virus, primarily prairie dogs that were shipped from Texas to Illinois. Information from an ongoing multi-state investigation suggests that the prairie dogs acquired the virus in Illinois after coming in contact with Gambian giant rats from Africa. The prairie dogs transmitted the virus to humans when they handled or provided medical care for the infected animals. Human cases of monkeypox virus have been confirmed in Wisconsin, Illinois, and Indiana. Monkeypox has not been diagnosed in either people or animals in Texas.
NOTICE** On June 11 the Centers for Disease Control and Prevention and the Food and Drug Administration issued a joint order immediately banning the importation of rodents from Africa into the United States. Please note that the order also announces that prairie dogs and certain types of rodents cannot be
transported between states,
sold either between states or within a state,
or let loose in the wild.
Further information on infection control, exposure management, guidance for veterinarians and pet owners, or to see the entire text of the embargo for prairie dogs and rodents.
Last updatedApril 18, 2019
Looks like monkey pox is on the move. Hopefully it'll be contained. Thanks for the heads up Helen, and for the work that you do. I remember years ago when we had the thread about smallpox, how to quarantine, treat, etc. Looks like it might need to come out of the archives if this goes hotter. It might not be as bad as small pox, but even chicken pox is a miserable thing to go through. Both our kids had it, not at the same time of course, and it was a month before I got out of the house.
(((Helen))
(((Helen))
intothatgoodnight
. . .
One of the underlying, unmentioned possibilities about recent monkeypox (or smallpox, for that matter) outbreaks - do such outbreaks represent potentially dangerous (read: WEAPONIZED) biological versions being tested in-the-wild?
intothegoodnight
intothegoodnight
helen
Panic Sex Lady
There's a new case in the UK today.
https://www.dailymail.co.uk/news/article-6146807/amp/Monkeypox-diagnosed-patient-UK-time-ever.html?
https://www.dailymail.co.uk/news/article-6146807/amp/Monkeypox-diagnosed-patient-UK-time-ever.html?
helen
Panic Sex Lady
Sometimes even Panic Sex Lady has an "oh, shit!" moment ...
Why do we need a new smallpox vaccine?
https://www.hhs.gov/blog/2019/09/24...h-security.html?amp&__twitter_impression=true
Why do we need a new smallpox vaccine?
https://www.hhs.gov/blog/2019/09/24...h-security.html?amp&__twitter_impression=true
helen
Panic Sex Lady
This article mentions climate change as a reason for this type of illness to make a comeback.
https://www.forbes.com/sites/brucel...ew-smallpox-monkeypox-vaccine-what-is-it-for/
Sep 25, 2019,2:07 am
FDA Approves New Smallpox, Monkeypox Vaccine: What Is It For?
Bruce Y. LeeSenior Contributor
Healthcare
I am a writer, journalist, professor, systems modeler, computational and digital health expert, avocado-eater, and entrepreneur, not always in that order.
Ft. Campbell DeploymentFt. Campbell Deployment
Military personnel are among those who get vaccinated against smallpox. (Photo by Rusty Russell/Getty Images)GETTY IMAGES
You may not wake up every morning and say, “I hope I don’t get monkeypox or smallpox.” In fact, right now, the risk of you getting smallpox or monkeypox may seem lower than the risk of getting smothered by cabbage. Nevertheless, the U.S. Food and Drug Administration’s (FDA’s) approval of the Jynneos Smallpox and Monkeypox Vaccine is significant in various ways. Bavarian Nordic will be manufacturing the vaccine.
Smallpox used to be a huge problem around the world. According to Colette Flight writing for the BBC, it killed an estimated 300 million people “in the 20th century alone.” About a third of those who got infected by the variola virus did not survive.
In fact, smallpox was so significant that it changed the course of history on many an occasion. For example, the virus may have helped the Spanish, British, and other European countries colonize the Americas. High school history books may not mention the fact that smallpox brought over by European settlers helped weaken and wipe out many of the Aztecs, Incas, and Native Americans who had been occupying the Americas and had never been previously exposed to the virus.
Indeed, not too long ago, smallpox was a major killer disease, with “killer” in this case being a very bad thing. That’s why the global eradication of smallpox that was declared complete in 1980 was such a big public health achievement. That’s also why any event that combines the words “accident” and “existing smallpox laboratory samples,” quickly results in worldwide news. This happened just last week when an explosion occurred in Vector, a Russian building that’s one of two facilities in the world housing the remaining samples of the smallpox virus. Fortunately, the explosion did not seem to affect the samples.
However, smallpox could always return from a more unfortunate accident or the use of the virus for bioterrrorism, as I have described previously for Forbes. There is even concern that climate change will eventually reveal smallpox virus that has so far remained frozen in colder climes. With smallpox eradicated before Justin Timberlake was born, not that the two are related in any way, at least two generations of people have developed no immunity to smallpox. A return of the virus could mean rapid spread across a sea of smallpox virgins, so to speak.
Madam SecretaryMadam Secretary
An episode of the CBS television show “Madam Secretary” starring Téa Leoni depicted a smallpox outbreak. Bio-terrorism is one way that smallpox could make a re-appearance. (Photo by David M. Russell/CBS via Getty Images) CBS VIA GETTY IMAGES
That’s why government agencies like the Biomedical Advanced Research and Development Authority (BARDA) continue to support the development of new ways to prevent and treat smallpox. Even though smallpox was successfully eradicated, major gaps remain in smallpox prevention and treatment. The major gap in treatment has been a lack of treatments, at least, until last year. That’s when the FDA approved TPOXX, the first real treatment for smallpox, an approval that I covered for Forbes.
Then there are the limitations of the long-used smallpox vaccines. These vaccines have contained live versions of the vaccinia virus, which is nowhere near as dangerous as the variola virus but still on some occasions can cause problems. A vaccinia virus can result in an infection that is typically mild but, in rare situations can be life-threatening. This is why the Centers for Disease Control and Prevention (CDC) web site warns against touching your injection site soon after you get the smallpox vaccination. Touching the area and then your best friend could help spread the live vaccinia virus to your friend, which may mean that you no longer will be besties. The risk of bad stuff happening goes up if you have certain chronic skin conditions such as eczema or a weakened immune system such as from HIV, cancer, or medications. Therefore, such conditions can be contraindications to getting the traditional smallpox vaccine.
The Jynneos vaccine does include the vaccinia virus, but it’s a modified version. This version is called the Modified Vaccinia Ankara and apparently “does not cause disease in humans and is non-replicating, meaning it cannot reproduce in human cells,” according to the FDA announcement. That means compared to the traditional smallpox vaccine, this new vaccine poses less risk and can be administered to a wider range of people.
Then there’s the vaccine’s ability to protect against monkeypox, which is a first. Monkeypox is not as bad as smallpox, and it isn’t exactly a common disease. Nonetheless, the virus can kill. According to the CDC, in Africa, up to one in 10 people who have developed monkeypox disease have ended up not surviving.
In 1958, scientists first discovered the monkeypox virus in, surprise, surprise, monkeys. That’s why it’s called monkeypox and not ferretpox. But this virus doesn’t just monkey around. Other mammals can be infected if the virus comes into contact with their broken skin, respiratory tracts, or mucous membranes. The first reported human case of monkeypox appeared in the Democratic Republic of Congo in 1970. Since then here’s the tally of reported cases by country, according the the CDC:
Cameroon has had a total of seven cases with two in 1979, four in 1989, and one in 2018.
The Central African Republic has had 55 cases with a high of 14 cases in 2018.
Côte d’Ivoire (Ivory Coast) had one case in 1971 and another in 1981
The Democratic Republic of Congo has by far had the most with over 1000 cases each year.
Gabon had five cases in 1987
Israel registered one case in 2018
Liberia had four cases in 1970 and two in 2017
Nigeria, after having three before 2017 since then they have had 115 cases
Republic of Congo has had 101 since 2003 with 88 in 2017.
Sierra Leone has had a total of three cases
Sudan had 19 cases in 2005
The United Kingdom experienced three cases in 2018
The United States had an outbreak of 47 cases in 2003 after a shipment of “exotic” animals arrived from Ghana.
Here’s a CDC Foundation video on the 2003 U.S. outbreak:
So, monkeypox is nowhere near as common as cabbage, but cases still continue to occur and as Joe Cocker and Jennifer Warnes sang, who knows what tomorrow brings.
Nevertheless, chances are you won’t be getting the Jynneos vaccine anytime soon unless you are a member of the military or someone else at higher risk to be exposed to bio-terrorism, frequent certain parts of the Democratic Republic of Congo, or work with smallpox or monkeypox viruses. However, just because a medical advance isn’t necessarily needed today doesn’t mean that it isn’t important. Some advances are good just to have around, just as insurance, just in case.
Get the best of Forbes to your inbox with the latest insights from experts across the globe.
Follow me on Twitter or LinkedIn. Check out my website.
Bruce Y. Lee
I am a writer, journalist, professor, systems modeler, computational and digital health expert, avocado-eater, and entrepreneur, not always in that order. Currently, I am
…Read More
© 2019 Forbes Media LLC. All Rights Reserved.
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https://www.forbes.com/sites/brucel...ew-smallpox-monkeypox-vaccine-what-is-it-for/
Sep 25, 2019,2:07 am
FDA Approves New Smallpox, Monkeypox Vaccine: What Is It For?
Bruce Y. LeeSenior Contributor
Healthcare
I am a writer, journalist, professor, systems modeler, computational and digital health expert, avocado-eater, and entrepreneur, not always in that order.
Ft. Campbell DeploymentFt. Campbell Deployment
Military personnel are among those who get vaccinated against smallpox. (Photo by Rusty Russell/Getty Images)GETTY IMAGES
You may not wake up every morning and say, “I hope I don’t get monkeypox or smallpox.” In fact, right now, the risk of you getting smallpox or monkeypox may seem lower than the risk of getting smothered by cabbage. Nevertheless, the U.S. Food and Drug Administration’s (FDA’s) approval of the Jynneos Smallpox and Monkeypox Vaccine is significant in various ways. Bavarian Nordic will be manufacturing the vaccine.
Smallpox used to be a huge problem around the world. According to Colette Flight writing for the BBC, it killed an estimated 300 million people “in the 20th century alone.” About a third of those who got infected by the variola virus did not survive.
In fact, smallpox was so significant that it changed the course of history on many an occasion. For example, the virus may have helped the Spanish, British, and other European countries colonize the Americas. High school history books may not mention the fact that smallpox brought over by European settlers helped weaken and wipe out many of the Aztecs, Incas, and Native Americans who had been occupying the Americas and had never been previously exposed to the virus.
Indeed, not too long ago, smallpox was a major killer disease, with “killer” in this case being a very bad thing. That’s why the global eradication of smallpox that was declared complete in 1980 was such a big public health achievement. That’s also why any event that combines the words “accident” and “existing smallpox laboratory samples,” quickly results in worldwide news. This happened just last week when an explosion occurred in Vector, a Russian building that’s one of two facilities in the world housing the remaining samples of the smallpox virus. Fortunately, the explosion did not seem to affect the samples.
However, smallpox could always return from a more unfortunate accident or the use of the virus for bioterrrorism, as I have described previously for Forbes. There is even concern that climate change will eventually reveal smallpox virus that has so far remained frozen in colder climes. With smallpox eradicated before Justin Timberlake was born, not that the two are related in any way, at least two generations of people have developed no immunity to smallpox. A return of the virus could mean rapid spread across a sea of smallpox virgins, so to speak.
Madam SecretaryMadam Secretary
An episode of the CBS television show “Madam Secretary” starring Téa Leoni depicted a smallpox outbreak. Bio-terrorism is one way that smallpox could make a re-appearance. (Photo by David M. Russell/CBS via Getty Images) CBS VIA GETTY IMAGES
That’s why government agencies like the Biomedical Advanced Research and Development Authority (BARDA) continue to support the development of new ways to prevent and treat smallpox. Even though smallpox was successfully eradicated, major gaps remain in smallpox prevention and treatment. The major gap in treatment has been a lack of treatments, at least, until last year. That’s when the FDA approved TPOXX, the first real treatment for smallpox, an approval that I covered for Forbes.
Then there are the limitations of the long-used smallpox vaccines. These vaccines have contained live versions of the vaccinia virus, which is nowhere near as dangerous as the variola virus but still on some occasions can cause problems. A vaccinia virus can result in an infection that is typically mild but, in rare situations can be life-threatening. This is why the Centers for Disease Control and Prevention (CDC) web site warns against touching your injection site soon after you get the smallpox vaccination. Touching the area and then your best friend could help spread the live vaccinia virus to your friend, which may mean that you no longer will be besties. The risk of bad stuff happening goes up if you have certain chronic skin conditions such as eczema or a weakened immune system such as from HIV, cancer, or medications. Therefore, such conditions can be contraindications to getting the traditional smallpox vaccine.
The Jynneos vaccine does include the vaccinia virus, but it’s a modified version. This version is called the Modified Vaccinia Ankara and apparently “does not cause disease in humans and is non-replicating, meaning it cannot reproduce in human cells,” according to the FDA announcement. That means compared to the traditional smallpox vaccine, this new vaccine poses less risk and can be administered to a wider range of people.
Then there’s the vaccine’s ability to protect against monkeypox, which is a first. Monkeypox is not as bad as smallpox, and it isn’t exactly a common disease. Nonetheless, the virus can kill. According to the CDC, in Africa, up to one in 10 people who have developed monkeypox disease have ended up not surviving.
In 1958, scientists first discovered the monkeypox virus in, surprise, surprise, monkeys. That’s why it’s called monkeypox and not ferretpox. But this virus doesn’t just monkey around. Other mammals can be infected if the virus comes into contact with their broken skin, respiratory tracts, or mucous membranes. The first reported human case of monkeypox appeared in the Democratic Republic of Congo in 1970. Since then here’s the tally of reported cases by country, according the the CDC:
Cameroon has had a total of seven cases with two in 1979, four in 1989, and one in 2018.
The Central African Republic has had 55 cases with a high of 14 cases in 2018.
Côte d’Ivoire (Ivory Coast) had one case in 1971 and another in 1981
The Democratic Republic of Congo has by far had the most with over 1000 cases each year.
Gabon had five cases in 1987
Israel registered one case in 2018
Liberia had four cases in 1970 and two in 2017
Nigeria, after having three before 2017 since then they have had 115 cases
Republic of Congo has had 101 since 2003 with 88 in 2017.
Sierra Leone has had a total of three cases
Sudan had 19 cases in 2005
The United Kingdom experienced three cases in 2018
The United States had an outbreak of 47 cases in 2003 after a shipment of “exotic” animals arrived from Ghana.
Here’s a CDC Foundation video on the 2003 U.S. outbreak:
So, monkeypox is nowhere near as common as cabbage, but cases still continue to occur and as Joe Cocker and Jennifer Warnes sang, who knows what tomorrow brings.
Nevertheless, chances are you won’t be getting the Jynneos vaccine anytime soon unless you are a member of the military or someone else at higher risk to be exposed to bio-terrorism, frequent certain parts of the Democratic Republic of Congo, or work with smallpox or monkeypox viruses. However, just because a medical advance isn’t necessarily needed today doesn’t mean that it isn’t important. Some advances are good just to have around, just as insurance, just in case.
Get the best of Forbes to your inbox with the latest insights from experts across the globe.
Follow me on Twitter or LinkedIn. Check out my website.
Bruce Y. Lee
I am a writer, journalist, professor, systems modeler, computational and digital health expert, avocado-eater, and entrepreneur, not always in that order. Currently, I am
…Read More
© 2019 Forbes Media LLC. All Rights Reserved.
AdChoicesPrivacy StatementTerms and ConditionsContact UsJobs At ForbesReprints & PermissionsForbes Press RoomAdvertise
helen
Panic Sex Lady
Fort Detrick is closed. Forgive me for screaming from the rooftops - helen
Fort Detrick's connection to a new smallpox vaccine |
www.fredericknewspost.com
The Food and Drug Administration recently approved a new vaccine for smallpox that has its roots in Fort Detrick.
The JYNNEOS vaccine, produced by pharmaceutical company Bavarian Nordic, was approved by the FDA in September. It is a live, non-replicating vaccine that will be used to prevent smallpox and monkeypox, according to a release from the U.S. Army Medical Research Institute of Infectious Diseases.
In a statement Bavarian Nordic CEO Paul Chaplin called the FDA approval a “tremendous milestone” for the pharmaceutical company and the U.S. Department of Health and Human Services.
“Together, we have shown that it is possible to develop a safe and effective medical countermeasure for national security threats like smallpox,” Chaplin said in the statement.
The smallpox and monkeypox is mostly aimed at military members who will be going to high risk areas. The last case of naturally-occurring smallpox was in 1977, with the World Health Organization declaring the disease eradicated on a global scale in 1980, according to the National Institutes of Health.
But even though smallpox does not naturally exist, the disease does still exist in laboratories in Atlanta, where the Centers for Disease Control and Prevention has its headquarters, and in Russia.
The vaccine was created in case the disease were to return, whether that was man-made or through melting of the permafrost, said Dr. Phillip Pittman, chief of USAMRIID’s Department of Clinical Research. While smallpox is likely in the permafrost in Russia, it is unclear if it could be grown, according to NPR.
“This vaccine does mark, it is a real game changer in terms of vaccinations against smallpox,” Pittman said.
Frederick-based BioFactura recently received a $67.4 million contract to work on a cure for the disease on the same in-case basis.
Monkeypox, which the vaccine also prevents, is a rare disease that is not eradicated. There have been few cases since the 1970s, mostly in African countries, although there were cases in the United States in 2003, according to WHO.
There were several reasons to create a new smallpox vaccine, Pittman said.
The current smallpox vaccine, which was discontinued for public use by 1983, has several side effects, he said. One of those is a scar due to how the vaccine was administered. Instead of single injected, it required multiple jabs.
The new vaccine is done as an injection instead of the pricks, he said, which means there will be no scar.
People who have HIV or are immunocompromised for other reasons could not get the old vaccine, which meant about 10 percent of soldiers could not get it, Pittman said.
Bavarian Nordic took on a call from the United States to modify their technology to create a safer smallpox vaccine, with the focus on immunocompromised populations, said Thomas Duschk, spokesman for Bavarian Nordic, in an email.
To get FDA approval, the vaccine had to go through multiple animal studies, including in nonhuman primates. The vaccine was shown to be quite effective at protecting nonhuman primates from monkeypox, Pittman said.
USAMRIID did not work with smallpox, said Caree Vander Linden, spokeswoman for USAMRIID. But they can work with related viruses like monkeypox.
Pittman led a phase 3 trial in South Korea from March 2015 to Aug. 17. A phase 3 trial is the final stage before licensing. The study showed promising results, Pittman said.
There will still need to do post-marketing to show the vaccine’s safety, he said.
Fort Detrick's connection to a new smallpox vaccine |
www.fredericknewspost.com
The Food and Drug Administration recently approved a new vaccine for smallpox that has its roots in Fort Detrick.
The JYNNEOS vaccine, produced by pharmaceutical company Bavarian Nordic, was approved by the FDA in September. It is a live, non-replicating vaccine that will be used to prevent smallpox and monkeypox, according to a release from the U.S. Army Medical Research Institute of Infectious Diseases.
In a statement Bavarian Nordic CEO Paul Chaplin called the FDA approval a “tremendous milestone” for the pharmaceutical company and the U.S. Department of Health and Human Services.
“Together, we have shown that it is possible to develop a safe and effective medical countermeasure for national security threats like smallpox,” Chaplin said in the statement.
The smallpox and monkeypox is mostly aimed at military members who will be going to high risk areas. The last case of naturally-occurring smallpox was in 1977, with the World Health Organization declaring the disease eradicated on a global scale in 1980, according to the National Institutes of Health.
But even though smallpox does not naturally exist, the disease does still exist in laboratories in Atlanta, where the Centers for Disease Control and Prevention has its headquarters, and in Russia.
The vaccine was created in case the disease were to return, whether that was man-made or through melting of the permafrost, said Dr. Phillip Pittman, chief of USAMRIID’s Department of Clinical Research. While smallpox is likely in the permafrost in Russia, it is unclear if it could be grown, according to NPR.
“This vaccine does mark, it is a real game changer in terms of vaccinations against smallpox,” Pittman said.
Frederick-based BioFactura recently received a $67.4 million contract to work on a cure for the disease on the same in-case basis.
Monkeypox, which the vaccine also prevents, is a rare disease that is not eradicated. There have been few cases since the 1970s, mostly in African countries, although there were cases in the United States in 2003, according to WHO.
There were several reasons to create a new smallpox vaccine, Pittman said.
The current smallpox vaccine, which was discontinued for public use by 1983, has several side effects, he said. One of those is a scar due to how the vaccine was administered. Instead of single injected, it required multiple jabs.
The new vaccine is done as an injection instead of the pricks, he said, which means there will be no scar.
People who have HIV or are immunocompromised for other reasons could not get the old vaccine, which meant about 10 percent of soldiers could not get it, Pittman said.
Bavarian Nordic took on a call from the United States to modify their technology to create a safer smallpox vaccine, with the focus on immunocompromised populations, said Thomas Duschk, spokesman for Bavarian Nordic, in an email.
To get FDA approval, the vaccine had to go through multiple animal studies, including in nonhuman primates. The vaccine was shown to be quite effective at protecting nonhuman primates from monkeypox, Pittman said.
USAMRIID did not work with smallpox, said Caree Vander Linden, spokeswoman for USAMRIID. But they can work with related viruses like monkeypox.
Pittman led a phase 3 trial in South Korea from March 2015 to Aug. 17. A phase 3 trial is the final stage before licensing. The study showed promising results, Pittman said.
There will still need to do post-marketing to show the vaccine’s safety, he said.
helen
Panic Sex Lady
President Trump stopped all flights except from the UK at 11:59 pm Eastern Time, Friday night, March 13, 2020.
On March 14, 2020, UK news reported that a hospital in London is treating a case of monkeypox in a Nigerian who had flown into the country.
Viral illnesses tend to start with similar symptoms. We're all getting our panties in a wad over coronavirus right now.
Screening for symptoms of illness should have taken place before the Nigerian was allowed to enter the UK. He was asymptomatic until after he arrived in the UK.
At some point, most likely last week, the Nigerian felt sick enough to seek medical treatment. The system is overwhelmed with coronavirus screening.
I'm purely guessing no one diagnosed the Nigerian correctly until he broke out in pox.
He must have been walking around last week and maybe longer shedding monkeypox virii.
No one can fly in now except from the UK, and those travelers must enter quarantine upon arrival.
President Trump asked everyone to pray Sunday.
If you're the praying type, and your place of worship is closed due to coronavirus, where will you pray? At home? With kids and college students newly kicked out of school?
You know what happens every hurricane season? People get maybe a week to leave, but many panic at the last minute and clog the roads. They get trapped in cars trying to get to a perceived safer place.
That's what happens even with a lot of warning, every time.
Stores are out of stuff. If you have a job to go on Monday you'll go on to bed Sunday night after praying all day at home. Public places are closed for the coronavirus. Nowhere to go but bed. Wait for Monday.
I'm just throwing this out there. You do better as a hive mind and I'm so tired my brain burns. Go look for yourselves.
The shutdown will probably be announced as a cell phone alert. Purely guessing.
Inbound travel from the UK and Ireland prohibited as of this afternoon.
crossbowboy
Certifiable
So yesterday I was talking to a guy...
Of course, he has a cousin or something at the Pentagon.
And also of course, Helen is right. National quarantine is in the works.
As always, ymmv. Buckle up anyway.
Of course, he has a cousin or something at the Pentagon.
And also of course, Helen is right. National quarantine is in the works.
As always, ymmv. Buckle up anyway.