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The World Health Organisation (<keyword id="19895006" type="General" weightage="20" keywordseo="WHO" source="keywords">WHO</keyword>) has announced that <keyword id="22989608" type="General" weightage="100" keywordseo="M-Pox" source="keywords">M-Pox</keyword> will continue to be classified as a <keyword id="21952478" type="General" weightage="20" keywordseo="public-health-emergency" source="keywords">public health emergency</keyword> of international concern (PHEIC), citing a resurgence in cases and the virus's ongoing geographic spread. <br /><br />The high-alert status initially declared in August, was reaffirmed following a meeting of the WHO Emergency Committee, The Express Tribune reported on Friday.<br /><br />The decision comes as M-Pox cases surge, particularly with the spread of the <keyword id="22875864" type="General" weightage="20" keywordseo="clade-Ib-variant" source="keywords">clade Ib variant</keyword> beyond its origin in the Democratic Republic of Congo to neighbouring African nations, Europe, and Asia. "Rising case numbers, the continuing geographic spread, and the need for a cohesive response have made it essential to maintain this emergency status," the WHO said in its statement. <br /><br />Confirmed cases of clade Ib have been detected in the United Kingdom, Germany, Sweden, and India, highlighting the global scale of the outbreak, reported The Express Tribune.<br /><br />M-Pox, a viral disease transmitted through close contact, presents flu-like symptoms and lesions. Although typically mild, it can be fatal, particularly in regions with inadequate healthcare. Over 46,000 suspected cases have been reported this year in Africa, with Congo accounting for the majority of the more than 1,000 suspected deaths. <br /><br />The new PHEIC declaration underscores the global threat posed by clade Ib and follows earlier alerts related to a separate strain during the 2022-2023 outbreak. <br /><br />In response to growing concerns, the WHO has expanded vaccine authorisations. Bavarian Nordic's <keyword id="24137585" type="General" weightage="20" keywordseo="M-Pox-vaccine" source="keywords">M-Pox vaccine</keyword> was approved earlier this year, with Japan's KM Biologics' vaccine added to the list of emergency-use vaccines in September. <br /><br />WHO officials have faced criticism for delays in <keyword id="21847727" type="General" weightage="20" keywordseo="vaccine-distribution" source="keywords">vaccine distribution</keyword> but stressed that vaccination remains a cornerstone of global response efforts, The Express Tribune reported.<br /><br />"The emergency status underscores the urgency to mount a unified global response," a WHO spokesperson stated. The organisation urged countries and health partners to collaborate on widespread vaccination campaigns and enhance public awareness to curb the virus's spread effectively.<br /><br />

M-Pox remains public health emergency: WHO

<p><div class="image-container float_right" style="width:480px"><div class="image"><p class="source">David Livingston/Getty</p></div></div>Last week the news broke that "<keyword id="358683" type="ENTERTAINMENT" weightage="60" keywordseo="The-View">The View</keyword>" was considering hiring <keyword id="38422" type="PERSON" weightage="60" keywordseo="Jenny-McCarthy">Jenny McCarthy</keyword>, one-time MTV sex symbol and notorious anti-vaccine campaigner.</p>
<p>Just the thought of this addition to the daytime talk show's cast was enough to spark <a href="http://www.slate.com/blogs/bad_astronomy/2013/07/09/jenny_mccarthy_antivax_advocate_considered_for_co_host_on_abc_s_the_view.html" target="_blank">petitions to ABC</a> and angry tweets and blog posts from scientists, <keyword id="6354750" type="CITY" weightage="60" keywordseo="health">health</keyword> researchers, skeptics and <keyword id="41551" type="ENTERTAINMENT" weightage="100" keywordseo="science">science</keyword> bloggers.</p>
<p>Now that the <a href="http://www.businessinsider.com/jenny-mccarth-new-the-view-co-host-2013-7">appointment has been made official</a>, <span>McCarthy has a national platform from which to spew her anti-vaccine conspiracy theories. This will have real and negative impacts on our future health.</span></p>
<p>The chief concern swirls around our <span style="font-size: 15px; line-height: 1.5em;">children, whose herd immunity against various infectious diseases will take a hit if </span><a href="http://www.businessinsider.com/jenny-mccarthy-the-view-the-benefits-of-vaccines-2013-7">vaccination rates continue to drop</a><span style="font-size: 15px; line-height: 1.5em;">. </span></p>
<p>We've already seen decreases in <keyword id="24209" type="UNKNOWN" weightage="60" keywordseo="vaccine">vaccine</keyword> coverage from faulty logic of the anti-vaxxers. And we've seen a resulting <a href="http://www.businessinsider.com/jenny-mccarthy-the-view-the-benefits-of-vaccines-2013-7">increase in preventable infectious diseases</a> killing kids.</p>
<p>Skeptic, science blogger, and astronomer Phil Plait, has been watching the anti-vaccine movement for years, and is disappointed by the news. He writes over in <a href="http://www.slate.com/blogs/bad_astronomy/2013/07/15/the_view_daytime_talk_show_hires_antivaxxer_jenny_mccarthy.html" target="_blank">his Bad Astronomy blog at Slate</a>:</p>
<div class="text parbase section">
<p style="padding-left: 30px;">Why? McCarthy’s views constitute, in my opinion, a threat to <keyword id="6364896" type="ORGANIZATION" weightage="60" keywordseo="Public-Health">public health</keyword>. She is loudly against vaccines, claiming they cause autism, claiming they are loaded with toxins, and claiming her own son became autistic after a vaccination and that she subsequently cured him with a gluten-free diet.</p>
<p style="padding-left: 30px;">To phrase it delicately, none of her claims has any medical merit at all. Vaccines have an incredibly small risk, compared to their <em>extremely</em> large benefit. Polio, measles, pertussis … these diseases and many more have infected, sickened, and killed far fewer people than they used to due to the development of vaccinations against them. Smallpox alone killed hundreds of millions of people, and it’s <em>gone</em> because of vaccines.</p>
</div>
<p style="padding-left: 30px;">Vaccines have been tested exhaustively to see if they cause autism, and it's become overwhelmingly clear: there is <em>no</em> good evidence that they do.</p>
<p><a href="http://www.theatlantic.com/health/archive/2013/07/destabilizing-the-jenny-mccarthy-public-health-industrial-complex/277695/" target="_blank">David M. Perry at The Atlantic</a> noted how outspoken McCarthy has been in the past:</p>
<p style="padding-left: 30px;">This is a mistake, as it would provide a platform for a dangerous voice. Over the last decade, McCarthy has become one of the most prominent voices against vaccinations. She declared, as a fact, that vaccinations had caused her son's autism, and promoted this idea in venues aimed at mothers, such as on Oprah.</p>
<p><a href="http://www.usnews.com/opinion/blogs/pat-garofalo/2013/07/12/keep-jenny-mccarthys-vaccine-and-autism-pseudoscience-off-the-view" target="_blank">Pat Garofalo wrote for US News &amp; World Report</a>:</p>
<p style="padding-left: 30px;">By giving a purveyor of faux science such a prominent platform, ABC could be contributing to serious health problems and the spread of some of the globe's nastiest diseases, the suppression of which has been a public health success story for the ages. According to the World Health Organization and the United Nations Children's Fund, 2.5 million deaths a year are prevented due to vaccinations against just four diseases: diphtheria, tetanus, pertussis (whooping cough) and measles. Small pox was eradicated due to vaccinations, and polio is no longer the threat it once was in the western world.</p>
<p>Even non-scientists are upset. <a href="https://twitter.com/julieklausner/status/356791539818708994" target="_blank">Comedian Julie Klausner tweeted</a> "Wow! Congratulations to Jenny McCarthy and Measles/Mumps/Rubella for spreading its reach!" and movie critic <a href="https://twitter.com/scottEweinberg/statuses/356800276881080320" target="_blank">Scott Weinberg tweeted </a>"Jenny McCarthy's views on vaccination are only slightly less barbaric and repulsive than a movie she made called Dirty Love."</p>

Science Community Is Furious Over Jenny McCarthy's New Job On 'The View'

<ul class="summary-list"><li>On Thursday, HHS Secretary Xavier Becerra declared monkeypox a national public health emergency.</li><li>The announcement comes 12 days after the WHO declared the monkeypox outbreak a global emergency.</li></ul><p>On Thursday, the federal government declared the national outbreak of monkeypox — which has been spreading almost entirely among men who have sex with men — a public health emergency.</p><p>"We're prepared to take our response to the next level in addressing this virus. We urge every American to take monkeypox seriously and to take responsibility to help us tackle this virus," Health and Human Services (HHS) Secretary Xavier Becerra said on a call to reporters.</p><p>News of the expected declaration was first reported Thursday by <a href="https://www.washingtonpost.com/health/2022/08/04/monkeypox-public-health-emergency-united-states-becerra/">The Washington Post</a> and subsequently <a href="https://www.nytimes.com/2022/08/04/health/monkeypox-emergency-us.html">The New York Times</a>.</p><p>By designating monkeypox a public health emergency, the White House will be able to utilize emergency funds to fast-track testing, treatments, and vaccine shipments.</p><p>"I have no doubt that this is going to improve the federal government's response," David Harvey, executive director of the National Coalition of STD Directors, told Insider. "However, I did not hear an explicit mention of STI clinics who are on the front line of the response right now. We need emergency resources allocated yesterday."</p><p>Since the first monkeypox case was diagnosed this year in mid-May, more than <a href="https://www.cdc.gov/poxvirus/monkeypox/response/2022/us-map.html">6,610 cases</a> have been confirmed. Many public health professionals believe that number is likely much higher. </p><p>The Biden administration's declaration comes 12 days after the World Health Organization (WHO) deemed monkeypox <a href="https://www.insider.com/world-health-organization-monkeypox-outbreak-global-emergency-2022-7">a global emergency</a>. Despite some disagreement among panelists, WHO director general Dr. Tedros Adhanom Ghebreyesus acted as the "tie breaker," saying the rapid spread of the virus required urgent action, and for all member states to "act together in solidarity."</p><h2>A public health emergency declaration makes more funds available, and lets the CDC access more data</h2><p>The HHS Secretary has the discretion to declare <a href="https://www.phe.gov/Preparedness/legal/Pages/phedeclaration.aspx">a public health emergency</a> in the event of a major disaster, infectious disease outbreak, or attack. </p><p>Doing so allows the government and health agencies to cut through bureaucratic red tape that can slow down access to treatment and testing. For example, a public health emergency declaration permits measures including:</p><ul><li>The Food and Drug Administration to authorize tests and treatments at a faster clip than usual, putting them through a fast-tracked review process;</li><li>Access to "no-year" funds — i.e., money that is exclusively reserved for emergencies — to fund research and contact-tracing, and coordination between federal, state, and local health agencies;</li><li>The Centers for Disease Control and Prevention to request more data from local health networks to get a better sense of the spread of the disease.</li></ul><p>Many experts have voiced their concern that this declaration is overdue. The first monkeypox case was <a href="https://twitter.com/HHS_Spox/status/1555177615396413440/photo/1">detected</a> in Massachusetts in mid-May. Within a month, there were 150 confirmed cases. One month later, the CDC had confirmed around 2,000 cases. Two weeks later, that number exceeded 5,000 cases.</p><p>"It's about time," Harvey said. "This declaration is late." </p><h2>Trying to make vaccine supply go further with <a href="https://www.insider.com/monkeypox-dose-sparing-us-may-give-smaller-vaccine-doses-supply-2022-8">'dose-sparing'</a></h2><p>The US is racing to increase its supply of Jynneos, <a href="https://www.insider.com/monkeypox-smallpox-vaccine-protect-virus-explained-biden-cases-disease-022-5">a smallpox vaccine that works against monkeypox</a>. According to Becerra, 600,000 doses of Jynneos have been administered. While millions more doses have been secured, getting them to local health clinics is taking time, and vaccine appointments are getting <a href="https://www.news4jax.com/health/2022/08/01/monkeypox-vaccine-now-available-in-southeast-georgia-limited-appointments-are-available/">booked up within minutes</a>.</p><p>One technique the HHS hopes to trial is called "dose-sparing," administering a fifth of the dose into the skin so five people can be immunized with one dose. This is done by sticking the needle within the skin to create "a pocket where the vaccine goes," FDA commissioner Dr. Robert Califf explained on the call.</p><p>The HHS is working with the FDA on whether to allow this approach, with a decision expected in the next couple of days.</p><p>"We're at a critical inflection point," Califf said. "The goal has always been to vaccinate as many people as possible," he said, adding that they are working "as quickly as we possibly can" to "significantly increase the number of doses available."</p><p>Califf said he is confident that administering the shot this way triggers a robust immune response, and that healthcare professionals nationwide are capable of doing so, since the technique is near identical to a PPD skin test, which is routine in US healthcare settings.</p><p>Dr. Kavita Patel, a primary care physician, <a href="https://twitter.com/kavitapmd/status/1555274828780896259">said on Twitter</a> that injecting in this way "might trigger a more efficient immune response," and it is a strategy that is used already for some rabies and tuberculosis vaccines, but it's also possible it "could result in less efficacy."</p><p>Scientists at the National Institutes of Health are hoping to answer that very question with a new study, but it won't be finished until November or December, at the earliest, as <a href="https://www.statnews.com/2022/08/04/with-monkeypox-vaccine-in-high-demand-nih-to-test-approaches-to-stretch-supplies/">Stat reported Thursday</a>. </p><p>"If there is evidence for the effectiveness of that, then that would be a strategy to stretch available vaccines," Harvey said, while also emphasizing that men who have sex with men "deserve" to have "the best regimen of vaccine possible."</p><p>"Shortages are just not acceptable," he added. "Anything less than full effectiveness of vaccine doses treats gay and bi men and MSM [men who have sex with men] as second class citizens."</p><h2>Monkeypox symptoms can vary widely</h2><p>Doctors at major medical centers in Miami and San Francisco say many monkeypox cases are going unreported because providers don't always know how to recognize the signs.</p><p>The outbreak has taken many experts by surprise, because <a href="https://www.insider.com/monkeypox-symptoms-butt-pain-fevers-lethargy-lesions-2022-7">patients are presenting with a wide array of symptoms</a> which differ from historical literature on monkeypox, and images in medical textbooks. Some clinicians might also be skittish to ask patients about their sexual history. </p><p>Some patients have pox in their <a href="https://www.insider.com/monkeypox-miserable-experience-man-timeline-symptoms-vaccine-2022-7">genital area</a> that are so painful it makes it difficult to go to the bathroom, or lymph node swelling that <a href="https://www.insider.com/monkeypox-man-hospitalized-couldnt-swallow-spit-feared-death-symptoms-2022-7">makes it difficult to swallow</a>. Others may have barely any signs of infection at all, other than perhaps a single pimple-like pock.</p><p>Common <a href="https://www.insider.com/monkeypox-smallpox-chickenpox-rash-symptoms-chart-virus-outbreak-2022-5">early symptoms</a> include fevers, which can create confusion with COVID, and swollen lymph nodes in the groin are also a tell-tale sign.</p>

US declares monkeypox outbreak a public health emergency. Here's what that means.

<p>Hello,</p><p>Welcome to Insider <keyword id="11897506" type="UNKNOWN" weightage="100" keywordseo="healthcare" source="Orion">Healthcare</keyword>. I'm healthcare editor Leah Rosenbaum, and today in healthcare news:</p><ul><li><a href="https://www.businessinsider.com/fauci-extra-shots-of-covid-19-vaccines-should-be-standard-2021-11">Dr. Fauci said in a recent interview that booster shots aren't a luxury</a>; </li><li><a href="https://www.businessinsider.com/delta-variant-most-sequenced-covid-tests-worldwide-past-60-days-2021-11">The Delta variant has caused the vast majority of COVID-19 cases worldwide over the last two months</a>;</li><li><a href="https://www.businessinsider.com/cdc-2nd-american-has-monkeypox-pus-boils-after-nigeria-visit-2021-11">A second American has come down with a rare disease called monkeypox.</a></li></ul><p>If you're new to this <keyword id="11894123" type="UNKNOWN" weightage="60" keywordseo="newsletter" source="Orion">newsletter</keyword>, <a href="http://newsletter.businessinsider.com/join/4np/newsletter.businessinsider.com/join/4np/insider-healthcare">sign up here.</a> Comments, tips? Email me at <a href="mailto:lrosenbaum@insider.com">lrosenbaum@insider.com</a> or tweet <a href="https://twitter.com/leah_rosenbaum">@leah_rosenbaum.</a> Let's get to it... </p><h3><strong><a href="https://www.businessinsider.com/fauci-extra-shots-of-covid-19-vaccines-should-be-standard-2021-11">Dr. Fauci says 'a booster isn't a luxury' — think of it as the final step in your COVID-19 vaccine regimen</a></strong></h3><ul><li>Dr. <keyword id="11933279" type="UNKNOWN" weightage="60" keywordseo="fauci" source="Orion">Fauci</keyword> predicts that Pfizer and Moderna <keyword id="11893994" type="UNKNOWN" weightage="60" keywordseo="covid-19" source="Orion">COVID-19</keyword> vaccines may, one day, be considered three shot vaccinations. </li><li>That's because the immune system learns better when shots are spaced several months apart.</li><li><a href="https://www.businessinsider.com/fauci-extra-shots-of-covid-19-vaccines-should-be-standard-2021-11">It's possible that "we're not going to see an absolute need to reboost every several months" after that, he said. </a></li></ul><p><strong><a href="https://www.businessinsider.com/fauci-extra-shots-of-covid-19-vaccines-should-be-standard-2021-11">Read more now&gt;&gt;</a></strong></p><h3><strong><a href="https://www.businessinsider.com/delta-variant-most-sequenced-covid-tests-worldwide-past-60-days-2021-11"><div type="image" title="tsa christmas" height="2754" width="3673" msid="87784269" hostid="261"></div>The Delta variant was detected on 99.7% of sequenced tests worldwide in the past 60 days</a></strong></h3><ul><li>Of almost 800,000 sequences collected in the last 60 days, 99.7% were Delta, a WHO report said. </li><li>Delta is highly infectious and has mutations that help it avoid the immune response.</li><li><a href="https://www.businessinsider.com/delta-variant-most-sequenced-covid-tests-worldwide-past-60-days-2021-11">It was first detected in India in October 2020 and has since spread to at least 166 countries.</a></li></ul><p><strong><a href="https://www.businessinsider.com/delta-variant-most-sequenced-covid-tests-worldwide-past-60-days-2021-11">Check it out&gt;&gt;</a></strong></p><h3><strong><a href="https://www.businessinsider.com/cdc-2nd-american-has-monkeypox-pus-boils-after-nigeria-visit-2021-11"><div type="image" title="pox viruses" height="2847" width="3806" msid="87784270" hostid="261"></div></a><a href="https://www.businessinsider.com/cdc-2nd-american-has-monkeypox-pus-boils-after-nigeria-visit-2021-11">A second American has come down with monkeypox, a rare virus that causes pus-filled boils</a><a href="https://www.businessinsider.com/cdc-2nd-american-has-monkeypox-pus-boils-after-nigeria-visit-2021-11"></a></strong></h3><ul><li>A US resident got monkeypox after returning from Nigeria to Maryland.</li><li>A similar but separate case was reported in Dallas in July.</li><li><a href="https://www.businessinsider.com/cdc-2nd-american-has-monkeypox-pus-boils-after-nigeria-visit-2021-11">Monkeypox is rare but can be deadly, so the CDC has urged vigilance around pox-like lesions.</a></li></ul><p><strong><a href="https://www.businessinsider.com/cdc-2nd-american-has-monkeypox-pus-boils-after-nigeria-visit-2021-11">Dive in&gt;&gt;</a></strong></p><p><strong>More stories we're reading:</strong></p><ul><li><a href="https://www.businessinsider.com/anthony-fauci-daily-covid-19-cases-us-below-10000-normality-2021-11">Fauci says COVID-19 cases need to fall below 10,000 per day for a 'degree of normality,' as daily cases reach 85,000</a> (Insider)</li><li><a href="https://www.businessinsider.com/reviews/out?u=https%3A%2F%2Fwww.wsj.com%2Farticles%2Fdrug-overdose-deaths-fueled-by-fentanyl-hit-record-high-in-u-s-11637161200%3Fst%3Drei9o4xgmu9da3o%26reflink%3Ddesktopwebshare_twitter">Drug overdose deaths have reached an all-time high in America</a> (The Wall Street Journal)</li><li><a href="https://www.businessinsider.com/covid-antibody-test-should-i-get-one-booster-vaccine-expert-2021-11">Antibody tests can show whether you need a COVID-19 booster shot, some experts say — but the FDA disagrees</a> (Insider)</li><li><a href="https://www.axios.com/schools-buy-air-filtration-systems-may-be-harmful-c4dd3dc5-4737-4280-aa33-1f4ebe1aa1c9.html?utm_source=twitter&amp;utm_medium=social&amp;utm_campaign=editorial&amp;utm_content=health-schoolscovid">School districts invested in air purifying systems, but they may not have worked as expected</a> (Axios) </li></ul><p>-Leah</p>

Fauci: Boosters aren't a luxury

<ul class="summary-list"><li>Experts in San Francisco, Miami, and the UK say many monkeypox cases are being "missed."</li><li>Some patients are receiving false negative monkeypox tests, while others are being misdiagnosed.</li></ul><p>More than <a href="https://www.cdc.gov/poxvirus/monkeypox/response/2022/us-map.html">7,100 monkeypox patients</a> have been diagnosed in the US since this outbreak began with a single case in mid-May.</p><p>But Dr. Graham Walker, an emergency physician in San Francisco, says that many more monkeypox patients are not being given the care and attention they deserve to prevent, diagnose, and treat this infectious disease efficiently.</p><p>Walker says he's seen "several patients" whose monkeypox diagnosis was "missed" by another provider before they landed in his ER in excruciating pain.</p><p>"I had a patient who, I saw their record from another facility, and it said, 'lesions only in the genitals, so unlikely to be monkeypox,'" he told Insider. </p><p>Other clinicians and scientists in the US, the UK, and West Africa say the same: monkeypox is being widely underdiagnosed. </p><h2>Some misdiagnosed patients end up in so much pain they can't wear clothes</h2><p>Across the country from Walker's ER, Dr. Lilian Abbo, an infectious disease specialist at the University of Miami, says she's noticed the same issue. </p><p>"We have seen patients that have been going up to seven centers: three different urgent cares, dermatologists, and ERs to try to figure out what is going on," she said during a recent Infectious Diseases Society of <a href="https://affiliate.insider.com?u=https%3A%2F%2Fvimeo.com%2F729999731%3Fsid%3Din%257C62d9a412884de613c421403c%257Cbrowser%26utm_campaign%3D3861930%26utm_source%3Daffiliate%26utm_channel%3Daffiliate%26cjevent%3Db9f54d9d14c111ed805a011f0a82b82d%26clickid%3Db9f54d9d14c111ed805a011f0a82b82d">America telebriefing</a>, stressing the need for better awareness of how monkeypox can present.</p><p>Better awareness can have huge implications for both treatment, and disease containment. It's possible that if close contacts find out early enough in the course of their infection (meaning, in the first 4 days after an exposure) the Jynneos smallpox vaccine may be <a href="https://www.cdc.gov/poxvirus/monkeypox/considerations-for-monkeypox-vaccination.html">used to prevent monkeypox infection altogether</a>.</p><p>But, "by the time they arrive," many patients who've been misdiagnosed "may have been healed, or some of them may have progression of disease," Abbo said. That progression can be painful. </p><p>Patients in this outbreak have, in some of the most severe presentations, been unable to use the toilet, because the pain around their anus and genitals becomes so severe. "One of my patients said 'I can't even wear pants or underwear without pain,'" Walker said. </p><h2>'Textbook' descriptions of symptoms aren't always accurate</h2><div type="image" title="Matt Ford shows monkeypox spots" height="1000" width="2000" msid="93393933" hostid="261" sizebytes="90386"></div><p>Part of the reason why monkeypox is being underdiagnosed is that <a href="https://www.insider.com/monkeypox-miserable-experience-man-timeline-symptoms-vaccine-2022-7">this disease outbreak isn't operating</a> like the "textbook" monkeypox presentations of the past, with a classical fever, swollen lymph nodes in the neck, and headache all appearing before pox surface on the face and on the hands.</p><p>Instead, monkeypox lesions may be lodged in the rectum, lymph node swelling may be present only in the groin, and it's not unusual for a single pock to be the only marker of a person's entire infection.</p><p>A July 21 <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2207323?query=featured_home">New England Journal of Medicine</a> compilation of 528 case reports from 16 countries around the world establishes some clear patterns for this outbreak. Nearly two-thirds of the patients studied had lesions in their anogenital (private) area, with a majority of patients counting less than 10 lesions on their entire body.</p><p>Patients were "presenting with symptoms that weren't part of the case definitions," NEJM study author Chloe Orkin told <a href="https://www.insider.com/monkeypox-symptoms-butt-pain-fevers-lethargy-lesions-2022-7">Insider</a>. "The important thing is to help doctors to recognize it."</p><p>Fever, fatigue, muscle aches and headaches were some of the most common pre-rash signs a monkeypox infection was budding, which also makes it easy for people to confuse the condition with COVID, initially. </p><p>"Every single patient I've talked to has done a COVID test when they had a fever, and they're like, 'oh, it's not COVID,'" Walker said. </p><p>Other times, diagnoses are missed because providers don't get a "good, aggressive scrub" of the lesions, he said.</p><p>"I've seen that before, where people have had a test that came back negative and I'm like, 'you have literally every symptom of monkeypox, this looks exactly like all the other monkeypox cases I'm seeing, and we've ruled out other stuff, like herpes, syphilis, whatever.'" </p><h2>Some people avoid monkeypox diagnosis because it can be stigmatizing, painful, and lonely</h2><p>Early treatment is key to curb a monkeypox infection and prevent the excruciating pain it causes. The antiviral drug Tecovirimat (TPOXX) can help, as well as prescription painkillers which are stronger than Motrin and Advil.</p><p>But many patients, fearing stigma and lacking information, are not seeking help.</p><p>One of Walker's patients had been managing his lesions alone for two full weeks, when he finally decided to seek treatment. </p><p>"He just wanted to manage it at home. He was worried about the stigma, he said he'd never had an STD before. But the pain was so severe, he finally came in," Walker explained. "There's lots of fear, there's lots of anxiety, and to be honest, there's probably a lot of people who aren't diagnosed yet," he added. </p><p>Dr. Jason Zucker, an infectious disease specialist at New York Presbyterian hospital, said "even patients with mild disease have been taking it very hard" when they receive a monkeypox diagnosis.</p><p>"In addition to this stigma, patients who are diagnosed then isolate at home for up to four weeks alone," he told journalists on a Zoom call Friday. "It's important to make sure that we're all cognizant of this, that we all work together to reduce stigma, and that we offer patients mental health and other supportive resources after their diagnosis." </p><h2>A Nigerian doctor spotted this kind of monkeypox in 2017. He hopes people will finally start funding research on this virus.</h2><p>In Nigeria, where Dr. Dimie Ogoina has been studying monkeypox outbreaks linked to sexual contact <a href="https://pubmed.ncbi.nlm.nih.gov/29619921/">since 2017</a>, he says he's struggled with similar issues of confusion and stigma, which both make it harder to get a sense of the true scope of any outbreak.</p><p>Often, he suspects, patients with "genital lesions" aren't coming to the hospital to be properly diagnosed, instead, they're just going to the pharmacy for STD treatment. </p><p>"There are a lot of things that still not known about monkeypox"  because "it has been a neglected disease," Ogoina told Insider. "Since the global north is now having cases, I'm sure there will be investments in research, and we will be able to uncover most of these unknowns."</p>

An ER doctor says he's sick of seeing monkeypox patients misdiagnosed, only to end up in the hospital in excruciating pain

<ul class="summary-list"><li>27-year-old Molly DeMellier donated her blood for the Mount Sinai antibody trial after she recovered from <keyword id="8763838" type="UNKNOWN" weightage="60" keywordseo="covid-19">COVID-19</keyword>.</li><li>The trial hopes to use the <keyword id="102007" type="TECHNOLOGY" weightage="60" keywordseo="Antibodies">antibodies</keyword> of people who've recovered from COVID-19 to treat those who currently have severe cases.</li><li>DeMellier's blood didn't have enough antibodies to be used in the trial. Her experience underscores questions about how antibodies work and what it means for recovered patients' <keyword id="48619" type="PERSON" weightage="60" keywordseo="Immunity">immunity</keyword>.</li><li>Researchers and doctors are still studying <keyword id="1754604" type="PERSON" weightage="60" keywordseo="coronavirus">coronavirus</keyword> immunity and are unsure if a person can get COVID-19 twice.</li><li><a href="https://www.businessinsider.com/?hprecirc-bullet">Visit Business Insider's homepage for more stories</a>.</li></ul><p>On March 21, 27-year-old Molly DeMellier finally got the call she'd been expecting for days.</p><p>Four days earlier, after waking up with a sudden onset of a tight chest, body aches, extreme fatigue, and a fever, she had gone to an urgent care center two blocks from her New York City apartment for a coronavirus test.</p><p>The doctor on the phone confirmed she had COVID-19, the disease caused by the novel coronavirus.</p><p>DeMellier rode it out at home. Her chest tightness and cough alarmed her, but she didn't want to get an Uber or public transport to the hospital, inevitably exposing herself to other people. On her worst days, it hurt to even watch TV, so she would sleep all day. On her best, pain relief helped to ease her joint pain and headaches. After about 10 days of symptoms, DeMellier woke up on March 25 symptom-free. She waited three days before going outside again.</p><p>Overwhelmed by her experience, she discussed it on the sex and relationships <a href="https://www.shootersgottashoot.com/listen">podcast</a> she co-hosts, and soon after a fan got in touch telling her to apply to the <a href="https://health.mountsinai.org/blog/mount-sinai-to-begin-the-transfer-of-covid-19-antibodies-into-critically-ill-patients/">Mount Sinai antibody trial</a>, a program seeking blood plasma donations from people who have survived COVID-19, in the hopes that it could be used to treat people in the ICU.</p><p>DeMellier knew she wanted to help in any way she could after feeling helpless in bed for two weeks, so she applied right away.</p><p>She was accepted, and went in to donate a month later, as directed. But her experience highlights the unanswered questions doctors have about COVID-19, and whether we can be sure that all people who've had the disease <a href="https://www.businessinsider.com/study-recovered-coronavirus-patients-antibodies-2020-4">will develop immunity</a>.</p><h2>Why survivors' blood could help people in the ICU battling COVID-19</h2><p><div type="image" title="A tube with a solution containing COVID-19 antibodies." height="2331" width="3108" msid="75332357" hostid="261"></div></p><p>Mount Sinai's trial is one of a number across the world looking into serum therapy as a possible treatment for people with critical cases of COVID-19, a little-understood disease. It is the second hospital in the United States to receive FDA approval for antibody tests.</p><p>Antibodies are proteins produced by plasma cells in the blood that help fight off bacteria and viruses. The immune system generates them as a first line of defense when an unknown "intruder" substance enters the body. </p><p>Serum therapy, where the antibodies of a recovered sick person are injected into a sick person to help boost their own immune response to a certain type of disease, has existed since 1891 and <a href="https://www.nobelprize.org/prizes/medicine/1901/behring/article/">won a Nobel Prize in 1901 for its uses in treating diphtheria and tetanus</a>. More recently, serum therapy was <a href="https://www.medicinenet.com/script/main/art.asp?articlekey=229963">used to treat Ebola patients</a>.</p><p>The same approach is being held up as a promising treatment for COVID-19, partly because there are few other options at this point. Antibodies are always specific to the pathogen, so it will only work for COVID-19 patients if doctors use plasma from someone who's recovered from COVID-19.</p><p>There are plenty of caveats. Serum therapy can't be widely instated because it requires donors and recipients have the same blood type. Additionally, a donor has to donate a lot of blood to yield enough plasma, and that will still <a href="https://www.usatoday.com/story/news/health/2020/04/01/coronavirus-plasma-therapy-5-us-patients-covid-19-donors/5090946002/">only be enough to help two sick patients</a>, USA Today reported. There are also concerns that the tests used to measure antibodies may not be perfectly accurate: they may spot antibodies for other pathogens, or present false positives.</p><p>The biggest obstacle is that it's unclear who develops antibodies, who doesn't, when they do, and why. For example, one not-yet-peer-reviewed study from China found that 6% of the 130 recovered COVID-19 patients studied <a href="https://www.businessinsider.com/study-recovered-coronavirus-patients-antibodies-2020-4">didn't develop any detectable antibodies</a>, and 30% developed very low amounts. The researchers also found that older patients developed more antibodies than younger ones.</p><h2>It takes 14 to 21 days to develop immunity to COVID-19, according to Mount Sinai's research</h2><p>To get accepted, DeMellier had to <a href="https://redcap.mountsinai.org/redcap/surveys/?s=RCC7FNHK3Y&amp;_ga=2.107025419.807058938.1587601646-2029440026.15864458735873">answer online questions</a> about her illness, her symptoms, and when her symptoms subsided. Soon after, a Mount Sinai employee called and scheduled an appointment for April 9 to ensure it had been more than 12 days, the amount of time they believe it takes for antibodies to show up in the blood.</p><p>Generally speaking, antibodies are at their highest when a person is almost recovered from the virus. When it comes to COVID-19, though, there's still much uncertainty about when antibody levels peak for the recovered, Dr. David L. Reich, President and Chief Operating Officer of Mount Sinai, told Business Insider.</p><p>"My position as a hospital president, I've been following everything that's been going on in the laboratory, but our impression is that the practical use of this test would be to look for people who develop immunity usually 14 or 21 days after the illness," is diagnosed, because that's when the researchers have observed peak antibody levels.</p><h2>Getting into the Mount Sinai trial</h2><p><div type="image" title="molly demellier" height="698" width="931" msid="75332361" hostid="261"></div></p><p>When the morning came, 15 days after her symptoms subsided, DeMellier confirmed with Mount Sinai that she felt well and, wearing a mask, took an Uber uptown to East 102 Street. Her driver had stuck a plastic sheet between them, creating a makeshift wall for extra protection.</p><p>On arrival, she was greeted by a security guard, then ushered to a healthcare worker who asked if she had any lingering symptoms. She was given a fresh mask, had her temperature and blood pressure taken, then sent upstairs.</p><p>"It was kind of eerie, to be honest," DeMellier told Business Insider. "I actually saw all of the nurses and doctors, who were working around all of the blood work and testing and that kind of thing. It was really emotional just to see how scared and sad everybody looked. I guess I just hadn't thought about what it would be like to see these healthcare workers in their environment right now."</p><p>After 15 minutes of waiting in a near-empty room, a nurse took two vials of DeMellier's blood for testing.</p><h2>DeMellier had nowhere near enough antibodies to donate</h2><p><div type="image" title="american flag cusion blood donation orlando shooting" height="2864" width="3818" msid="75332365" hostid="261"></div></p><p>Antibodies are <a href="https://www.ucsfhealth.org/medical-tests/003333">measured by taking a small amount of person's blood</a>, creating a serum with it, and seeing how many antibodies are concentrated into that serum.</p><p>DeMellier was told that if her tested sample came back with fewer than 1:320 COVID-19 antibodies, they wouldn't be able to use her plasma in the trial. It came back with 1:150 antibodies.</p><p>What does that mean for DeMellier? She's technically not allowed to take this as a "diagnosis" because the FDA has not approved Mount Sinai's measuring system to test patients; it's only to use in a research context, Reich said.</p><p>"Most people are saying that a titer of 1:320 or stronger is optimal for a convalescent plasma [to treat COVID-19 patients]," Reich said. "So somewhere around 90% of the people that we tested have antibodies, have high concentrations of antibodies greater than that 1:320 threshold. But I'll mention that that's more in a research context, not in the FDA testing context."</p><h2>Her doctors aren't sure why she doesn't have enough</h2><p>A few days following her donation appointment, DeMellier received an email from Mount Sinai saying her antibody levels could rise in the coming weeks, making her blood viable for use. But the doctors could not say whether she has any kind of immunity just yet.</p><p>"It says that my body may not have had enough time yet to develop enough antibodies, and that I can try to follow up with my primary care physician in three weeks to see if they are able to retest for antibodies at that time," DeMellier said.</p><p>Reich said it's possible this could be the case for DeMellier and others who have lower antibody counts.</p><p>"They might come back a week later and the antibody levels might be higher. But you would expect, as with anything else in medicine, that there is probably a variable response that people's bodies have to this virus," he said. "And it's unclear if it has anything to do with severity of disease or other factors because it's just way too soon in the history of this disease to have figured that out."</p><p><div type="image" title="Antibody testing starts in California" height="1333" width="1777" msid="75332380" hostid="261"></div></p><h2><keyword id="6354750" type="UNKNOWN" weightage="60" keywordseo="health">Health</keyword> experts don't know if all recovered COVID-19 patients will be immune — and how long immunity lasts</h2><p>Researchers are still studying how COVID-19 immunity could work, and though they hope recovered patients won't be able to get sick again, they don't know for sure.</p><p>"What we hope is, if you get it once, you'll be protected against it for at least a year. We don't know that, but that's what we hope," Elizabeth Halloran, a biostatistician at Fred Hutchinson Cancer Research Center and University of Washington, told Business Insider. "We hope that a vaccine could induce an immunity that will keep people at least from dying. The immunity is still under research and it's got some potential bad qualities, but we don't know for sure."</p><p>On April 8, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said people who already had the coronavirus are unlikely to get sick again in the near future. At the same time, Fauci said it's difficult to tell how long a formerly sick person's immunity could last because the <a href="https://www.businessinsider.com/fauci-recovering-from-coronavirus-immunity-through-september-antibodies-2020-4">virus has the potential, albeit small, to mutate</a>.</p><p>"If we get infected in February and March and recover, next September, October, that person who's infected — I believe — is going to be protected," Fauci said during a <a href="https://www.youtube.com/watch?v=c0cYneu-hlc&amp;feature=youtu.beu.be">livestreamed conversation</a> with Howard Bauchner, editor of the Journal of the American Medical Association.</p><h2>'I'm treating it like I can definitely get sick again'</h2><p><div type="image" title="molly demellier covid 19 antibodies test" height="696" width="928" msid="75332382" hostid="261"></div></p><p>DeMellier said she's been staying home as much as possible and practicing social distancing while running errands because she doesn't want to get sick again.</p><p>"I'm treating it like I can definitely get sick again," DeMellier said. "I'm really limiting my time outside. I go for like one good run a day and if I need to run errands, I try and just do it all in one shot and I clean everything.</p><p>She said that her antibody test results make her feel like she doesn't have enough to be protected from reinfection.</p><p>"I'm not banking on that I can't get sick again. I was also a kid who had chicken pox twice, so..." DeMellier said.</p><p>Reich said it's still too early to know what blood antibody levels mean for immunity against the virus.</p><p>"There is a presumption that the higher the number of antibodies in the bloodstream, the more likely it is to quote unquote neutralize virus in the bloodstream," he said. "But remember this is primarily a respiratory virus. That's how people get infected. And so it's unclear what it means to have immunity in the bloodstream."</p>Read the original article on <a href="https://www.businessinsider.com/woman-with-covid-19-worried-she-could-get-it-again-2020-4">Business Insider</a>

A woman who recovered from the coronavirus tried to donate her plasma, but she barely had any antibodies. It highlights lingering questions about immunity.

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