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Some gay and bisexual men, who are at a higher risk of contracting <keyword id="7616951" type="General" weightage="100" keywordseo="monkeypox" source="Orion">monkeypox</keyword>, should be offered a vaccine, say the UK health officials. According to the BBC, this could help to control the recent outbreak of the rare virus in the UK in which 793 people have been infected so far. The report mentioned that Monkeypox is not defined as a sexually-transmitted infection. However, it can be passed on by close contact during sex, and with bedding, towels and skin. The <keyword id="11923364" type="General" weightage="20" keywordseo="UK-Health-Security-Agency" source="Orion">UK Health Security Agency</keyword> (<keyword id="12577993" type="General" weightage="50" keywordseo="ukhsa" source="Orion">UKHSA</keyword>) said that a vaccine designed to protect against smallpox, called <keyword id="14073922" type="General" weightage="20" keywordseo="imvanex" source="Orion">Imvanex</keyword>, will help protect people who could be exposed to monkeypox. The vaccine is effective against monkeypox because it is from the same family of viruses. Its use has been signed off by the UK's vaccine experts, the Joint Committee on Vaccination and Immunisation (JCVI). Health officials say they are continuing to see "a notable proportion of cases in gay, bisexual and other men who have sex with men". They say they hope to roll out vaccines to those at higher risk that will "break chains of transmission". SEE ALSO: <a target="_blank" class="c-link c-message_attachment__title_link" href="https://www.businessinsider.in/science/space/news/nasa-selects-three-firms-to-design-nuclear-power-plant-for-moon/articleshow/92379824.cms">NASA selects three firms to design nuclear power plant for Moon</a> <a target="_blank" class="c-link c-message_attachment__title_link" href="https://www.businessinsider.in/tech/news/twitter-will-soon-allow-you-to-post-longer-tweets-in-the-form-of-notes/articleshow/92379591.cms">Twitter will soon allow you to post longer tweets in the form of Notes</a>

Monkeypox jab be given to at-risk gay, bisexual men, says UK report

Sydney, Aug 15 (The Conversation): The <keyword id="19896311" type="General" weightage="20" keywordseo="World-Health-Organization" source="keywords" meta.keywordsubtype="org" meta.entityname="World Health Organization" meta.hostid="261" meta.entityid="World Health Organization">World Health Organization</keyword> (<keyword id="19895006" type="General" weightage="20" keywordseo="WHO" source="keywords">WHO</keyword>) has declared <keyword id="20965747" type="General" weightage="100" keywordseo="mpox" source="keywords">mpox</keyword> a public health emergency of international concern, after rising cases in the <keyword id="22796094" type="General" weightage="20" keywordseo="Democratic-Republic-of-the-Congo" source="keywords">Democratic Republic of the Congo</keyword> and the potential for further spread. This now triggers a coordinated international response to an extraordinary event and the mobilisation of resources, such as vaccines and diagnostic testing, to curb the spread of this infectious disease. But WHO has not declared mpox a <keyword id="19913581" type="General" weightage="20" keywordseo="pandemic" source="keywords">pandemic</keyword>. Rather, the measures it has triggered are designed to prevent it from becoming one. <h2>What triggered this latest alert?</h2> Mpox, once known as monkeypox, is a viral infection closely related to <keyword id="22362924" type="General" weightage="20" keywordseo="smallpox" source="keywords">smallpox</keyword>. Initial symptoms include a fever, headache, swelling of the lymph nodes and muscle ache. A typical rash follows, mainly on the face, hands and feet. The spread of mpox through certain African countries led the Africa Centres for Disease Control and Prevention to declare earlier this week mpox a public health emergency of continental security. This is the first time the organisation has issued such an alert since it was established in 2017. The situation in the Democratic Republic of the Congo in central Africa has been particularly worrying for more than a year. There are two types or clades of mpox. Clade II, which originates in west Africa, is less severe. It has a fatality rate of up to 1 per cent (in other words, roughly one in 100 are expected to die from it). But clade I, from central Africa, has a fatality rate of up to 10 per cent (up to one in ten die). This compares to a 0.7 per cent fatality rate for the Omicron variant of SARS-CoV-2, the virus that causes COVID. The Democratic Republic of the Congo is seeing large epidemics of the more deadly clade I mpox. Mpox is endemic in some parts of central and west Africa, where the virus exists in animals and can spread to humans. Outbreaks have been increasing, with more human-to-human spread, since 2017. This is partly due to very low levels of immunity to the mpox virus, which is related to the virus that causes smallpox. Mass vaccination against smallpox ceased more than 40 years ago globally, resulting in minimal immunity in populations today against mpox. The WHO designation announced this week relates to the clade I. Not only does this have a higher fatality rate, it has new mutations that enhance spread between people. These changes, and the global lack of immunity to mpox, makes the world's population vulnerable to the virus. <h2>There are two different epidemics</h2> In 2022, an epidemic of mpox swept through non-endemic countries, including beyond Africa. This was a variant of clade II originating from Nigeria, called clade IIb. This was sexually transmitted, predominantly affecting men who have sex with men, and had a low fatality rate. That epidemic peaked in 2022, with vaccines made available to people at risk in high-income countries, but there has been an uptick in 2024. At the same time, large clade I epidemics were occurring in the Democratic Republic of the Congo, but with far less attention. Vaccines were not available there, even in 2023, when there were 14,626 cases and 654 deaths. Mortality was 4.5 per cent, and higher in children. In fact, most cases and deaths in the Democratic Republic of the Congo have been children. This means most transmission there is non-sexual and is likely to have occurred through close contact or respiratory aerosols. However, in 2023 an <keyword id="20877025" type="General" weightage="20" keywordseo="outbreak" source="keywords">outbreak</keyword> in a non-endemic part of the country, South Kivu in the east, appeared to be by sexual transmission, indicating more than one epidemic and different transmission modes in the Democratic Republic of the Congo. By mid-2024, there were already more cases in the country than all of 2023 - more than 15,600 cases and 537 deaths. Testing capacity is low in the Democratic Republic of the Congo, most cases are not confirmed by lab testing, and the data we have are from a small sample of genomic sequences from the Kamituga region of South Kivu. This show mutations to the clade I virus around September 2023, to a variant termed clade Ib, which is more readily transmissible between people. We do not have much data to compare these viruses with the viruses causing cases in the rest of the country. <h2>Mpox is spreading internationally</h2> In the past month, the virus has spread to countries that share a border with the Democratic Republic of the Congo - Rwanda and Burundi. It has also spread to other east African countries, such as Kenya and Uganda. None of these countries have had mpox cases previously. In an interconnected, mobile world, cases may spread to other continents, as mpox did in 2018 from Nigeria to the United Kingdom and other countries. A few travel-related cases between 2018 and 2019 may have led to the large multi-country 2022 clade IIb epidemic. <h2>We have vaccines, but not where they are needed</h2> As the mpox virus and smallpox viruses are related (they are both orthopoxviruses), smallpox vaccines offer protection against mpox. These vaccines were used to control the 2022 clade IIb epidemic. However, most of the world has never been vaccinated, and has no immunity to mpox. The newer <keyword id="19959412" type="General" weightage="20" keywordseo="vaccine" source="keywords">vaccine</keyword> (called Jynneos in some countries and Imvamune or Imvanex in others) is effective. However, supplies are limited, and vaccine is scarce in the Democratic Republic of the Congo. WHO's declaration of mpox as a public health emergency of international concern will help mobilise vaccines to where they are needed. The Africa Centres for Disease Control had already begun negotiations to secure 2,00,000 doses of vaccine, which is a fraction of what is required to control the epidemic in the Democratic Republic of the Congo. <h2>What happens now?</h2> Ultimately, a serious epidemic anywhere in the world is a concern for all of us, as it can spread globally through travel, as we saw with the COVID pandemic. Controlling it at the source is the best measure, and WHO's latest declaration will help mobilise the required resources. Surveillance for spread of this more serious version of mpox is also essential, bearing in mind that many countries do not have the capacity for widespread testing. So we'll have to rely on "suspected cases", based on a clinical definition, to keep track of the epidemic. Open-source epidemic intelligence - such as using AI to monitor trends in rash and fever illness - can also be used as an early warning system in countries with weak health systems or delayed reporting of cases. A further complication is that 20-30 per cent of people with mpox may simultaneously have chickenpox, an unrelated infection that also causes a rash. So an initial diagnosis of chickenpox (which is easier to test for) does not rule out mpox. Effective communication and tackling push-back against public health measures and disinformation is also key. We saw how important this was during the COVID pandemic. Now, WHO will coordinate the global mpox response, focusing on equity in disease prevention and access to diagnostics and vaccines. It is up to individual countries to do their best to comply with the International Health Regulations, and the protocols for how such a global emergency are managed.

WHO has declared mpox a global health emergency. What happens next?

<ul class="summary-list"><li><keyword id="13900629" type="UNKNOWN" weightage="60" keywordseo="monkeypox" source="Orion">Monkeypox</keyword> has spread to more than a dozen countries including several in Europe, the US, and Canada.</li><li>The <keyword id="12554315" type="UNKNOWN" weightage="60" keywordseo="smallpox" source="Orion">smallpox</keyword> vaccine is 85% effective against monkeypox, but no longer widely available.</li></ul>Google searches for "smallpox vaccine" have rocketed since monkeypox cases started turning up in people across Europe and North America who have no recent travel history to Africa. The search curiosity is not unprompted — President Joe Biden promoted the US' smallpox vaccine stockpile when he<a href="https://edition.cnn.com/2022/05/23/politics/biden-monkeypox-not-as-bad-as-covid-intl-hnk/index.html"> told reporters</a> on Monday he doesn't think the monkeypox outbreak merits the same level of concern as COVID-19."Look, we've had this monkeypox …<a href="https://www.businessinsider.com/heres-how-the-us-handled-its-first-ever-monkeypox-outbreak-2022-5"> in the past</a>," Biden said, referring to an outbreak that occurred across six states and infected dozens of people in 2003. "The smallpox vaccine works for it."However, while a smallpox vaccine <a href="https://www.cdc.gov/poxvirus/monkeypox/clinicians/smallpox-vaccine.html">may be around 85% cross-protective</a> against monkeypox, not everyone can just run to their local pharmacy and get a shot right now. There are two smallpox vaccines in the US. For the newer, safer one, supply is scarce — representatives from the Centers for Disease Control and Prevention said on Monday that upwards of 1,000 doses of the Jynneos vaccine are available right now, and that "we expect that level to ramp up very quickly in the coming weeks." The US has also stockpiled more than 100 million doses of another, older smallpox vaccine, called ACAM2000, but infectious disease experts warn it carries a higher risk of <a href="https://www.fda.gov/vaccines-blood-biologics/vaccines/acam2000">heart problems, brain swelling</a>, blindness, and in the most severe cases (one in a million) — <a href="https://www.fda.gov/media/75792/download">death</a>. <h2>Eradicating smallpox may have had 'unintended consequences' for monkeypox</h2><div type="image" title="Models line up for their smallpox vaccinations on 2nd October 1955." height="3330" width="4440" msid="91792079" hostid="261"></div>Routine smallpox vaccination was stopped in the US in 1972, more than <a href="https://www.cdc.gov/smallpox/index.html#:~:text=Smallpox%20Virus&amp;text=Thanks%20to%20the%20success%20of,occurring%20smallpox%20have%20happened%20since.">30 years</a> after the last smallpox cases were diagnosed in the country. In 1980, smallpox was declared eradicated worldwide — it's <a href="https://asm.org/Articles/2020/March/Disease-Eradication-What-Does-It-Take-to-Wipe-out#:~:text=To%20date%2C%20the%20World%20Health,the%20rinderpest%20virus%20(RPV).">the only human disease</a> that vaccines have successfully <a href="https://pubmed.ncbi.nlm.nih.gov/6293036/">wiped off the planet</a> entirely. Babies today aren't vaccinated against smallpox, and the last people vaccinated in large numbers are around<a href="https://www.chop.edu/centers-programs/vaccine-education-center/vaccine-details/smallpox-vaccine#:~:text=How%20long%20does%20immunity%20to,never%20been%20vaccinated%20against%20smallpox."> 50 years</a> old, or older. (You can see tell-tale signs that some older adults had a smallpox vaccine, because they have characteristic scars on their arms.) <div type="image" title="A doctor points to a patient's scars from a smallpox vaccinatio." height="2000" width="2666" msid="91792080" hostid="261"></div>While the eradication of smallpox through vaccination has saved more than <a href="https://www.euro.who.int/en/media-centre/events/events/2019/11/culture-and-health-webinar-series-2019-200-million-lives-saved-smallpox-eradication-40-years-on">200 million lives</a> and many <a href="https://www.amnh.org/explore/science-topics/disease-eradication/countdown-to-zero/smallpox">billions of dollars</a> over the past four decades, infectious disease experts have been warning for several years now that the lack of vaccine-induced immunity to smallpox worldwide may carry some "unintended consequences." It's estimated that roughly <a href="https://pubmed.ncbi.nlm.nih.gov/32417140/">70% of the world has no immunity to smallpox</a> today, and experts suspect that may be at least part of the reason why monkeypox outbreaks have become more common in some western African countries, like <a href="https://ncdc.gov.ng/news/366/monkeypox-case-in-the-united-kingdom-with-travel-history-to-nigeria">Nigeria</a>, in recent years. <h2>Older smallpox vaccines leave scars, and carry risks of spreading the disease </h2><div type="image" title="A smallpox vaccine is administered to a sailor on a ship in the Gulf of Aden off the coast of Djibouti" height="2000" width="2666" msid="91792081" hostid="261"></div>The US keeps a strategic national stockpile of smallpox vaccine on hand at all times, <a href="https://www.naccho.org/blog/articles/smallpox-preparedness-planning-understanding-the-strategic-national-stockpile-and-potential-weaponization">just in case of a bioterror attack</a>, but during peacetime the CDC <a href="https://www.cdc.gov/smallpox/vaccine-basics/who-gets-vaccination.html">only recommends</a> the smallpox vaccine to lab workers who work with smallpox, or smallpox-like orthopoxviruses, including monkeypox. According to the CDC, there are enough vaccines to vaccinate "everyone who would need it" if a smallpox disaster occurred. (Unlike COVID-19 vaccines, <a href="https://www.health.ny.gov/publications/7004/">if you take a smallpox vaccine in the week after you're exposed</a> to the <keyword id="12241888" type="UNKNOWN" weightage="60" keywordseo="virus" source="Orion">virus</keyword>, it can still offer some protection.) But the US's national stockpile includes many doses of the older, more dangerous ACAM2000 vaccine, which experts are understandably cautious about taking off the shelf unless it is absolutely necessary.The UK — where the first monkeypox case of the 2022 outbreak was<a href="https://www.businessinsider.com/monkeypox-virus-symptom-treatment-spread-case-detected-uk-2022-5"> announced on May 7</a> — also uses the newer, safer smallpox vaccine from <a href="https://www.bavarian-nordic.com/investor/news/news.aspx?news=6574">Bavarian Nordic</a> (called Jynneos in the US) but in Europe it's referred to as <a href="https://www.vaxini.com/en/vaccine-product-characteristics-prescription-information/imvanex/">Imvanex</a>. (The UK began offering Imvanex to healthcare workers that may have been exposed to the virus on<a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1077329/20220520_monkeypox-contact-tracing-classification-and-vaccination-matrix.pdf"> May 20.</a>)Infectious disease expert Andrea McCollum, who investigates monkeypox outbreaks for the CDC, said she decided to <a href="https://www.fda.gov/emergency-preparedness-and-response/mcm-issues/smallpox-preparedness-and-response-updates-fda">get vaccinated</a> with ACAM2000 because it was recommended for her work, at a time when the newer, safer Jynneos vaccine wasn't available yet."I felt as if the benefit of vaccination far outweighed any risk associated with handling specimens, not vaccinated," she told Insider. ACAM2000 is a live virus vaccine (Jynneos is not) and as such it prompts a <a href="https://www.fda.gov/vaccines-blood-biologics/vaccines/acam2000-smallpox-vaccine-questions-and-answers">smallpox-like "pock" to form on the arm</a>, in the days after it is injected. "With ACAM2000 you do develop, it's called a 'take,' you develop the lesion on the arm — it's an indication of successful vaccination," McCollum said. For her, it wasn't a big deal, because she knew what to expect — feeling "crummy" for a "couple days" — and she knew how to take care of the blister, which scabs, falls off, and eventually leaves a small scar. "It has to remain covered, and you have to do frequent handwashing and appropriately take care of the site and any of the bandages," to avoid infecting others in the roughly three weeks after vaccination, McCollum said.Correction: A previous version of this story mistakenly said that Imvanex and Jynneos are different vaccines — they are not, they are just <a href="https://www.bavarian-nordic.com/investor/news/news.aspx?news=6574">different brand names</a> for the same product in the US and Europe.

Yes, a smallpox vaccine protects against monkeypox, but it comes with its own set of risks

European countries will be told to prepare a vaccination plan to tackle the spiralling monkeypox outbreak, as Denmark became the latest country to be struck down. EU authorities are set to publish a risk assessment, which will advise all member states to draw up an inoculation strategy to control the spread of the tropical virus, <keyword id="35773" type="General" weightage="80" keywordseo="daily-mail" source="Orion">Daily Mail</keyword> reported. No monkeypox-specific vaccine exists but smallpox jabs which were routinely offered to Brits until the virus was eradicated four decades ago, is 85 per cent effective, Daily Mail reported. The strategy likely to be recommended is the same already deployed in Britain. Officials were attempting to contain the spread by vaccinating all close contacts of the 20 confirmed monkeypox cases, including <keyword id="135579" type="General" weightage="50" keywordseo="nhs" source="Orion">NHS</keyword> workers. The strategy, called ring vaccination, involves jabbing and monitoring anyone around an infected person to form a buffer of immune people to limit the disease's spread. It comes as experts warn nations could bring in travel restrictions to control the spread of the illness, if the <keyword id="43588" type="General" weightage="50" keywordseo="world-health-organization" source="Orion">World Health Organization</keyword> (WHO) declares the outbreak an emergency. But the vaccine, called Imvanex and made by Denmark-based drugmaker Bavarian Nordic, has not been authorised for use against monkeypox in <keyword id="28249" type="General" weightage="100" keywordseo="europe" source="Orion">Europe</keyword> or the UK, Daily Mail reported. The <keyword id="114599" type="General" weightage="50" keywordseo="european-medicines-agency" source="Orion">European Medicines Agency</keyword> approved the jab for use against smallpox in 2013, while the <keyword id="6356255" type="General" weightage="50" keywordseo="us-food-and-drug-administration" source="Orion">US Food and Drug Administration</keyword> greenlit the injection for both infections in 2019. And there is no data available on how safe it is for immunocompromised people or youngsters, the groups at highest risk from the outbreak. It comes as WHO bosses had been informed of 92 confirmed cases by Saturday and 28 suspected infections, most of which have been detected in Europe. But the true toll will be many times higher, with top scientists warning community transmission means some of the spread is inevitably going undetected, Daily Mail reported. A disproportionate number of cases are in gay and bisexual men. SEE ALSO: <a target="_blank" class="c-link c-message_attachment__title_link" href="https://www.businessinsider.in/business/startups/news/former-twitter-india-head-is-looking-to-wind-down-his-metaverse-college-in-less-than-six-months/articleshow/91743472.cms">Former Twitter India head is looking to wind down his metaverse college in less than six months</a> <a target="_blank" class="c-link c-message_attachment__title_link" href="https://www.businessinsider.in/business/news/vaccine-makers-are-making-over-1000-per-second-and-furiously-holding-on-to-their-monopolies/articleshow/91743852.cms">Vaccine makers are making over $1,000 per second and furiously holding on to their monopolies</a>

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Monkeypox jab be given to at-risk gay, bisexual men, says UK report

IANS

WHO has declared mpox a global health emergency. What happens next?

PTI

Yes, a smallpox vaccine protects against monkeypox, but it comes with its own set of risks

Dr. Catherine Schuster-Bruce,…

Europe on red alert for monkeypox as EU health chiefs ask nations to prepare vaccination strategies

IANS

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