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Mpox - news and discussion

I hope they find a way to make it less uncomfortable
The current licensed smallpox/monkeypox vaccine, Imvanex (aka JYNNEOS in the US), based on a live attenuated vaccinia virus, is administered subcutaneously in two doses. The old percutaneous (scarification) method of multiple punctures with a bifurcated needle to administer a reconstituted live vaccinia virus (from calf lymph) is no longer used.
 
This is an odd coincidence (read the executive summary)…

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In March 2021, the Nuclear Threat Initiative (NTI) partnered with the Munich Security Conference (MSC) to conduct a tabletop exercise on reducing high-consequence biological threats. Conducted virtually, the exercise examined gaps in national and international biosecurity and pandemic preparedness architectures
and explored opportunities to improve capabilities to prevent and respond to high-consequence biological events. Participants included 19 senior leaders and experts from across Africa, the Americas, Asia, and Europe with decades of combined experience in public health, biotechnology industry, international security, and philanthropy.
The exercise scenario portrayed a deadly, global pandemic involving an unusual strain of monkeypox virus that emerged in the fictional nation of Brinia and spread globally over 18 months. Ultimately, the exercise scenario revealed that the initial outbreak was caused by a terrorist attack using a pathogen engineered in a laboratory with inadequate biosafety and biosecurity provisions and weak oversight. By the end of the exercise, the fictional pandemic resulted in more than three billion cases and 270 million fatalities worldwide.
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This is an odd coincidence (read the executive summary)…

————————————————
In March 2021, the Nuclear Threat Initiative (NTI) partnered with the Munich Security Conference (MSC) to conduct a tabletop exercise on reducing high-consequence biological threats. Conducted virtually, the exercise examined gaps in national and international biosecurity and pandemic preparedness architectures
and explored opportunities to improve capabilities to prevent and respond to high-consequence biological events. Participants included 19 senior leaders and experts from across Africa, the Americas, Asia, and Europe with decades of combined experience in public health, biotechnology industry, international security, and philanthropy.
The exercise scenario portrayed a deadly, global pandemic involving an unusual strain of monkeypox virus that emerged in the fictional nation of Brinia and spread globally over 18 months. Ultimately, the exercise scenario revealed that the initial outbreak was caused by a terrorist attack using a pathogen engineered in a laboratory with inadequate biosafety and biosecurity provisions and weak oversight. By the end of the exercise, the fictional pandemic resulted in more than three billion cases and 270 million fatalities worldwide.
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Brinia is clearly a barely disguised code name for Britain. :hmm:
 
An interview with an ex-soviet bioweapons scientist. There’s fuck all evidence this Monkeypox outbreak is man made but this is an interesting read….

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And you found that animal pox viruses provided sufficiently close models for human smallpox?
Yes. When the Ministry of Defense realized that it wouldn’t be possible in the future to work intensively with Variola major, they decided to start working with monkeypox virus, which infects humans but is much less contagious than smallpox. So the Ministry of Defense decided to work with monkeypox instead of smallpox to create future biological weapons.

When was this decision made?
In the late 1980s. And so when I now hear that the Russian MOD is working with monkeypox virus, how should I react? Everybody can try to convince me of something different, but I cannot believe it.

Would the object be to genetically engineer monkeypox to make it more contagious?
First, you could conduct genetic manipulations with the aim of making monkeypox virus as contagious as smallpox virus. This could be done by determining what parts of the viral genome are responsible for the contagiousness of this virus. In this case, of course, you would never be accused of working with smallpox.
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A paper, 'Major increase in human monkeypox incidence 30 years after smallpox vaccination campaigns cease in the Democratic Republic of Congo' (2010), concerning a couple of potentially unfortunate adverse consequences of the conclusion of the successful global programme to eradicate smallpox.
Comparison of active surveillance data in the same health zone [Central DRC] from the 1980s (0.72 per 10,000) and 2006–07 (14.42 per 10,000) suggests a 20-fold increase in human monkeypox incidence. Thirty years after mass smallpox vaccination campaigns ceased, human monkeypox incidence has dramatically increased in rural DRC.
Comparison of average annual cumulative incidence of human monkeypox by age group Kole Health Zone, DRC: 1981-6 vs. 2006-7. *=Proportion of the population vaccinated in 2006-7 and in 1981-6 based on vaccination scar surveys in 1981-6 and in 2006. ^=Vaccination rate steadily declined from 41.0% in 1981 to 4% in 1985.
Although the eradication of smallpox was a tremendous public health achievement, the subsequent global cessation of vaccinia virus vaccination has had two major adverse consequences. First, the majority of the world's population is now vulnerable to a bioterror attack with variola virus; second, the people of central Africa who are in frequent contact with monkeypox-infected animals are no longer protected against infection. The United States and other high-income countries have taken steps to deal with the first problem, by stockpiling vaccine and investigating new antiviral therapies for use in the event of bioterrorism. However, no country has taken responsibility for dealing with the increased burden of monkeypox in impoverished rural African populations. Thirty years after the singular accomplishment of smallpox eradication, the increasing incidence of human monkeypox we observe in DRC should be closely monitored. Failure to pursue a more comprehensive assessment of epidemiology, risk, and possible control measures could have serious implications. Inaction ignores the preventable morbidity suffered by indigenous populations, in the worst case risking increased adaptation of monkeypox to humans and potentially resulting in a lost opportunity to combat this infection while its geographic range is still limited.
DOI: 10.1073/pnas.1005769107.
 
Wrong, Magnus McGinty was right, the first cases in the UK were in York at the end of Jan., followed by Brighton in early Feb.
First detected cases at that time, not really the first cases at all. I wish we had a better picture of the real first cases, their timing and the initial seeding picture in general.

Likewise even the first reported deaths werent really the first ones, and those started showing up only once we actually bothered to look for severely ill cases using a broader methodology, going well beyond the ridiculously narrow criteria that enabled officialdom to spend far too long only looking at people who matched a particular travel history. I probably droned on about 'seek and you shall find' at the time and sure enough, as soon as they started looking more closely deaths were reported.

Thanks to one person insisting on tissue samples being investigated months later, we do have one confirmed Covid death from the end of January 2020. Which acts as a simple demonstration that the reality in terms of early cases was quite different to the perceptions we got from formal identification and reporting of the 'first' cases in late January and deaths quite some time later at the end of Feb/early March. Deaths from earlier community transmission were already happening by the time we were just getting round to spotting those first few isolated, travel related positive cases.


Because that example of an earlier covid death was eventually formally recorded, it does show show up on the official dashboard in the death certificate deaths by date of death data. As does a second one a few days later which I know much less about. It is unlikely thrse were really the first deaths either, just the first we later identified with the benefit of hindsight.

Anyway sorry to be a bore about that, its just I am reminded that this sort of thing, the difference between formal identification and early rhetoric compared to the reality of infectious disease spread, is one of the main reasons I had something vaguely useful to say back in the early months of the pandemic. And I was still inevitably behind the curve back then too, since my understanding of the limitations of our surveillance, and the bullshit about containment, still could not fully compensate for a lack of detail about the true picture at the time, and the timing gap between this disease emerging in humans and us being told about it by China etc. Hopefully as a result of what happened back then, some people were at least left with a better sense of how far behind the curve the reporting and general perceptions can get, and learnt not to place too much weight in reassuring talk about containment and being on top of things that the daily news cycles and public health rhetoric often delivers to start with. Likewise recognising the difference between the real first cases and the first formally identified cases.

There are diseases where the lag between reality and perceptions/surveillance does not end up having insurmountable consequences, but Covid wasnt one of those. And I suppose that was the main basis for me being pretty confident that my 'pessimism' and warnings back then were actually realism, and that there was going to be quite the reality check once people realised that they had been given the wrong impression about wave timing, scale of seeding and prospects for containment for way too long in those crucial early months. And so I'm afraid when I see people now return to using the same sort of language about 'first cases', I feel the need to make tedious post like this one. Whether that matters much in this monkeypox thread remains to be seen. Since it was easier to know what would happen in the UK with the covid outbreak because by the time we talked about that virus we'd already seen what was happening in Wuhan, we got an idea of how easily transmission could occur and the extent to which an outbreak could really scale up. I dont have that sort of guide with this monkeypox outbreak yet, far from it. We can see some 'seek and you shall find' going on now in terms of more countries detecting monkeypox cases, but I still cant run all that far with predictions. But we can at least be mindful of the lag between detection, perceptions and disease spread reality. At least the period where inappropriate reassurances about cases all being travel-related and no signs of community transmission were not clung to for very long with this monkeypox in the UK, how the story is being reported has evolved quite rapidly, and the symptoms are reasonably distinct enough to further aid detection.
 
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This is a list of recorded cases up to 2018. There was relatively few people catching this during these years. So, the current outbreak may end up being a curious oddity.
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Île-de-France - this is
First case confirmed in France. No travel history.
Île-de-France - hefty African dimension ... if this takes off at all it's not going to help community relations ...

I wonder if there ends up being a Covid connection like the childhood hepatitis thing possibly has ...

And in any case the social aspects of Covid - along with the conflicts and migration going on, will doubtless affect things ...

EDIT:-

So it's largely being transmitted sexually.
 
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Île-de-France - this is

Île-de-France - hefty African dimension ... if this takes off at all it's not going to help community relations ...

I wonder if there ends up being a Covid connection like the childhood hepatitis thing possibly has ...

And in any case the social aspects of Covid - along with the conflicts and migration going on, will doubtless affect things ...

EDIT:-

So it's largely being transmitted sexually.
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If you were vaccinated for small pox as a kid would you be relatively safer than someone who has not been vaccinated at all?
 
Hmm I think Fiegl Ding is a bit of a crank tbh. I would take his posts on the subject with a bit of a pinch of salt.

I was speaking to someone who works in the NHS who said they had cases where they worked and apparently it was transmitted through bedding and wet towels :eek:

I'm not going to worry too much about it tbh. We do have a vaccine for it iirc
 
There seems to be a theory going around on social media that has at least some rational basis that this may be caused by a sort of immune exhaustion following covid exposure - that people are vulnerable to monkeypox who would not be if they hadn't recently had covid. But the counter argument seems to be that this should also be showing up in other ways - for example a wave of activation of the chickenpox virus in the form of shingles.
 
There seems to be a theory going around on social media that has at least some rational basis that this may be caused by a sort of immune exhaustion following covid exposure - that people are vulnerable to monkeypox who would not be if they hadn't recently had covid. But the counter argument seems to be that this should also be showing up in other ways - for example a wave of activation of the chickenpox virus in the form of shingles.
I had shingles recently, awful bloody thing.
 
There seems to be a theory going around on social media that has at least some rational basis that this may be caused by a sort of immune exhaustion following covid exposure - that people are vulnerable to monkeypox who would not be if they hadn't recently had covid. But the counter argument seems to be that this should also be showing up in other ways - for example a wave of activation of the chickenpox virus in the form of shingles.
"theory going around on social media" - that's about as scientifically credible as the musings of a drunken baboon.
 
A bit of positive news, let's hope that remains the case.

Experts say we are not on the brink of a national outbreak and, according to Public Health England, the risk is low.

Prof Jonathan Ball, professor of molecular virology, University of Nottingham, said: "The fact that only one of the 50 contacts of the initial monkeypox-infected patient has been infected shows how poorly infectious the virus is. It is wrong to think that we are on the brink of a nationwide outbreak."

Public Health England is following up those who have had close contact with patients to offer advice and to monitor them.

 
There seems to be a theory going around on social media that has at least some rational basis that this may be caused by a sort of immune exhaustion following covid exposure - that people are vulnerable to monkeypox who would not be if they hadn't recently had covid. But the counter argument seems to be that this should also be showing up in other ways - for example a wave of activation of the chickenpox virus in the form of shingles.

On paper there is a small world of science that involves the immune system and potential complex interactions between different diseases and our immune systems. The Covid pandemic has brought this into focus, but really its still blurry because of the gaps in our complete understanding of the immune system. And both some legitimate scientists and cranks will have theories which they become attached to and promote before the reality is actually fully demonstrated.

I'd say it is legitimate to keep these possibilities in mind, but I wont promote any of them as facts or solid predictions, and I would avoid overly simplistic language and concepts such as immune exhaustion. And any changes to our immune response are likely a complex business, with plenty of speculation at this stage, eg see the hypothesis 2hats drew attention to recently in regards the child hepatitis cases #4,397
 
OTOH this is not so positive.


It brings the total number reported in the country to 20 - although there are concerns many cases of the virus, which has similarities to smallpox and can be confused with chicken pox, are going undetected.

Apparently close contacts of known cases are already being offered the smallpox jab.
 
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