Monkey Pox declared a Global Health Emergency

[GloomCookie]

On July 23, 2022 the World Health Organization declared Monkey Pox a Global Health Emergency. This thread is to discuss the disease and the information we know about it.

Link to World Health Organization website on Monkey Pox: https://www.who.int/emergencies/situations/monkeypox-oubreak-2022

Information from the WHO Fact Sheet as of the time of this post:
Vaccines used during the smallpox eradication programme also provided protection against monkeypox. Newer vaccines have been developed of which one has been approved for prevention of monkeypox
Monkeypox is caused by monkeypox virus, a member of the Orthopoxvirus genus in the family Poxviridae.
Monkeypox is usually a self-limited disease with the symptoms lasting from 2 to 4 weeks. Severe cases can occur. In recent times, the case fatality ratio has been around 3–6%.
Monkeypox is transmitted to humans through close contact with an infected person or animal, or with material contaminated with the virus.
Monkeypox virus is transmitted from one person to another by close contact with lesions, body fluids, respiratory droplets and contaminated materials such as bedding.
Monkeypox is a viral zoonotic disease that occurs primarily in tropical rainforest areas of central and west Africa and is occasionally exported to other regions.
An antiviral agent developed for the treatment of smallpox has also been licensed for the treatment of monkeypox.
The clinical presentation of monkeypox resembles that of smallpox, a related orthopoxvirus infection which was declared eradicated worldwide in 1980. Monkeypox is less contagious than smallpox and causes less severe illness.
Monkeypox typically presents clinically with fever, rash and swollen lymph nodes and may lead to a range of medical complications.

[Beorning]

I'll admit something:

Considering we still have an ongoing Covid crisis, along with the war and the war-related resource crisis... as well as out-of-control PLN inflantion back here... and the global climate disaster, too... I just don't have the mental capacity to worry about monkeypox. There's too much, I can't process all of it emotionally.

So, gimme the funny monkey warts. I just don't care anymore...

[Azy]

I remember hearing about how only a few people in the US were infected, and since it's not airborne officials weren't worried.  In my head I was like oh goody, another plague before Covid is even completely gone.  Because lessons were not learned with Covid, I knew this was gonna spread too.  This doesn't seem nearly as serious, though we will see.  I heard only a few days ago that every state is now reporting at least one infection. 

[GloomCookie]

I'll admit something:

Considering we still have an ongoing Covid crisis, along with the war and the war-related resource crisis... as well as out-of-control PLN inflantion back here... and the global climate disaster, too... I just don't have the mental capacity to worry about monkeypox. There's too much, I can't process all of it emotionally.

So, gimme the funny monkey warts. I just don't care anymore...

Honestly I can get behind this sentiment entirely. Holy hell, can we just get a break? Fortunately it seems to be operating like a new STD and since my real life sex life is non-existent I should be safe.

[RedRose]

I can't be bothered anymore.

[Iniquitous]

Honestly I can get behind this sentiment entirely. Holy hell, can we just get a break? Fortunately it seems to be operating like a new STD and since my real life sex life is non-existent I should be safe.

Uh. Hm.  It is NOT functioning as a new STD.

Monkeypox can be passed on from person to person through:

1. any close physical contact with monkeypox blisters or scabs (including during sexual contact, kissing, cuddling or holding hands)
2. touching clothing, bedding or towels used by someone with monkeypox
3. the coughs or sneezes of a person with monkeypox when they're close to you

Please, please, please research stuff so that misinformation is not spread around.

[GloomCookie]

https://www.nbcnews.com/nbc-out/out-health-and-wellness/monkeypox-driven-overwhelmingly-sex-men-major-study-finds-rcna39564

95% of cases are spread between gay men, the rest from fluid contact. Since the majority of such cases are from sexual intercourse, and it spreads similar to most STDs, it's pretty close to being one though I am aware that yes, technically it isn't one. My point about my non-existent sex life still remains.

[TheGlyphstone]

For the more statistically adept among us, is a 3.3% sample - 528 out of 16,000 cases - enough to project accurate conclusions? I'm wondering if the paper might have gotten a corellation bias of some kind if 95% of their subjects all happened to be gay men.

[Oniya]

Uh. Hm.  It is NOT functioning as a new STD.

Monkeypox can be passed on from person to person through:

1. any close physical contact with monkeypox blisters or scabs (including during sexual contact, kissing, cuddling or holding hands)
2. touching clothing, bedding or towels used by someone with monkeypox
3. the coughs or sneezes of a person with monkeypox when they're close to you

Please, please, please research stuff so that misinformation is not spread around.

As a pox virus (like chicken, small, and cow) - I'd pretty much expect it to spread in these ways.  Intimate contact is going to facilitate the spread of a lot of infectious diseases, even those without a 'sexually transmitted' component.  Someone caring for a sick individual would at least need to be aware of #2 and #3.

[Vekseid]

For the more statistically adept among us, is a 3.3% sample - 528 out of 16,000 cases - enough to project accurate conclusions? I'm wondering if the paper might have gotten a corellation bias of some kind if 95% of their subjects all happened to be gay men.

Sqrt(.05*.95/528) ~= .0095, doubled for 95% confidence so the margin of error is ~1.9%

As long as the overall population is sufficiently large, only the sample size matters.

[TheGlyphstone]

Right. I guess my actual concern was if that sample was sufficiently random or not. I didn't read the paper itself where their methodology would be laid out.

[CopperLily]

*clears her throat*

So this is what I actually do for a living.

The sample isn't actually random, and while the study itself is fairly well conducted, the study population originated thusly: "...academic researchers within the London-based Sexual Health and HIV All East Research (SHARE) Collaborative contacted peers in affected countries through informal clinical and research networks and formed a global collaborative group (SHARE-net). Members of this group contributed to a convenience-sample case series in the interests of improving case identification."

The infectious disease epidemiology research world has a large over-representation (likely fairly) of HIV researchers, and it's likely that this group skews that sample pretty heavily. The authors discuss this in the paper:

"Established links between persons receiving preexposure HIV prophylaxis and sexual health clinics and between persons living with HIV infection and HIV clinics could have led to a referral bias, especially given the potential for early care seeking in these groups."

What one can say is among gay men with monkeypox it appears sexual contact is a major form of transmission. But it's not at all clear that it works as an STI in typical sense - it's far more likely, IMO, that the disease spreads via prolonged skin-to-skin or skin-to-object-to-skin contact. Sex is an *extremely* common form of that contact, but that doesn't make monkeypox an STI in the way most people think it does. There's no reason that sharing utensils, handling bedding or clothing, sharing a towel or other forms of prolonged touch won't do the trick just as well. For reference, those are all ways that MRSA has been transmitted.

The response we're seeing is, IMO, a combination of public...lack of giving a shit, which in the presence of a co-occuring pandemic that's killed millions I get, and honestly exhaustion on the part of public health. It's already stretched to the limit, people are burnt the fuck out, people have left the field, etc.

But I'd be *very* skeptical of assuming that if you're not a gay man, you're not at risk.

[Humble Scribe]

Weirdly, I'm old enough that I grew up before smallpox was eradicated, and so was vaccinated against it as a baby (the UK discontinued smallpox vaccination in 1971, when I was 4), which apparently means I still have a reasonable degree of protection against monkeypox.

[Secretwriter]

I have to also agree with Beorning. I just don't have it in my being to be able to care about monkeypox. I don't care about the percents. I don't care about the demographic. Not even the slightest.

[Oniya]

Weirdly, I'm old enough that I grew up before smallpox was eradicated, and so was vaccinated against it as a baby (the UK discontinued smallpox vaccination in 1971, when I was 4), which apparently means I still have a reasonable degree of protection against monkeypox.

I'm now wondering if/when the US discontinued it, and whether I might have gotten the vax.

[Azy]

I doubt I did.  I'm pretty sure smallpox was long gone in the US by 1985.  My mom was vaccinated for smallpox I think.  Would having had chicken pox help?  When I was a kid our parents still wanted us to catch it so we wouldn't have to worry about it as adults.  It swept through my kindergarten class like wildfire.  The vaccine for that didn't exist until I was in high school, maybe later.  I might've preferred a vaccine.  I ended up with I think a lung infection as well, and that was how we found out I'm allergic to penicillin.  But hey, no school for nearly a month.   

[Secretwriter]

I doubt I did.  I'm pretty sure smallpox was long gone in the US by 1985. 

I think the US stopped vaccinating for it in 1972? 1975?

[stormwyrm]

Chickenpox is caused by a totally unrelated virus. Despite the name of the disease it's actually a kind of herpes virus that causes chickenpox, not one of the pox viruses. You probably won't get cross-reactivity that would confer immunity that way, the way the smallpox vaccine seems to.

[CopperLily]

I'm now wondering if/when the US discontinued it, and whether I might have gotten the vax.

1972.

[Oniya]

I think the US stopped vaccinating for it in 1972? 1975?

I might have gotten that one, then.  I'm not inclined to call my mom and ask, though.

[Iniquitous]

I might have gotten that one, then.  I'm not inclined to call my mom and ask, though.

If I hadn't left Germany when I did I'd have my smallpox vaccination since they were still doing them in 73.  Now I am wondering if I should talk to my doctor since I do work under conditions that would have me in multiple instances of prolonged contact with potential carriers (specifically inmates clothing/towels).

[Secretwriter]

I might have gotten that one, then.  I'm not inclined to call my mom and ask, though.

*snugs* I'm not sure what the right words here are, but my heart has so much love for you. 

[Azy]

I wonder since it's an emergency now if they'll bring back that vaccine or alter it to cover monkeypox. 

[GloomCookie]

I wonder since it's an emergency now if they'll bring back that vaccine or alter it to cover monkeypox. 

According to the CDC, there are currently 2 different vaccines for the Monkey Pox virus: JYNNEOS (aka Imvamune or Imvanex) and ACAM2000. Currently JYNNEOS is limited in the United States but there is ample supply of ACAM2000, though they recommend against using it if you have a weakened immune system, skin conditions like atopic dermatitis/eczema, or are pregnant. They also report there's little current data on their effectiveness for the current outbreak.

https://www.cdc.gov/poxvirus/monkeypox/considerations-for-monkeypox-vaccination.html

[CopperLily]

Honestly, if you're seeing some resistance to mass vaccination from the public health sphere, it's because the smallpox vaccine does genuinely have some very serious side effects.