CDC: Confirmed cases of monkeypox exceed 1,000 in 29 countries

By June 7, there had been 1,088 confirmed cases of monkeypox in 29 countries worldwide, according to the US Centers for Disease Control and Prevention (CDC). Most of these have been found, in order, in the United Kingdom (302), Spain (198), Portugal (166), Canada (80), Germany (80), France (66), the Netherlands (54), the US (34), Italy (20), and Belgium (17).

The CDC now advises travelers to «take increased precautions» to avoid infection, in particular to avoid close contact with people who have rashes on their skin and genitals, as well as with materials used by patients with the disease, such as clothing and bedding, and to refrain from consuming wild animal meat.

The risk of monkeypox infection is still considered low for the general population. However, in some cases, transmission can occur through the air, at least over short distances. Although airborne transmission is only a minor factor in the spread of monkeypox, experts are not yet able to make a reliable estimate of how much this route contributes to the spread of the disease, according to the New York Times.

The CDC recommends that patients with monkeypox wear a mask, especially if they have respiratory symptoms, and advises those living with them to do the same when approaching a patient. Scientists still have many questions, such as why only relatively mild cases have been reported in the current international outbreak, whether transmission is possible from asymptomatic carriers, how long the virus has been circulating outside Africa, whether it can be transmitted through semen or vaginal secretions, etc.

Those who have recently been exposed to the virus can receive two vaccines (ACAM200 or JYNNEOS) to reduce the severity of their symptoms or even avoid getting sick altogether. The CDC recommends that vaccines be given within four days of exposure to monkeypox virus. If given 4 to 14 days after exposure, vaccination may not prevent infection. ACAM200 is approved for smallpox (in humans), while JYNNEOS (known in Europe as Imvanex) is approved for both smallpox and monkeypox.

Jynneos-Imvanex is produced by the Danish pharmaceutical company Bavarian Nordic and is based on the older MVA (Modified Vaccinia Ankara) vaccine against smallpox, which was discovered in 1959 by German microbiologist Anton Meyer, according to Science. As it is currently the only approved vaccine against monkeypox, it is expected to play a key role if needed. Several countries (the US, the UK, Canada, etc.) have already begun selectively vaccinating people who have come into contact with a confirmed case of the disease and healthcare workers.

The role of the vaccine will ultimately depend on several factors: whether those belonging to high-risk groups for infection are identified and vaccinated, if the vaccine proves to be as effective as hoped, and if there will be enough vaccines available in time to «slow down» the epidemic outbreak. The World Health Organization (WHO) has so far not advocated widespread vaccination, but only selective vaccination.

On the other hand, hundreds of millions of doses of smallpox vaccine (not monkeypox) are stored around the world as a protective shield against a possible deliberate release of the terrible virus (e.g., by terrorists or during war). These vaccines provide some protection against monkeypox, but they can cause rare but serious side effects, such as encephalitis.

Danish company Bavaria Nordic is in contact with the European Medicines Agency (EMA) for approval in Europe of its monkeypox vaccine, which has already been approved in the US and Canada, and this is expected to happen in one to two months. According to Marco Cavaleri of the EMA, once the vaccine is approved and available, it will be the one used to start the vaccination program.

The main topic of discussion is expected to be how widespread vaccination should be in Europe and elsewhere. Another question to be answered is how well this approved vaccine will protect people from monkeypox. Also, whether one dose of the vaccine, which is usually administered in two doses four weeks apart, will be sufficient.