(Bloomberg) — US health officials have sought to reassure the public that the risk of monkeypox is low and the country is prepared to deal with its spread, although they acknowledge the potential for more cases.
While monkeypox does not appear to be a significant threat to the general public, health authorities say there are stocks of vaccines and antiviral drugs ready to use if needed. Treatment guides are also being developed for those who would benefit the most.
New and suspected cases of the disease have emerged in Europe and North America in recent days. Traditionally, the spread of the rare and deadly smallpox virus has been restricted to areas in Africa, but health officials are concerned about its widespread spread.
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With one confirmed case in Massachusetts and four suspected cases in New York City, Florida and Utah, US health officials are investigating the source of the virus. Within 48 hours, the case of the Massachusetts patient was determined to be an exact match with the case reported from Portugal.
The American cases are a West African monkeypox strain, which tends to be milder than another type more common in central Africa. The currently circulating strain is believed to kill about 1% of those infected. No one has died in this current outbreak yet.
Although anyone can contract monkeypox or spread it through sexual or intimate contact, many of those affected by the current global spread are considered gay and bisexual, Department of Public Health officials said in a call with reporters Monday. Sharing bedding, clothing, or a toothbrush with an infected person may pose a greater risk.
The United States is in a better position to combat monkeypox outbreaks than it was for Covid-19 at the start of the pandemic, said Catherine Wallace, an epidemiologist at the University of Illinois School of Public Health at Chicago. This is partly because monkeypox is less transmissible than SARS-CoV-2.
The United States has also ramped up its preparation for smallpox and monkeypox for decades at both the local and federal levels due to long-standing concerns that smallpox could be used as a biological weapon. As a result, public health departments across the country have continued to regularly update training and response protocols to deal with a potential outbreak of smallpox or monkeypox, Wallace said. So when cases were identified in the United States last week, it was easy for health departments to publish those years of practice.
“Covid was a completely new virus, we had no knowledge of it and it was much more widespread,” Wallace said. “That is not the case here.”
At the federal level, the Strategic National Stockpile has a supply of smallpox vaccines and FDA-licensed treatments, most of which have also shown effectiveness against monkeypox, officials said.
During a call with reporters Monday, health officials from the Centers for Disease Control and Prevention said the United States has stockpiled doses of the North Bavarian Jynneos vaccine and is seeking more. The United States has contracts in place for millions of doses of the vaccine.
Officials added that there are more than 100 million doses of the ACAM2000 vaccine from Emergent BioSolutions Inc. , which the company acquired from Sanofi in 2017. Two years later, Emergent entered into a $2 billion contract with the Department of Health and Human Services to supply ACAM2000 to national inventory for a 10-year period.
This vaccine is not specifically approved for monkeypox, but because smallpox is closely related, it can resist both viruses. However, CDC officials warned that it could have dangerous side effects in those with certain health conditions because the vaccine contains live virus.
Officials said there has already been a request to release doses of the Jynneos vaccine to people considered high-risk contacts of identified monkeypox cases in the United States. The vaccine is considered to be much safer than ACAM2000.
“There are relatively few governments willing or taking medical countermeasures seriously,” said Bavarian Nordic CEO Paul Chaplin, in an interview Monday, adding that the United States was one of the few countries ready. “Most governments are purely reactionary, but vaccine production cannot be turned on and off like a light switch.”
Bavarian Nordic is now working to get its vaccine approved in the European Union and other large markets.
He said, “We get a lot of calls, there is a lot of anxiety here in Europe. But this is not a product we have much stock on the shelf. It really is made to order. We have some potions in stock. We are preparing for production as we speak.”
He said he hopes to have supplies available to states this summer. Chaplin, who has been in charge of the smallpox program in northern Bavarian since its inception, said his company had “a very large amount” of the main substance for the Jynneos vaccine, but that it would take up to 6 weeks for it to be ready for end users.
Bloomberg reported earlier on Monday that northern Bavaria may ramp up production to offset up to 30 million doses a year, if needed. Chaplin said the company is expanding, and is seeking to hire another 200 employees before the end of the year to meet warehousing requirements.
It’s unlikely the entire population will need to be vaccinated against monkeypox, said Wallace, of the University of Illinois at Chicago. Because it spreads primarily through close contact, the United States can only vaccinate those who have come into contact with an infectious person. Requests have already arrived to release doses of Jynneos to high-risk contacts of the four monkeypox cases identified in the United States so far.
In addition to smallpox vaccines, there is an abundant supply of antiviral drugs that have shown the possibility of developing monkeypox based on animal experiments. This is SIGA Technologies Inc.’s Tpoxx. , in the national inventory.
During Monday’s call, CDC officials said they are also in the process of negotiating with Chimerix Inc. To purchase Tembexa, another antiviral, for National Stock.
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