Dr. Gene Olinger Offers Expertise on the Virus
The World Health Organization (WHO) recently declared the monkeypox outbreak a public health emergency of international concern. Since, the Biden administration declared it a public health emergency in the United States, following similar declarations in the states of New York, Illinois, and California, as the virus continues to spread.
The experience of our team and immediate access to our world-class labs enables us to start working with emerging infectious diseases rapidly, as we did with SARS-CoV2 (COVID-19) beginning in early 2020. We are also registered to work with select agents and toxins such as monkeypox. This ability to work with a broad range of pathogens supports customers with specific testing of vaccines or therapeutics.
To learn more about the monkeypox virus, how it spreads, and prevention and treatment options, we spoke with chief science advisor Dr. Gene Olinger.
What is monkeypox and how does it spread?
Monkeypox is a viral zoonosis disease, which is acquired through close contact with an infected animal or individual. Normally the virus is rarely seen outside of several central and western African countries. Being called monkeypox is based on the cases observed in monkeys that originated from the tropical regions, however, just like in humans, monkeys are not a normal reservoir of the virus in the wild. The genus of orthopoxviruses have virus members that can infect nearly all mammals, including rodents, deer, camels, and humans. The natural host for monkeypox is yet to be identified, though likely a rodent, that comes into contact with monkeys resulting in a viral spillover event. Sometimes this may happen between the natural host and humans, but likely more often the virus infects humans through contact with monkeys. The virus survives on surfaces of materials coming into contact with a person with infectious fluids or blisters. However, the primary mode of transmission requires very close contact, often intimate contact with an infected person. It is unlikely a person would be exposed by passing by them while shopping, or public transportation, or other similar situations we were concerned with during COVID-19.
What are the differences between smallpox and monkeypox?
Smallpox is a human DNA virus that belongs to the same Poxviridae family of viruses as monkeypox. Smallpox is an orthopoxvirus that adapted to humans more than 3,000 years ago. In fact, there is evidence of smallpox lesions on the mummified body of Ramses V in Egypt. Estimates suggest that every three out of 10 people who got smallpox before a vaccine or treatments were developed died from the disease.
In 1796, the basis of vaccination was developed by Edward Jenner by using another poxvirus family member called cowpox to create the first “vaccines” and the first protection against smallpox in humans. This similar virus was able to generate immunity in people that had not been infected. Many changes and improvements have since occurred in the production of the vaccines used to protect against smallpox. Because humans were the only host and reservoir for the virus, it was targeted for elimination using vaccines and public health case contact tracing of infected patients and their contacts. In 1959, a global campaign to rid the world of smallpox was started and on May 8, 1980, the eradication of smallpox was achieved.
This success meant that vaccinating the public against smallpox was no longer necessary. Broad vaccination and the similarity of these viruses allowed for protection against other pox viruses that could infect humans when in close contact with their animal reservoirs. Unfortunately, sporadic spillover cases of other pox viruses in the wild have been observed in humans. These cases have often been limited, though cases of monkeypox have been observed in children in multiple African countries since the 1970s. Smallpox was highly lethal, easily transmitted between people and is of great concern if it were to re-emerge naturally or through nefarious intent and is the reason a national stockpile of vaccines and drugs to treat it exists. Fortunately, monkeypox is relatively more difficult to transmit between people and is rarely lethal.
What are the first symptoms of monkeypox to look for and do they appear in a certain order?
Most infected individuals infected with monkeypox will first experience a rash, which is often associated with a rash and more often a pock, and small blisters that appear on the skin. Some people also experience symptoms like fever, headache, and chills which are nearly identical to all infections including colds, influenza, or even COVID-19. Visiting your health care provider and getting tested is essential to understanding what is causing your illness with or without pox lesions.
Are there ways to prevent monkeypox?
Avoiding skin-to-skin contact with an infected person is the best prevention. This could include touching their skin, having sex, or even sharing bedding or clothes. Good hygiene, washing hands, and keeping six feet of distance between people in the community is very effective at protecting individuals from monkeypox.
Individuals vaccinated for smallpox are likely protected from monkeypox infection. There are multiple vaccines that may be used to protect high risk individuals – vaccination is also important for people at risk of exposure, such as those in contact with infected individuals. If you are in the same household with someone who has monkeypox, there are specific precautions suggested to prevent transmission in the home. Immuno-suppressed individuals that are in close contact or infected themselves should talk to their health care provider to prevent the disease from progressing.
What are the best treatment options for monkeypox?
Though there are no approved treatments for monkeypox specifically, there are antiviral drugs and vaccines developed for similar viruses that can be used to treat it. Tecovirimat is a drug developed for smallpox infection and can be used through special authorizations by clinicians for monkeypox. Furthermore, the smallpox vaccines can be used to help prevent spread of monkeypox, but again requires specialized authorization to distribute. Other drugs that were developed to treat possible smallpox outbreaks and are in the national stockpile, and which are relatively more difficult to provide to patients, are also being considered for use with severe cases of monkeypox. Monkeypox patients can often suffer from secondary bacterial infections on the lesions and may require antibiotic treatments. However, the virus itself is not susceptible to the antibiotics. More work is underway to make treatments available for patients.
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