MNKYPOX Monkeypox - Consolidated Thread.
- Thread starter Tigerlily
- Start date
bw
Fringe Ranger
So either we're doing a way better job of spreading it, or no one else is reporting it, or the CDC is ratcheting up the narrative.
Posted for fair use.....
news.yahoo.com
Rong-Gong Lin II, Luke Money, Grace Toohey
Fri, August 19, 2022 at 10:43 AM·8 min read
The number of cumulative monkeypox cases has more than doubled in Los Angeles County in the last two weeks as officials race to better track the virus and more widely vaccinate more vulnerable communities.
There have been 1,105 cumulative monkeypox cases reported countywide as of Friday, according to data from the Department of Public Health. As of this week, that total includes the region's first cases in a jail and in a homeless shelter, according to health officer Dr. Muntu Davis. The median age of people with confirmed monkeypox cases in L.A. County is 35.
Fewer than half the county’s cases for which geographic information is available have been reported in the health service planning area for the central part of the county, which includes West Hollywood, Hollywood, downtown Los Angeles, Eagle Rock, Highland Park, Echo Park, Silver Lake, Los Feliz and Boyle Heights. About 12% of the county’s residents live in this region.
About 15% of L.A. County’s monkeypox cases are in an area that includes the San Fernando and Santa Clarita valleys, county health data show. Roughly 22% of county residents live in that region.
The Antelope and San Gabriel valleys have reported the fewest cases.
The disease — characterized by a rash and lesions that can look like pimples, bumps or blisters — primarily spreads through prolonged skin-to-skin contact with those lesions, which may be in hard-to-see places or mistaken for other skin issues. The lesions can appear first in the genital area and rectum before spreading to other parts of the body.
"Although cases are increasing in Los Angeles County, the risk of infection in the general population continues to remain very low," Davis said during a briefing Thursday.
About 98% of cases for which there is gender identity information available are among males, county figures show. And 98% of cases for which sexual orientation is known are among people who identify as gay or bisexual, Davis said.
Although the disease can be quite painful, it is rarely fatal. Globally, there have been five deaths in the outbreak, none of which have been in the U.S.
“I want to reiterate that we continue to approach this outbreak with the utmost urgency to slow its spreading in California,” Dr. Tomás Aragón, California's public health director and health officer, said Friday.
Wastewater testing, which continues to prove useful in estimating the spread of the coronavirus, is also now being employed to track monkeypox.
In late June — about a month after the first California case was confirmed — monkeypox DNA was detected in wastewater in San Francisco, according to the WastewaterSCAN coalition, a group of scientists who have been testing sewage for the coronavirus since 2020.
“It helps understand how widespread this is,” said Stanford civil and environmental engineering professor Alexandria Boehm, one of the lead researchers on the WastewaterSCAN team.
The monkeypox virus also has been detected in L.A. County wastewater. Samples from the Joint Water Pollution Plant in Carson, which serves about 4 million residents and businesses in southern and eastern L.A. County, showed a small presence on July 31 and for three days during the first week in August, according to WastewaterSCAN data. The virus has not been detected there since, despite the rising case rates in the county.
By comparison, monkeypox DNA has been detected almost every day since June 27 at two wastewater facilities in San Francisco — and at much higher levels than in L.A. County.
Still, Boehm said that doesn’t mean there’s not more monkeypox in Los Angeles County; it’s just been difficult to detect among the massive sample size.
Because the L.A. County wastewater facility serves such a large number of people “you have to think about the sensitivity of detecting monkeypox relative to the incident rate in the population,” Boehm said. “Just because you don’t detect monkeypox, doesn’t mean there’s nobody [in that waste watershed] with monkeypox.”
It is not immediately clear whether the L.A. County Department of Public Health plans to expand monkeypox testing in wastewater. The county has been monitoring wastewater for the coronavirus for months, including at the Joint Water Pollution Plant, as well as at the Hyperion Water Reclamation Plant in Playa del Rey and facilities near Lancaster and Malibu.
“It will take some time to look and assess the correlations between the concentrations and the case counts. ... [But] we’re excited to be part of a larger group that’s figuring out how to best use the wastewater data,” L.A. County Public Health Director Barbara Ferrer said.
As of last week, L.A. County had received more than 43,000 doses of the Jynneos monkeypox vaccine. Nearly all — 91% — of those have already been administered, with the county offering second doses of the two-shot series for the first time this week. People are eligible for their second shot 28 days after their first dose and are considered fully vaccinated two weeks after their second dose.
An additional 29,000 doses of the vaccine have just been received, Davis said Thursday. The latest vaccines will be used in the new method of administering doses intradermally — between layers of skin — instead of subcutaneously, in which the shot is injected in the fat beneath the skin. The new strategy allows each dose to now be one-fifth the volume of the originally sized doses, thus stretching the limited supplies.
People eligible for the monkeypox vaccine in L.A. County include gay or bisexual men and transgender people who have had multiple or anonymous sex partners in the last 14 days. Residents who are immunocompromised, including those with advanced or controlled HIV infection, are being prioritized for the immunization.
Prior data from Africa suggest the Jynneos vaccine is at least 85% effective in preventing monkeypox. Because the vaccine is not 100% effective, health officials still advise taking measures to lessen infection risk. But should infection still occur, "hopefully, it will make the infection less severe," Davis said.
Aragón said the state has positioned close to 3,000 oral and 345 IV versions of Tpoxx treatments. Vaccines are being distributed in communities based on the number of cases reported by a county, he said.
He noted that the trendline in cases will start to flatten or decrease when the virus "has trouble finding susceptible people to infect." That could happen by people developing immunity through vaccination or prior infection, or if they "change their behavior and they're not out there having as much contact, so that means there's less opportunities for transmission to occur."
"Those three things coming together is what's going to drive the epidemic curve down," Aragón said.
The California Department of Public Health this week released updated guidance recommending that those with a confirmed or suspected monkeypox case should isolate at home until either infection has been ruled out or their lesions are fully healed, a fresh layer of skin has formed and they've been free of other symptoms for at least 48 hours.
Residents can resume limited, lower-risk activities if they've been free of fever, respiratory symptoms or new lesions for at least 48 hours and any lesions that can't be covered — like those on the face — are fully healed. In that instance, residents would need to bandage or cover any unhealed lesions, wear a well-fitting mask when around others; and avoid crowded settings, sharing towels or personal objects, and direct skin-to-skin contact.
People who have had monkeypox do not need the vaccine because they are immune, according to the county Department of Public Health. People who got the first dose of vaccine and were later infected generally don't need the second dose; however, a second dose may be suggested by a healthcare provider.
County officials have begun to make vaccinations available to high-risk people in the county jail system and among homeless people.
Officials have long said the risk of monkeypox exposure is primarily through intimate skin-to-skin contact, and transmission of the virus has not been seen in this outbreak through surfaces at gyms or other public surfaces.
However, in 2018, there was a single documented case of monkeypox transmission in Britain in which a healthcare assistant was infected with monkeypox after changing “presumably contaminated bedding” without wearing a face mask or respirator. The worker had contact with the sheets during a time at which the patient had skin lesions but hadn’t yet been diagnosed with monkeypox and placed under isolation, according to medical journals.
Davis suggested that workers who are cleaning surfaces in settings that are touched frequently, such as gym equipment, or laundering bedding, towels and uniforms, take care to implement reasonable general-prevention practices that also protect against COVID-19 and other illnesses.
Workers should wear disposable gloves when cleaning, and workplaces should make handwashing facilities and hand sanitizer available for employees and customers, Davis said.
“We also encourage businesses where workers provide personal care services — such as massages or skin treatment — to consider posting signage asking customers or clients to delay services if they are experiencing symptoms, or if they have new or unexplained rashes, bumps, pustules, blisters or scabs that started as blisters,” he said.
Also recommended is "that workers visually inspect the area of skin that will be touched. And, of course, workers should not under any circumstances touch a rash," Davis continued.
Residents can request the monkeypox vaccine through their regular healthcare provider or sign up online with the county Department of Public Health to request a vaccination. They also can call the health agency at (833) 540-0473, seven days a week between 8 a.m. and 8:30 p.m.
Times staff writer Melody Gutierrez contributed to this report.
This story originally appeared in Los Angeles Times.
Monkeypox cases more than double in L.A. County. One region is hit particularly hard
Los Angeles County has also reported its first cases of monkeypox in a jail and in a homeless shelter, health officials said.
Monkeypox cases more than double in L.A. County. One region is hit particularly hard
Rong-Gong Lin II, Luke Money, Grace Toohey
Fri, August 19, 2022 at 10:43 AM·8 min read
The number of cumulative monkeypox cases has more than doubled in Los Angeles County in the last two weeks as officials race to better track the virus and more widely vaccinate more vulnerable communities.
There have been 1,105 cumulative monkeypox cases reported countywide as of Friday, according to data from the Department of Public Health. As of this week, that total includes the region's first cases in a jail and in a homeless shelter, according to health officer Dr. Muntu Davis. The median age of people with confirmed monkeypox cases in L.A. County is 35.
Fewer than half the county’s cases for which geographic information is available have been reported in the health service planning area for the central part of the county, which includes West Hollywood, Hollywood, downtown Los Angeles, Eagle Rock, Highland Park, Echo Park, Silver Lake, Los Feliz and Boyle Heights. About 12% of the county’s residents live in this region.
About 15% of L.A. County’s monkeypox cases are in an area that includes the San Fernando and Santa Clarita valleys, county health data show. Roughly 22% of county residents live in that region.
The Antelope and San Gabriel valleys have reported the fewest cases.
The disease — characterized by a rash and lesions that can look like pimples, bumps or blisters — primarily spreads through prolonged skin-to-skin contact with those lesions, which may be in hard-to-see places or mistaken for other skin issues. The lesions can appear first in the genital area and rectum before spreading to other parts of the body.
"Although cases are increasing in Los Angeles County, the risk of infection in the general population continues to remain very low," Davis said during a briefing Thursday.
About 98% of cases for which there is gender identity information available are among males, county figures show. And 98% of cases for which sexual orientation is known are among people who identify as gay or bisexual, Davis said.
Although the disease can be quite painful, it is rarely fatal. Globally, there have been five deaths in the outbreak, none of which have been in the U.S.
“I want to reiterate that we continue to approach this outbreak with the utmost urgency to slow its spreading in California,” Dr. Tomás Aragón, California's public health director and health officer, said Friday.
Wastewater testing, which continues to prove useful in estimating the spread of the coronavirus, is also now being employed to track monkeypox.
In late June — about a month after the first California case was confirmed — monkeypox DNA was detected in wastewater in San Francisco, according to the WastewaterSCAN coalition, a group of scientists who have been testing sewage for the coronavirus since 2020.
“It helps understand how widespread this is,” said Stanford civil and environmental engineering professor Alexandria Boehm, one of the lead researchers on the WastewaterSCAN team.
The monkeypox virus also has been detected in L.A. County wastewater. Samples from the Joint Water Pollution Plant in Carson, which serves about 4 million residents and businesses in southern and eastern L.A. County, showed a small presence on July 31 and for three days during the first week in August, according to WastewaterSCAN data. The virus has not been detected there since, despite the rising case rates in the county.
By comparison, monkeypox DNA has been detected almost every day since June 27 at two wastewater facilities in San Francisco — and at much higher levels than in L.A. County.
Still, Boehm said that doesn’t mean there’s not more monkeypox in Los Angeles County; it’s just been difficult to detect among the massive sample size.
Because the L.A. County wastewater facility serves such a large number of people “you have to think about the sensitivity of detecting monkeypox relative to the incident rate in the population,” Boehm said. “Just because you don’t detect monkeypox, doesn’t mean there’s nobody [in that waste watershed] with monkeypox.”
It is not immediately clear whether the L.A. County Department of Public Health plans to expand monkeypox testing in wastewater. The county has been monitoring wastewater for the coronavirus for months, including at the Joint Water Pollution Plant, as well as at the Hyperion Water Reclamation Plant in Playa del Rey and facilities near Lancaster and Malibu.
“It will take some time to look and assess the correlations between the concentrations and the case counts. ... [But] we’re excited to be part of a larger group that’s figuring out how to best use the wastewater data,” L.A. County Public Health Director Barbara Ferrer said.
As of last week, L.A. County had received more than 43,000 doses of the Jynneos monkeypox vaccine. Nearly all — 91% — of those have already been administered, with the county offering second doses of the two-shot series for the first time this week. People are eligible for their second shot 28 days after their first dose and are considered fully vaccinated two weeks after their second dose.
An additional 29,000 doses of the vaccine have just been received, Davis said Thursday. The latest vaccines will be used in the new method of administering doses intradermally — between layers of skin — instead of subcutaneously, in which the shot is injected in the fat beneath the skin. The new strategy allows each dose to now be one-fifth the volume of the originally sized doses, thus stretching the limited supplies.
People eligible for the monkeypox vaccine in L.A. County include gay or bisexual men and transgender people who have had multiple or anonymous sex partners in the last 14 days. Residents who are immunocompromised, including those with advanced or controlled HIV infection, are being prioritized for the immunization.
Prior data from Africa suggest the Jynneos vaccine is at least 85% effective in preventing monkeypox. Because the vaccine is not 100% effective, health officials still advise taking measures to lessen infection risk. But should infection still occur, "hopefully, it will make the infection less severe," Davis said.
Aragón said the state has positioned close to 3,000 oral and 345 IV versions of Tpoxx treatments. Vaccines are being distributed in communities based on the number of cases reported by a county, he said.
He noted that the trendline in cases will start to flatten or decrease when the virus "has trouble finding susceptible people to infect." That could happen by people developing immunity through vaccination or prior infection, or if they "change their behavior and they're not out there having as much contact, so that means there's less opportunities for transmission to occur."
"Those three things coming together is what's going to drive the epidemic curve down," Aragón said.
The California Department of Public Health this week released updated guidance recommending that those with a confirmed or suspected monkeypox case should isolate at home until either infection has been ruled out or their lesions are fully healed, a fresh layer of skin has formed and they've been free of other symptoms for at least 48 hours.
Residents can resume limited, lower-risk activities if they've been free of fever, respiratory symptoms or new lesions for at least 48 hours and any lesions that can't be covered — like those on the face — are fully healed. In that instance, residents would need to bandage or cover any unhealed lesions, wear a well-fitting mask when around others; and avoid crowded settings, sharing towels or personal objects, and direct skin-to-skin contact.
People who have had monkeypox do not need the vaccine because they are immune, according to the county Department of Public Health. People who got the first dose of vaccine and were later infected generally don't need the second dose; however, a second dose may be suggested by a healthcare provider.
County officials have begun to make vaccinations available to high-risk people in the county jail system and among homeless people.
Officials have long said the risk of monkeypox exposure is primarily through intimate skin-to-skin contact, and transmission of the virus has not been seen in this outbreak through surfaces at gyms or other public surfaces.
However, in 2018, there was a single documented case of monkeypox transmission in Britain in which a healthcare assistant was infected with monkeypox after changing “presumably contaminated bedding” without wearing a face mask or respirator. The worker had contact with the sheets during a time at which the patient had skin lesions but hadn’t yet been diagnosed with monkeypox and placed under isolation, according to medical journals.
Davis suggested that workers who are cleaning surfaces in settings that are touched frequently, such as gym equipment, or laundering bedding, towels and uniforms, take care to implement reasonable general-prevention practices that also protect against COVID-19 and other illnesses.
Workers should wear disposable gloves when cleaning, and workplaces should make handwashing facilities and hand sanitizer available for employees and customers, Davis said.
“We also encourage businesses where workers provide personal care services — such as massages or skin treatment — to consider posting signage asking customers or clients to delay services if they are experiencing symptoms, or if they have new or unexplained rashes, bumps, pustules, blisters or scabs that started as blisters,” he said.
Also recommended is "that workers visually inspect the area of skin that will be touched. And, of course, workers should not under any circumstances touch a rash," Davis continued.
Residents can request the monkeypox vaccine through their regular healthcare provider or sign up online with the county Department of Public Health to request a vaccination. They also can call the health agency at (833) 540-0473, seven days a week between 8 a.m. and 8:30 p.m.
Times staff writer Melody Gutierrez contributed to this report.
This story originally appeared in Los Angeles Times.
108 Comments
psychgirl
Has No Life - Lives on TB
There are now 35 children in the United States, infected with monkeypox. This figure includes “probable” cases.
View: https://mobile.twitter.com/RolandBakerIII/status/1560697656610934784?cxt=HHwWgMCigf6P26grAAAA
View: https://mobile.twitter.com/RolandBakerIII/status/1560697656610934784?cxt=HHwWgMCigf6P26grAAAA
somewherepress
Has No Life - Lives on TB
Video at link 28 minutes
www.voiceforscienceandsolidarity.org
August 19, 2022
Dr. Geert Vanden Bossche: Warning Against Monkeypox Vaccinations
In America, the strategy to tackle the monkeypox outbreak is focused on vaccinations of people considered at-risk.
Yet monkeypox vaccinations will drive adaptive evolution of the virus in the countries heavily vaccinated against Covid, such as the United States, warned Dr. Geert Vanden Bossche. That means that the virus will become more transmissible to cohorts other than homosexual and bisexual men. Because of the mechanism of their action, these shots would prevent the establishment of herd immunity. Moreover, Dr. Vanden Bossche called on people not to vaccinate against the seasonal flu and Covid.
The current monkeypox outbreak is a result of the Covid vaccinations that are connected to Covid reinfections and the related reactivation of cytotoxic t-cells, reminded the scientist. That issue was discussed in detail in his previous interview with The New American.
Also see on Rumble
Dr. Geert Vanden Bossche: Warning Against Monkeypox Vaccinations | Voice for Science and Solidarity
www.voiceforscienceandsolidarity.org
August 19, 2022
Dr. Geert Vanden Bossche: Warning Against Monkeypox Vaccinations
In America, the strategy to tackle the monkeypox outbreak is focused on vaccinations of people considered at-risk.
Yet monkeypox vaccinations will drive adaptive evolution of the virus in the countries heavily vaccinated against Covid, such as the United States, warned Dr. Geert Vanden Bossche. That means that the virus will become more transmissible to cohorts other than homosexual and bisexual men. Because of the mechanism of their action, these shots would prevent the establishment of herd immunity. Moreover, Dr. Vanden Bossche called on people not to vaccinate against the seasonal flu and Covid.
The current monkeypox outbreak is a result of the Covid vaccinations that are connected to Covid reinfections and the related reactivation of cytotoxic t-cells, reminded the scientist. That issue was discussed in detail in his previous interview with The New American.
Also see on Rumble
psychgirl
Has No Life - Lives on TB
Super interesting thread discussing the 1972 smallpox outbreak.
It’s very relevant. I highly recommend reading this.
View: https://mobile.twitter.com/EnemyInAState/status/1560719194223689730
View: https://mobile.twitter.com/EnemyInAState/status/1560725691322212353
It’s very relevant. I highly recommend reading this.
View: https://mobile.twitter.com/EnemyInAState/status/1560719194223689730
View: https://mobile.twitter.com/EnemyInAState/status/1560725691322212353
Samuel Adams
Has No Life - Lives on TB
Samuel Adams
Has No Life - Lives on TB
^^^^^^
No way !!!
No way !!!
phloydius
Veteran Member
Even though it feels like the numbers are accelerating with Monkeypox, the rate of infection is actually slowing down. As of this morning, the USA is 14595 and world is 42039 total cases. The new rates are considerably lower than I was expecting, and I am very happy for the good news if not a bit suspicious. With the schools & colleges opening up, hopefully the numbers will not accelerate -- which seems unlikely.
The US rate has decreased to about 4% daily new cases, and the world to about 3% daily new cases.
If the US holds at 4% daily new cases, these are the projections for total cumulative cases:
→ 01 Sep 2022: 23,749
→ 01 Oct 2022: 76,993
→ 01 Nov 2022: 259,674
→ 01 Dec 2022: 842,200
→ 01 Jan 2023: 2,84,026
psychgirl
Has No Life - Lives on TB
Good news!
But I think*** case reports do not become updated after Friday
bw
Fringe Ranger
Fraudulent but useful.
jward
passin' thru
Regarding that woman who is described as the first monkeypox-infected woman in Georgia and who is claiming she thinks she got the virus at work from handling money as she makes thousands of dollars from her self-started Gofundme...this is the public health dept's statement about the likely source of her infection:
https://www.wsbtv.com/news/local/atl...L45OP5AOXKSMA/
Atlanta DPH confirms first case of monkeypox in female in Georgia
The Georgia Department of Public Health says the state has confirmed its first case of monkeypox in a female.
The health department said the woman had close person contact with a man that was previously diagnosed with the virus.
In fact, the same Atlanta outlet that reported the public health information later ignored their own report and did an 'exclusive' interview with the woman without questioning her sensationalistic claim.
https://www.wrdw.com/2022/07/26/heal...-case-georgia/
Health officials announce first female monkeypox case in Georgia
She reported contact with an infected individual
This is CDC's headquarters. You would hope for better journalism there, instead of poorly fact-checked sensationalism that is spreading anxiety-provoking misinformation.
https://www.wsbtv.com/news/local/atl...L45OP5AOXKSMA/
Atlanta DPH confirms first case of monkeypox in female in Georgia
The Georgia Department of Public Health says the state has confirmed its first case of monkeypox in a female.
The health department said the woman had close person contact with a man that was previously diagnosed with the virus.
In fact, the same Atlanta outlet that reported the public health information later ignored their own report and did an 'exclusive' interview with the woman without questioning her sensationalistic claim.
https://www.wrdw.com/2022/07/26/heal...-case-georgia/
Health officials announce first female monkeypox case in Georgia
She reported contact with an infected individual
This is CDC's headquarters. You would hope for better journalism there, instead of poorly fact-checked sensationalism that is spreading anxiety-provoking misinformation.
Discussion - Thoughts on a global outbreak of monkeypox - FluTrackers News and Information
Discussion - Thoughts on a global outbreak of monkeypox
flutrackers.com
jward
passin' thru
You are still convinced it is in order to shut us down for midterms? I'm still assuming that the primary factor here is so that it becomes a "white country" disease too, and thus the $$$ can be redirected to poor black nations, and of course, the pockets of those who make, market, sell influence and own stock in the products. I am also, always, concerned about the ways the gov does power grabs into our culture and erodes our self sufficiency; seeding this into our wildlife remains a huge concern, though this stench of the SJW suggests the former is more likely than the later.
psychgirl
Has No Life - Lives on TB
Interesting. Thanks for posting.
SouthernBreeze
Has No Life - Lives on TB
This just goes to show that we can't believe everything we hear and read on the internet about all of this. People do lie and deceive just for attention and to mislead. No doubt some/most of these children and other breakthrough cases have come in contact with infected persons, but the admission might not be too forthcoming.
Meemur
Voice on the Prairie / FJB!
I think a case can be made for both outcomes. I don't believe a single faction is running the show.
However, I think the goal of those handling Biden and the WH is to shut us down for midterms to avoid further Trump supporters from getting into office, which will greatly hinder their plans. They have a lot riding on that outcome, so I expect anything to happen from a monkeypox outbreak, dirty bomb false flag, or something I haven't even considered to allow them to manipulate voting.
bw
Fringe Ranger
As I've mentioned, MP really surprised me. I was expecting something completely different.
Samuel Adams
Has No Life - Lives on TB
bw
Fringe Ranger
No way.Do tell ?
DryCreek
Veteran Member
Monkeypox cases more than double in L.A. County. One region is hit particularly hard
Wow. I sure hope they get to the bottom of this!
Especially with that "one region hit especially hard"!
Last edited:
DryCreek
Veteran Member
Heliobas Disciple
TB Fanatic
Monkeypox virus: first the facts, then a skewering of the current WaPo narrative
First, I’d like to show you the current $1 billion plus contract for Jynneos, inked in 2017. This came after the contract for the first 20 million doses had been completed, which cost (approximately) a first $Billion. But the USG can’t find the doses.
merylnass.substack.com
Monkeypox virus: some truth about the virus and the horribly false solution
The real truth. Some links omitted as they are included in earlier articles by me.
Meryl Nass
16 hr ago
Monkeypox is a real virus that spreads due to skin contact, almost exclusively. If you don’t want to call it a virus, that is okay with me. It is a contagious something that spreads person to person or rarely between animals and humans. If you are not in really closely contact with someone while they are harboring a replicating virus, you won’t get it. Okay, sheets and towels and [smallpox] blankets might spread it, based on experience with smallpox.
The CDC wants to reinvent itself so we can all trust it again. This would require it to produce guidance that is helpful, not harmful, and to be truthful—which it has been unable to do so far, and I don’t think it knows how.
But I can remind the CDC how to make itself useful. Remember the AIDS epidemic, Tony and Rochelle? Aren’t you both supposed to be among America’s top experts on AIDS? That’s your specialty, right?
When NYC faced an HIV epidemic, it closed the bathhouses. It didn’t raise the status of its equity office, Rochelle. Simple, but it made a difference.
Monkeypox is a mild disease but the “pocks” are a great annoyance, because we hate seeing and dealing with them. In some areas, like the mouth and private parts, their downstream effects can be rather painful. The pocks may result in scarring.
Let’s face it: we don’t like dealing with pocks, especially the majority of us who always want to look good. And so the media have taken our distaste and projected it back to us, making the illness appear a lot worse than it actually is. Most cases have only had a few pocks.
The disease (open pocks) lasts from 1-4 weeks. The viral syndrome (fever, malaise) only lasts a few days. CDC said to its ACIP Advisory Committee on June 24 that only symptomatic care is generally needed, and I think that is correct: drink fluids, rest. I don’t think they necessarily want the rest of the population to know that.
I think my case of measles around age 7 was probably worse—I had the things in my mouth and all over my body and eating and drinking was painful and I felt miserable. Here is what my measles looked like:
[picture of a child with the measles]
I am not sure how long people remain contagious with monkeypox; our public health officials have not informed us yet.
From UptoDate:
… until the 2022 outbreak, transmission outside of a household and sustained human-to-human spread had been rare….Viral shedding and period of infectiousness — A person is considered infectious from the onset of clinical manifestations until all skin lesions have scabbed over and re-epithelialization has occurred.
A report of seven cases in the United Kingdom between 2018 and 2021 demonstrated polymerase chain reaction (PCR) positivity in blood and upper respiratory tract samples for at least three weeks in three of the patients. However, it is not clear what this means with respect to infectivity, and the correlation of PCR and culture positivity was not described in the report. Thus, PCR testing of throat or blood samples is generally not done for clinical decision making, and the duration of isolation is determined by clinical evaluation.
Which means, treat the lesions like we treat shingles, cause we don’t really know the duration of contagiousness. If they told us you stop being infectious after a few days or a week, it would seem milder, and the powers that be don’t seem to want that.
Instead the PTB and media are really milking it. For example, writing in depth articles about this serious threat to the nation. Like this one from the WaPo, which is desperately helping the USG to stay on top of the narrative, after I and perhaps others spilled the beans about how much vaccine the USG actually owns. (16 million doses, they say, but it could be more, despending how much has been trashed.) My guess is none has been destroyed and we probably have 30-40 million full doses, some of which may have expired. Sitting frozen in Denmark, hidden from view. Excerpts from the in depth article of August 17 are below, with commentary:
Chaplin [CEO of the Jynneos manufacturer] threatened to cancel all future vaccine orders from the United States, throwing into doubt the administration’s entire monkeypox strategy.
“People are begging for monkeypox vaccines, and we’ve just pissed off the one manufacturer,” said one official who spoke on the condition of anonymity because they were not authorized to comment.
Juice up the story by creating a fake conflict. Make sure it hints of future shortages. CYA by making it anonymous. BTW, this WaPo article includes 3 videos of three gay men showing off their lesions. Because the Yuck! factor is critical to sell the vaccines.
a plodding bureaucracy left hundreds of thousands of gay men facing the threat of an agonizing illness
Nobody has died after 10,000 US cases identified, so it better at least be agonizing. Occasionally.
Demetre Daskalakis, a senior official at the Centers for Disease Control and Prevention, was working from home on HIV prevention projects over the May 14 weekend when CDC colleagues summoned him to an urgent call as cases of unusual lesions had begun to appear in Britain.
Daskalakis quickly brushed up on the symptoms and origins of monkeypox.
“I did the yeoman’s work of getting my infectious-disease biology textbook out and just reviewing stuff about monkeypox to be ready,” Daskalakis said.
Are you impressed? Senior CDC official reads a few paragraphs in a textbook to bone up on monkeypox. What about reading the original literature, bonehead, so you actually might know something, given your responsibility for the entire country’s response?
I have to tell you, I was at a discussion of anthrax about 20-25 years ago with scientists from Fort Detrick and CDC scientists (CDC made the decisions about handling the anthrax letters response). David Ashford and Art Friedlander were there. The CDC people were ignorant about anthrax then; they never had bothered to read the primary literature. That’s why CDC let people keep working in the AMI building in Florida for several days after anthrax was discovered, and minimized the risk to postal workers.
Some things never change.
At the time, the national emergency stockpile held 2,400 doses of Bavarian Nordic’s Jynneos, the only vaccine approved by the Food and Drug Administration for monkeypox. While the United States had purchased millions more potential doses, they sat in Bavarian Nordic’s factory in Denmark, either as finished doses in freezers or as raw materials, waiting to be turned into vaccines.
The U.S. stockpile also had hundreds of millions of shots of an older vaccine approved for the related smallpox virus, ACAM2000, although health officials were wary of using that vaccine — given the increased risk of side effects and even inadvertent illnesses — and considered it a fallback.
But the Jynneos doses in the stockpile were losing shelf life because its freezers were capable of storing the doses only at negative 20 degrees Celsius, while Bavarian Nordic’s freezers in Denmark kept doses stored at negative 50 degrees Celsius.
Before, the media and CDC said the ACAM-2000 stockpile was “at least 100 million.” After I pointed out we bought 300 million doses back in the early 2000s and plenty more since, the story got updated to hundreds of millions. The ACAM-2000 production company is now under the ownership of the anthrax vaccine manufacturer, Emergent BioSolutions. Which means there will be no quality control on vaccine production. This company had to throw away nearly 400 million COVID vaccine doses due to contamination. The taxpayer’s loss. Congress said so: “Committees’ Report on Emergent BioSolutions Uncovers Extensive Vaccine Manufacturing Failures, Deliberate Efforts to Hide Deficiencies. May 10, 2022”
Okay, so the US had already spent around $1.6 billion on the Jynneos vaccine, intended mainly for smallpox, before monkeypox showed up in May. The company had been producing doses for the USG since 2013 or a bit earlier. But the WaPo, the USG mouthpiece, is hinting to us that the government was too cheap to buy the necessary freezers to store it, and that is the excuse why they have been sitting in Denmark? AYFKM?
No, they weren’t kidding.
Shipping the doses would create additional challenges in keeping the vaccines as cold as possible for their 4,000-mile voyage to the United States.
“Every time we move doses from their freezer to the [stockpile] … we lose two years of shelf life,” said Dawn O’Connell, head of the Administration for Strategic Preparedness and Response, which oversees the national stockpile. “Every time we convert doses from [raw materials] to a vial, we lose seven years of shelf life.”
Wait, what? Nearly the entire stockpile of tens of millions of doses has been produced in the past 9 years, and Assistant Secretary of HHS O’Connell just talked about them losing 9 years of shelf life when they get shipped and bottled. Sounds like they must be starting with more than 9 years of shelf life at minus 50 C. Which suggests virtually none of the stockpile expired, after earlier claims that 20 million doses had expired.
Didn’t the USG know this before spending $1.6 Billion to have them manufactured and stored in bulk in Denmark?
Wasn’t the purpose to buy this huge stockpile of vaccine in case of a smallpox emergency? Don’t you need to get it over here pronto when that happens? Like yesterday? Who is blowing smoke by implying there was no plan to rush this stuff from Denmark into arms in days or at most a few weeks, had smallpox occurred?
Early on, every monkeypox test required physicians to first get permission from a city or state epidemiologist, often an hours-long process that required multiple phone calls or emails — before the sample was sent to a public health laboratory, which could take days to release results.
Just like at the start of COVID, CDC controlled all US monkeypox testing. [I don’t know why they did this, but this is one way to control the number of reported cases. And maybe to let it spread more?] Only CDC had the test, and it wasn’t until around July 1 that CDC shipped tests to public health labs and commercial labs and allowed them to do testing as well.
The restrictions created a chokehold: Only about a dozen tests per day were being performed nationwide in early June, at a time when officials believed hundreds or thousands of daily tests were needed to detect infection clusters and head off an outbreak.
Sound familiar?
And communicating the risks of monkeypox to the public was proving to be a challenge, with officials struggling to warn the gay men who were disproportionately contracting the virus, often through sex with multiple partners, while not stigmatizing them.
This stigmatizing BS is a bad joke. Public health officials have been doing contact tracing for syphilis, for example, forever. No one ever said it would stigmatize the polyamorous, or sex workers. All the data are supposed to be strictly confidential. It’s what you do to save lives and prevent fetal malformations. Warn those at risk, dammit. Don’t stigmatize them. Inform them. Keep it confidential. You already have the syphilis protocols and know how to do this. Stop playing coy. Couldn’t CDC come up with a better excuse for not doing its job?
The job today: explain the nation’s plan to split vaccine doses in fifths and administer them with a new injection method, transforming about 441,000 doses of Jynneos into more than 2 million potential shots. The plan was finalized by the FDA over the pharmaceutical company’s safety concerns and after the company backed away from its CEO’s threat to cancel future orders.
So we are ‘unable’ to quickly get the Denmark 16 plus millions of doses shipped and bottled for use. The vaccine is fully licensed and legally could very well have liability attached to it if injuries occur (and plenty will-I previously wrote about very high numbers of recipients in the clinical trials with elevated cardiac enzymes and worsening HIV status). Hello Rochelle and Tony, was this deliberate? Instead of worrying about stigmatizing, are you warning HIV positive people that the vaccine is known to cause higher HIV virus titers and lower CD4 counts?
And then there is this: the USG is ‘able’ to get the already bottled doses sucked out of vials, diluted and totally rebottled as diluted product, never having undergone testing of the process, whether it works, whether the dose makes sense. The administration announced it will be doing that, which is not simple.
But they can’t just defrost and bottle the bulk vaccine? Seems to me it is a lot more complicated to remove, dilute and rebottle than to simply bottle what we already own. Especially since we own plenty. Buy the freezers, ship the stuff over, and have US companies bottle it. That is, if we really need it and this whole thing is not a clown show.
The diluted product got an EUA on August 9, which removes essentially all liability. How convenient. Maybe that is why the USG is diluting it? Or will they just bottle the old vaccine, call it diluted, and still get the liability waiver?
BTW, the intradermal injection method is the exact same method used when doing a TB test. Not hard to learn or to do.
So many gay men across the country still struggling to get vaccinated. A second dose needed 28 days after the first shot. At least 14 days after the second dose for full protection.
Full protection? STAT, as I previously noted, recently carried an Op-Ed by 2 former top officials at FDA on the monkeypox vaccines. They revealed that the Jynneos vaccine does not prevent transmission! It supposedly reduces severity of the disease.
Where have we heard that before? Go get vaccinated, risk myocarditis or a worsening of HIV, wait 42 days for “full protection” from a diluted dose (or not) that has never been tested in humans—and then find out you can still catch and spread monkeypox.
Fool me once, shame on you. Fool me twice…
UPDATE Aug 20: Breakthrough monkeypox cases emerge
Breakthrough monkeypox cases emerge
Preliminary reports on monkeypox vaccinations suggest the vaccine is not 100 percent effective, and some breakthrough cases are occurring, the World Health Organization said during an Aug. 17 media briefing.
In some cases, breakthrough infections are occurring in people vaccinated after a monkeypox exposure, which is intended to reduce disease severity. The breakthrough cases should not come as a surprise, as the WHO was not expecting 100 percent efficacy, according to Dr. Rosamund Lewis, the organization's technical lead for monkeypox. [Is it a surprise to the gay men lining up for hours for a shot at the shot?—Nass]
"We have known from the beginning that this vaccine would not be a silver bullet, that it would not meet all the expectations that are being put on it, and that we don't have firm efficacy data or effectiveness data in this context," she said.
Dr. Lewis cited a limited study from the 1980s, which showed that smallpox vaccines used at the time were about 85 percent effective against monkeypox. [It used a different vaccine, believed to be much more effective than Jynneos, however.—Nass]
She said it's unclear what the current vaccine's overall efficacy will be, but still stressed the importance of vaccination to protect those at high risk.
Last edited:
They had good luck with covid as a control mechanism, so ... . Doubling down is what they do.
naegling62
Veteran Member
I've got a secret, I'll type it in very small font....the aliens are in the vaccine.
bw
Fringe Ranger
One of the points that has come up in a couple documents is that they want the public to DEMAND lockdowns this time. They're looking for more buy-in. I presume that will give them license to push further.
Old Gray Mare
TB Fanatic
Fair use. - Humor.Updated information from Dr. Glacomfleken.
Monkeypox
May 21, 2022 Don’t say I didn’t warn yourun time 2:18
jward
passin' thru
journalofinfection.com
Search for articles by this author
14-17 minutes
], highlighting the frequent co-presence of sexually transmitted infections (STI). To date, no reports of co-infection with monkeypox virus and SARS-CoV-2 have been published. Therefore, in this study we present the clinical features and diagnostic procedure of the first documented case of co-infection with monkeypox virus, SARS-CoV-2 and HIV-1.
Since January 2022, more than 16,000 people in over 74 countries have been affected by monkeypox, prompting the World Health Organization to declare this outbreak a public health emergency of international concern [
,
]. Human-to-human transmission occurs through close contact with infectious material from skin lesions, fomites, seminal fluids and oropharyngeal secretions [
,
4
5
,
6
]. The majority of cases were registered in gay or bisexual men often suffering from other STI [
,
[5]
,
[6]
]. At the same time, SARS-CoV-2 is still a major cause of morbidity and mortality globally. COVID-19 shares with monkeypox both the transmission by air droplets and the symptoms of fever, lymphadenopathy, headache, sore throat and fatigue [
[5]
]. As these pathogens continue to spread, individuals can be simultaneously infected with monkeypox virus, SARS-CoV-2 and STI, making it difficult for physicians to perform the correct diagnosis, also considering that not all patients with monkeypox develop skin lesions [
[6]
] and that COVID-19 may rarely present with rash and vesicles [
].
Our patient, an Italian 36-year-old male spent 5 days in Spain from 16 to 20 June 2022 (Figure 1). Nine days after, he developed fever (up to 39°C), accompanied by sore throat, fatigue, headache and right inguinal lymphadenomegaly. On 2 July he resulted positive for SARS-CoV-2. On the afternoon of the same day a rash started to develop on his left arm. The following day small, painful vesicles surrounded by an erythematous halo appeared on the torso, lower limbs, face and glutes. On 5 July, due to a progressive and uninterrupted spread of vesicles that began to evolve into umbilicated pustules, he went to the emergency department of the Policlinico “G. Rodolico - San Marco” University Hospital in Catania, Italy, and was subsequently transferred to the Infectious Diseases unit.
On admission, the patient reported being treated for syphilis in 2019. In September 2021, he performed an HIV test with a negative result. He suffered from bipolar disorder, for which he regularly took carbamazepine 200 mg daily. He was vaccinated for SARS-CoV-2 with two doses of Pfizer's BNT162b2 mRNA vaccine (the last in December 2021) and had already contracted COVID-19 in January 2022. He also reported of having condomless intercourse with men during his stay in Spain. Fever (37.5°C), pharyngodynia, fatigue, headache was still present. On physical examination his body was dotted, including the palm of the right hand and the perianal region, with skin lesions in various stages of progression, ranging from small vesicles (Figure 1, Panel A) to reddened haloed pustules (Figure 1, Panel B and Panel C) and umbilicated plaques (Figure 1, Panel D). The oral mucosa was normal, except for bilateral tonsillar hypertrophy. A modest hepatosplenomegaly and an enlarged (2 cm), hypomobile and painful lymph node in the right inguinal region were found. Laboratory test showed elevated C-reactive protein (69 mg/L, normal values 0.0 - 5.0 mg/L), fibrinogen (713 mg/dL, normal values 170 - 400 mg/dL) and prothrombin time (1.21, normal values 0.8 - 1.2). Chest X-ray revealed a parenchymal hypodiaphany in the right parailary region.
On the second day of admission (July 6, 2022), given the high suspicion of monkeypox supported by suggestive skin lesions and a recent trip to Spain [
], swabs of pustule exudate and nasopharynx secretions were sent to the Regional Reference Laboratory hosted at the University Hospital “A.O.U.P. P. Giaccone” of Palermo (Italy) for monkeypox orthopoxvirus detection and SARS-CoV-2 sequencing. To this purpose, monkeypox virus DNA was extracted using Quick-DNA™ Miniprep Plus extraction kit (Zymo Research), whereas SARS-CoV-2 RNA was extracted using QIAamp Viral RNA extraction kit (QIAGEN). Eluted DNA/RNA was stored immediately at -80°C until further use or analysed by means of rt-PCR assays. Three different singleplex rt-PCR assays targeting the TNF receptor gene of monkeypox were used: a monkeypox generic assay and two further rt-PCR assays specifically designed to differentiate monkeypox Congo Basin and West African strains [
]. All rt-PCR assays were performed with a QuantStudio™ 7 Flex Real-Time PCR System (Applied Biosystems, Carlsbad, USA) and a test was considered positive when its cycle threshold value was <40. SARS-CoV-2 genome was generated by next-generation sequencing on an Ion GeneStudio™ S5 System (Applied Biosystems, Carlsbad, USA) using the Ion Ampliseq™ SARS-CoV-2 Research Panel and virus lineage was designated using the Pangolin dynamic nomenclature system [
[9]
,
First case of monkeypox virus, SARS-CoV-2 and HIV co-infection
Search for articles by this author
14-17 minutes
HIGHLIGHTS
- •
Monkeypox virus and SARS-CoV-2 infections can occur simultaneously. - •
Flu-like symptoms and SARS-CoV-2 positivity should not exclude monkeypox in high-risk individuals. - •
Monkeypox is often diagnosed in subjects with a previous or concomitant sexually transmitted infection. - •
The oropharyngeal swab for monkeypox virus may still be positive for several days after clinical remission. - •
Since there is no widely available treatment or prophylaxis, rapid diagnosis is key to containment.
KEYWORDS
Dear Editor
In this journal E. Orviz and colleagues recently described the clinical presentation of the first monkeypox patients in Spain [], highlighting the frequent co-presence of sexually transmitted infections (STI). To date, no reports of co-infection with monkeypox virus and SARS-CoV-2 have been published. Therefore, in this study we present the clinical features and diagnostic procedure of the first documented case of co-infection with monkeypox virus, SARS-CoV-2 and HIV-1.
Since January 2022, more than 16,000 people in over 74 countries have been affected by monkeypox, prompting the World Health Organization to declare this outbreak a public health emergency of international concern [
,
]. Human-to-human transmission occurs through close contact with infectious material from skin lesions, fomites, seminal fluids and oropharyngeal secretions [
,
4
- Peiró-Mestres A
- Fuertes I
- Camprubí-Ferrer D
- Marcos MÁ
- Vilella A
- Navarro M
- et al.
5
- Thornhill JP
- Barkati S
- Walmsley S
- Rockstroh J
- Antinori A
- Harrison LB
- et al.
,
6
- Raccagni AR
- Mileto D
- Canetti D
- Tamburini AM
- Rizzo A
- Bruzzesi E
- et al.
]. The majority of cases were registered in gay or bisexual men often suffering from other STI [
,
[5]
- Thornhill JP
- Barkati S
- Walmsley S
- Rockstroh J
- Antinori A
- Harrison LB
- et al.
,
[6]
- Raccagni AR
- Mileto D
- Canetti D
- Tamburini AM
- Rizzo A
- Bruzzesi E
- et al.
]. At the same time, SARS-CoV-2 is still a major cause of morbidity and mortality globally. COVID-19 shares with monkeypox both the transmission by air droplets and the symptoms of fever, lymphadenopathy, headache, sore throat and fatigue [
[5]
- Thornhill JP
- Barkati S
- Walmsley S
- Rockstroh J
- Antinori A
- Harrison LB
- et al.
]. As these pathogens continue to spread, individuals can be simultaneously infected with monkeypox virus, SARS-CoV-2 and STI, making it difficult for physicians to perform the correct diagnosis, also considering that not all patients with monkeypox develop skin lesions [
[6]
- Raccagni AR
- Mileto D
- Canetti D
- Tamburini AM
- Rizzo A
- Bruzzesi E
- et al.
] and that COVID-19 may rarely present with rash and vesicles [
].
Our patient, an Italian 36-year-old male spent 5 days in Spain from 16 to 20 June 2022 (Figure 1). Nine days after, he developed fever (up to 39°C), accompanied by sore throat, fatigue, headache and right inguinal lymphadenomegaly. On 2 July he resulted positive for SARS-CoV-2. On the afternoon of the same day a rash started to develop on his left arm. The following day small, painful vesicles surrounded by an erythematous halo appeared on the torso, lower limbs, face and glutes. On 5 July, due to a progressive and uninterrupted spread of vesicles that began to evolve into umbilicated pustules, he went to the emergency department of the Policlinico “G. Rodolico - San Marco” University Hospital in Catania, Italy, and was subsequently transferred to the Infectious Diseases unit.
On admission, the patient reported being treated for syphilis in 2019. In September 2021, he performed an HIV test with a negative result. He suffered from bipolar disorder, for which he regularly took carbamazepine 200 mg daily. He was vaccinated for SARS-CoV-2 with two doses of Pfizer's BNT162b2 mRNA vaccine (the last in December 2021) and had already contracted COVID-19 in January 2022. He also reported of having condomless intercourse with men during his stay in Spain. Fever (37.5°C), pharyngodynia, fatigue, headache was still present. On physical examination his body was dotted, including the palm of the right hand and the perianal region, with skin lesions in various stages of progression, ranging from small vesicles (Figure 1, Panel A) to reddened haloed pustules (Figure 1, Panel B and Panel C) and umbilicated plaques (Figure 1, Panel D). The oral mucosa was normal, except for bilateral tonsillar hypertrophy. A modest hepatosplenomegaly and an enlarged (2 cm), hypomobile and painful lymph node in the right inguinal region were found. Laboratory test showed elevated C-reactive protein (69 mg/L, normal values 0.0 - 5.0 mg/L), fibrinogen (713 mg/dL, normal values 170 - 400 mg/dL) and prothrombin time (1.21, normal values 0.8 - 1.2). Chest X-ray revealed a parenchymal hypodiaphany in the right parailary region.
On the second day of admission (July 6, 2022), given the high suspicion of monkeypox supported by suggestive skin lesions and a recent trip to Spain [
], swabs of pustule exudate and nasopharynx secretions were sent to the Regional Reference Laboratory hosted at the University Hospital “A.O.U.P. P. Giaccone” of Palermo (Italy) for monkeypox orthopoxvirus detection and SARS-CoV-2 sequencing. To this purpose, monkeypox virus DNA was extracted using Quick-DNA™ Miniprep Plus extraction kit (Zymo Research), whereas SARS-CoV-2 RNA was extracted using QIAamp Viral RNA extraction kit (QIAGEN). Eluted DNA/RNA was stored immediately at -80°C until further use or analysed by means of rt-PCR assays. Three different singleplex rt-PCR assays targeting the TNF receptor gene of monkeypox were used: a monkeypox generic assay and two further rt-PCR assays specifically designed to differentiate monkeypox Congo Basin and West African strains [
]. All rt-PCR assays were performed with a QuantStudio™ 7 Flex Real-Time PCR System (Applied Biosystems, Carlsbad, USA) and a test was considered positive when its cycle threshold value was <40. SARS-CoV-2 genome was generated by next-generation sequencing on an Ion GeneStudio™ S5 System (Applied Biosystems, Carlsbad, USA) using the Ion Ampliseq™ SARS-CoV-2 Research Panel and virus lineage was designated using the Pangolin dynamic nomenclature system [
[9]
- Tramuto F
- Reale S
- Lo Presti A
- Vitale F
- Pulvirenti C
- Rezza G
- et al.
,
jward
passin' thru
]. SARS-CoV-2 genome included in the study was submitted to the Global Initiative on Sharing All Influenza Data (GISAID) repository (GISAID - gisaid.org).
The specimens were confirmed positive to monkeypox virus and SARS-CoV-2. The first belonged to the West African clade, the variant responsible for the Spanish outbreak [
], while SARS-CoV-2 genome classified by Pangolin as lineage BA.5.1 (GISAID Accession ID: EPI_ISL_13876417). Serology tests for viral hepatitis, herpes simplex, gonorrhoea, chlamydia and lymphogranuloma venereum were negative. However, HIV-1 resulted positive with a viral load of 234,000 copies/mL. The CD4 lymphocyte count was unaltered with 812 cells/μL (normal values within 410-1590 cells/μL).
The third day almost all skin lesions began to turn to crusts. Sotrovimab 500 mg was infused intravenously. On day 5 (July 9, 2022), almost all constitutional symptoms were resolved and previously altered laboratory test values normalized. On day 6 (July 11, 2022), nasopharyngeal swabs for SARS-CoV-2 and monkeypox virus were still positive, despite the absence of new skin lesions. Since symptoms had resolved, the patient was discharged to home isolation. On 19 July 2022 he returned to our institute to underwent a new oropharyngeal swab for monkeypox virus, which was still positive. The crusts had healed almost completely, leaving a small scar (Figure 2, Panels E to H). A triple combination of dolutegravir, abacavir and lamivudine was initiated for HIV treatment.
This case highlights how monkeypox and COVID-19 symptoms may overlap, and corroborates how in case of co-infection, anamnestic collection and sexual habits are crucial to perform the correct diagnosis. SARS-CoV-2 BA.4 and BA.5 subvariants are currently responsible for more than 1 million COVID-19 cases per day worldwide. Hence, clinicians should be aware of the possibility of SARS-CoV-2 and monkeypox virus co-infection, particularly in subjects with a recent history of travel to monkeypox-outbreak areas. If monkeypox is suspected, an oropharyngeal swab should be performed even in the absence of cutaneous manifestations as the skin may be spared, but the oral or rectal mucosa may be involved [
4
5
,
6
].
Our case emphasises that sexual intercourse could be the predominant way of transmission. Therefore, complete STI screening is recommended after a diagnosis of monkeypox. In fact, our patient tested positive for HIV-1 and, given his preserved CD4 count, we could assume that the infection was relatively recent. To note, the monkeypox oropharyngeal swab was still positive after 20 days, suggesting that these individuals may still be contagious for several days after clinical remission. Consequently, physicians should encourage appropriate precautions. As this is the only reported case of monkeypox virus, SARS-CoV-2 and HIV co-infection, there is still not enough evidence supporting that this combination may aggravate patient's condition. Given the current SARS-CoV-2 pandemic and the daily increase of monkeypox cases, healthcare systems must be aware of this eventuality, promoting appropriate diagnostic tests in high-risk subjects, which are essential to containment as there is no widely available treatment or prophylaxis.
The specimens were confirmed positive to monkeypox virus and SARS-CoV-2. The first belonged to the West African clade, the variant responsible for the Spanish outbreak [
], while SARS-CoV-2 genome classified by Pangolin as lineage BA.5.1 (GISAID Accession ID: EPI_ISL_13876417). Serology tests for viral hepatitis, herpes simplex, gonorrhoea, chlamydia and lymphogranuloma venereum were negative. However, HIV-1 resulted positive with a viral load of 234,000 copies/mL. The CD4 lymphocyte count was unaltered with 812 cells/μL (normal values within 410-1590 cells/μL).
The third day almost all skin lesions began to turn to crusts. Sotrovimab 500 mg was infused intravenously. On day 5 (July 9, 2022), almost all constitutional symptoms were resolved and previously altered laboratory test values normalized. On day 6 (July 11, 2022), nasopharyngeal swabs for SARS-CoV-2 and monkeypox virus were still positive, despite the absence of new skin lesions. Since symptoms had resolved, the patient was discharged to home isolation. On 19 July 2022 he returned to our institute to underwent a new oropharyngeal swab for monkeypox virus, which was still positive. The crusts had healed almost completely, leaving a small scar (Figure 2, Panels E to H). A triple combination of dolutegravir, abacavir and lamivudine was initiated for HIV treatment.
This case highlights how monkeypox and COVID-19 symptoms may overlap, and corroborates how in case of co-infection, anamnestic collection and sexual habits are crucial to perform the correct diagnosis. SARS-CoV-2 BA.4 and BA.5 subvariants are currently responsible for more than 1 million COVID-19 cases per day worldwide. Hence, clinicians should be aware of the possibility of SARS-CoV-2 and monkeypox virus co-infection, particularly in subjects with a recent history of travel to monkeypox-outbreak areas. If monkeypox is suspected, an oropharyngeal swab should be performed even in the absence of cutaneous manifestations as the skin may be spared, but the oral or rectal mucosa may be involved [
4
- Peiró-Mestres A
- Fuertes I
- Camprubí-Ferrer D
- Marcos MÁ
- Vilella A
- Navarro M
- et al.
5
- Thornhill JP
- Barkati S
- Walmsley S
- Rockstroh J
- Antinori A
- Harrison LB
- et al.
,
6
- Raccagni AR
- Mileto D
- Canetti D
- Tamburini AM
- Rizzo A
- Bruzzesi E
- et al.
].
Our case emphasises that sexual intercourse could be the predominant way of transmission. Therefore, complete STI screening is recommended after a diagnosis of monkeypox. In fact, our patient tested positive for HIV-1 and, given his preserved CD4 count, we could assume that the infection was relatively recent. To note, the monkeypox oropharyngeal swab was still positive after 20 days, suggesting that these individuals may still be contagious for several days after clinical remission. Consequently, physicians should encourage appropriate precautions. As this is the only reported case of monkeypox virus, SARS-CoV-2 and HIV co-infection, there is still not enough evidence supporting that this combination may aggravate patient's condition. Given the current SARS-CoV-2 pandemic and the daily increase of monkeypox cases, healthcare systems must be aware of this eventuality, promoting appropriate diagnostic tests in high-risk subjects, which are essential to containment as there is no widely available treatment or prophylaxis.
STATEMENT OF ETHICS
Written informed consent was obtained from the patient for publication of this case report and any accompanying images.CONTRIBUTORSHIP STATEMENT
All authors contributed equally to this work.Declaration of Competing Interest
The authors have no conflicts of interest to declare.FUNDING
None.REFERENCES
- Orviz E
- Negredo A
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- Monkeypox outbreak in Madrid (Spain): clinical and virological aspects.
J Infect [Internet].
- 2022 Monkeypox outbreak global map [Internet]. Cdc.gov. 2022 [cited 2022 Jul 23]. Available from: Monkeypox in the U.S.
- Who.int. [cited 2022 Jul 23]. Available from: Second meeting of the International Health Regulations (2005) (IHR) Emergency Committee regarding the multi-country outbreak of monkeypox
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- Monkeypox virus infection in humans across 16 countries.
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J Am Acad Dermatol [Internet].
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- Real-time PCR assays for the specific detection of monkeypox virus West African and Congo Basin strain DNA.
J Virol Methods [Internet].
- Tramuto F
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- Pulvirenti C
- Rezza G
- et al.
- Genomic analysis and lineage identification of SARS-CoV-2 strains in migrants accessing Europe through the Libyan route.
Front Public Health [Internet].
- Rambaut A
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- A dynamic nomenclature proposal for SARS-CoV-2 lineages to assist genomic epidemiology.
Nat Microbiol [Internet].
Article Info
Publication History
Accepted: August 14, 2022Publication stage
In Press Journal Pre-ProofIdentification
DOI: RedirectingCopyright
© 2022 The British Infection Association. Published by Elsevier Ltd. All rights reserved.ScienceDirect
Access this article on ScienceDirectFigures
-
Figure 1Symptoms and skin lesions, from June 20 to July 19, 2022. -
Figure 2Monkeypox skin lesions: small vesicles (Panel A), reddened haloed pustules (Panel B and Panel C) and umbilicated plaques (Panel D). After 16 days, the lesions had almost healed, leaving a small scar (Panels E to H).
helen
Panic Sex Lady
I think this is a "breakthrough infection".
2 vaccinated guys + mpox experience
My partner and I are fully-vaccinated gay, cis-men in our late 20s, and we have mpox. Our journey:
8/3 - we both receive our 2nd dose of the Jynneos vaccine. We had “closed” our relationship up to this point bc of the increased risk of mpox
8/12 - we have a sexual encounter with another couple (the first since pre- first vaccine). No one in the mix has symptoms of mpox or knowledge of prior exposure
8/16- Me: i first observe a pimple on the shaft of my penis Him: no symptoms
8/17 - Me: i observe 4 more pimples in my groin area. the glands in my pelvic region have intense swelling — causing pressure in that area. I see an urgent care doc who takes swabs of the pimples and orders tests for herpes and syphillis Him: he is feverish, has body aches and sweats/chills. His pelvic glands are also swollen which he describes as “having marbles in your pelvis”. He comes with me to urgent care but doesn’t have any pimples to swab.
8/18- Me: no significant changes but pimples are becoming increasingly painful Him: he suffers from bouts of fatigue. Even nausea if he stands for too long. Body chills continue. For the first time, he notices an itch near his anoperineal region
8/19: Me: mpox test comes back positive. Ordered to isolate and given prescription for high-dose ibuprofen. Him: the anoperineal itch progresses to constant pressure (periodic bouts of relief) and sometimes sharp pains. He’s noticing discharge and we suspect proctitis based on accounts we’ve read
Tbd - here’s to hoping that being double-vaxxed will provide us with relief soon!
View: https://www.reddit.com/r/monkeypoxpositive/comments/wt9ubp/2_vaccinated_guys_mpox_experience/
2 vaccinated guys + mpox experience
My partner and I are fully-vaccinated gay, cis-men in our late 20s, and we have mpox. Our journey:
8/3 - we both receive our 2nd dose of the Jynneos vaccine. We had “closed” our relationship up to this point bc of the increased risk of mpox
8/12 - we have a sexual encounter with another couple (the first since pre- first vaccine). No one in the mix has symptoms of mpox or knowledge of prior exposure
8/16- Me: i first observe a pimple on the shaft of my penis Him: no symptoms
8/17 - Me: i observe 4 more pimples in my groin area. the glands in my pelvic region have intense swelling — causing pressure in that area. I see an urgent care doc who takes swabs of the pimples and orders tests for herpes and syphillis Him: he is feverish, has body aches and sweats/chills. His pelvic glands are also swollen which he describes as “having marbles in your pelvis”. He comes with me to urgent care but doesn’t have any pimples to swab.
8/18- Me: no significant changes but pimples are becoming increasingly painful Him: he suffers from bouts of fatigue. Even nausea if he stands for too long. Body chills continue. For the first time, he notices an itch near his anoperineal region
8/19: Me: mpox test comes back positive. Ordered to isolate and given prescription for high-dose ibuprofen. Him: the anoperineal itch progresses to constant pressure (periodic bouts of relief) and sometimes sharp pains. He’s noticing discharge and we suspect proctitis based on accounts we’ve read
Tbd - here’s to hoping that being double-vaxxed will provide us with relief soon!
View: https://www.reddit.com/r/monkeypoxpositive/comments/wt9ubp/2_vaccinated_guys_mpox_experience/
