What to make of monkeypox? | WORLD
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What to make of monkeypox?


WORLD Radio - What to make of monkeypox?

Understanding monkeypox can help decide what steps to take next

This 2003 electron microscope image made available by the Centers for Disease Control and Prevention shows mature, oval-shaped monkeypox virions, left, and spherical immature virions, right, obtained from a sample of human skin associated with the 2003 prairie dog outbreak. Cynthia S. Goldsmith, Russell Regner/CDC via Associated Press

MYRNA BROWN, HOST: Coming up next on The World and Everything in It: what to make of monkeypox?

Reacting to the surprising outbreak of the virus, U.S. health officials this week expanded the group of people recommended to get vaccinated against the virus.

They also said they’re providing more monkeypox vaccine, working to expand testing, and taking other steps to try to get ahead of the outbreak.

PAUL BUTLER, HOST: The announcement came after the World Health Organization said the virus is not a global health emergency at the moment.

But what exactly is monkeypox and should we be concerned about it?

BROWN: Here now to help us answer that question is Dr. Zach Jenkins. He is a pharmacist and pharmacology professor at Cedarville University, a Christian college in Cedarville, Ohio. Doctor, good morning!

ZACH JENKINS, GUEST: Good morning!

BROWN: First of all, what are the symptoms of monkeypox?

JENKINS: So, monkeypox—generally speaking—begins with flu-like symptoms in individuals. So, you may have a fever, swollen lymph nodes and the kinds of things you might normally associate with the flu. And then what ends up happening is there's a progression from that, after somewhere in the neighborhood of four to six days, to this place where people start to develop rashes. And those rashes will eventually move from just being just redness, this patchy redness towards forming these blister-like lesions all over the body. So what happens as those things progress is they can actually rupture. And then that will crust over. And it's very, very, very painful for people. What's interesting about this particular monkeypox that’s floating around at the moment, though, is there are people that are actually manifesting those skin lesions earlier on than we would normally expect.

BROWN: And what is the recommended treatment for monkeypox? Is this something that typically clears up on its own, or is medical treatment important?

JENKINS: Most of the treatment we can offer is more supportive than anything else. Pain management would actually be a big one. If you look at the number of patients that have had monkeypox that we know of in the United States, up until now, through this particular outbreak, it's around 300. Only some of those individuals have been hospitalized. And the reason they've been hospitalized is not from the illness itself, it's actually from the pain from the illness. So it's a case where those lesions get very painful as the blisters rupture, and that's a place where medical management is helpful. Other than that, it's largely supportive care, traditionally speaking. There are some antivirals that we have actually used before to manage smallpox. But we don't have any information to tell us what that would look like with monkeypox, which is a relative of smallpox. So no real clinical trials in humans to speak of.

BROWN: How long does it last?

JENKINS: Yeah, so how monkeypox typically introduces itself is it's a slower incubation than you might think of with COVID-19 where you have the exposure and then somewhere between two to three days later you start to have symptoms. With monkeypox, it can take a full week before you might actually start having symptoms—sometimes a little bit longer in some individuals. But once it actually has hit, usually after about I would say four to six days into it is when those rashes would start to develop and people—those lesions all over the skin, the blisters—from there what ends up happening is it lasts somewhere around two to four weeks in most individuals.

BROWN: Tell us about the monkeypox vaccine. Who does the U.S. government say should get the vaccine, and what kind of vaccine is it?

JENKINS: We're talking about a smallpox vaccine, which does have some evidence to say that it is helpful in these cases. The question is who should actually receive that. And so originally, we actually had vaccines stored in the strategic national stockpile in the event of maybe a bio terrorist attack with smallpox. What's happened now, though, is as people have been concerned with possible infections, they've actually sort of taken some of the restrictions in place that required a proof of infection before—because we have testing limitations with detecting this right now—to where if you've been around people and you were most likely exposed, then you could potentially qualify for this, especially if you're in the higher risk groups. So it's not for everyone, for sure. But if you were directly around someone who had monkeypox that was confirmed, that's where you would probably be a candidate for this.

BROWN: And if someone feels they need the vaccine, where should they turn to get that?

JENKINS: That’s a great question. It would start with your primary care provider. And then from there, it actually would escalate up to a discussion with the Health Department. And the reason that that would take place is because supplies are limited. We only have about 30,000 of those vaccines that we had in the stockpile. And so they're sort of a distribution house when it comes to that vaccine, at least at present. So that's what we have in place right now. It doesn't mean it will stay like that. But in all likelihood, this is not something like COVID or like the flu where you'll see the spread wildly, uncontrolled in mass. This is something that's a lot more slowly moving. It spreads more through direct contact with body and body fluids than it does through the air. So that's why you're not going to see this spread maybe the same way you would have seen with other kinds of viruses. So probably the need for it is not going to be huge.

BROWN: Is it a more traditional vaccine or mRNA like the Pfizer and Moderna COVID vaccines?

JENKINS: So as far as this vaccine platform, it's more in the traditional sense. It's actually a live virus, but it isn't able to replicate. So when you think about the vaccines that have been used for COVID, those are newer platforms, the messenger RNA platforms. And so there's obviously some concern over that but if you had to have one of these for some reason, this is using an older technology.

BROWN: Okay, we’ve been talking with Dr. Zack Jenkins. Thanks so much!

JENKINS: Absolutely. Happy to help.

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