Understanding outbreaking Mpox Clade 1b: Features, Vaccination and avoiding ways

Mpox spreads primarily through close contact with an infected person, animal, or contaminated objects. The virus can be transmitted in the following ways:

1. Human-to-Human Transmission:

• Direct contact: The virus spreads through direct skin-to-skin contact with the lesions, scabs, or body fluids (such as pus or blood) of an infected person.
• Respiratory droplets: Prolonged face-to-face contact can lead to transmission through respiratory droplets, though this is less common compared to diseases like COVID-19.
• Intimate contact: This includes kissing, hugging, sexual contact, or any close physical contact with someone who has the virus. Many recent outbreaks have involved transmission through sexual networks.
• Contaminated objects: Touching clothing, bedding, towels, or other materials that have been in contact with an infected person’s lesions or body fluids can also spread the virus.

2. Animal-to-Human Transmission:

• Zoonotic transmission: Mpox is originally a zoonotic disease, meaning it can spread from animals to humans. This can occur through direct contact with infected animals like rodents (rats, squirrels) or monkeys, particularly through bites, scratches, or handling of their body fluids or lesions.
• Eating undercooked meat: Consuming meat from infected animals, especially in areas where the disease is endemic, may pose a risk.

3. Mother-to-Child Transmission:

• Vertical transmission: Mpox can spread from a pregnant mother to her fetus through the placenta, potentially causing complications.

4. Other Modes:

• Fomites: Surfaces or objects that have been in contact with the lesions or fluids of an infected individual can harbor the virus and infect others who touch them.
• Healthcare settings: Inadequate use of protective equipment (PPE) in healthcare or caregiving settings can lead to transmission.

Risk Factors:

• Close physical contact with an infected person.
• Living in or traveling to areas where mpox is endemic.
• Handling wild animals in endemic regions.

Proper hygiene, isolation of infected individuals, and vaccination in high-risk groups can help reduce the spread of mpox.

How to avoid mpox?

To avoid mpox, it’s important to reduce your risk of exposure to the virus. Here are key preventive measures:

1. Avoid Close Contact with Infected Individuals:

• Avoid direct contact with skin lesions, scabs, or bodily fluids of people who are infected.
• Refrain from intimate contact, such as kissing, hugging, or sexual activity, with someone who has symptoms of mpox (rashes, lesions, fever, etc.).
• Isolate infected individuals until they have fully recovered and their skin lesions have healed.

2. Practice Good Hygiene:

• Wash hands frequently with soap and water, or use alcohol-based hand sanitizer, especially after contact with people or objects that could be contaminated.
• Wear gloves and appropriate personal protective equipment (PPE) if caring for someone who is infected.

3. Avoid Contact with Contaminated Materials:

• Do not share bedding, towels, clothing, or other personal items with an infected person.
• Clean and disinfect any surfaces, objects, or materials that may have been in contact with an infected individual.

4. Use Protective Measures in High-Risk Environments:

• If you work in healthcare or caregiving, use appropriate PPE, including gloves, masks, and gowns when caring for infected individuals.
• In outbreak settings, avoid crowded places or areas where close physical contact is likely.

5. Vaccination:

• JYNNEOS (Imvamune/Imvanex): This vaccine can help prevent mpox and is recommended for high-risk groups such as healthcare workers, laboratory personnel, and individuals who may have been exposed to the virus.
• Post-exposure vaccination: Vaccination shortly after exposure (within 4 days) can help prevent the disease or reduce its severity.

6. Avoid Contact with Animals:

• Avoid contact with wild animals that could carry the virus, especially rodents and monkeys in areas where mpox is endemic.
• Practice caution when handling or preparing animal products, and avoid consuming undercooked or wild game meat in endemic areas.

7. Safe Sexual Practices:

• Use condoms and practice safer sex, as mpox has been known to spread through sexual networks.
• Be cautious of physical interactions in environments like parties or events where close contact is common.

8. Travel Precautions:

• Avoid travel to areas where mpox outbreaks are occurring, or take extra precautions when traveling to endemic regions.
• Follow local public health guidance if you are in or near an outbreak zone.

By following these precautions, you can significantly reduce your risk of exposure to mpox and help prevent its spread.

How long does mpox last?

Mpox typically lasts for 2 to 4 weeks from the onset of symptoms to full recovery. The illness generally progresses through the following phases:

1. Incubation Period:

• 5 to 21 days: After being exposed to the virus, there is an incubation period during which the person is infected but shows no symptoms. This phase usually lasts around 7 to 14 days.

2. Initial Symptoms (Prodromal Phase):

• 1 to 5 days: The initial symptoms include fever, headache, muscle aches, back pain, swollen lymph nodes, chills, and exhaustion. This is when the virus starts spreading within the body.

3. Rash and Lesion Development:

• A few days after the onset of fever, a rash develops, starting on the face and spreading to other parts of the body, including the hands, feet, and genitals. The rash progresses through several stages, including macules (flat spots), papules (raised bumps), vesicles (fluid-filled blisters), pustules (pus-filled lesions), and finally scabs.
• This rash phase can last 2 to 4 weeks as the lesions go through these stages and then heal.

4. Healing Phase:

• The lesions scab over, dry up, and eventually fall off. Once all the scabs have fallen off, the person is no longer contagious.
• The healing process varies by individual, but by the end of the 3rd to 4th week, most people are fully recovered.

Factors Influencing Duration:

• Severity of illness: Some individuals, particularly those with weakened immune systems, may have longer or more severe cases of mpox.
• Medical care: Access to supportive care and, in some cases, antiviral treatment can influence the course of the disease.

Once the lesions have fully healed and all scabs have fallen off, individuals are generally no longer contagious.

Does mpox have a vaccine?

Yes, mpox has vaccines that can help prevent infection or reduce the severity of the disease. Two vaccines, originally developed for smallpox, have been found effective against mpox due to the similarity between the two viruses:

1. JYNNEOS (Imvamune or Imvanex):

• Type: Live, non-replicating vaccine.
• Approval: Licensed by the U.S. FDA, the European Medicines Agency (EMA), and other health authorities for use against both smallpox and mpox.
• Use: JYNNEOS is the preferred vaccine for mpox prevention, particularly in high-risk groups (e.g., healthcare workers, individuals exposed to mpox).
• Dosing: Administered as two doses, given four weeks apart.
• Advantages: It is safer for people with weakened immune systems or skin conditions (like eczema) because it contains a non-replicating virus.

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2. ACAM2000:

• Type: Live, replicating vaccine.
• Approval: Approved for smallpox in the U.S. but can be used for mpox under certain circumstances.
• Use: This vaccine is an option when JYNNEOS is unavailable or in situations of high risk. It is administered as a single dose via a unique method involving multiple pricks on the skin (scarification).
• Dosing: Single dose.
• Risks: Because it contains a live virus that can replicate, ACAM2000 is not recommended for people with weakened immune systems, heart conditions, or skin disorders like eczema.

Who Should Get the Vaccine:

• Pre-exposure: Individuals at higher risk, such as healthcare workers, laboratory personnel working with orthopoxviruses, and people in areas with ongoing outbreaks.
• Post-exposure: Vaccination after exposure to mpox can help prevent infection or lessen the severity of symptoms if given within 4 days of exposure (up to 14 days for reduced symptoms).

Availability:

During outbreaks, these vaccines are distributed to at-risk populations based on public health guidance. The JYNNEOS vaccine is generally preferred due to its favorable safety profile.

Vaccination, alongside other preventive measures, can significantly reduce the spread and impact of mpox.

How to test for monkeypox?

Testing for monkeypox (mpox) involves detecting the virus through a series of laboratory tests. Here’s how the testing process typically works:

1. Sample Collection:

• Skin lesions: The most reliable sample comes from the lesions or rash that develop on the skin. Healthcare providers will swab the fluid, scabs, or tissue from the active lesions or vesicles (fluid-filled blisters) on the skin.
• Oropharyngeal or nasopharyngeal swabs: In some cases, samples may be taken from the throat or nasal passages, especially if lesions are found there.
• Other specimens: In rare cases, blood, urine, or saliva samples might be collected, but these are less common for accurate diagnosis.

2. PCR Testing (Polymerase Chain Reaction):

• Primary method: The standard and most widely used test for mpox is a PCR test. This molecular test detects the viral DNA in the collected sample.
• Sensitivity: PCR tests are highly sensitive and specific, making them the preferred method for confirming mpox.
• Turnaround time: Depending on the lab, results can be available within a few hours to a couple of days.

3. Genomic Sequencing:

• If necessary, further analysis of the virus can be done through genomic sequencing to identify the specific strain or clade (e.g., Clade 1 or 2). This helps with tracking outbreaks and understanding transmission patterns.

4. Blood Tests:

• Serology: Blood tests can be used to detect antibodies to the mpox virus. However, this method is not widely used for diagnosing active infections, as it is better suited for identifying past exposure or immune response.

5. Where to Get Tested:

• Healthcare providers: If you suspect mpox, visit a healthcare professional. They will assess your symptoms and, if necessary, collect the appropriate samples for testing.
• Public health authorities: In many countries, public health departments coordinate testing during outbreaks. Specialized laboratories, often government or CDC-affiliated, process the tests.
• Laboratories: Some specialized and accredited labs can perform mpox tests, particularly those with the capacity for PCR analysis.

When to Get Tested:

• Testing is recommended if you have symptoms of mpox, especially if you develop an unusual rash or lesions, and particularly if you’ve been in contact with someone diagnosed with the virus or traveled to areas with an outbreak.
• Close contacts of confirmed cases may also be advised to undergo testing, even if they aren’t showing symptoms yet.

Testing plays a crucial role in confirming mpox infection, helping to isolate cases and prevent further transmission.