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Mobilizing against monkeypox

Posted on August 3rd, 2022 by in Pharma R&D

As the world continues to navigate Covid and its many strains, it would be an understatement to say that everyone is on high alert for other types of outbreaks. Monkeypox is now top of mind, as the disease – first identified in humans in 1970 and mostly found in rainforest areas in Central and West Africa – is now seeing its largest-ever outbreaks outside of the African continent.

Monkeypox now a public health emergency

As of July 23, STAT reported that the number of cases had grown to 16,000, covering 75 nations across North and South America, Europe, Asia, Australia and Africa. This has prompted the World Health Organization to declare the monkeypox outbreak a public health emergency. This was done somewhat controversially, as a panel of experts convened to advise on the matter had not made the recommendation for WHO to announce it as a public health emergency.

But WHO’s decision to make this designation may be a result of lessons learned from Covid and a desire to not waste any time in mobilizing internationally against the spread of monkeypox. WHO Director-General Tedros Adhanom Ghebreyesus believes that the announcement could be a galvanizing force and spur coordinated international efforts to address monkeypox.

Transmission and tracking

Monkeypox usually presents with a rash on the face and limbs, and symptoms often include fever, headache and swollen lymph nodes. It can spread from person to person due to contact with lesions, bodily fluids, respiratory droplets and via contaminated materials like bedding.

Keeping on top of outbreaks like this as they spread can be tricky. Reporting from hospitals and doctors, as well as tracing mechanisms, can help, but they can be inconsistent and don’t enable healthcare professionals to really stay ahead of the problem. A recent article in The Guardian suggests that testing wastewater could be an easier way to track the spread.

The newspaper reports that “researchers in Thailand are examining wastewater for signs of monkeypox,” using a technique that has also been used to track the spread of Covid. “Previously, wastewater monitoring has allowed researchers to spot the arrival of new Covid strains before widespread outbreaks occur, allowing local areas to prepare health services.”

What vaccines are available right now?

Fortunately, unlike with Covid, there is already a vaccine available for monkeypox. Bavarian Nordic manufactures the JYNNEOS vaccine (known as Imvanex in Europe) for smallpox and monkeypox, and doses from the U.S. federal stockpile are already being made available to eligible people in places like New York City, where case rates are growing quickly. So far some localities have been limiting vaccine availability to what are deemed high-risk groups, such as gay, bisexual, and men who have sex with other men (MSM). However, this guidance could change soon as monkeypox spreads further.

The supply of vaccines is currently quite limited, and that’s where cooperation and coordination – on local and international levels – is going to become important, in order to ensure that manufacturing can be rapidly ramped up to meet the need for more vaccines. Already, as of July 29, the FDA announced that it had given the green light to additional manufacturing of the Jynneos monkeypox vaccine at a facility in Denmark – and demand is likely to increase exponentially by the day.

In addition to the Jynneos vaccine, new vaccines against monkeypox are in the works, including:

* Moderna announced in May that they are “investigating potential monkeypox vaccines at a preclinical level”

* Tonix Pharmaceuticals is currently developing its TNX-801 as a vaccine against monkeypox

* EpiVax’s VennVax is a smallpox vaccine candidate that is predicted to be highly effective against monkeypox

Treating monkeypox

The only significant treatment available for monkeypox right now is the antiviral TPOXX (manufactured by SIGA), but the smallpox drug is not actually approved by the FDA to treat monkeypox yet, making it hard for Americans to obtain it. Clinical trials are needed, and while they are deep in the planning stages in Europe, the U.S. is lagging behind.

It is precisely situations like this where we need to see better mobilization. As with Covid-19, researchers, scientists and the medical community worldwide must be prepared to work together to advocate for patients, tackle regulatory hurdles and partner to create needed responses like treatments and vaccines.

Monkeypox information hub

If you are a healthcare professional or organization that wants to keep up with the latest on monkeypox, visit the Elsevier Healthcare Hub for Monkeypox to find evidence-based clinical resources such as clinical overviews, patient education, and drug monographs.

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