Monkey pox. What vaccines and drugs does the world have?

Monkey pox has reached Poland, confirmed Minister Adam Niedzielski on June 10. The so far endemic disease is present in over 30 countries around the world, many of which are European countries (including our neighbors: Germany and the Czech Republic). Are we able to protect ourselves from monkey pox? Are there effective vaccines against this disease? Finally – how and with what can we treat it, once it reaches us?

1. Monkey pox is increasing its range, so more and more countries are examining treatment options and protection against the disease
2. Among the available drugs, a product successfully used in the treatment of smallpox may have a potentially high effectiveness
3. There is no vaccine dedicated to monkey pox, but research shows that the smallpox vaccine is highly effective. There are two such preparations authorized for marketing
4. More current information can be found on the Onet homepage

Is there monkey pox?

Monkey pox is a viral disease that has so far mainly occurred in Africa. Apart from the 2003 epidemic in the US, where dozens of infections occurred, only a few cases outside Africa have been detected in the last decade. This is because current infections are worrying – monkey pox has never spread on such a scale, both in terms of the number of cases (currently it is 296 – as of May 26), as well as the range of occurrence (almost all continents).

The disease, like most viral diseases, is very contagious, but the good news is that you become infected primarily when you already have symptoms of an infection (fever, chills, muscle and joint pain, headache, fatigue, swollen glands, characteristic rash after a few days). This is a big difference between monkey pox and COVID-19, which we also get infected before or without symptoms. This factor, experts say, is what decides that monkey pox will not trigger a new pandemic.

The course of the disease is (in most cases) mild, and the mortality rate is relatively low (1%, although in some varieties and in groups at risk of severe SMP it may increase to 10%). The disease lasts for two to four weeks and is treated primarily symptomatically.

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What medications are used to treat monkey pox?

Although monkey pox is a different disease from smallpox (and chicken pox), some medications used to treat the latter disease may be effective against the monkey pox virus.

Scientific research (published in The Lancet Infectious Diseases) shows that such an effective agent can be tecovirimate – an antiviral drug that blocks the transmission of the virus between cells. In laboratory tests, the active substance has shown high efficiency in protecting animals against diseases caused by orthopoxiviruses, i.e. smallpox, monkey pox or rabbit pox.

According to scientists, tekovirimate can significantly shorten the course of the disease (or more precisely: the occurrence of the symptoms of monkey pox), but also reduce the transmission of the virus that causes it. In studies, this drug fared much better than brincidofovir, which is much less effective in treating monkey pox. However, experts point out that more effectiveness research is needed.

Tecovirimate is the first antioxidant drug approved in the United States. The first occasion for its use in treatment was a vaccinia virus infection in 2018.

The drug was authorized in the European Union in January 2022.

Another antiviral drug developed by Chimerix (CMRX. O) may be potentially effective. Tembexa is approved as a treatment for smallpox in the US, but it is not known if it can help people infected with monkey pox as well.

Is there a vaccine against monkey pox?

We do not have a dedicated monkey pox vaccinebut smallpox vaccines are available. Scientists have found that vaccination against smallpox gives 85 percent. protection also against monkey pox. People who received such a vaccine (in Poland, injections were completed at the end of the 70s, because smallpox was considered an eradicated, eliminated disease), most likely are also protected against monkey pox.

There are currently two preparations of this type on the market. The first is produced by the Danish company Bavarian Nordic (BAVA.CO) as Jynneos, Imvamune or Imvanex (the name depends on the country in which it is marketed).

The weakened vaccine is approved for protection against smallpox and monkey pox in the United States. In the European Union, the authorization applies only to smallpox, but doctors have the right to prescribe it outside the indications resulting from registration, e.g. in the case of monkey pox. However, it is already known that Bavarian Nordic intends to submit an application to the European Medicines Agency (EMA) for the extension of the indications for use of the preparation.

The second smallpox vaccine is ACAM2000, manufactured by Emergent Biosolutions (EBS. N). It is older than the Bavarian Nordic product and is different in terms of production. ACAM2000 is made using the live cow pox virus (it is related to the smallpox virus). Its action is based on causing a slight infection, as a result of which the body produces antibodies to fight the right pathogen, i.e. the smallpox virus. As it is a live virus, care should be taken when injecting to prevent the pathogen from spreading beyond the vaccination site.

The Emergent Biosolutions vaccine is not licensed in the EU, but is available in the US for people at risk of being infected with the smallpox virus.

WHO stores 2,4 million doses of BAVA.CO vaccine in case of new outbreaks. The United States also has large reserves (of both preparations). As a result of recent reports of monkey pox, many countries have attempted to procure vaccines to keep them in stock in case the disease spreads. Among them are Germany, which placed an order for 40 thousand. doses of the first vaccine mentioned.

Check out the list of countries where cases of monkey pox have been identified:

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