mpox

Bavarian Nordic and CEPI partner to advance Mpox vaccination in Africa

dlegge — Tue, 04 Jun 2024 04:50:15 +0000

Bavarian Nordic and CEPI partner to advance Mpox vaccination in Africa

31 May 2024

dlegge Tue, 04/06/2024 - 14:50

CEPI

Bavarian Nordic and CEPI partner to advance Mpox vaccination in Africa

CEPI has awarded USD 6.5 million to support a Phase 2 clinical study evaluating the immunogenicity and safety of the MVA-BN® non-replicating vaccine in children from 2 years to less than 12 years of age compared to adults aged 18-50 years of age for the prevention of smallpox, mpox and related orthopoxvirus infections. Subject to regulatory approvals, the study plans to enroll a total of approximately 460 healthy individuals in endemic regions without previous mpox infection or poxvirus vaccination, who will receive two doses of the MVA-BN vaccine. Bavarian Nordic will be the sponsor of the trial which will be conducted in one or more African countries with planned initiation later in 2024. The new trial follows the publication of a continental plan by Africa CDC and African Ministries of Health to strengthen mpox preparedness and response efforts, as well as the World Health Organization’s (WHO) framework for enhancing prevention and control of mpox. Results from this study could provide assurance of the use of this vaccine in children, and thus support an extension of the current regulatory approvals for use of the vaccine in adults to also include children 2-12 years of age. Importantly, the study will also generate evidence on the vaccine in endemic African populations and could potentially support regulatory approval of MVA-BN in endemic countries.

Keywords

mpox

C.D.C. Warns of a Resurgence of Mpox

dlegge — Fri, 17 May 2024 23:48:35 +0000

C.D.C. Warns of a Resurgence of Mpox

16 May 2024

dlegge Sat, 18/05/2024 - 09:48

Author/s

Apoorva Mandavilli

NYT

C.D.C. Warns of a Resurgence of Mpox

A deadlier version of the infectious disease is ravaging the Democratic Republic of Congo, while the type that caused a 2022 outbreak among gay and bisexual men is regaining strength.

With Pride events scheduled worldwide over the coming weeks, U.S. officials are bracing for a return of mpox, the infectious disease formerly called monkeypox that struck tens of thousands of gay and bisexual men worldwide in 2022. A combination of behavioral changes and vaccination quelled that outbreak, but a majority of those at risk have not yet been immunized.

On Thursday, the Centers for Disease Control and Prevention warned of a deadlier version of mpox that is ravaging the Democratic Republic of Congo and urged people at risk to be vaccinated as soon as possible. No cases of that subtype have been identified outside Africa so far. But the escalating epidemic in Congo nevertheless poses a global threat, just as infections in Nigeria set off the 2022 outbreak, experts said.

“This is a very important example of how an infection anywhere is potentially an infection everywhere, and why we need to continue to improve disease surveillance globally,” said Anne Rimoin, an epidemiologist at the University of California, Los Angeles.

Dr. Rimoin has studied mpox in Congo for more than 20 years, and first warned of its potential for global spread in 2010.

The C.D.C. is focusing on encouraging Americans at highest risk to become vaccinated before the virus resurges. The agency’s outreach efforts include engaging with advocacy groups and social media influencers who have broad appeal among the L.G.B.T.Q. community. In December, the agency urged clinicians to remain alert for possible cases in travelers from Congo.

There are two main types of mpox: Clade I, the type that is dominant in Congo, and Clade II, a version of which caused the 2022 global outbreak. (A clade is a genetically and clinically distinct group of viruses.) Both clades have circulated in Africa for decades, sporadically erupting into outbreaks.

People with mpox may have fever, intense headache and back pain, followed by a rash. Many patients also develop painful sores, often at the site of infection. People who have weakened immune systems, including those living with H.I.V., are at highest risk of becoming severely ill and dying.

The version of mpox that caused the 2022 outbreak, called Clade IIb, led to more than 30,000 cases in the United States that year. The epidemic quieted in 2023 with only about 1,700 cases but is now showing signs of a resurgence: The number of cases in the United States this year is nearly double the tally at this time last year.

In Congo, as of April 14, the Clade I virus has led to about 20,000 cases and nearly 1,000 deaths since January 2023. Infection with Clade I has a mortality of roughly 5 percent, compared with less than 0.2 percent for Clade IIb.

More than three-quarters of deaths in Congo related to Clade I mpox have been among children under 15.

Even if the deadlier clade were to emerge in the United States, American children would be less likely to be exposed to mpox, and less vulnerable to it, than those in Congo, experts said.

Most cases among children in Congo are thought to result from direct contact with infected animals such as monkeys, prairie dogs, squirrels and shrews, or from eating contaminated bush meat. The children may live in crowded households and be in poor health generally.

The country is troubled by armed conflicts, floods, poverty, malnutrition and multiple infectious diseases, including cholera, measles and polio.

“There’s just a difference in living in D.R.C. that probably promotes higher spread among kids,” said Dr. Jennifer McQuiston, the deputy director of the Division of High Consequence Pathogens at the C.D.C.

Adult cases in Congo have likewise been attributed to interactions with infected animals or close, sustained contact with infected people. But last year, for the first time, scientists discovered sexual transmission of Clade I mpox among male and female sex workers and their contacts.

In one outbreak in Kamituga, a mining town in Congo, heterosexual prostitution in bars appeared to be the main form of transmission. Genetic analysis showed that, sometime around September, the virus gained mutations, enabling it to spread more readily among people.

This chain of transmission appears to be a second, distinct outbreak in the country, caused by a new version of the virus called Clade Ib, with cases split about equally among young men and women, said Marion Koopmans, a virologist at Erasmus Medical Center in Rotterdam, the Netherlands.

“I do think there is more than one outbreak ongoing, and it is important to continue to evaluate what that means,” Dr. Koopmans said. “We cannot assume” all forms of mpox behave in the same way, she said.

The development has also alarmed scientists because miners and sex workers in the region are transient and may ferry the virus to the neighboring nations of Rwanda, Burundi, Uganda and Tanzania.

In many of these countries, limited access to tests, vaccines and treatments gives the virus ample opportunity to thrive and evolve. A vast majority of mpox cases are diagnosed based on symptoms alone.

Some countries rely on tests that detect only Clade I or only Clade IIb. Those tests may not pick up Clade Ib, the new version that emerged in September, according to a recent study.

That finding prompted the World Health Organization to alert nations to revisit their testing procedures “and make sure they don’t miss a diagnosis,” said Dr. Rosamund Lewis, who leads the W.H.O.’s mpox response.

In the United States, a test approved by the Food and Drug Administration detects all versions of mpox but cannot distinguish between them. A positive result on that test should be followed by more specific tests that can identify the clade, Dr. McQuiston said.

So far at least, the available vaccines and antiviral drugs are expected to be effective against all forms of the virus. The 2022 outbreak began in Europe in May and picked up steam in the United States during Pride Month in June and afterward.

Early in the outbreak, there was a shortage of the two-dose mpox vaccine, called Jynneos. But many gay and bisexual men, accustomed to heeding public health messaging on H.I.V., curbed their sexual activity, precipitating a decline in cases even before vaccines were broadly available.

The drop in numbers may have produced a false sense of security, however.

“A sense of complacency set in that this wasn’t really something that people needed to have an ongoing worry about, and we saw those vaccination rates rapidly decline,” said Dr. Boghuma Titanji, a virologist and infectious disease physician at Emory University.

Behavioral changes are difficult to sustain, so vaccination is important for long-term control of the virus, Dr. Titanji said.

Two doses of the vaccine are more powerful than one, with an effectiveness of up to 90 percent, according to an analysis last month of 16 studies. Even when the vaccine did not prevent infections, it tempered the severity and duration of illness.

Still, fewer than one in four Americans at risk received two doses.

“We’ve continued to saturate the space with the messaging, and uptake is not really shifting a lot,” Dr. McQuiston said, suggesting a need for more creative approaches.

In 2022, the vaccine was available only in the United States through federal agencies and plagued by problems with delivery, limiting its availability; it is now commercially available. The W.H.O., which recommends vaccines for African countries, has been slow to approve it, and has not even initiated the approval process.

Still, the W.H.O.’s advisory group on immunizations has recommended that, where available, the vaccine can be used to protect adults and children at risk of mpox, Dr. Lewis said.

In addition to preparing for mpox’s return to the United States, the C.D.C. is supporting Congo’s efforts to obtain vaccines and drugs and contain the epidemic.

“It’s much better to help them get this outbreak under control before it spills over into other areas and becomes more of a global risk,” Dr. McQuiston said. “And, ethically, it’s the right thing to do.”

Keywords

mpox

DRC is seeing its worst mpox outbreak — but has no vaccines or treatments yet. Why?

dlegge — Thu, 09 May 2024 01:23:48 +0000

DRC is seeing its worst mpox outbreak — but has no vaccines or treatments yet. Why?

26 April 2024

dlegge Thu, 09/05/2024 - 11:23

Author/s

Gabrielle Emanuel

NPR: Goats and Soda

DRC is seeing its worst mpox outbreak — but has no vaccines or treatments yet. …

In the Democratic Republic of Congo, the fight against mpox – previously known as monkeypox – is entering a new phase.

While many are anxious to contain the outbreak – the largest mpox outbreak ever recorded in the DRC with more than 4,500 cases so far this year – experts say that's not yet possible: There are no vaccines or treatments in the country right now, and even the testing capacity is severely limited. Instead, this new phase of the mpox fight involves simply getting a better understanding of what exactly is going on.

[...]

The DRC's mpox outbreak is noteworthy not only for its size but for the changing nature of the virus.

According to Africa CDC, 11 African countries have reported mpox cases but the DRC is the clear epicenter, with a caseload three times what it was this time last year. The virus, which usually jumps from a small animal to a human and then spreads between people, causes painful lesions and sometimes fever, malaise and even death.

The concern is heightened because the type of mpox circulating, called Clade I, is 10 times deadlier than the type of mpox that caused a worldwide outbreak in 2022. About 10% of Clade I cases are fatal; DRC has confirmed 311 mpox deaths this year. In addition, early evidence suggests there is a new strain of the mpox virus in the eastern part of the DRC that's circulating among sex workers and seems to be sexually transmitted. Clade I has never been known to transmit sexually.

Keywords

mpox

DRC is seeing its worst mpox outbreak — but has no vaccines or treatments yet. Why?

dlegge — Sun, 05 May 2024 03:23:33 +0000

DRC is seeing its worst mpox outbreak — but has no vaccines or treatments yet. Why?

26 April 2014

dlegge Sun, 05/05/2024 - 13:23

Author/s

Gabrielle Emanuel

DRC is seeing its worst mpox outbreak — but has no vaccines or treatments yet. …

In the Democratic Republic of Congo, the fight against mpox – previously known as monkeypox – is entering a new phase.

"We've been doing a lot of groundwork and building support and trying to strengthen things. And now, I hope, we're at a pivot point," says Dr. Jennifer McQuiston of the U.S. Centers for Disease Control and Prevention. "Over the next three weeks, we expect to learn a lot about what's happening on the ground."

Keywords

mpox

Children at centre of dangerous mpox outbreak ‘accelerating’ in DRC

dlegge — Sat, 17 Feb 2024 23:18:50 +0000

Children at centre of dangerous mpox outbreak ‘accelerating’ in DRC

30 January 2024

dlegge Sun, 18/02/2024 - 10:18

Author/s

Sarah Newey and Ben Farmer

The Telegraph

Children at centre of dangerous mpox outbreak ‘accelerating’ in DRC

The Democratic Republic of Congo is struggling to control a far deadlier form of mpox, known as clade one, which is spreading unchecked

Children account for a majority of infections and deaths in the world’s worst mpox outbreak, which is “accelerating” at a far greater rate than previously assumed, new figures show.

Mpox is best known for the outbreak that erupted internationally in 2022, predominantly spreading in gay and bisexual men.

But the Democratic Republic of Congo is struggling to control a much deadlier form of mpox, known as clade one, which has been spreading unchecked in the population for many years.

e one, which is spreading unchecked

Keywords

mpox