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August 18, 2022

Monkeypox roundup: Asymptomatic men test positive for monkeypox

Daily Briefing

    Millions of new doses of the monkeypox vaccine may not be ready until early 2023, monkeypox is detected in asymptomatic men, and more in this week's roundup of monkeypox news.

    Just how effective are monkeypox vaccines? Here's what we know—and don't.

      • The Biden administration is currently exploring deals with several companies to bottle millions of new doses of the monkeypox vaccine through a process known as "fill and finish." According to senior administration officials and people familiar with the situation, the new doses may not be ready for distribution for another three to six months. After the new doses have been bottled, regulators will likely conduct an inspection of the doses before they can be distributed—a process that may extend into 2023. The exact timeline will depend on the finalized deal and the number of doses the United States receives from Bavarian Nordic's Jynneos supply in Denmark. According to an HHS official, the administration is "exploring multiple avenues to accelerate production and distribution" of the vaccine. Despite comments made by health officials during Tuesday's briefing, the HHS official said the administration made a decision on the dose-sparing "independently of [its]efforts ... to procure and produce additional vaccine." (Banco/Cancryn, Politico, 8/10)
      • U.S. health officials said they are shipping more doses of the monkeypox vaccine than initially planned because of a strategy shift to administer one-fifth of the dose intradermally—a process that allows more doses to be taken from each vial. Previously, HHS planned to allow 221,000 doses to be ordered by state, local, and territorial health departments this week. Instead, health officials said they released 442,000 doses—the equivalent of around 88,000 vials. Health officials noted that the new strategy has allowed them to release hundreds of thousands of additional doses while gathering data on how the shots are used, which will help ultimately help them ensure that the doses are being distributed to those who need them most. (Stobbe, Associated Press, 8/15)
      • A retrospective study found that monkeypox was detected on the anal swabs of asymptomatic men who have sex with men (MSM) during routine STI screenings at a sexual health clinic in Paris. Of 213 MSM who had anal swabs collected to screen for STIs, 200 also underwent monkeypox PCR testing. According to Charlotte Charpentier of Hôpital Bichat-Claude Bernard, 6.5% of MSM who were tested for the virus were positive. "Whether this indicates viral shedding that can lead to transmission is unknown. If so, the practice of ring postexposure vaccination around symptomatic persons with probable or confirmed monkeypox virus infection may not be sufficient to contain spread," the study authors wrote. While none of the 13 affected men initially reported symptoms, two experienced symptoms after they were tested. In addition, three of the 187 men who initially tested negative for the virus returned to the clinic with symptoms more than 3 weeks later and tested positive. The study's findings align with a recent study that identified two asymptomatic patients who tested positive for the virus. "Although it is not yet clear whether the positive PCR result represents the presence of infectious virus, it will not be surprising if it is present because the possibility of asymptomatic infections is not a new finding," said Stuart Isaacs of the Perelman School of Medicine at the University of Pennsylvania. (Hein, MedPage Today, 8/16)
      • On Friday, FDA said it does not recommend screening blood donors for monkeypox, citing "the robustness" of existing measures for blood safety. However, the agency will continue monitoring monkeypox cases while assessing the potential risk of transmission during blood transfusions. Notably, FDA's announcement follows the American Red Cross's decision to check potential blood donors for signs of the rash that appears on individuals infected with monkeypox during its routine arm exams. In addition, the Red Cross said it plans to enforce a 21-day waiting period before allowing blood donations from individuals who have been diagnosed with the virus or exposed to anyone with an infection in October. "There's a lot of uncertainty right now about the potential for bodily fluids to cause monkeypox infections," said Peter Chin-Hong, an infectious disease expert at the University of California, San Francisco. "We don't know what detection in blood means for transmissibility." (AHA News, 8/15)
      • The World Health Organization (WHO) on Saturday announced that it renamed certain variants of the monkeypox virus. "Newly identified viruses, related diseases & virus variants are given names to avoid causing offence to any cultural, social, national, regional, professional, or ethnic groups, & minimize the negative impact on trade, travel, tourism, or animal welfare," WHO said. According to WHO's announcement, the Congo Basin and West African variants have been reclassified as Clade I and Clade II. A panel of global experts changed the naming convention "as part of ongoing efforts to align the names of the monkeypox disease, virus, and variants—or clades—with current best practices." Currently, WHO is evaluating new names for the virus and the disease it causes—a move that follows concerns over potential stigmatization. WHO said it is holding "an open convention" to assign a new name to monkeypox. (Mueller, The Hill, 8/14)

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