https://twitter.com/BNOFeed/status/1552410200111517696
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WHO report dated today (this doesnât look like a permanent link):
3.3 Case profile (overall)
The following outputs reflect various demographic characteristics in confirmed monkeypox cases. Note that these data are only derived from detailed case data, and as a result, total numbers of cases and deaths may differ from those reported via aggregate case data where reporting is not fully aligned.
As shown below, and stated previously, the ongoing outbreak is largely developing in MSM (Men who have Sex with Men; defined as homosexual or bisexual males in reporting forms) networks. In the following analyses, we have re-coded men reported as bisexual as MSM. Note that reported sexual orientation does not necessarily reflect who the case has had recent sexual history with nor does it imply sexual activity. Generally, severity has been low, with few reported hospitalisations and deaths:
- 98.9% (13740/13893) of cases with available data are male, the median age is 36 years (IQR: 31 - 43) .
- Males between 18-44 years old continue to be disproportionately affected by this outbreak as they account for 77.1% of cases.
- Of the 13,933 cases where age was available, there were 84 (0.6%) cases reported aged 0-17 , out of which 24 (0.2%) were aged 0-4.
- Among cases with known data on sexual orientation, 98.3% (5996/6099) identified as MSM . Of those identified as MSM, 54 / 5996 (0.9%) were identified as bisexual men.
- Among those with known HIV status 38.0% (2,352/6,197) were HIV-positive . Note that information on HIV status is not available for the majority of cases, and for those for which it is available, it is likely to be skewed towards those reporting positive HIV results.
- 322 cases were reported to be health workers . However, most were infected in the community and further investigation is ongoing to determine whether the remaining infection was due to occupational exposure.
- Of all reported types of transmission, a sexual encounter was reported most commonly, with 3,603 of 3,939 (91.5%) of all reported transmission events.
- Of all settings in which cases were likely exposed, the most common was in party setting with sexual contacts , with 569 of 1,380 (41.2%) of all likely exposure categories.
So it looks like a really high percentage is likely transmitted via sexual contact, but youâve got to take that with an enormous grain of salt because of the bias in the tested population and the self-selection in reporting. (Here, youâve got roughly 14,000 cases and theyâre reporting sexual orientation for less than half that group. The reported transmission numbers are based on less than a third of that number.)
So you could say that transmission via sexual contact could be >90%, as the WHO report suggests, but it could also be as low as 26% if none of the omitted cases were via sexual contact. Big range!
If this stuff spills back into the rodent population weâre never getting rid of it.
Sounds like we need to quarantine Richard Gere STAT.
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It is already showing up in the wastewater, so, we are probably past that point.
Fortunately, we can just start mass vaccinating everyone for smallpox again. A bit trickier than the vaccination programs we are used to, but can get that rolling reasonably fast I think.
Canât tell if leveling.
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If the rodents start to get it, we might have to vaxx children in perpetuity.
Not levelling. Not 100% sure what the uptake will be, but this is a much more solvable problem than COVID. We just turn the small pox vaccines back on especially in the normal pediatric vax regime.
Right now the US only has a few million doses of the smallpox vaccine. It also has pretty significant side effects.
Personally I wouldnât be in favor of mass vaccination if it truly is mostly spread sexually.
Smallpox vaccines were horrible. I mean they worked but they had a high incidence of bad side effects effects including death. The cost/benefit analysis for using them broadly for monkeypox might not be that simple. No idea about how modern smallpox vaccines may have improved, but this isnât an easy situation. We need new better vaccines specifically for monkeypox.
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Except huge portions of the population will never get it because they arenât no homos or whatever bullshit. The messaging on this has been fucking awful. The vaccine is pretty gnarly too from a rational perspective as well.
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I understand that. It is not perfect, but thats the way out if/when Monkeypox gets bad and it provides durable immunity at least. We didnt take the public health measures to eliminate it this time, so, onto Plan B. The other solution I guess is that we all get monkeypox.
Turning on the smallpox vax machine means toning down the COVID vax machine, so thats not ideal. Society kind of turning off the COVID vax machine on their own anyways so maybe not a big deal.
The Bavarian Nordic vaccine is way better in that regard. Thatâs the newest/best one. Unfortunately we only have ~20M doses right now and itâs a two dose schedule. We have ~200M doses of the older vaccine but thatâs the one that can cause death and serious side effects.
Americaâs public health policy is:
Plan B, unless youâre trying to prevent a pregnancy.
Given that the current outbreak has led to zero deaths I donât see how using the old vaccine passes the cost/benefit analysis right now.
Most of the history of humanity involved a high chance of catching dangerous infectious diseases. Maybe like the 50 year ish period up to 2019 was just the exception to the normal order.
Modern pox vaccine is much safer. And who knows what theyâll come up with in a few years. It should be possible to eradicate, but not if it slips into a rodent reservoir.
Really? Not that I remember getting it, but I guess I did and my siblings and all my friends growing up. A lot of people got a blister at the injection site which left a scar, but I didnât. (that has made me wonder if I got the vaccine, but it seems like I must have since I was 4 or 5 when they stopped giving them in the US)
Gotta be roughly 60 to have gotten the smallpox vaccine I think. They stopped in 1972, but pretty sure it was winding down before then. My mom got one, has the scar to prove it. My dad did not despite being a year older.
I agree, but I think we should be ordering a ton of the new vaccine and making it broadly available if this continues - which it seems extremely likely to do. Problem is, Bavarian Nordic is a relatively small company and may not be able to make enough doses fast enough. I suspect theyâll end up partnering with a big pharma company to do that, similar to what BioNTech did with their covid vaccine.