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Monkeypox Outbreak: Weekly Update (August 16, 2022)


The US Food and Drugs Administration (FDA) approved splitting the monkeypox vaccine doses to stretch the supply. Moreover, the US government will buy $26 million worth of intravenous formulation of the drug TPOXX.

As of July 16, there are 11,890 confirmed monkeypox cases in the US. One-fifth of them were recorded in New York, 1,945 in California, and 1,085 in Florida.

Green light for dose-sparing

The FDA issued an emergency use authorization (EUA) for the JYNNEOS vaccine on Tuesday. It allows healthcare providers to split the existing dose into five and use it by intradermal injection in individuals 18 years and older who are at high risk for monkeypox infection.

The dose-sparing approach may increase the number of available doses by up to five-fold. However, there are concerns that healthcare providers will need additional training to deliver the vaccine intradermally — into the outer layers of the skin — as the monkeypox vaccine is usually injected into the subcutaneous tissue.

The EUA also allows the use of the JYNNEOS vaccine by subcutaneous injection in individuals younger than 18 years who are at high risk of monkeypox infection.

The JYNNEOS developer has "some reservations"

The JYNNEOS developer Bavarian Nordic reportedly told the Biden administration that the company has "some reservations" about the new dose-sparing approach "due to the very limited safety data available," The Washington Post reports.

The US will buy an IV formulation of TPOXX

The US government will buy $26 million worth of Siga Technologies Inc.'s intravenous (IV) formulation of the antiviral drug TPOXX (tecovirimat), the company announced on Tuesday.

The FDA approved TPOXX in 2018 to treat smallpox in adults and children. However, in monkeypox treatment, it is currently classed as an investigational new drug.

Human-to-dog transmission

The Lancet described the first case of a dog with a confirmed monkeypox virus infection that might have been acquired through human transmission.

Two men living in the same household in Paris, France, contracted monkeypox in June. Twelve days after symptom onset, their male Italian greyhound, aged four years with no previous medical disorders, developed lesions. The PCR test confirmed the dog was positive for monkeypox. The men reported co-sleeping with their dog.

“Our findings should prompt debate on the need to isolate pets from monkeypox virus-positive individuals. We call for further investigation on secondary transmissions via pets,” the authors wrote.

WHO changed names for monkeypox variants

A group of global experts convened by the World Health Organization (WHO) has agreed on new names for monkeypox virus variants — or clades — using Roman numerals.

The names were changed in alignment with the best practice that virus variants should be given names “with the aim to avoid causing offense to any cultural, social, national, regional, professional, or ethnic groups, and minimize any negative impact on trade, travel, tourism or animal welfare.”

According to the WHO, the consensus was reached to now refer to the former Congo Basin (Central African) clade as Clade one (I) and the former West African clade as Clade two (II).

Resources:

1. CDC. 2022 U.S. Map & Case Count.

2. The Washington Post. Monkeypox vaccine maker voices concerns on U.S. dose-splitting plan.

3. Global News Wire. SIGA Announces BARDA Exercise of Procurement Options Valued at Approximately $26 Million for IV TPOXX®.

4. The Lancet. Evidence of human-to-dog transmission of monkeypox virus.

5. WHO. Monkeypox: experts give virus variants new names.

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