I edited my original post to include the following.
And here's an excerpt from a pre-print titled "Air and surface sampling for monkeypox virus in UK hospitals"
"Findings We identified widespread surface contamination (66 positive out of 73 samples) in occupied patient rooms (MPXV DNA Ct values 24·7-38·6), on healthcare worker personal pro…
I edited my original post to include the following.
And here's an excerpt from a pre-print titled "Air and surface sampling for monkeypox virus in UK hospitals"
"Findings We identified widespread surface contamination (66 positive out of 73 samples) in occupied patient rooms (MPXV DNA Ct values 24·7-38·6), on healthcare worker personal protective equipment after use, and in doffing areas (Ct 26·3-34·3). Five out of fifteen air samples taken were positive. Significantly, three of four air samples collected during a bed linen change in one patient’s room were positive (Ct 32·7-35·8). Replication-competent virus was identified in two of four samples selected for viral isolation, including from air samples collected during the bed linen change."
You're correct to point out the nuance. I'm still concerned. In my original post, I cited documentation from African doctors who spoke about the potential of airborne transmission. Taking that with the pre-print, I worry that our public communication is so focused on talking about risk from person-to-person contact that we're ignoring other risks.
I don't think we're prioritizing. So much of the public discourse about MPX keeps framing it as basically an STI that only impacts MSM. It's neither of those things.
I think it is fair to say that MSM happen to be most acutely impacted right now. It is appropriate to focus medical outreach, intervention, and support on the MSM community. Accompanying that, we should get communication about the broader risks or MPX including all the possible ways it can spread (from most likely to less likely) so that people can make informed decisions for their health and safety (and so that bad actors don't get empowered to vomit misinformation and homophobia).
Maybe it's just my perspective from my own corner of the world. But so far, I don't think we're prioritizing. I think we're toeing the line of marginalizing and ignoring. At any rate, I hope things don't get worse and that they get better instead.
Hopefully, we make all the right moves to control MPX while also finally doing something to get COVID-19 under control. I am really hoping for a better world.
What we're worried about is a repeat of the AIDS/HIV initial outbreak. I'm not as old as Fauci but I was around for that. I watched it unroll in real time. The media and the public bought into the "Gay Men Disease" and we didn't think/know any better until we started seeing spill-over. I'm prioritizing the potential for spillover now. The outbreak, worldwide, has been ongoing for at least 3 years, and we've seen some unusual mutations in that time which affect, among other things, changes in the clinical presentation. Further, most of the clinical providers did not have a high index of suspicion for MPX until only recently and CDC is still trying to get information out to make them more aware of the presentation, risks, need to test vesicles that might be present, perform full body exams, etc.
The MSM population, we believe, is somewhat more attuned to potential for STDs (which is what MPX is acting like in their community overall) and thus is more likely to present to a clinic or their primary provider. However, once again: The Media seems to have already identified this as a MSM issue and an STI, when the reality is different.
Or to put it another way, Monkeypox Virus has been circulating since approximately 2019 and is now being recognized as an outbreak but it's been relegated to a "Gay Men Only" disease by a large portion of the population, THEREFORE, we need to educate the public at large of the potential for spread and of the disease process.
In my opinion, we need to see more available vaccine, and it currently needs to be prioritized to the population segment that is at greatest apparent risk but we need to also make it available to others who test positive, thus producing a barrier to further spread. We also need to reinvigorate our contact tracing process to make it more nimble and able to respond to new risks as they present.
I'm not interested in marginalizing or ignoring. I have too many vivid memories of walking into the ICU in the morning and not recognizing half or more of the names on the board because we lost too many overnight (and I'm not talking COVID; that happened there, too) to a disease process we didn't understand and a viral agent we had not yet detected. We need to push hard in the MSM community but educate that this is a population risk disease. Right now the mortality appears to be relatively low, but even 1% is a frightening number of absolute deaths.
We're likely to start seeing more disease outbreaks in my estimate. Blame it on climate change, population growth, or the fact that people are encroaching at an ever-rapid rate on animal habitats and are intermingling with those populations. Zoonotic cross-over has been the mainstay for viral disease outbreaks; it's unlikely to change soon.
I edited my original post to include the following.
And here's an excerpt from a pre-print titled "Air and surface sampling for monkeypox virus in UK hospitals"
"Findings We identified widespread surface contamination (66 positive out of 73 samples) in occupied patient rooms (MPXV DNA Ct values 24·7-38·6), on healthcare worker personal protective equipment after use, and in doffing areas (Ct 26·3-34·3). Five out of fifteen air samples taken were positive. Significantly, three of four air samples collected during a bed linen change in one patient’s room were positive (Ct 32·7-35·8). Replication-competent virus was identified in two of four samples selected for viral isolation, including from air samples collected during the bed linen change."
Link to pre-print = https://www.medrxiv.org/content/10.1101/2022.07.21.22277864v1
You're correct to point out the nuance. I'm still concerned. In my original post, I cited documentation from African doctors who spoke about the potential of airborne transmission. Taking that with the pre-print, I worry that our public communication is so focused on talking about risk from person-to-person contact that we're ignoring other risks.
We're not forgetting other risks, and pointing them out is a good thing, but we ARE prioritizing the risks.
I don't think we're prioritizing. So much of the public discourse about MPX keeps framing it as basically an STI that only impacts MSM. It's neither of those things.
I think it is fair to say that MSM happen to be most acutely impacted right now. It is appropriate to focus medical outreach, intervention, and support on the MSM community. Accompanying that, we should get communication about the broader risks or MPX including all the possible ways it can spread (from most likely to less likely) so that people can make informed decisions for their health and safety (and so that bad actors don't get empowered to vomit misinformation and homophobia).
Maybe it's just my perspective from my own corner of the world. But so far, I don't think we're prioritizing. I think we're toeing the line of marginalizing and ignoring. At any rate, I hope things don't get worse and that they get better instead.
Hopefully, we make all the right moves to control MPX while also finally doing something to get COVID-19 under control. I am really hoping for a better world.
Essentially, you and I are in violent agreement.
What we're worried about is a repeat of the AIDS/HIV initial outbreak. I'm not as old as Fauci but I was around for that. I watched it unroll in real time. The media and the public bought into the "Gay Men Disease" and we didn't think/know any better until we started seeing spill-over. I'm prioritizing the potential for spillover now. The outbreak, worldwide, has been ongoing for at least 3 years, and we've seen some unusual mutations in that time which affect, among other things, changes in the clinical presentation. Further, most of the clinical providers did not have a high index of suspicion for MPX until only recently and CDC is still trying to get information out to make them more aware of the presentation, risks, need to test vesicles that might be present, perform full body exams, etc.
The MSM population, we believe, is somewhat more attuned to potential for STDs (which is what MPX is acting like in their community overall) and thus is more likely to present to a clinic or their primary provider. However, once again: The Media seems to have already identified this as a MSM issue and an STI, when the reality is different.
Or to put it another way, Monkeypox Virus has been circulating since approximately 2019 and is now being recognized as an outbreak but it's been relegated to a "Gay Men Only" disease by a large portion of the population, THEREFORE, we need to educate the public at large of the potential for spread and of the disease process.
In my opinion, we need to see more available vaccine, and it currently needs to be prioritized to the population segment that is at greatest apparent risk but we need to also make it available to others who test positive, thus producing a barrier to further spread. We also need to reinvigorate our contact tracing process to make it more nimble and able to respond to new risks as they present.
I'm not interested in marginalizing or ignoring. I have too many vivid memories of walking into the ICU in the morning and not recognizing half or more of the names on the board because we lost too many overnight (and I'm not talking COVID; that happened there, too) to a disease process we didn't understand and a viral agent we had not yet detected. We need to push hard in the MSM community but educate that this is a population risk disease. Right now the mortality appears to be relatively low, but even 1% is a frightening number of absolute deaths.
We're likely to start seeing more disease outbreaks in my estimate. Blame it on climate change, population growth, or the fact that people are encroaching at an ever-rapid rate on animal habitats and are intermingling with those populations. Zoonotic cross-over has been the mainstay for viral disease outbreaks; it's unlikely to change soon.