“This is, in fact, the largest group of cases of monkeypox occurring simultaneously in several countries outside the endemic region,” said Bahuma Cabisen Titanji, a Cameroonian physician from Emory University in Atlanta.

Bavarian Nordic, maker of monkeypox vaccine Jynneos is approved by the Food and Drug Administrationsaid POLITICO that he had received calls from “many, many countries” wanting to purchase his shot.

“We are talking to a lot of countries that are asking us to buy, because the problem is getting bigger and bigger every day,” said Rolf Sass Sorensen, vice president of investor relations and communications.

Bavarian Nordic is confident that it can provide the necessary doses – if immediate and acute demand does not increase. “Of course, we do not have stocks available for the whole planet, but only in the medium and long term we will have a fairly large capacity to produce vaccines,” he said.

That’s nearly 50 million doses a year, Sorensen said. He said the vaccines have been in effect for at least three years.

Health officials have confirmed more than 250 cases in 16 countries, most of them in Europe. The UK, Spain and Portugal have reported the majority of cases of the virus, which usually causes fever, rashes and swollen lymph nodes. The U.S. Centers for Disease Control and Prevention said Monday it has confirmed one case of monkeypox in Massachusetts and is considering four cases from New York, Utah and Florida that are thought to be monkeypox. On Tuesday, California said it was working with the agency to investigate another suspect case.

Cases of monkeypox outside the endemic region are very rare, usually brought to non-endemic countries by people who came from this area. Last year, for example, there were two cases of smallpox in the United States brought by travelers who were in Nigeria, according to the CDC.

While routine smallpox vaccination was still taking place around the world, monkeypox was not seen because the vaccine protected against both diseases. After smallpox was global liquidated in 1980 and those vaccinations stopped, monkeypox appeared, health officials say.

“We have a strong concern that the virus is spreading in different ways,” Jennifer McQueston, deputy director of the High-Impact Pathology and Pathology Division of the CDC, told reporters at a briefing Monday.

U.S. health officials say the country has a “good supply” of monkeypox vaccines. But the current containment strategy, which includes high-risk vaccination, close contact with infected patients, could quickly strain Jynneos ’current supply as cases increase.

“It’s one of the few diseases you can be vaccinated against after being infected, and it prevents you from getting sick,” said Eric Toner, a senior fellow at the Johns Hopkins School of Public Health in Bloomberg.

The U.S. National Strategic Reserve has just over 1,000 doses of Jynneos approved by the FDA in 2019, as well as about 100 million doses of the old smallpox vaccine, which has more side effects, according to the CDC.

“We expect this level to increase very quickly in the coming weeks as the company provides us with more doses,” McQueston said of the Jynneos vaccine. She said the agency has already requested some of these doses from stock for patient contacts.

The UK has already started vaccinating people, having already introduced 1,000 doses of a vaccine called Imvanex there. There are 3.5 thousand doses left in the country. Germany ordered 40,000 doses, This was reported by Reuters.

Two FDA approved antivirals for the treatment of smallpox can also be used in monkeypox, told reporters on Monday Brett Petersen, a medical officer in the Department of Pathogens and Pathologies with High Consequences CDC.

One of the drugs, Tecovirimat, is already in national stock, and the CDC is now developing treatment guidelines to help health authorities and clinicians apply it when needed, he said.

Tecovirimat has also been approved in Europe for the treatment of monkeypox. A spokesman for SIGA, its manufacturer, said the company could not comment on the orders.

The U.S. government is in talks with the manufacturer of the second drug, brincidafovir, to buy doses for stock and provide emergency access to use the drug to treat monkeypox.

Vaccines and drugs are not widely available because they are relatively new, said Rosamund Lewis, head of the World Health Organization’s smallpox secretariat. WHO will work with the industry “to see what we can do now to increase the availability of these products,” she said at an information session on Monday.

However, monkeypox is not as transmitted as Covid-19, and it is not expected to cause millions of infections and deaths like Covid.

“Of all the things in the world that people need to worry about, this is probably not one of them,” Toner said.

In recent days, the Biden administration has struggled to characterize how concerned Americans should be about the outbreak, wanting to raise awareness of a disease most people are unfamiliar with but hate to cause new panic in a weary pandemic country.

On Sunday, President Joe Biden said monkeypox was something everyone should worry about just to soften its message the next day, saying it did not pose the same level of risk as Covid-19.

The virus is usually transmitted to humans through direct contact with infected animals, usually in forest areas, in Eleven African countries, including Cameroon, the Democratic Republic of the Congo and Nigeria. Over the past six months, four endemic countries have reported approximately 1300 cases and about 60 deaths.

Among humans, the virus is also transmitted through close contact with skin lesions or newly infected objects.

Many of the cases reported outside of endemic countries appear to have spread through sex and other close contacts in several super-common events in Europe. Many, but not all, are among men who have sex with men.

Andy Seal, WHO advisor on the sexually transmitted infections program, warned against stigmatizing men who have sex with men in light of the outbreak. “It’s not a gay disease, as some people on social media have tried to call it,” he said. “Anyone can get monkeypox from close contact.”

In African countries, where the virus has been commonly reported for the past 50 years, outbreaks have been commonly controlled without vaccines and antivirals, Cabinen told Titanji. This means that local health authorities have isolated the infected people until the symptoms disappear and trace their close contacts, she said. Healing can take up to four weeks, and an infected person is contagious as long as the rash persists, she said.

Belgium has already presented mandatory quarantine 21 days for infected people. Self-isolation in Belgium does not require close contacts as well UK recommends they do. Biden said Monday that quarantine in the U.S. is not needed because the country has enough doses of the vaccine to fight any serious outbreak. This was reported by the Washington Post.

Outbreaks in Western countries could potentially be beneficial to endemic countries if increased funding for vaccines and treatments to stop the outbreak of monkeys at the source, Cabinsen told Titanji.


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