Vaccines, drugs, care conditions, diagnosis, and communication, when implemented synchronously, will help reduce the number of infections and deaths caused by monkeypox.
Monkeypox continues to spread in many African countries. The World Health Organization (WHO) reports that by October 13, 16 countries had reported new cases. The two countries recording the most cases include the Republic of Congo, which recorded more than 6,000 cases and 25 deaths; Burundi with more than 980 cases of infection.
According to the Gavi Vaccine and Immunization Alliance, efforts to prevent monkeypox are focusing on vaccines, but encounter barriers in resources, infrastructure… Therefore, countries need to combine many measures. to end the epidemic.
Vaccine
There is currently no WHO-approved monkeypox vaccine. Some countries use smallpox vaccine instead, which also helps create cross-immunity and help control infections. Like the Ankarra vaccine developed by Bavarian Nordic, the effectiveness in preventing infection is about 76% with one injection, increasing to 82% after the second dose.
Both the experimental monkeypox vaccine and the smallpox vaccine need to be further tested for protection in different groups, such as children and immunocompromised people, whose effectiveness against the Clade 1 monkeypox strain is being tested. causing major outbreaks today. Emergency vaccine deployments also need to collect a lot of data on vaccine effectiveness, which plays an important role in shaping vaccination strategies if the outbreak continues.
A doctor holds a vial of monkeypox vaccine at the free information, healthcare and diagnostic service center (CeGIDD) in Montpellier, southern France. Image: AFP
Medicine
There is no specific treatment for monkeypox, mainly care and control of symptoms of pain, fever, and rash on the skin to reduce the risk of scarring, infection, and avoid superinfection. Scientists also tested several antiviral drugs to treat the disease.
For example, the Palm007 trial evaluating the effectiveness of the drug tecovirimat, preliminary results in August provided some clues about reducing deaths from the disease, but did not help reduce the duration of skin lesions in children and adults. Several companies are evaluating other antivirals in the treatment of monkeypox, such as brincidofovir and cidofovir, or intravenous vaccinia immunoglobulin (IVIG) purified from the plasma of healthy donors vaccinated with smallpox.
Improved care
The Palm007 trial showed that tecovirimat had no effect in reducing the duration of illness, but showed that the overall mortality rate after drug or placebo was 1.7%, only about half the overall mortality rate in the Republic of Korea. Congo. The specific cause has not been given, experts speculate that all patients in the study had to be hospitalized to ensure enough food and accurate data collection. They receive better care than other sick people.
Diagnose
Testing is important in the fight against monkeypox. When cases are identified quickly and accurately, patients can be isolated before the pathogen continues to spread, and traced more quickly.
Currently, diagnostic testing is performed by taking samples of skin lesions and PCR testing to detect viral DNA. Gavi believes that it is necessary to add a number of other tests that are faster and simpler to reduce tracing time.
Communication about public health
Health professionals need to have more creative strategies to communicate information about the disease and prevention measures to the community, especially when the new Clade 1b strain has new symptoms compared to previous forms of monkeypox.
For example, officials in the Republic of Congo must combat misinformation about diseases and vaccines. Patients go to traditional healers and shamans for treatment instead of looking for doctors and medical facilities. 56% of people in this country have heard of the monkeypox virus, but they do not want to get vaccinated. Gavi assesses that this situation needs to be improved soon, to avoid serious public health consequences.