Monkeypox

DDP Newsletter Vol. XXXVII, No. 3

The new media disease crisis to follow COVID-19 is monkeypox, or whatever it will be called after its supposedly racist name is changed. The World Health Organization (WHO) is considering whether to call it a “public health emergency of international concern,” which could lead to “temporary” international measures to stem the spread.

The name is really a misnomer. The disease was discovered in 1958 in research monkeys, but its natural hosts are likely rodents and other small mammals. It was first diagnosed in humans in 1970 in what is now the Democratic Republic of the Congo (DRC), causing fever, headaches, and lymph node swelling followed by an eruption of pus-filled blisters. The skin lesions can resemble those of shingles, chickenpox, or syphilis. The rash tends to start on the face and has the unusual feature that blisters can form on the palms (https://tinyurl.com/2p8t24ph).

Most people recover within 2–4 weeks, and outbreaks usually fizzle out on their own. The biggest known outbreak in the U.S. occurred in 2003, when 47 people were infected by pet prairie dogs that had picked up the virus from rodents imported from Ghana (Jon Cohen, Science 5/2/022, https://tinyurl.com/33pjenrk).

This outbreak is different because of the simultaneous appearance of around 2,500 cases by late June, in 20 countries on four continents, of a disease that has previously been mostly confined to Africa. Could a rave or two with international attendance explain it? Or does the simultaneous occurrence of widespread cases, and apparent increased human-to-human transmission, suggest it was spread deliberately and may have been engineered, asks Dr. Meryl Nass (tinyurl.com/yc2rp2rm).

The outbreak seems to be tightly associated with two large European dance party events (“raves”), a “Madrid sauna” and a “Gay Pride” event in the Canary Islands on May 5–15, which drew some 80,000 people. Recalling the early history of AIDS, someone who was seeking to introduce a pathogen into a highly mobile international population might see this as an ideal opportunity, writes Robert Malone, M.D. (https://tinyurl.com/pjsby78p).

Monkeypox is not generally considered to be a sexually transmitted infection, but it is transmitted by close contact and victims have so far been mostly gay or bisexual men. The way to stop the spread would be for people to stop having sex with men who have sex with men, for about two-to-three weeks. Public health officials had no trouble telling people not to go outside, not to visit their family, not to go to church, etc. for two weeks stretching into years to stop COVID-19. But the Centers for Disease Control and Prevention (CDC) apparently believes that a few weeks of abstinence is too much to ask. On its website, it suggests some ways to be a little safer if you must go to a rave, party, club, festival, or gay bathhouse (https://tinyurl.com/y3a8r89b).

An amazing coincidence is that the Canary Island rave occurred on the same date as a hypothetical bioterror attack modeled in an Event 201-style wargame exercise about release of an engineered monkeypox virus, “a pathogen engineered in a laboratory with inadequate biosafety and biosecurity provisions and weak oversight.” This tabletop exercise was conducted in March 2021 by the Nuclear Threat Initiative (NTI) (tinyurl.com/5b4zfcra). The modeling predicted 3.2 billion cases and 271 million deaths by Dec 1, 2023. As Dr. Malone points out, the predictive accuracy of the simplistic public health models such as that used to support this scenario have repeatedly proven to be abysmal, as in the initial catastrophic predictions for COVID-19.

In another “bizarre coincidence,” writes Cohen (op. cit.), Bavarian Nordic held a meeting in May with David Heymann of the London School of Hygiene & Tropical Medicine and nine other public health leaders from around the world, planned 6 months earlier, to discuss the need for more countries to stockpile its vaccine, given the increase in monkeypox cases over the past few years. This vaccine (JYNNEOS) uses a nonreplicating form of vaccinia, and has been approved by the Food and Drug Administration (FDA) for use against both smallpox and its cousin monkeypox.

Conveniently, JYNNEOS was approved in 2019, when there had been only about 50 human cases of monkeypox diagnosed in the U.S. over a period of 60 years. It could not be tested for efficacy against either disease; so, FDA relied on neutralizing antibody titers.

Another interesting coincidence is that Anthony Fauci’s National Institute of Allergy and Infectious Disease (NIAID) was funding research to study treatments for monkeypox beginning in September 2020, well before the outbreak (https://tinyurl.com/245uzdfc).

The U.S. government has reportedly stockpiled enough smallpox vaccine for the entire population in the event of a biowarfare attack, and has recently ordered $113 million worth of vaccine from Bavarian Nordic, with an option to buy $180 million more for a total of 13 million doses (https://tinyurl.com/4x6s4hp5). Should you rush out to get a shot as soon as possible?

Myocarditis/pericarditis is a well-known side effect of smallpox vaccination. FDA acknowledges a rate of 5.7 per 1,000 (1 in 175) in persons given the ACAM2000 vaccine, the other US-licensed smallpox vaccine. The incidence might be higher with JYNNEOS; two studies showed elevated troponin (cardiac enzyme) levels in 11–18% of recipients (https://tinyurl.com/3hkz74kc). Moreover, use of replicating smallpox vaccines can cause disseminated vaccinia infections in immunocompromised persons (tinyurl.com/ydvuu24v). Some worry that COVID-19 vaccines can cause immunocompromise.

Could the virus be engineered? The first full genome showed that the strain most closely resembles viruses carried by travelers from Nigeria to Singapore, Israel, and the UK in 2018 and 2019. However, as Dr. Malone writes, the outbreak virus differs from the 2018 and 2019 viruses by a mean of 50 single nucleotide polymorphisms (SNPs), which is far more than one would expect considering the estimated substitution rate for Orthopoxviruses. (DNA viruses evolve slowly.) Monkeypox virus is the subject of gain-of-function research in many labs, including the Wuhan Institute of Virology.

Although the pox viruses are unrelated to the varicella-zoster virus, the monkeypox rash can be confused with shingles. The CDC’s Vaccine Adverse Event Reporting System (VAERS) has processed more than 18,000 reports of herpes/shingles outbreaks in association with COVID-19 vaccines (https://tinyurl.com/yvr62th9).

Monkeypox might be just the latest cause for fear porn, but it raises more questions than answers at present.

Remember the Italian saying: Niente e lasciato al caso (nothing happens by chance).


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