Thread by @HelenBranswell

1. #ACIP is talking #monkeypox right now. Gonna try to live tweet.
This is the prior history in the US with #MPXV.

2. "Everything changed in May of 2022," @CDCgov's Agam Rao tells #ACIP.

3. The US #monkeypox case total is up to 176, @CDCgov says. There is some local transmission occurring, Rao said.

4. These are the symptoms US #monkeypox cases have presented with. Rash is either scattered or diffuse.
@CDCgov says a number of cases have had other STIs as well.

5. @CDCgov's Rao says the #monkeypox lesions can be very small.

6. More images of how #monkeypox lesions appear. These images are all from the current outbreak and are US patients.

7. @CDCgov is asked: Any evidence of transmission of #monkeypox before rash is present?
Rao says to date CDC has not seen evidence to suggest that is happening.

8. Now @CDCgov's Brett Petersen, deputy chief, Poxvirus and Rabies Branch is now presenting on the medical countermeasures (ie vaccines and drugs) available to prevent and treat #monkeypox.

9. Jynneos, the only vaccine approved for use for monkeypox, is for use in people over the age of 18. @CDCgov's Petersen said CDC is working on a protocol for use in children; 1 child has received the vaccine.

10. Here's an update on vaccine supply. #monkeypox

11. #ACIP voted last November to recommend that people who have occupational risk of exposure to orthopoxviruses should be able to get pre-exposure vaccination. #monkeypox

12. Petersen says @CDCgov is working on recommendations for expanded use of #monkeypox vaccine, keeping in mind the currently limited supply of Jynneos and the health risks associated with use of the other smallpox vaccine (which should offer some protection), ACAM2000.

13. #ACIP's Camille Kotton asked about brincidofovir, an antiviral she said was better tolerated than tecovirimat. @CDCgov's Petersen said it isn't currently authorized for #monkeypox & isn't available in the strategic national stockpile, but that CDC is working with @US_FDA.

14. Yvonne Maldonado, an #ACIP liaison, asks whether, if the @WHO declares #monkeypox a Public Health Emergency of International Concern, that changes responses to the the outbreak.
Petersen says if a PHEIC is declared & the US also declares a health emergency...

15. ... that could change the mechanisms under which #monkeypox medical countermeasures could be used.
@WHO's Emergency Committee met today. There hasn't yet been word if a decision was taken or what it is. There may be a statement tomorrow.

16. #ACIP member Sarah Long asked if there is reason to believe the virus strain responsible for this outbreak is more transmissible than previous #monkeypox strains.
Should the general US population worry they could get this at the grocery story, at day care, etc.

17. @CDCgov's Rao says that that most of the cases appear to have had intimate contact. "The risk to the general public... we believe to be low." She may have said "very low."

18. A total of 18 patients have received antiviral meds, @CDCgov's Petersen said. This gets to the point that most of the US #monkeypox cases to date haven't been severely ill. @CDCgov's Rao said a few patients have been hospitalized, generally for pain management. #ACIP
The End.