Thread by @NewYorkACP

1/
Hey #medtwitter @MedTweetorials , let's talk about #MPOX (formerly monkeypox)
✴️Mpox is caused by an orthopoxvirus (like smallpox)
✴️ Endemic to sub-Saharan Africa; recent outbreak in Europe and the Americas
✴️ On 8/4/22 the US declared the outbreak a public health emergency

@MedTweetorials 2/
We will be using the term “mpox” in place of the complete phrase “monkeypox” in line with the November WHO decision to change the term in recognition of racist and stigmatizing language used in association with this condition in 2022

@MedTweetorials 3/
Q: Which group has the highest number of #mpox cases in the US?
a)21-25
b)26-30
c)31-35
d)36-40

@MedTweetorials 4/
That's right, ⭐️31-35-year-olds ⭐️ have had the highest number of #mpox cases (6642), with the overwhelming majority being men (95.5%)!
Overall, there have been 29,367 cases in the US, and 80,489 cases globally
image: @CDCgov

@MedTweetorials @CDCgov 5/
There have been a few hundred new #mpox cases every day, with a peak 📈infection rate in August 2022
images: @WHO @OurWorldInData @CDCgov

@MedTweetorials @CDCgov @WHO @OurWorldInData 6/
#mpox can be transmitted through direct contact with infectious lesions/scabs/fluids, indirect contact via fomites, respiratory droplets during prolonged face-to-face and intimate contact, vertical transmission in pregnancy, and zoonotic contact
photo: kislinka @Vecteezy

@MedTweetorials @CDCgov @WHO @OurWorldInData @Vecteezy 7/
Although most cases of #mpox have been among men who have sex with men (MSM), mpox can spread in ALL communities, regardless of gender, sex assigned at birth, or sexual orientation
image: @CDCgov

@MedTweetorials @CDCgov @WHO @OurWorldInData @Vecteezy 8/
Stigma surrounding #mpox has been a major issue, with many people paralleling the ways in which some patients with mpox are treated socially to the stigmatization occurring during the HIV/AIDS epidemic.

@MedTweetorials @CDCgov @WHO @OurWorldInData @Vecteezy 9/
“I saw Ricky terrified, grappling with the stigma and shame that is traveling along with the monkeypox outbreak. With my gloved hands, I grasped and held his. Doing that made me think of the days I’ve heard about in the 1980s” - Ofole Mgbako, MD (ID) @nyulangone

@MedTweetorials @CDCgov @WHO @OurWorldInData @Vecteezy @nyulangone 10/
10)The aforementioned quote is from Dr. Ofole Mgbako, an Infectious Disease physician at @nyulangone . In his article, he recounts experiences with patients who have mpox and the parallels between the HIV epidemic

@MedTweetorials @CDCgov @WHO @OurWorldInData @Vecteezy @nyulangone 11/
A majority of patients with #mpox have debilitating pain with a vesicular/pustular rash on their face/mouth/torso/hands/feet/genitals/anus. Patients can present with as few as one sore, contrasted with the “classical” generalized rash.
images: @GOVUK @NHSEngland

@MedTweetorials @CDCgov @WHO @OurWorldInData @Vecteezy @nyulangone @GOVUK @NHSEngland 12/
Additional signs and symptoms of #mpox can include:
🚩 Fever
🚩 Headache
🚩 Muscle aches and backache
🚩 Exhaustion
🚩 Localized lymphadenopathy
🚩 Chills
🚩 Proctitis
🚩 Ulcerative tonsillitis/pharyngitis
image 1: @NFIDVaccines @CDCgov

@MedTweetorials @CDCgov @WHO @OurWorldInData @Vecteezy @nyulangone @GOVUK @NHSEngland @NFIDVaccines 13/
Q: You're screening a patient at an urgent care in NYC. Which symptoms would prompt you to test for #mpox ? Assume a 3-day history
a)Fever, chills, 2 lesions
b)Proctitis, facial rash
c)Vesicular rash on hands
d)All of the above

@MedTweetorials @CDCgov @WHO @OurWorldInData @Vecteezy @nyulangone @GOVUK @NHSEngland @NFIDVaccines 14/
⚠️Limited #mpox testing due to a shortage of test kits delayed diagnosis early in the current mpox outbreak so providers should strive to expand considerations for testing as test kits are now more readily available in commercial labs.

@MedTweetorials @CDCgov @WHO @OurWorldInData @Vecteezy @nyulangone @GOVUK @NHSEngland @NFIDVaccines 15/
Treatment for #mpox depends on a person’s symptoms and immune status:
🚧Mild-to-moderate – supportive care for pain and pruritus, education on wound hygiene
🚨 Severe – top agents available: brincidofovir, tecovirimat (TPOXX) and vaccinia IG

@MedTweetorials @CDCgov @WHO @OurWorldInData @Vecteezy @nyulangone @GOVUK @NHSEngland @NFIDVaccines 16/
💊While cidofovir is commercially available, brincidofovir (prodrug form) may be preferable in treating #mpox due to a higher safety profile. TPOXX is available for use via the STOMP trial. These antivirals are only approved for smallpox

@MedTweetorials @CDCgov @WHO @OurWorldInData @Vecteezy @nyulangone @GOVUK @NHSEngland @NFIDVaccines 17/
🌟NYS is offering the JYNNEOS vaccine as a 2-dose intradermal series for the prevention of #mpox (and as PEP if within 4 days of exposure, at most 14 days post-exposure) in adults 18 years of age and older

@MedTweetorials @CDCgov @WHO @OurWorldInData @Vecteezy @nyulangone @GOVUK @NHSEngland @NFIDVaccines 18/
Ongoing support is needed from local health systems and public health officials to address the inequitable distribution of vaccinations and treatments for #BIPOC communities as the percentage of ##mpox cases in BIPOC people continues to rise
images: @CDCgov

@MedTweetorials @CDCgov @WHO @OurWorldInData @Vecteezy @nyulangone @GOVUK @NHSEngland @NFIDVaccines 19/
This #Tweetorial is meant to raise awareness about #mpox while decreasing the associated stigma.
🔑Knowledge about this outbreak, the stigma associated with the illness, testing, prevention, and treatment are important for our community.
💡 Learn more with links below

@MedTweetorials @CDCgov @WHO @OurWorldInData @Vecteezy @nyulangone @GOVUK @NHSEngland @NFIDVaccines 20/ Sources:
buff.ly/3M1cbHU
buff.ly/3YkeYDo
buff.ly/3MM2EFV
buff.ly/3YlBLPd
buff.ly/3AjCxRH
buff.ly/3j28yst
buff.ly/3QX0Evw
buff.ly/3YfmXS6

@MedTweetorials @CDCgov @WHO @OurWorldInData @Vecteezy @nyulangone @GOVUK @NHSEngland @NFIDVaccines 21/
Sources continued:
buff.ly/3FQsw25
buff.ly/3j28ybX
buff.ly/3WizNxi
buff.ly/3YhFc9L

@MedTweetorials @CDCgov @WHO @OurWorldInData @Vecteezy @nyulangone @GOVUK @NHSEngland @NFIDVaccines 22/ 22
Thank you, Medical Student Authors
Rachelle Moneau @MonteauRachelle from @CSOM_Official
Samuel Soff from @StonyBrookMed
Salvatore G. Volpe @laseplov from @sunydownstate

Special thanks to
Dr. Michael Locurcio from @nyulangone
Dr. Luis Marcos Raymundo from @StonyBrookID