Thread by @Rpshahmemorial1

After 120 updates on #monkeypox we will now put up 150 updates . The previous 120 are herein below

https://twitter.com/Rpshahmemorial1/status/1528894483307192322?s=20&t=y_8IPyURo2sOBZaqKjX4Fg

The next set will start from 121 & further in thread below ctd)

121/n WHO warns that the outbreak is "only the tip of the iceberg" It , however, does not believe that the spread of the monkeypox virus outside of Africa requires mass vaccinations as measures like good hygiene & safe sexual behaviour will help control its spread🤔 ctd)

122/n Moderna's preclinical exploration on a #monkeypox jab will join the biotech's work on a host of vaccines beyond Covid, including shots to defend against the flu, common cold and RSV. Ctd)

123/n #monkeypox spreads beyond Israel into Arab Peninsula as UAE reports the first patient ctd)

124/n From the archives of the WHO on monkey pox spread . Interesting

125/n While we agree that Chickenpox should be ruled out BUT does a recent infection with chickenpox predispose to #monkeypox ?? What about other recent infections that can ? Ctd)

126/n 15 years ago #monkeypox was a disease of kids & chickenpox in young adults it BUT now the age for #monkeypox has changed to young adults & there was 0.7% confection rates then , we dont know what it will be now BUT #Covid19 patients complain of shingles , life messy ctd)

127/n constantly surprised by the story of monkeys being eaten leading to #monkeypox, animal game hunting & climate change, civil unrest increase such problems as humans go deeper into forests &/ or have to use more forest produce ctd)

128/n Has been shown in influenza that even if not directly infected by aerosols still fomites can be aerosolized causing infection ( movement of fomite laden bedsheets , bandages etc) H/t @denise_dewald . That means meticulous attention #monkeypox ctd
doi.org/10.1038/s41467…

@denise_dewald 129/n @sebpoule has shared with us a great instance wherein there was no fever & just one localized rash .He correctly warns of anecdotal information BUT we need to understand that such cases will lead to spread of infection and we need high index of suspicion

130/n consistently said that other viruses/bacteria #monkeypox are advantages by immunosupression #COVID19 , 20 times higher numbers of hand, foot & mouth disease .3 main viruses Isolated -Coxsackie A16 (CA16); Coxsackie A6 (CA6)& Enterovirus 71 (EV71).2 kids needed ICU.ctd)

@medriva @emilygraymd_mph @EnemyInAState @DonEford @NjbBari3 @LeonardiBot @DmodosCutter @ELHopkins @joshmcgoo @vmuecke_k 131/n
If you think that the solution to monkeypox transmission is slapping an N95 on a monkeypox patient, rather than covering the lesions, you are guilty of the same sort of tunnel vision as the droplet dogmatists , agree @denise_dewald - sexual, Fomites &wounds also count ctd)

132/n @drpenking has graciously shared the picture of the first case of #monkeypox in Ghana , must say nobody wants that lesions ctd)

133/n @Antonio_Caramia has reported 12% of confirmed cases needed hospitalization, I am sure that since we are seeing iceberg phenomenon we will initially see more .However if it stays 6% or above it will mean higher load especially when system groans under #BA4/5 wave Ctd)

134/n Virologists consider that ~47 mutations in #monkeypox sequences suggest potential for genetic component that would facilitate human-to-human transmission of the current outbreak viruses compared to previous human outbreaks of monkeypox ctd)

135/n Yesterday WHO put a cut off as 15th May for any cases of #monkeypox to be considered, meanwhile @ECDC_EU pushed it back to 1st May , is there more to it that meets the eye?? May be this has been going undetected longer & that's why the multiple country out break ??
Ctd)

@ECDC_EU 136/n In 130/n we saw hand foot & mouth disease is spreading however there is worser news from @guardian Ebola, plague in Congo ,ticks disease in India ,China, Iraq & parts of USA #ClimateCrisis & #COVID19 have created a very perfect milieu for organisms to spread in humans ctd)

137/n When discovered #monkeypox had no human to human transmission but as immunity to small pox waned & vaccination got lower it flourished . the longest documented chain of transmission in a community has risen in recent years to 9 successive person-to-person infections ctd)

138/n Indias 1974 small pox was the worst outbreak of the 20th century. Over 15,000 died between January and May 1974. India reported 61,482 cases ,86% of the world’s cases in 1974, by 1975 India eradicated small pox .Now 48 yrs later more immunity BUT advantage lost ctd)

139/n because India has one of the youngest population below 50 .There are large human animal interactions therefore urgesnt need to take immediate steps to prevent animal reservoirs from developing, same for China one difference being Indians dont consume exotic animals ctd)

140/n Denmark will get 2000 monkeypox vaccines from the Netherlands this week and is working on buying thousands more, as the country mulls vaccinating close contacts of those infected with the disease, its health minister said.Good example of #Globalcooperation ctd)

141/n with Argentina reporting a suspected case , #monkeypox is now officially there in all continents except Antartica , we accept that this is not #Covid19 BUT it has rapidly spread compated to it's old experience ctd)

142/n In post 1/n -1/4 we learned how T cell responses & hypocomplementemia caused by #COVID is helping #monkeypox while in 114/n it hides from T cells by suppressing recognition ,now we find that it causes Natural Killer cells to increase BUT they cannot work normally ctd)

143/n On 21 April the Canadians ordered small pox vaccine to be stockpiled 500,000 by December 23 and another 250,000 by December 24 . Did they do this in response to fear of Covid induced issues , Ukraine or breakout of #monkeypox at Congo /Nigeria we will never know ctd)

144/n BUT I don't think there is any conspiracy here. The Canadians have shown much better forward planning than anyone during #COVID19 as well preordering the largest vaccine number/ head , they were short charged by the companies though (under pressure) ctd)

145/n Roche and its subsidiary TIB Molbiol have developed three PCR test kits for #monkeypox .The first kit detects viruses in the wider orthopoxvirus group. The second detects monkeypox viruses only, while the third detects both simultaneously. ctd)

146/n One of the advantages of #COVID19 is the upgradation of technology, the genetic sequencing & diagnostic analysis are just another examples in addition to vaccines & #monkeypox fight is benefiting from the investment made.With Roche comes Autobio PCR. ctd)

147/n The WHO Country Office for India has sought the assistance of India’s -ICMR-National Institute of Virology, help to test suspected cases of #MonkeyPox for the south-east Asia region (SEAR) member-states. The ICMR-NIV lab has in principle agreed , ❤❤ #Globalcooperation

148/n Bavarian Nordic plant to make #monkeypox vaccine has the capacity to make up to 30 million doses of the shot a year, although the company would need to scale back production of other vaccines to do so,it also makes vaccines for rabies, tick-borne encephalitis & Ebola ctd)

149/n UKHSA has procured over 20,000 doses of a safe smallpox vaccine (called Imvanex, supplied by Bavarian Nordic) as part of our rapid response to rising #monkeypox cases, it said in an announcement. Ctd)

150/n The Imvanex vaccine is a non replicating vaccine , making it safer than the 1st generation vaccines which were able to replicate . It can also be given by regular syringe compared with old which needed special syringe & 15-20 punctures. Ctd)