Thread by @Rpshahmemorial1

After touching 175 we will try and keep everyone updated about #monkeypox, will post the 175 first followed by the updates all the way till 200 .Here we go

https://twitter.com/Rpshahmemorial1/status/1529782918503370752?s=20&t=6EV3jX8DfdIV0YKq_hfyYQ

Updates below ctd)

176/n @karmonyk has graciously shared a story, these delays have cost the patient the chance to prevent a bad outcome , vaccine best within 4 days and works all the way till 2 weeks , we've lost that window period , we are up for a bad outcome if we treat #monkeypox this way ctd)

177/n As Argentina logs up its second case, Mexico joins the league logging its first one ctd)

178/n The idea that Tecovirimat is available in US therefore no need to fear isn't good since it can't be used in young & secondly it works best when used within 4/ 5 days , just because we have antibiotics doesnt mean we should get a salmonella infection ,also resistance ctd)

179/n As Ecuador becomes the next country in South America as need to heed scientists who predicted #monkeypox pandemic years ago. This is the beginning plague is the next in the list ctd)

180/n We expect monkeypox virus to evolve slowly with perhaps 1-2 changes per genome per year out of a 200,000 nucleotide genome( DNA virus) . For Covid( RNA) we've seen ~25 changes per genome per year , however small changes seen in #monkeypox genome are as important ctd)

181) a paper last year looking at genomic sequencing data over a long period of time found how the areas of intense migration were at higher risk of #monkeypox, political stability is important ctd)
doi.org/10.1038%2Fs415…

182/n @alexmeshkin reports that they are in process of validating a saliva based PCR assay for MonkeyPox , should launch in two weeks (depending on CDC policies ).Whether we will have enough virus in saliva to make it sensitive is a question🤞🏾Hope it is ctd)

@alexmeshkin 183/n In 176/n we see a case where probable #monkeypox was mismanaged,@UKHSA seemingly is being overwhelmed by calls, we agree that there may be many who are getting paranoid BUT there are many being missed , that's what a pandemic on a pandemic doing @dgurdasani1 ,@chrischirp

184/n WHO’s Dr. Rosalind Lewis said in Geneva “there is no need for mass vaccination” vaccination against #monkeypox “contact tracing, investigation, & isolation” is required BUT if we are doing contact tracing like 176/n & getting overwhelmed like 183/n we'll soon need it ctd.

185/n Important study #monkeypox firstly it describes women , household cluster outside UK , finds that PCR can remain +ve for a long time just like #COVID19( whether infective or not after the scabs have dried is not known, describes an abscess ctd)
DOI:doi.org/10.1016/S1473-…

186/n It also describes how at day 6 vaccine was not able to prevent infection in a health care worker who developed it at day 18 , so those who are overconfident on vaccines need to step back and pause for a moment, nothing is perfect ,efforts to prevent infection are imp ctd)

187/n The patients all had #monkeypox in the upper respiratory tract so respiratory tract dissemination is important #airborne,#N19 important , oral brincidofovir started at day 7 ( delayed diagnosis), none could complete course ( hepatotoxicity??)& HCW got conjunctivitis Ctd)

188/n seemingly just like #COVID19 PCR of #monkeypox remains positive for a much longer time though we will have to confirm whether the patient was still infective enough ctd)

189/n there was a relapse post sex in a patient with viremia showing the #monkeypoxvirus hiding in testis & not finding the virus in early samples just like #covid when virus numbers may be lesser ctd)

190/n It also describes prompt resolution of #monkeypox viremia within 48 hrs of #Tecovirimat with 5 day course good enough but 2 weeks better to allow immunity to kick in & prevent rebound just like #paxlovid in #COVID19 ctd)

191/n the study didn't find any large complications BUT whether it will happen now we never know because we feel #COVID19 has played havoc with immunity, still fingers crossed 🤞🏾ctd)

192/n As of 28 May 2022 at 2 p.m., 16 confirmed cases of Monkeypox have been reported in France (Source: SpFrance): 12 in Ile-de-France, 1 in Auvergne-Rhône-Alpes and 2 in Occitanie and 1 case in Normandy. The next update will take place on Monday, May 30. ctd)

193/n what was earlier thought of as pretty close to the 2018 Nigerian outbreak of #monkeypox seems now to SOME virologists enough differences to postulate the chance of an intermediate host

https://twitter.com/richardneher/status/1530843395740024832?s=20&t=LOfIrjtavrmJX0jcEC6nWA

194/n Germany has signed contract for 40,000 doses of Bavarian Nordic’s Imvanex .Doses should be delivered in first 2 weeks of June.Another 200,000 doses for later.This is huge & agree with @Karl_Lauterbach & @kakape on this assessment, speed trumps perfection in emergency ctd)

195/n UAE announces 3 new cases of monkeypox.Authorities urged residents to take preventive measures while travelling and in gatherings & infected / close contacts to undergo 21 days of quarantine, meanwhile many European countries havent enforced quarantine. Ctd)

196/n As of today, the monkeypox outbreak (at a total of 507 suspected cases) is about to pass the total of 511 suspected cases in the 1997 DRC outbreak, which @WHO flagged as a notable shift to human-to-human transmission , we have become much more tolerant due to #covid ctd)

197/n CDC raises level of travel alert from L1 to L2 over #monkeypox

198/n THE Nigeria Centre for Disease Control,has reported FIRST DEATH ( Immunocompromised patient),21 confirmed cases of Monkeypox from nine states & the Federal Capital Territory,FCT.This came as it activated Monkeypox Emergency Operations Centre & animal surveillance ctd)

199/n Pakistan says it doesn't have any case of #monkeypox rubbishing claims in media HOWEVER accepts that they dont have testing capabilities and will have to send samples elsewhere, they still have been a reservoir of polio globally, another disease ready to be added 🤔
Ctd)

200/n As Afghanistan gets 2 cases at the borders with Pakistan and Iran , a word of appreciation for Dr @BasgozNesli who diagnosed 1st case of #monkeypox in USA . We have put up 200 updates now . If you've liked feel free to share & like .🙏will add more tomorrow 🙏🙏