Thread by @DrEricDing

⚠️WORRISOME TRANSMISSION—We need to get sober on how & why #monkeypox is tricky to contain: thread🧵below. Many reasons outlined by DHS report:

📌MPXV is “very stable in environment”—for “days/weeks”

📌Human asymptomatic contagiousness documented *before visible rash*

🧵More—

2) 📌Furthermore, to protect against #monkeypox—doctors and nurses are recommended to wear N95 masks plus gown and gloves.

📌Decontamination protocols requires using bleach or using (harsh) quaternary ammonium reagents — which are chemicals found in pretty aggressive cleaners.

3) Routes of infection of #MPXV: (excerpted from below)
📌Intravenous
📌Oral
📌Intranasal
📌Inhalation / aerosol in primates (cough, @CDCgov, cough)
📌Intradermal
📌Cutaneous (skin)

4) Regarding #monkeypox transmission via cutaneous (skin) route… there is a recent story about a man in Spain who possibly contracted #MPXV via a handshake and 15 minutes using a scooter 🛴’s handlebars (& no sexual exposure). 👀

coronaheadsup.com/health/monkeyp…

https://twitter.com/mei_rito/status/1553299019211968513

https://twitter.com/mei_rito/status/1553299032826679296

5) while there are a few treatments and vaccines… the only vaccine of easy administration and low side effects is the Jynneos vaccine made by Bavarian Nordic. This one is in extremely short supply worldwide. The US can’t get more for months.

dhs.gov/sites/default/…

6) let this sink in— the US will not get more Jynneos #monkeypox vaccine for month - until October at the earliest, according to @ddiamond. We are facing a vaccine cliff of no more for months. washingtonpost.com/health/2022/07…

7) the Mean incubation is 7-17 days for #monkeypox, but as short as 1 day and long as 31 days. And notably, “humans can be contagious before a visible rash appears”! 👀

8) Again, kids are much more vulnerable than adults for severe #monkeypox disease. While CDC says kids <8 are at high risk, the DHS report says kids <10 years old have been more frequently affected. Let’s take care to protect kids please! 🙏

dhs.gov/sites/default/…

9) this will not end well. There are those who can see around corners, and those who cannot. Don’t be the latter. Acting late is not better than never. Act fast and furious — furious precautionary action is the only thing can save us from even worse outcomes.

https://twitter.com/drericding/status/1554552376748453891

10) 📌Asymptomatic Transmission of Monkeypox:

"The existence of asymptomatic #monkeypox infection indicates that the virus might be transmitted to close contacts in the absence of symptoms." 👀

➡️we are now in deep trouble.

medrxiv.org/content/10.110…