I’m Dr. Marta Lado, I’ve battled pandemics for the last 8 years in 3 countries and now work to prepare and respond to the next pandemic, AMA about Monkeypox!

Is there any worry about it mutating into more transmissible strains or otherwise?

Hi u/Matisaro, thanks for a great question!

The probability of monkeypox mutating to a higher transmissible virus is very minimal. Our concern is more that it may affect populations that are vulnerable like children, pregnant women, and people with low immune systems—those who can get more seriously sick with this infection.

This is why we want to perform good surveillance of cases and contact tracing to make sure it does not affect people who can develop more severe diseases beyond just skin lesions.

In previous outbreaks of monkeypox on the African continent, we have seen that a small proportion of cases continue to develop complications or even face death from the infection’s complications; again, these cases are mainly in vulnerable populations: children, pregnant women, malnourished people or with weak immune systems.

Overall, these are reasons to follow monkeypox closely.

Lol tell them the stats on infections within the gay community and then compare stats for infection for the hetero community.

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https://theconversation.com/monkeypox-an-expert-explains-what-gay-and-bisexual-men-need-to-know-187882

According to our study, 95% of monkeypox infections so far were spread as a result of sexual contact. Around 95% of the people in our study had a rash, mostly occurring on the genitals. Approximately 41% had sores inside the body (including in the anus or mouth).

https://www.cdc.gov/mmwr/volumes/71/wr/mm7135e2.htm

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https://www.cidrap.umn.edu/news-perspective/2022/08/monkeypox-cases-reach-7500-us-99-cases-males

These are very important and helpful links as we review the evolving epidemiology of the current outbreak. It is true that the current outbreak of monkeypox has been affecting clusters of people that belong to a specific group at a higher rate, but as we know, monkeypox can be spread to other populations if close contact happens with an infected person. In endemic countries, before this outbreak, monkeypox was known to affect people from many different communities: including children, women, elderly people, etc. Not only those from or in specific sub-sets of the population or those with specific sexual practices. With this in mind, we need to be careful to not create stigma around those who are homosexual or a part MSM communities.

Monkeypox is a viral infection transmitted through close contact and droplets with someone who is infected, regardless what social group they belong to. It is not a purely sexually transmitted disease. Sexual contact implies a close contact, skin-to-skin, and that can make it more easily spread if one of the sexual partners is infected.

Thank you everyone for your questions on monkeypox! I have had a wonderful experience answering your questions and sharing my insight on this topic. I will be stepping away from the Reddit AMA but I encourage you to continue conversing with one another about monkeypox and its impact on global health.

And If you want to learn more about the current state of monkeypox, please check out the blog piece I contributed to with Partners in Health: https://www.pih.org/monkeypox

Why are conditions like psoriasis and eczema associated with negative outcomes regarding monkeypox, and what exactly does monkeypox specifically do to people with these conditions?

Monkeypox can produce severe lesions in the skin of some patients and can lead to too many or numerous lesions and with extensive desquamation in those impacted by the virus. If the patient has a pre-existing skin condition like eczema or psoriasis, these dermatological conditions can make an infection with monkeypox worse as the skin is already more delicate and sensitive at baseline.

The COVID pandemic caused a lot of damage in the public's trust for the government. How can that be repaired?

Came here to ask the same. The amount of lies spread by both anti-vaxxers AND governments and big pharma should have ppl worried. Science is an institution based on peoples trust in its methodology. The erosion of this trust has left ppl wondering who they can trust, but it really seems like the answer is no one. I honestly don't know how we as a society can undo the damage done to the integrity of what should be our most trusted institutions.

Hi u/mikeblas and u/d0rf47

These are both very strong and real points!!!

COVID was a new disease that we knew very little of when it started. Because of its novelty, it created a lot of trial and error in the methodology from the science community, and politics also ended up being involved in the process.

Monkeypox, on the other hand, is not a new disease. As a disease, it has previously produced outbreaks on an annual basis in some African countries. Therefore although it seems new to those in many higher-income countries as monkeypox has not been endemic to these areas, monkeypox is not new for the overall scientific community. The difference is that monkeypox has been affecting those in poorer countries that don't get the attention that this current outbreak has.

I strongly believe that the approach to monkeypox should transcend our trust in governments and go towards how important promotion of Global health is… There are diseases that affect more vulnerable populations and those in poor countries that only become important when they come within Western society’s borders.

We need to fight against this social and health injustice. Vaccines, antivirals… these need to be developed, promoted, and studied for the wellbeing of all humanity, not only rich countries.

We need to continue working together—as a scientific community and as a population—to ensure that we achieve a model of Global health that can protect everyone, regardless of where one is born or lives.

And we need to work strongly to avoid pollicization of health inequalities and social injustice. Take together, this is what is needed to strengthen community trust in measures that are required to fight against the occurrence of any new outbreaks.

Should we be concerned about going to crowded events?

Hi u/Think-Might1411, great question!

Monkeypox is an infection that is transmitted mainly through very close contact, as is the case, for example, with the recent incidents which occur through sexual contact skin-to-skin.

Being at events that are crowded should not imply a big risk unless there is real close contact "skin-to-skin" with the lesions of people who have the infection.

Nevertheless, we are recommending that to minimize exposure of potential cases, to be aware of any lesion(s) you may develop on your skin that may be compatible with developing monkeypox. Consult with your physician or GP if you notice any new lesion(s) that have appeared on your skin or on the skin of any close contacts you may have.

If you present any suspicious lesion that can be compatible with monkeypox, you should isolate yourself and report to your healthcare provider to ensure they review them and make a proper diagnosis.

Apparently the small pox vaccine will work with monkey pox until a more targeted vaccine is available. How proactive is the vaccine effort in vaccinating the disparaged or at risk communities?

Hi u/notwithagoat!

There are some vaccines that were developed for smallpox in the last few years that, as you well note, can be effective also against monkeypox. These vaccines (ACAM 2000, JYNNEOS, and LC16) were developed to protect from a potential new outbreak of smallpox; as a disease, smallpox has been eradicated since the 1980s.

Nowadays, we know these vaccines also have the ability to protect against monkeypox, but their production takes time. In addition, the amount of vaccines currently available is not enough to vaccinate all populations. Despite this, we are working on getting more information about how the vaccines work in humans, as many of the previous studies have been in animals.

This means that although we know these vaccines are safe in humans, we don’t know exactly how much protection they may give for their use in monkeypox, as there have not been human studies before this outbreak.

Because of this, we haven't yet had campaigns for vaccination against monkeypox. And the newer vaccines were not designed to cover a large number of at-risk populations.
That being said, currently with this outbreak, and considering that it has affected a specific population, there have been efforts to use vaccines to control the spread among high-risk groups or affected peoples. Campaigns of mass vaccination is not something that is recommended right now
unless you belong to a population that may have been exposed to any clusters of cases.

Having said all this, we know there are countries on the African continent that have been suffering from outbreaks of monkeypox annually since the 1970's and they tend to have more mortality as they affect more vulnerable populations. In these cases, we need to continue promoting and advocating to produce more vaccines and be able to use them in endemic countries.

My second dose of Jynneos is closer to two months from my first dose than one month. Will this reduce effectiveness?

Hello u/bondfool. You are correct: The regular vaccine interval between the first and second dose of Jynneos should be, if possible, one month. But if you will receive the second dose closer to 2 months later instead, it should work anyway.

It is more effective to have the vaccine twice as recommended than having only one dose. It is always better protection to follow the recommendations of the interval, but the vaccination still works well if you receive it 2 months later.

Which paramedics put up the best fight? How many battles did you have in those 8 years and what's your win/lose record?

I’m assuming you mean pandemic* and not paramedic, u/PooInPooper!

All pandemics or outbreaks are different and with it, implies different challenges… We just need to be ready to have an open mind to learn and to move with it like a good dance!

There are no “wins or losses'' more than the lives taken through it... those deaths are the ones that we need to prevent!