Monkeypox is usually
contracted in Africa by eating rodents or monkeys, or being bitten. The first
episode of monkeypox in the US occurred in May, contracted from pet rodents.
Cute prairie dogs, at $100 a pop, have been traded at swap meets and sold at pet
stores. They are fuzzy and adorable. But these little Tribbles have also
acquired some deadly traits in the form of an African virus apparently caught
from a Gambian rat.
Twenty kindergarteners were
exposed to an infected pet prairie dog at their school. Now those kids are
quarantined. Several families in the Midwest have contracted the disease.
Monkeypox has spread, along with the infected prairie dogs, to Illinois, Indiana,
Michigan, Wisconsin, Ohio, and New Jersey. The count of suspected cases
is nearing the hundred mark. One child in the US has encephalitis. No one has
died. Yet.
Some prairie dogs have
died. They could easily be discarded in the trash. The scenario of rats in the
trash dump contracting the disease and spreading deadly monkeypox through the
wild rodent population is juicy enough to warrant a Hollywood movie pitch. Dust
off that faded copy of Dustin Hoffmans movie, Outbreak, at your local video
store.
Although monkeypox is
usually contracted from infected animals, the disease will spread between
people. In Africa, monkeypox infection usually stops after the first
person-to-person transmission, but the disease was once tracked through four
human transmissions among children. Officials expect monkeypox to spread between
people in the US as well. Two health care workers now have monkeypox symptoms,
and the boyfriend of one of the nurses has developed suspicious symptoms, which
would represent a second-generation transmission. Not everyone with monkeypox
disease has obvious symptoms. Like smallpox, this pox disease can cause
inapparent infections, and those people could conceivably spread the disease.
Because the disease can
spread between people, the federal government has issued guidelines for the use
of smallpox vaccine to prevent this form of transmission even though the FDA has
not approved the vaccine for this use. Health officials have evoked emergency
powers protocols to make the vaccine available. Indiana is the first state to
adopt these guidelines and make the smallpox vaccine available for this purpose.
Does the smallpox
(vaccinia) vaccine work to prevent monkeypox?
Officials are claiming that
the vaccine is 85 percent effective. That figure is based on one study done in
the 1980s in Africa. That study evaluated 209 cases of monkeypox that occurred
during a five-year period from 1980-1984 in the dense tropical rainforests of
the Democratic Republic of Congo (at that time Zaire). These cases represented
125 separate episodes of disease occurrence. More than half of the cases did not
spread to anyone else (only one case occurred in most episodes). The incidence
of disease among vaccinated contacts of people with monkeypox was compared to
the incidence in unvaccinated contacts. Both household contacts and people
living in other residences were included. Over 1500 contacts of patients with
the disease were identified. Only 12 cases of disease occurred in 1,099
vaccinated contacts (one percent) compared to 35 cases in 474 unvaccinated
contacts (7.4 percent). The calculation (7.4-1.1 / 7.4) yields the 85 percent
effectiveness conclusion. The assumption that smallpox vaccine works is based on
this small sample of 47 cases, hardly a definitive answer. Many other factors,
including the ability to identify and locate contacts in this environment could
have altered the results.
Will monkeypox spread
through a population?
That question has been
evaluated in a few studies. In the study quoted above, 11 percent of household
contacts contracted the disease. The majority of cases (78 percent) did not
spread the disease at all in this partially vaccinated population. The longest
recorded chain of human-to-human transmission of mankeypox lasted five
generations, where the disease spread from one child who had eaten monkey meat
with his family to four other children who had no contact with infected animals.
The authors of this study constructed a mathematical model based on the
transmission rate in that African setting. Based on an assumption that each
individual with monkeypox would come into contact with ten other people while
the individual was contagious, the authors concluded that 54 percent of cases
are predicted to cause at least one subsequent case in an unvaccinated
population. Theoretically, this could result in one additional case for every
case of monkeypox, and the persistence of the disease in a population. However,
the tactics of isolation, quarantine, and (perhaps) the vaccination of contacts
would have the potential of stopping the diseases spread. And monkeypox does
tend to lose its infectous quality through transmissions in humans. The human is
not considered a very good host for the disease, compared to rodents and other
mammals. The spread of monkeypox from person to person is considerably less
common than the spread of smallpox. Only 11 percent of unvaccinated household
contacts of those with monkeypox acquired the disease compared to 40 to 97
percent of household contacts of people with smallpox (different strains of the
virus having more or less virulence).
Media stories on monkeypox
have repeatedly stated that vaccination within four days of exposure will
prevent the disease. This figure has been estimated for smallpox prevention
using the vaccinia vaccine and is erroneously attributed to monkeypox
prevention. Several authorities have even questioned the veracity of this
statement about smallpox prevention. In 1960, one researcher stated that
smallpox vaccination given
within four days of exposure still results in a 10-40 percent incidence of
smallpox (Kempe, 1960).
What should you do?
If you live in an area
where monkeypox has been identified, begin taking supplements that boost immune
function.
Adults can take vitamin C (3-4 grams), vitamin A
(20,000 IU), zinc (25 mg), and colostrum (2 tspns) every day.
Children can take vitamin C (500-1000 mg), vitamin A
(1,000-5,000 IU), zinc (10-20 mg), and colostrum (1/2-1 tspn). The lower dose
for infants and children up to three years old, the higher dose for children
four and over.
I do not recommend that
people get the smallpox vaccine unless a local clinic can supply vaccinia immune
globulin (VIG) in the event of severe adverse reactions to the vaccination. For
a more detailed discussion of the smallpox vaccine see the excerpt from my book,
The Vaccine Guide, at:
DISCLAIMER: All
information, data, and material contained, presented, or provided here is for
general information purposes only and is not to be construed as reflecting the
knowledge or opinions of the publisher, and is not to be construed or intended
as providing medical or legal advice. The decision whether or not to vaccinate
is an important and complex issue and should be made by you, and you alone, in
consultation with your health care provider.
"A foolish faith in authority is the worst enemy of truth."
-- Albert Einstein, letter to a friend, 1901
"I know of no safe depository of the ultimate powers of the society but the people themselves, and if we think them not enlightened enough to exercise control with a wholesome discretion, the remedy is not to take it from them, but to inform their discretion by education."
-- Thomas Jefferson, letter to William C. Jarvis, September 28, 1820
"What's the point of vaccination if it doesn't protect you from the unvaccinated?"
-- Sandy Gottstein
"Who gets to decide what the greater good is and how many will be sacrificed to it?"