Monkeypox patients may not have typical symptoms making infection harder to spot

Monkeypox patients that are being infected as part of the current worldwide outbreak may not be exhibiting all of the typical symptoms of the virus, allowing some cases to go undetected, experts fear.

A Belgian study released in pre-print on Tuesday found that some patients who had tested positive for the virus right at the start of the outbreak. It comes a week after a UK study found that many patients in the current outbreak were not experiencing fatigue or a fever – often telltale signs of infection.

While this is a signal the strain of monkeypox circulating around the world is likely more mild than previous versions of the virus, it also allows for it to more easily circulate undetected.

The findings have some officials alarmed as concerns that the tropical virus will become endemic outside of Africa are raised.

In the US, 560 cases have been detected so far as part of the outbreak though real figures are likely higher because of poor surveillance in America.

In the UK study, published Friday in The Lancet, 54 men who have sex with other men were inspected for potential monkeypox infection.

None had any recent travel history to a nation where the virus is endemic or any known exposure to the virus. All also had at least one new sexual partner in the last three weeks.

‘The commonly observed symptom of skin lesions in the anal and penile areas, and the fact that a quarter of the patients tested positive for gonorrhoea or chlamydia at the same time as the monkeypox infection, suggests that transmission of the monkeypox virus in this cohort is occurring from close skin-to-skin, for example in the context of sexual activity,’ Dr Ruth Byrne, of the NHS, said in a release.

The lesions were the primary symptoms experienced by the men, though, with reports of the usual fever and fatigue being limited.

A Belgian study, that it still pending peer-review before official publication, made similar findings.

Three men tested positive for the virus despite experiencing no symptoms and having no known contact with an infected person.

This likely means they picked up the virus from someone else that was asymptomatic, and had they not found out of their own infection, could have continued to spread it to others.

‘The existence of asymptomatic monkeypox infection indicates that the virus might be transmitted to close contacts in the absence of symptoms,’ researchers wrote.

‘Our findings suggest that identification and isolation of symptomatic individuals may not suffice to contain the outbreak,’

This undetected spread is the worst fear of health officials around the world.

Experts are warning that in the US in particular, the undetected spread is also occurring because of how poorly federal officials have expanded access to testing and vaccines.

‘Where we have lagged is streamlining testing, making vaccines available, streamlining access to the best therapeutics,’ David Harvey, executive director of the NCSD told The Hill.

‘All three areas have been bureaucratic and slow, and that means we haven’t contained this outbreak.’

First American to go public with monkeypox infection is a gay actor in Los Angeles

The first American monkeypox patient to go public with his battle against the tropical virus has slammed health officials for a ‘lackluster’ job of testing for the virus, which has left many cases undiagnosed.

Matt Ford, a self-employed actor who splits his time between Los Angeles and New York City, has spoken out to warn people that the disease ‘sucks’ and they should take it ‘seriously.’

He blasted the Centers for Disease Control and Prevention (CDC) for their poor testing efforts, saying it took officials three days to diagnose his illness by which point he ‘already knew’ what they would say.

Revealing his diagnosis to Buzzfeed, Ford said he caught the virus after having ‘skin-to-skin contact’ with another patient.

The actor and writer, who describes himself as a ‘proud openly gay man,’ revealed he initially noticed spots in and around his ‘underwear zone,’ which indicated to him he had caught the virus.

Over the next few days they spread across the rest of his body, including his face, arms, hands and abdomen.

In total, he has counted 25 spots and said after appearing they began to ‘fill with puss’ and became itchy. Several — especially in the ‘sensitive area’ — became so painful they left him unable to sleep at night without taking painkillers.

Testing for the virus has been a slow and arduous process so far. When a patient begins exhibiting symptoms of the virus they are first examined for the orthopox family of viruses.

The lineage includes monkeypox – along with the extinct smallpox virus – and it is likely that anyone who tests positive for it does have the tropical infection.

In order to confirm a monkeypox case, samples must be sent to the CDC for testing, where it is then confirmed.

Testing is slow, though. Access to these tests is limited as well. This makes many experts fear that cases are going undetected.

The federal government has taken steps to expand capacity but access to tests is still relatively limited.

On Wednesday, the CDC announced that it had partnered with Labcorp to expand testing, doubling the capacity of testing to 20,000 per week in the near future.

There have also been cases detected so far with no links to international travel or to another case of the virus – meaning there is some undetected circulation of the virus ongoing.

‘We’ve been sort of screaming for a month about how bad the diagnostic situation is for monkeypox,’ James Krellenstein, cofounder of Prep4All, told The Hill.

‘And that really was a clear error, preventable, and it’s very clear that this administration has not learned lessons from early Covid.’

The nation’s vaccine rollout has been under intense scrutiny as well.

American officials have ordered around 4.4 million doses of the Jynneos vaccine – including an additional 2.5 million last week.

Getting the shots into arms has been a challenge, though. New York City had its first public vaccine event two weeks ago – ahead of Pride festivities in the Big Apple – but demand for the jabs was so high officials had to cut off walk-in appointments in a matter of hours.

People waiting at the clinic for the shot told that the barely a thousand doses available as ‘ridiculous’ in a city of nearly eight million.

Other eager recipients accused officials of giving ‘contradictory’ information on how to get jabbed.

Some experts are comparing the currently broken response to monkeypox to that of COVID-19 when it first erupted in March 2020.

‘I think we’ll continue to repeat these mistakes because that’s been our track record. That’s been our track record,’ Jon Andrus, a global health professor at GW, said.

‘We’ve had, what, more than five or six waves of Covid, and we seem every time to be a little bit caught off guard,… stopping transmission requires that we’re all reading from the same page. We all have the same road map.’


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