{"id":24082,"date":"2022-05-27T08:56:33","date_gmt":"2022-05-27T07:56:33","guid":{"rendered":"https:\/\/research.reading.ac.uk\/research-blog\/?p=24082"},"modified":"2023-02-22T17:06:41","modified_gmt":"2023-02-22T17:06:41","slug":"monkeypox-we-have-vaccines-and-drugs-to-treat-it","status":"publish","type":"post","link":"https:\/\/research.reading.ac.uk\/research-blog\/2022\/05\/27\/monkeypox-we-have-vaccines-and-drugs-to-treat-it\/","title":{"rendered":"Monkeypox: we have vaccines and drugs to treat it"},"content":{"rendered":"

Medicines are not\u00a0normally needed<\/a>\u00a0to treat monkeypox. The illness is\u00a0usually mild<\/a>\u00a0and most people infected will recover within a few weeks without needing treatment. But there are vaccines that can be used to control monkeypox outbreaks, which some countries are already using. And treatments do exist for those who become quite ill from the virus.<\/p>\n

\"\"
Monkeypox_Virion by Cynthia S. Goldsmith, Russell Regnery, CDC – https:\/\/www.cdc.gov\/poxvirus\/monkeypox\/response\/2022\/index.html, Public Domain, https:\/\/commons.wikimedia.org\/w\/index.php?curid=118333703<\/figcaption><\/figure>\n

<\/p>\n

Monkeypox belongs to the\u00a0Orthopoxvirus<\/em><\/a>\u00a0genus of viruses, which includes smallpox. Luckily, due to something called cross-protection, smallpox vaccines also work for monkeypox.<\/p>\n

Although the world was declared free of smallpox in 1980, many countries keep stocks of smallpox vaccines for emergencies. For example, the smallpox vaccine is used to protect\u00a0laboratory workers<\/a>\u00a0who accidentally come into contact with pox viruses (such as monkeypox or\u00a0vaccinia<\/a>\u00a0\u2013 a pox virus that is similar to smallpox but less harmful). They are also kept in case of a\u00a0terrorist attacks<\/a>\u00a0that might use smallpox as a\u00a0biological weapon<\/a>.<\/p>\n

Smallpox vaccine can be up to\u00a085%<\/a>\u00a0effective in stopping infection with the monkeypox virus if it is given before people are exposed to the virus.<\/p>\n

There are two types of smallpox vaccine. Both types are based on the vaccinia virus. An older type of smallpox vaccine contains the \u201clive\u201d vaccinia virus. The main one in this group is\u00a0ACAM2000<\/a>, which is approved in the US for protecting people against smallpox.<\/p>\n

Although ACAM2000 cannot cause smallpox, the vaccinia virus it contains can replicate after the vaccine is given,\u00a0transmitting<\/a>\u00a0from the vaccinated person to an unvaccinated person who comes into close contact with the injection site or any leaking fluid for up to 21 days afterwards.<\/p>\n

This also means that ACAM2000 can cause many\u00a0side effects<\/a>\u00a0and shouldn\u2019t be given to at-risk groups, such as pregnant or breastfeeding women, and those with weakened immune systems. People with weakened immune systems, including those with\u00a0HIV<\/a>, can get very ill from the vaccine.<\/p>\n

The other \u201clive\u201d vaccinia virus is the\u00a0Aventis Pasteur Smallpox Vaccine<\/a>. It is not formally approved, but can be made available if other supplies run out.<\/p>\n

A newer type of smallpox vaccine, called Imvanex, contains a live but modified form of the vaccinia virus called vaccinia Ankara. Imvanex, made by Danish biotechnology firm Bavarian Nordic, has been\u00a0licensed in the European Union<\/a>\u00a0for preventing smallpox.<\/p>\n

In the US, the vaccine goes by the brand name\u00a0Jynneos<\/a>\u00a0and is licensed for preventing both smallpox and monkeypox in adults at risk of these diseases. Jynneos has been used\u00a0in the UK<\/a>\u00a0in previous monkeypox cases.<\/p>\n

Because Bavarian Nordic vaccines are made of a modified form of the vaccinia virus, they are considered safe for people in at-risk groups.<\/p>\n

It would usually take between five and 21 days for someone who comes into close contact with an infected person to\u00a0show symptoms<\/a>\u00a0of monkeypox (and most likely seven to 14 days) so it is hard to tell if giving the vaccine after someone has been exposed to monkeypox will fully protect them. However, the recommendation in the\u00a0US<\/a>\u00a0and the\u00a0UK<\/a>\u00a0is that, after a risk assessment, people exposed to the monkeypox virus are offered a modified vaccinia Ankara vaccine dose as soon as possible, ideally within four days, but up to 14 days afterwards.<\/p>\n

Antivirals<\/h3>\n

Apart from vaccines, there are\u00a0some medicines<\/a>\u00a0that could be used for treating monkeypox.<\/p>\n

One such drug is\u00a0tecovirimat<\/a>\u00a0which stops the spread of infection by interfering with a protein found on the surface of\u00a0Orthopoxviruses<\/em>.<\/p>\n

Tecovirimat is\u00a0approved<\/a>\u00a0in the US for treating smallpox only. It has been\u00a0tested in healthy humans<\/a>\u00a0and shown to stop the smallpox virus in the lab. However, it has not been tested in people with smallpox or other\u00a0Orthopoxviruses<\/em>. Still, in Europe\u00a0tecovitimat<\/a>\u00a0has been authorised for treating smallpox, monkeypox and cowpox under exceptional circumstances.<\/p>\n

Another antiviral that might be used is cidofovir \u2013 an injectable drug licensed in the UK to\u00a0treat a serious viral eye infection<\/a>\u00a0in people with Aids.<\/p>\n

In the body, cidofovir is converted into the antiviral ingredient cidofovir diphosphate. Because cidofovir stops smallpox in the laboratory, it could be authorised for emergency use in\u00a0smallpox<\/a>\u00a0or\u00a0monkeypox<\/a>\u00a0outbreaks.<\/p>\n

However, cidofovir is quite a potent medicine and can\u00a0damage<\/a>\u00a0the kidneys, so a better alternative might be the closely related drug\u00a0brincidofovir<\/a>, which has been\u00a0approved<\/a>\u00a0in the US for treating smallpox.<\/p>\n

Brincidofovir (brand name Tembexa) is\u00a0given by mouth<\/a>\u00a0and can be prescribed to people of any age. Its special design helps get the right amount of the drug into cells to release the cidofovir component and also makes it\u00a0less damaging<\/a>\u00a0to the kidneys.<\/p>\n

Brincidofovir has been\u00a0tested in humans<\/a>\u00a0for other viral conditions. Its approval for use in smallpox in the US comes from\u00a0laboratory studies<\/a>\u00a0showing that it works against\u00a0Orthopoxviruses<\/em>. For this reason, brincidofovir is also listed as a potential drug for treating\u00a0monkeypox<\/a>.<\/p>\n

What we still lack, though, is data on how effective cidofovir, brincidofovir and tecovitimat will be in treating monkeypox infections in humans. A recent paper, published in\u00a0The Lancet Infectious Diseases<\/a>\u00a0investigated the effectiveness of brincidofovir (three patients) and tecovirimat (one patient) in monkeypox cases between 2018 to 2021 in the UK. The researchers reported poor efficacy for brincidofovir and called for more studies of tecovirimat in human monkeypox infection.<\/p>\n

Parastou Donyai is\u00a0<\/span>Professor of Social and Cognitive Pharmacy at the University of Reading.<\/p>\n

This article is republished from\u00a0The Conversation<\/a>\u00a0under a Creative Commons license.<\/p>\n","protected":false},"excerpt":{"rendered":"

Medicines are not\u00a0normally needed\u00a0to treat monkeypox. The illness is\u00a0usually mild\u00a0and most people infected will recover within a few weeks without needing treatment. But there are vaccines that can be used…Read More ><\/a><\/p>\n","protected":false},"author":469,"featured_media":24086,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"__cvm_playback_settings":[],"__cvm_video_id":"","footnotes":""},"categories":[1785],"tags":[2068,2069,1895,929],"class_list":["post-24082","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-agriculture-food-and-health","tag-monkeypox","tag-smallpox","tag-vaccine","tag-virus"],"acf":[],"yoast_head":"\nMonkeypox: we have vaccines and drugs to treat it<\/title>\n<meta name=\"description\" content=\"There are vaccines that can be used to control monkeypox outbreaks, and treatments do exist for those who become quite ill from the virus.\" \/>\n<meta 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