Monkey pox

I saw an interesting article which noted that scientists have been warning of a threat from monkey pox for a long time.  It turns out that the smallpox vaccine also provided strong protection against monkey pox.  Now that nobody is vaccinated for small pox any more, monkey pox outbreaks are becoming more common.

https://www.npr.org/sections/goatsandsoda/2022/05/27/1101751627/scientists-warned-us-about-monkeypox-in-1988-heres-why-they-were-right?fbclid=IwAR2ZR_s0nqwTUmN7Q5tgSJ_2eBlBVH3jvGeA7UcmpCLHpwrNh8Gre2pK8oQ

Seems we did a great job of stamping out smallpox and have left the door open for monkeypox or some other Poxviridae orthopoxvirus species to flourish (sorta) now that we no longer vaccinate for smallpox.

Here is some information from the WHO. This virus is popping up in places it isn't usually found. Scientists are wondering if it is something new or if we're just noticing it more this year. The Democratic Republic of the Congo has had over 1200 cases since January but that is far more than any of the other countries where monkeypox is considered endemic. But Europe, Australia and North America?? The wonders of world travel. But why hasn't monkeypox been a problem for a while now, not just recently?

https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON385

I don't know if the people claiming a link between SARS-CoV-2 and Monkeypox are to be taken seriously. Certainly not a crank claiming the vaccines are causing it.

https://www.forbes.com/sites/brucelee/2022/05/22/alex-jones-unfounded-claims-that-monkeypox-outbreak-due-to-covid-19-vaccines/?sh=565b7801413b

I recall reading that the US has an emergency supply (well guarded, no doubt) of smallpox, which could be used to create new vaccines should it be required.  Any info on this, Peter?

dave said:

I recall reading that the US has an emergency supply (well guarded, no doubt) of smallpox, which could be used to create new vaccines should it be required.  Any info on this, Peter?

This is what I have from PubMed. It's from 22 years ago though.

https://pubmed.ncbi.nlm.nih.gov/11040489/

Abstract

It is 20 years since the 33rd World Health Assembly (WHA) declared that "worldwide eradication of smallpox" was achieved. This was the outcome of many years intensive work of the World Health Organization (WHO) and its member countries. In 1958 the WHA adopted the recommendation that WHO should initiate the eradication of smallpox on a worldwide scale. In 1967 the eradication activities in hitherto endemic countries became more intense. Smallpox affected 31 countries and 15 countries recorded from occasional cases. Every year more than 10 million people contracted the disease and two million of them died. A ten-year limit for the eradication was set. Gradually smallpox were eradicated in South America, then in Asia and last in Africa where the last case of endemic smallpox was recorded in 1977 in Somalia. WHO ensured international collaboration, close coordination of activities and mobilization of financial, personal and material resources. It ensured also that tested methods were fully applied in the affected countries regardless of their political, religious and cultural differences. In the eradication activities participated hundreds of thousands of local and 700 health professionals from abroad, incl. 20 Czechoslovak epidemiologists. The worldwide costs of eradication amounted to some 300 million dollars, i.e. some 23 million per year. The most important contribution of the eradication of smallpox was in addition to the termination of human suffering, worldwide financial savings estimated to 1-2 billion US dollars per year. These saved personal and financial resources could be used for other important health projects. The eradication of variola was defined as eradication of clinical forms of smallpox not as the final eradication of the variola virus. The importance of laboratories keeping the variola virus increased steeply at the time when clinical cases of smallpox were eradicated. From the beginning of the eighties WHO made an effort to reduce their number to a minimum. Since 1984 strains of variola are officially kept only in two centres collaborating with WHO. The Organization suggested destruction of the kept viruses in 1987, i.e. ten years after the eradication of smallpox. Unfortunately some political and scientific circles did not agree with this intention. Even recommendations to destroy the virus in 1993 and again in 1999 were not accepted. In the nineties fear of bio-terrorism and secret modernization of biological weapons influenced some member countries to change their opinion on the intended destruction of the virus. Despite this in May 1999 the WHA adopted a resolution that the final destruction of all variola strains is the objective of all member countries of WHO and recommended to postpone the destruction of the virus to the year 2002. The reason for postponement is current research of new antiviral preparations and better vaccines. There is again hope that all that will be left of the variola virus will be magnetic signals on computer diskettes.

This is the part you were looking for but there is more discussion below these sentences:

The eradication of variola was defined as eradication of clinical forms of smallpox not as the final eradication of the variola virus. The importance of laboratories keeping the variola virus increased steeply at the time when clinical cases of smallpox were eradicated. From the beginning of the eighties WHO made an effort to reduce their number to a minimum. Since 1984 strains of variola are officially kept only in two centres collaborating with WHO.

Abstract

Smallpox, caused by variola virus, was a terror for civilizations around the world for more than 3000 years. Although the disease is eradicated, hundreds of variola virus isolates are kept in two WHO-collaborating facilities, one in USA and one in Russia. In spite of several agreements on destruction, it is now doubtful that these virus isolates will be destroyed. Variola virus may exist in other places and may be used as a biological weapon in war or for terror. Further research on variola virus is thus essential in order to achieve a better understanding of the pathogenicity of the virus and to develop new anti-variola virus vaccines and antiviral drugs.

https://pubmed.ncbi.nlm.nih.gov/15534643/    A 2004 editorial

A little more scary now that there are things such as easy reliable crispr gene editing
https://pubmed.ncbi.nlm.nih.gov/32373931/

Abstract

Introduction: 

Smallpox, caused by variola virus, was eradicated in 1980, but remains a category A bioterrorism agent. A decade ago, smallpox ranked second after anthrax in a multifactorial risk priority scoring analysis of category A bioterrorism agents. However, advances in genetic engineering and synthetic biology, including published methods for synthesizing an Orthopoxvirus, require the assumptions of this scoring for smallpox and other category A agents to be reviewed.

Materials and methods: 

The risk priority framework was reviewed and revised to account for the capability for creation of synthetic or engineered smallpox and other category A agents.

Results: 

The absolute score for all agents increased because of gene editing and synthetic biology capability, which was not present when the framework was developed more than a decade ago, although new treatments revised scores downward for smallpox, Ebola, and botulism. In the original framework, smallpox scored 0 for global availability, given the high security around known seed stocks of variola in two laboratories in the United States and Russia. Now, smallpox can be created using synthetic biology, raising the score for this criterion to 2. Other agents too, such as Ebola, score higher for availability, based on synthetic biology capability. When advances in synthetic biology and genetic engineering are considered, smallpox and anthrax are now equally ranked the highest category A bioterrorism agents for planning and preparedness.

Conclusions: 

Revision of a risk priority framework for category A bioterrorism agents shows that smallpox should be elevated in priority for preparedness planning, and that gene editing and synthetic biology raises the overall risk for all agents. The ranking of categories A, B, and C agents should also be revisited, as there is an endless possibility of engineered threats that may be more severe than any agent on the category A list.

© The Association of Military Surgeons of the United States. 2020 All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

There are many more citations to look at if you go to any of those links.

https://pubmed.ncbi.nlm.nih.gov/32167685/

Abstract

The review contains a brief analysis of the results of investigations conducted during 40 years after smallpox eradication and directed to study genomic organization and evolution of variola virus (VARV) and development of modern diagnostics, vaccines and chemotherapies of smallpox and other zoonotic orthopoxviral infections of humans. Taking into account that smallpox vaccination in several cases had adverse side effects, WHO recommended ceasing this vaccination after 1980 in all countries of the world. The result of this decision is that the mankind lost the collective immunity not only to smallpox, but also to other zoonotic orthopoxvirus infections. The ever more frequently recorded human cases of zoonotic orthopoxvirus infections force to renew consideration of the problem of possible smallpox reemergence resulting from natural evolution of these viruses. Analysis of the available archive data on smallpox epidemics, the history of ancient civilizations, and the newest data on the evolutionary relationship of orthopoxviruses has allowed us to hypothesize that VARV could have repeatedly reemerged via evolutionary changes in a zoonotic ancestor virus and then disappeared because of insufficient population size of isolated ancient civilizations. Only the historically last smallpox pandemic continued for a long time and was contained and stopped in the 20th century thanks to the joint efforts of medics and scientists from many countries under the aegis of WHO. Thus, there is no fundamental prohibition on potential reemergence of smallpox or a similar human disease in future in the course of natural evolution of the currently existing zoonotic orthopoxviruses. Correspondingly, it is of the utmost importance to develop and widely adopt state-of-the-art methods for efficient and rapid species-specific diagnosis of all orthopoxvirus species pathogenic for humans, VARV included. It is also most important to develop new safe methods for prevention and therapy of human orthopoxvirus infections.

One of the reasons that we were able to eliminate human smallpox is that there was no animal reservoir for the virus.   This is an important difference from Ebola, flu, and covid.   The ring vaccination of all contacts eventually worked in eliminating human smallpox.  This ring vaccination method should hopefully work for monkeypox if vigilance and quick public health action are able to work.  But since there are animal reservoirs for monkeypox, this is a many-year project akin to Ebola control.  

Some smallpox info that most of us know is that George Washington had his Revolutionary soldiers vaccinated in order to keep the troops healthy.  George Washington like many Americans of his time had smallpox and survived.  Smallpox was devastating to American native tribes as the Europeans brought it with them to the Americas.  And the happy story of healthy skin like a milk maid was due to the fact that milkmaids got the less dangerous cowpox which protected them from the skin scaring smallpox.  

Is there any residual immunity for those of us who had smallpox vaccinations in our childhood?

The CDC website has lots of really good info that answers your question and more.  

It's getting real. 

The exposure happened on The Last Train to Clarksville.