What does Monkeypox teach us about pandemic preparedness?

Posted on May 24, 2022

Airfinity's Pandemic Platform now includes a real-time Monkeypox Tracker, showing the number of reported and suspected cases by country over time. We are also providing Monkeypox deep dives in our weekly Pandemic Preparedness Intelligence Briefing, providing commentary and insight into everything from transmissibility, to high risk groups, to vaccines. 

Monkeypox has a 1-15% mortality rate depending on healthcare system and strain 

The case fatality ratio has been reported to range between 1-15%, with WHO reporting 3-6% more recently. CFR depends on the circulating strain and healthcare systems; cases in the UK have been confirmed as the west clade which has a lower CFR of 1%. Transmission via close contact with lesions, body fluids, respiratory droplets and contaminated materials, such as clothing or bedding. Symptoms usually present 6-13 days after exposure, but can from 5-21 days. 

Smallpox vaccine is <85% effective in preventing monkeypox

MVA-BN was been approved for use in monkeypox in 2019 by the EMA. Vaccination is recommended <4 days after exposure to prevent disease but may reduce symptoms when given <14 days post-exposure. CDC suggest those receiving a vaccination >3 years ago need reimmunisation if exposed.

Bavarian Nordic have an overall capacity of 40 million doses; the US have ordered 13 million doses recently. An antiviral agent known as tecovirimat that was developed for smallpox was licensed by the European Medical Association (EMA) for monkeypox in 2022 based on data in animal and human studies; however, Tecovirimat is not yet widely available. 

Belgium becomes first country to impose compulsory quarantine for positive cases

Belgium is the first country to implement a compulsory quarantine for those testing positive for monkeypox. Other countries have introduced quarantine policies for positive, cases and close contacts. In addition, countries, such as Denmark, have published guidance on the handling of patients with monkeypox.

A long incubation period could mean disruption in healthcare systems if many HCWs need to isolate. Distinctive symptoms, long incubation interval and transmission mostly after symptoms appear may mean that isolation, contact tracing and post-exposure vaccination can be very effective for monkeypox.

The rise and spread of Monkeypox further highlights the need for greater preparedness on emerging infectious diseases. How will viruses such as this impact both short and long term vaccine development and demand? What are the implications for policy makers and drug procurement strategies?

Get in touch to learn more about Airfinity's Monkeypox analysis and tracker, as well as our country-level risk metrics and forecasts for global infectious diseases.

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