How to treat monkeypox?

Monkeypox is mainly symptomatic treatment, specific drugs are used for severe cases and special conditions, according to the Ministry of Health.

On the morning of October 3, the Department of Health of Ho Chi Minh City recorded a case of monkeypox through epidemiological surveillance, the first case of monkeypox in Vietnam. Epidemiological factors of this case are waiting for the Ministry of Health to announce.

According to the Ministry of Health, the general principles of treatment of monkeypox are surveillance and isolation, mainly symptomatic treatment, nutrition assurance, electrolyte balance and psychological support, and group-specific drug use. high risk and watch for signs of progression or complications.

In mild form, the patient is treated to reduce fever, relieve pain, take care of skin, eye and mouth lesions; monitoring complications such as pneumonia, skin infections, bacteremia, encephalitis… Severe patients are treated in the intensive care unit, using specific drugs such as tecovirimat, cidofovir, brincidofovir, immunoglobulins (also known as is serum).

Tecovirimat is an oral and infusion drug. Brincidofvir is an oral drug and cidofovir is for intravenous infusion. These drugs are used for both adults and children, but the dosage is different. As for immunoglobulins, the Ministry of Health asked to consider safety and effectiveness when used for monkeypox patients.

Around the world, people with monkeypox are also treated with the same drugs, but the US Centers for Disease Control (CDC) notes that these drug groups do not have data on effectiveness. Cidofovir and brincidofovir have been shown against viruses of the poxvirus family (which can cause smallpox) in animal and test-tube studies. Scientists still don’t know if the drug can treat people with severe symptoms. Tecovirimat is effective against viruses of the genus orthopoxvirus (of the poxvirus family) that can cause smallpox, clinical trials have shown that the drug is safe and well tolerated, causing only negligible side effects.

Electron micrograph of a monkeypox virus strain. Image: Smith Collection

In addition to medication, monkeypox vaccine are also interested. The leader of the Central Institute of Hygiene and Epidemiology said that the world currently has only two vaccines licensed by the US for use, both of which are live virus vaccines. The vaccine has a two-dose schedule, given 4 weeks apart, for people over 18 years of age. However, the World Health Organization (WHO) recommends against mass vaccination of this vaccine, but only for high-risk groups.

“Vietnam currently has no vaccine as well as recommendations on monkeypox vaccination,” a representative of the National Institute of Hygiene and Epidemiology said, October 3 afternoon.

The two vaccines used in the world are Jynneos and ACAM2000. Jynneos was originally used to prevent smallpox, but the US Food and Drug Administration (FDA) approved emergency use of this vaccine to prevent monkeypox in 2019. It is a vaccine that uses an unusual virus. active, cannot replicate, so the smallpox virus in the vaccine does not spread in the body. The vaccine is given in two doses, 4 weeks apart. Data from Africa show that vaccines are at least 85% effective in preventing the virus from infecting. The effect of Jynneos on monkeypox was drawn from previous immunogenicity and preclinical studies.

The ACAM2000 vaccine is FDA-approved for use in people at high risk for smallpox. The US CDC recommends vaccination for people 1 year of age and older, given as a single dose. Post-injection side effects include myocarditis, pericarditis, and viral infection from vaccination to family contacts.

Smallpox and monkeypox vaccines are most effective if given before exposure to the virus. Experts also suggest that injecting immediately after infection can prevent illness or make symptoms less severe.

Transmission route and symptoms of monkeypox (click photo).  Graphics: Ta Lu

Transmission route and symptoms of monkeypox (click photo). Graphics: Ta Lu

Monkeypox can lead to serious complications, including decreased vision, decreased consciousness, coma, convulsions, respiratory failure, bleeding, decreased urine output, sepsis, and septic shock. These cases must be treated at a higher level hospital. Patients are discharged from the hospital if they are isolated for at least 14 days and have no symptoms, no new lesions appear on the skin for at least 48 hours, and old lesions have crusted over.

WHO calls on countries to strengthen surveillance, contact tracing and case management. However, the organization warned that the massive and indiscriminate procurement of drugs and vaccines when the infections were still relatively low would have a negative impact.

Le Nga – Thuc Linh


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