Monkeypox treatment: smallpox antivirals are promising

The report examines seven cases of monkeypox in the United Kingdom between 2018 and 2021. In three of these cases, individuals acquired the virus in the United Kingdom.Africa. In the remaining cases, individuals were infected with the virus in Nigeria.

Dr. Nick Price of Guy’s & St Thomas’NHS Foundation Trust In London, England, the senior author of the paper explained the importance of sharing these data.

“Until now, monkeypox has been a rare import in the UK and NHS. [National Health Service] The High Consequence Infectious Diseases Network has treated all seven confirmed cases in the United Kingdom until 2021. Outbreaks outside Africa are rare, but recently significant outbreaks have been reported in several European countries, including the United Kingdom, and even globally. Due to the lack of clinical trial data, we are pleased to share some of our collective experience in managing this rare and sporadic condition. “

Symptoms described include fever, headache, night sweats, skin lesions, and complications such as deep tissue abscesses, pain, and depression.However, no patient experienced serious complications from infections such as the lungs. inflammation Also Sepsis..

In previous outbreaks, doctors believed that the patient was no longer infectious when all skin lesions formed scabs. However, in this study, viral DNA was detected in the respiratory tracts of several patients for at least three weeks. This indicates that the infectivity remains after the skin lesions form crusts.

This is an important finding, as most cases of monkeypox have previously occurred in parts of the world. PCR test We couldn’t get these data either because they weren’t readily available.

The study also attempted to use two antiviral drugs that doctors have traditionally used to treat smallpox: Brinsidefovir and Tecobilimat. Tecovirimat is currently approved for the treatment of monkeypox. european union And that we This use is not approved in the UK

Treatment with Brynside Fobill resulted in a short-term reduction in viral load, but these improvements were not sustained and the patient developed side effects that affected the liver. In other words, treatment had to be stopped early.

One was given Tecobilimat, and doctors observed the person’s infection shortened in length.

Although researchers cannot be sure that this was a direct result of tecovirimat,The results of the treatment suggest that Tecobilimat may help prevent progression to serious illness and reduce hospital stays. They recommend a two-week treatment course to completely eliminate the virus.

Talk to Today’s medical news, Dr. Stephen Morse“Tekobirimat is the most resistant to orthopox virus, including smallpox (now officially eradicated) monkeypox,” said the director of the Epidemiology Certificate Program at the University of Columbia Medical Center. It is an effective known antiviral drug. “

“The mechanism of action of the drugs and the association of these viruses suggests that tecovilimat is equally effective against other orthopox viruses, but due to the small number of cases, it cannot be compared exactly. It was, “he added.

Most of the patients described by the researchers in this study experienced a relatively mild illness and recovered completely. However, all patients were young, had no pre-existing condition, and were infected with the monkeypox clade in West Africa. This is usually milder than the ramifications of the Congo Basin.

Case fatality rate of the clade of the Congo Basin of monkeypox 10.6%Compared to 3.6% of West African clades.

Despite the mild symptoms experienced by patients, the author emphasizes the challenging nature of managing monkeypox, even in high-income situations in the United Kingdom.

They say that healthcare professionals should pay attention to the possibility of monkeypox in travelers with fever and rash. They also say that a network of specialized treatment centers will be important to help manage monkeypox patients.

“In addition to recent outbreaks, the cases reported in our study are to maintain a joint network of waiting centers to manage sporadic outbreaks of high-impact pathogens such as monkeypox. We emphasize the importance, “says Dr. Price.

“The cases we observed were difficult to manage and resource-intensive, even in the UK’s high-income environment. Public health authorities and healthcare around the world have returned to pre-pandemic levels of overseas travel. Workers are a new case of monkey pox, “he adds.

It is important to note that this study is observational and is based on a small number of cases — a total of 7 patients, and only 1 patient treated with tecovirimat. The authors state that further research is needed on the use of antiviral drugs to treat the disease.

Dr. Morse also emphasized this aspect. He called this an “interesting case report series,” [with] Individual patients […] Well characterized, “he warned. “The number is too small to draw a conclusion.”

Still, according to him, the study takes the care of people sick with monkeypox one step further.

“”[T]His paper adds a suggestion that tecovirimat should help treat human monkeypox infections as well as other monkeypox infections. The drug has an excellent safety profile tested by human volunteers, “Dr. Morse told us.