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Vaccine and drug for monkeypox are approved by Anvisa, understand better


*Image by jcomp on Freepik

Monkeypox is a disease caused by the Monkeypox virus, which, despite its name, has no origin and is not transmitted by monkeys. The disease takes its name because, although the reservoirs are believed to be rodents, it was recently identified in monkeys.

The main forms of contagion are through contact with respiratory droplets or secretions (such as body fluids, during sexual intercourse) from an infected person, or objects contaminated with the virus. According to the WHO (World Health Organization), the ingestion of undercooked meat from infected animals is also a possible risk factor.

Symptoms can appear between the 5th and 13th day after infection, and are most often similar to those of the flu: fever, headache, muscle, body and back pain, deep weakness and swollen lymph nodes, requiring an exam to confirm or rule out the disease. Pustules (blisters) appear on the skin, usually first on the face and then on the rest of the body, which last about 2 to 4 weeks.


Curiosities

Smallpox was a serious disease that haunted humanity for centuries as it was highly lethal and very transmissible. In 1796, British physician Edward Jenner developed the first vaccine to be introduced to the world, the smallpox vaccine. In Brazil, vaccination of children and adults was mandatory in 1846, however, due to the low production of vaccines, this obligation was not actually fulfilled. When in 1884 the commercial scale of production was reached, to make vaccination mandatory in fact, a new bill was passed in the Chamber, being regulated in November of the same year.

With the mandatory vaccination, a strangeness began and a rejection of the new law and the vaccine, which at the time was used by the republicans as a pretext against President Rodrigues Alves. After a meeting at the Centro das Classes Operárias, in 1904, led by the republican senator Lauro Sodré, the League Against Mandatory Vaccine was created, and then the so-called Vaccine Revolt began.


Oswaldo Cruz, general director of public health at the time, argued that in several European countries the vaccine had been applied and had saved lives. However, due to lack of information and for not understanding the science behind the vaccine, people believed in several rumors that circulated at the time, such as, because it was made from the virus that causes cowpox (vaccinia virus), whoever took the immunizer would look like an ox.

In the image, Jenner is vaccinating people and bovine characteristics appear in some of them. Source: http://www.invivo.fiocruz.br/saude/variola-erradicacao/, 2022.


In 1906, two years later, the law was repealed and the Revolt was controlled. In that period, the number of deaths caused by smallpox plummeted to nine cases. But in 1908, an intense epidemic of the disease brought the number to 6.500 cases. With fear, the population began to voluntarily seek health centers to get vaccinated.

With the development of a specific vaccine in the 1960s, and thanks to mass vaccination of the population until the mid-1970s, smallpox was considered eradicated in Brazil by the World Health Organization (WHO) in 1980, and thus, the production of the vaccine was discontinued.


Prevention

Smallpox can cure itself over time in the vast majority of cases, but it can be serious in some individuals, such as children, pregnant women, or immunosuppressed people. If the person has any symptoms, isolation in an airy place is recommended.

For the protection of other people, it is necessary to wear a fitted mask covering nose and mouth and to constant and correct hand wash; it is also not recommended to share objects and food.


Vaccine and drug approved by ANVISA

In recent weeks, ANVISA (National Health Surveillance Agency) approved the release of the Jynneos/Imvanex vaccine against monkeypox and the emergency use of the drug Tecovirimat®, an antiviral, in Brazil. According to the Ministry of Health, the vaccine should arrive in Brazil from this month of September and priority will be given, at first, to health professionals who are more exposed to the virus. Mass population vaccination is not required at this time for monkeypox. For now, experts strongly recommend controlling the spread of smallpox through early case detection and diagnosis, isolation and contact tracing.

The Jynneos/Imvanex vaccine is made with attenuated (softened) versions of the modified vaccinia virus, the virus that causes smallpox. The recommended schedule is two doses to be given four weeks apart in people over 18 years of age.

The antiviral drug Tecovirimat® is an inhibitor of the Vp37 protein, this inhibition prevents the replication of the virus, preventing its spread in the body. Therefore, the severity of injuries can be minimized, which can prevent the condition from getting worse.

The forecast is that this drug will be distributed only by the SUS (Brazilian Unified Health System) and its use will be limited to patients with more severe symptomatic conditions, since most cases of the disease are mild.

Tecovirimat® will be recommended when there is:

  • Severe lesion of penile edema (paraphimosis, when the lesion prevents the patient from recovering the penile glans);

  • Proctitis (rectum injury);

  • Appearance of more than 200 lesions, which can cause secondary bacterial infections;

  • Retinal involvement.

Despite the health authorities monitoring the cases being alert, monkeypox has not yet been declared a health emergency in Brazil. The disease is not considered to have a high power of contagion or transmission and, at least for now, there is no concern about a new global pandemic. However, it is important to always protect yourself and continue to put into practice the lessons learned during the COVID-19 pandemic, so you can take care of your health and the health of all those close to you.

ImunoTera prepared this article as a source of information and curiosity, being unassociated with projects related to monkeypox.


REFERENCES

Ministério da Saúde. O que é Monkeypox? Publicado em: 03/08/2022. Disponível em: https://www.gov.br/saude/pt-br/assuntos/variola-dos-macacos/o-que-e-monkeypox. Acesso em: 30/08/2022.

Instituto Butantan. Varíola dos macacos: sintomas, transmissão, origem e número de casos são atualizados pela OMS. Publicado em: 23/05/2022. Disponível em: https://butantan.gov.br/noticias/variola-dos-macacos-sintomas-transmissao-origem-e-numero-de-casos-sao-atualizados-pela-oms. Acesso em: 30/08/2022.

GRANCHI, G. Vacina e remédio contra varíola dos macacos são aprovados no Brasil; entenda como vai funcionar. Publicado em: 26/08/2022. Disponível em: https://www.bbc.com/portuguese/geral-62695029. Acesso em: 30/08/2022.

Instituto Butantan. Há mais de 100 anos, Revolta da Vacina foi marcada por mortes, estado de sítio e fake News. Publicado em: 05/11/2021. Disponível em: https://butantan.gov.br/noticias/ha-mais-de-100-anos-revolta-da-vacina-foi-marcada-por-mortes-estado-de-sitio-e-fake-news. Acesso em: 30/08/2022.

AGÊNCIA Fiocruz de Notícias (AFN). Monkeypox - Perguntas e Respostas: Vacina. Publicado em: 10/08/2022. Disponível em: https://portal.fiocruz.br/noticia/monkeypox-perguntas-e-respostas-vacina. Acesso em: 02/09/2022.

SANTOS, T. INVIVO. Varíola: a única doença humana erradicada no planeta. Publicado em: 30/08/2022. Disponível em: http://www.invivo.fiocruz.br/saude/variola-erradicacao/. Acesso em: 02/09/2022.

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