Monkeypox Update: Vaccine shortage, sewage surveillance and global testing

As concern over the monkeypox outbreak continues to rise, we take a look at major developments from the first week of August.   

More than 80 countries where monkeypox is not endemic have reported outbreaks of the viral disease, which the World Health Organisation has declared a global health emergency. Confirmed cases have crossed 27,800 and non-endemic countries Brazil, India and Spain have reported their first deaths from the virus. 

Vaccine shortage 

On Tuesday, US health officials authorised a plan to stretch out the country’s limited supply of monkeypox vaccine by giving people just one-fifth of the usual dose. The dose-sparing approach calls for intradermal injection of the Jynneos (also known as Imvanex) vaccine just under the skin instead of a full dose into the underlying fat — a practice that may improve immune response. Recipients would still get two shots spaced four weeks apart.  

This unusual measure is being taken to supplement the country’s shortfall in vaccine doses. Currently, the US has just 440,000 doses available, which increases to 2 million if the dose-sparing method is used. 

Robert Fenton, the White House’s monkeypox response coordinator, told reporters: ‘It’s safe, it’s effective, and it will significantly scale the volume of vaccine doses available for communities across the country.’ 

European officials are now considering whether to follow suit, given spiraling case numbers on the continent. Speaking to Reuters, a spokesperson for the European Medicines Agency said the agency would ‘discuss the approach’ with Bavarian Nordic, who makes the vaccine, as well as individual member states.  

Sewage surveillance  

A team of researchers who used wastewater surveillance to track the incidence of COVID-19 is now turning their attention to monkeypox.  

Surveillance and testing of sewage water has long held promise for the early detection of health threats but had limited applications before the COVID pandemic. In the US, such risk monitoring was largely confined to academic projects.  

When COVID-19 emerged, a research group made up of scientists at Stanford University, the University of Michigan, and Emory University pioneered efforts to recalibrate surveillance techniques for detection of the virus, marking the first time that wastewater has been used to track a respiratory disease.  

This research team, the Sewer Coronavirus Alert Network, is now expanding wastewater monitoring to detect monkeypox in the US.  

Test kits  

SaaS company WeTrade Group has struck a strategic partnership with Jiqing Biomedical Technology to produce monkeypox virus test kits and antigen tests.  

Jiqing, a Chinese biotech focused on medical research and experimental development, created an antigen self-test kit for COVID-19 which was granted EU approval. With the emergence and spread of monkeypox, Jiqing developed a nucleic acid RT-LAMP test and a colloidal gold technique antigen test.   

Working with Jiqing, WeTrade Group will leverage its digital tools to rapidly bring monkeypox virus test kits to market with the power of YCloud, a cloud intelligent system for microbusinesses, and its industry accumulation in computer technology and big data.   

Read the full story here.

Therapeutics 

SIGA Technologies confirmed this week that it will deliver $26 million worth of an intravenous formulation of smallpox drug TPOXX to the United States in 2023, after the US government elected to exercise certain procurement options.  

Oral and intravenous formulations of TPOXX are approved by the US FDA for the treatment of smallpox, but not yet monkeypox. However, the US CDC provided guidance for its use under expanded access as an investigational drug. 

The IV treatment will be a vital option for patients unable to swallow the oral pill as monkeypox symptoms include rashes and blisters in the mouth. 

For more information on the global monkeypox response, read our recent feature: Vaccine industry must help fight monkeypox and secure supply chains