MONKEYPOX -- A LITTLE BIT ABOUT IT

​President Biden declared a national emergency a few weeks ago on MonkeyPox. At the time, there was only a handful of cases nationwide. We currently have 29 cases in Mississippi. We are to understand this to be an emergency. But, we do not have a national emergency of syphilis cases of which there are 130,000 cases yearly, nor of HIV cases of which there about 35,000 cases each year. But we must have a national emergency of the MonkeyPox with about 2,891 cases nationwide as of August 1st. Why? Because unless there is a declared emergency by the administration, the government, by its own regulations, would not be able to legally pre-purchase from the pharmaceutical companies, the MonkeyPox vaccine, nor the untested (on humans) drug that is supposed to treat the MonkeyPox rash. We’re talking $7 BILLION. 

The MonkeyPox virus started in monkeys in Africa. Then the monkeys mixed with giant pouch rats which then mixed with pet prairie dogs. Through human handling of these infected animals it was transmitted to four dozen humans. Nobody died and nobody got real sick. From here, someone went to a gay sexual rave in Europe. Then, reportedly, with a lot of planned, unplanned, and anonymous yet robust sexual contact, the transmission between humans exploded, then was transmitted from community to community, primarily in the homosexual community – where now 95% of the MonkeyPox cases are located, and within this demographic, 41% are HIV-positive (that is, immune suppressed). So the public health control strategy should be: safe sex, and early treatment. But when the New York State Health Department made the safe sex recommendation, homosexual activists balked and so much said “gay men are going to have sex regardless.” Perhaps there’s a lesson here: While it’s okay to have passions, uncontrolled passions (of all types) can have consequences for others.

Early treatment? With what? With a new medication. If you happen to catch the MonkeyPox and wish to be treated, then you will be called upon to exercise patience. Not so much for the disease itself, which is limited to 2-4 weeks with a significant rash, and from which thus far no one who is healthy is dying – but rather with the process you and your doctor will have to negotiate in getting the drug. Like its namesake, you will have to jump (monkey-like) from bureaucratic tree limb to tree limb, through hoop to hoop, to get your treatment for this skin rash.

The drug is called TPOXX. It is an antiviral that is indicated for smallpox, but has never been tested in humans. But because the CDC holds an Expanded Use protocol for national emergencies this allows it to be used for treatment of MonkeyPox in adults and children. As of this writing, this medication that’s not been tested on humans, is not FDA-approved – thus, perhaps the reason for the contortionary acquisition process.

In order to receive this medication, the doctor must complete a 3-page “Request Form”. If and when it’s approved, a 3-page “Patient Intake Form” must be processed by the State Health Department. Then, before the TPOXX can be distributed the CDC requires the patient complete a 5-page (6-page in Spanish) “Informed Consent” form. Additionally, the doctor’s office or facility must complete an “FDA Form 1572” which is 2 pages. Then there are follow up documents after the medication is started, during and post treatment – this 4-page form has a name too, the “Clinical Outcome Form”.

By the way, in the event you are seriously injured by this medication, unlike the COVID injection, there is liability coverage for compensation to the patient, paid for and provided by someone somewhere. There is no cost to the patient or the doctor for the drug.

TPOXX is only shipped on business days to the patient or provider. Like most working people, it stays at home on Saturday and Sundays. As a patient, if you have questions regarding TPOXX you are told to direct your questions to TPOXX@msdh.ms.gov. 

So, 17 pages of documentation must be completed before you can take the first capsule of TPOXX, which is administered as a 600 mgm capsule every 12 hours over 14 days – the length of time it takes for some people to be over the virus-induced chickenpox-like skin rash, which occurs primarily on the hands, feet, and face, and depending on your sexual preferences, the oral, anal, and genital areas. If for some reason you are unable to ingest it orally, it can also be given intravenously every 12 hours for 14 days.

As anyone can see, this is not your regular medication that comports with our orthodox way in which patients obtain their prescription medication. On top of this, testing you for MonkeyPox requires the doctor or nurse to wear maximum protective covering, face, body, and hands. It’s probably for this reason that it’s been shared with me that only 2 hospitals, thus far, on the Coast are collecting the specimen for diagnostic testing which involves swabbing a skin lesion with a special Q-tip, then forwarding it to the lab, the State Health Department. You may be able to find a medical clinic that is collecting the specimen for testing, but it appears most clinics are punting on this one. 

PREVENTION: Stay away from people who are infected. Avoid having sex with people who are infected. Avoid touching a person with the rash. If you’re a woman, or a man, it would be wise not to have sex with a man who happens to be having sex with another man, even if the man is your husband (this is a good rule to follow even if there wasn’t an affliction called MonkeyPox). In other words, mind your own monkey-business – or – one monkey shouldn’t monkey with another monkey’s monkey.

On the bright side, if you are over 50 and have had the smallpox vaccine, you are more likely to be immune from the MonkeyPox virus.

Meantime, be careful, stay safe, and take care.