17 June 2022 Episode 267 Human Monkeypox

Fri, 06/17/2022 - 12:14

Dear colleagues,

Sorry, this is just a short and quick update on monkeypox.  You may have seen most of it, just to bring everybody at the same level.  I have to prepare for the “sweet duty” of spending the weekend with our grandsons and friends at the beach in Westende.  A short break, I promise to be back with more COVID on Tuesday or Wednesday at the latest….

Ep 267-1: Estimated incubation time Eurosurveillance

Mean incubation period was 8.5 days (5th–95th percentiles: 4.2–17.3), underpinning the

current recommendation to monitor or isolate/quarantine case contacts for 21 days.


Ep 267-2:  Tracking the 2022 monkeypox outbreak with epidemiological data in real-time




Ep 267-3: Investigation into monkeypox outbreak in England: technical briefing 1 - GOV.UK


Clear evidence for transmission related to sexual practice in “diffuse sexual networks”:


  •  Nearly all (98%) of interviewed cases reported sex with other men during the incubation period (5 to 21 days).
  • The majority (60%, 27 out of 45) were diagnosed with an STI int he previous year,
  • 44% (20 out of 45) reported more than 10 sexual partners in the previous 3 months, and 44% (20 out of 45) reported group sex during the incubation period.
  • Sexual networks involved in this outbreak are interconnected both within and outside the UK, as 30% (13 out of 45) of cases reported sexual activity in cities other than their place of residence, 20% (9 out of 45) reported sexual activity abroad, and 24% (11 out of 45) reported sexual activity with men who are not UK residents during the incubation period.


Mutations: 21 (out of 48) that cause differences in proteins.  Of these


2 mutations of low priority:

  • C9L(R48C): Interferon agonist, when deleted the virus replicates worse in the presence of interferon
  • (H221Y): Virulence factor, deletion of gene reduces virus virulence in mice.


4 mutations at medium priority:

  • C23L(S105L): Chemokine binding protein, deletion of this gene from the virus increases disease severity in rabbits
  • C22L(S54F): Tumour necrosis factor (TNF) receptor-like protein – deletion may increase lung pathology in mice
  • C19L(D266N): Ankyrin repeat protein (unknown function-might be host range or virulence)
  • F13L(E353K): Target of antiviral drug tecovirimat. Tecovirimat resistance has been shown to be conferred by a single mutation atF13L(G277C)


3 mutations in one protein which are classed as high priority:

B21/B22(D209N, P722S, M1741I): T-cell inhibitor also found in cowpox, camelpox and horsepox, knock-in of this protein into non-virulent cowpox strains increased disease severity and mortality in rats.



The mean serial interval time was estimated at 9.8 days (95%CI 5.9 to 21.4),


Ep 267-4: Renaming Monkeypox to avoid stigmatization


Human monkeypox (hMPXV) as a placeholder name with numbers representing clades: 1 for Congo Basin as it was the first to be detected, 2 for West African, and 3 for the current “European” strain.


Best wishes,