Monkeypox: What's Going On?

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I'm Wendy Zuckerman and you're listening to Science Versus from Gimlet.
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So we were on a break working on new episodes
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for the next season. But then, well, something came up.
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The numbers keep rising, but not necessarily for COVID-19.
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Monkeypox is spreading all across the globe, including here in
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the United States. Monkeypox.
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Monkeypox.
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Monkeypox. Monkeypox.
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This outbreak really got going in early May. It turned
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up in the UK, but then the numbers for monkeypox
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started ticking up and up.
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11 more cases in England.
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By mid-May, new cases were being spotted all over. In Portugal, Spain.
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Australia, Israel and Switzerland are the latest to report a
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presence of the virus.
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Eventually, hundreds turned to thousands.
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Why so many people are developing monkeypox is perplexing scientists.
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The vast majority of people who have gotten sick are
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men who have sex with men, but not all.
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Two more children have been infected in Indiana, a total
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of four now in the US.
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There are more than 23,000 cases in more than 70
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countries and territories. And this all led the World Health
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Organization to say that this outbreak represents a public health
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emergency of international concern. And this disease, monkeypox, it can
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be awful. Stories of people suffering are being shared all
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over the internet. We heard some of the worst cases
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from Dr. Carlton Thomas. He's a gastroenterologist and queer health
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educator on social media.
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The pain has been described as a shard of glass
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corkscrewing up your ass for 10 days straight with no relief.
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Or a potato peeler. Going round and round and round
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in your ass.
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Oh, God.
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This one guy said his penis was so swollen and
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his foreskin was so swollen around his penis that he
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couldn't even have urine escape. And he had to go
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to the hospital and get a catheter put into his penis,
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which was probably one of the worst experiences of his life,
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I would imagine. One of my most recent Instagram and
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TikTok posts is the audio of a guy crying in
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the bathroom because it hurt so bad. I can't even
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describe the pain, man. He's got the shower running and
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he's crying and he's screaming.
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I'm like shaking.
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This is not.
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Okay.
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I wouldn't wish this on anybody. It's just heart-wrenching. And
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I have pictures and videos that will forever haunt me.
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of how bad this is. Horrific what people are going through,
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the amount of suffering and pain.
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Today on the show, what the hell? Is it always
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this bad? How is this disease spreading? And how can
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we stop it?
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Science vs.
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Monkeypox is coming up just after the break.
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Welcome back. Today on the show, the monkeypox outbreak.
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Monkeypox is a virus which science has known about for
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about half a century. The first case they saw was
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in monkeys, hence the name monkeypox. But actually, this virus
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can infect lots of different animals, rats, squirrels, shrews, and yeah,
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you and me. It's endemic in some countries in Africa,
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and when people get infected, the virus spreads to your
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lymph nodes, ultimately moving to the skin, where it creates
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these lesions or pus-filled blisters. And they are packed with
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the virus, which can then spread this from one person
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to another.
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But here's what's really strange.
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Usually, monkeypox doesn't really spread that much between people. Like
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in past outbreaks of this, someone got it, generally from
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an infected animal, maybe spread it to one person, maybe another,
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and that was it. It was pretty rare to spread
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from person to person to person like we're seeing now.
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And one doctor who's been trying to work out what
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is happening here is Professor Chloe Orkin. She's an infectious
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disease doctor at Queen Mary University of London. Chloe specialises
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in HIV care. And a few months ago, she started
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to see cases of monkeypox at the clinic that she
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works at in East London.
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So, yeah, as a doctor who's been working in HIV
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for my whole career, obviously I could see that this
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was something that was affecting men who have sex with
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men and very upsetting.
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She got to work.
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And one of the things that she's helped sorting out
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is to find out how bad this virus is for people.
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Like those horror stories we heard from Carlton. How often
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is that kind of thing happening? Chloe looks at the
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map of where cases are popping up around the world
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and she starts reaching out to doctors in those places.
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And I said, are you looking after anybody with monkeypox?
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And sometimes they would say no, but my friend is.
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And then they'd say no, but my friend is. And
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I just keep writing emails until eventually I found somebody
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who was looking after people.
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It was the most complex and difficult thing I've ever done.
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And also the most wonderful because I'd wake up in
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the morning to emails from every country, 16 countries, and
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it just escalated. And we ended up with 16 countries
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involved and 43 different centres and literally hundreds of different
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doctors collaborating.
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Chloe ended up putting together a study of some of
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the first patients who got monkeypox in this outbreak. It
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included more than 500 people. They were almost all men,
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almost all were gay or bisexual. And here's what she found.
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In some cases, people got these very general viral symptoms
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like fever, fatigue, headaches.
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But then there was this big thing, she kept saying.
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What was the most common symptom?
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So the majority of people presented with genital skin lesions.
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It could be, you know, in the bottom. It could
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be on the penis.
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Around 70% of the people in Chloe's study had lesions
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around their anus or genitals, but they could be found
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in lots of places, on their face, legs or hands.
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And some of them are very, very tiny, single lesions,
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and that makes it difficult because it can look like
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many things. But in the majority of cases, they look
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like blisters, similar to chickenpox, and then they become sort
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of pussy, and then they scab over. That's the normal
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way in which the lesions look.
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Chloe says that in past outbreaks of monkeypox, people often
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reported hundreds, sometimes thousands of lesions all over their body.
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But that doesn't seem to be happening here.
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About two-thirds of the people in Chloe's study had less
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than 10 lesions. But these lesions, they can be super painful,
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particularly when they're in people's butts or mouths. In Chloe's study,
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around 100 people, or 20%, went to the emergency department.
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Well, it's excruciating.
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They're describing excruciating agony like they've never experienced in their lives.
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What causes that pain, that, like, incredible pain?
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Okay, so it's like a deep sore or multiple deep sores.
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So I'm trying to think of– so you know if
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you get a cold sore?
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Yes.
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So if you can imagine multiple painful sores like that
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inside the mouth, you know, which are swollen and open
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and sort of pussy and, you know, that right going
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down the back of your throat so that, you know,
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all of the surrounding tissue is really red and inflamed
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and painful. You know, imagine it like a terrible sore
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throat that's so bad that you can't swallow.
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But monkeypox wasn't this terrible for everyone.
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On the other side of the spectrum, sometimes people presenting
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with such minor findings, just single lesions, very, very minor,
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tiny little lesions. We had, you know, in 10% of people,
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just a single spot that you wouldn't even notice.
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Like in Chloe's study, about one in 10 people only
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had a single lesion. And out of more than 20,000
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people in this outbreak so far, only a handful have died.
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Our next question is how is this thing spreading? There's
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some talk out there that monkeypox has gone airborne. And
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we do know that it can spread through our saliva.
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So could it be floating around in the air, coming
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out when we talk to each other? Well, a preprint
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study that got a bit of buzz tested the air
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in the hospital rooms of 15 monkeypox patients in the UK.
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And it found that in five of them, virus samples
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were in the air. And I know we're getting a
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bit of deja vu here from the early days of COVID,
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but If this was as contagious as COVID, we'd know
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by now.
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Think about it.
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Some of those thousands of infected people would have spread
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it to their parents, co-workers. Many were travelling when they
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got this. They would have given it to hotel workers
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and other tourists. But we're not really seeing that. And
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what about surfaces? Well, we know from lab studies that
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monkeypox can be a sturdy bastard. Viruses like it can
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survive on surfaces for a while, in some cases, maybe
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even months. And in the UK a few years ago,
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scientists think that a healthcare worker got monkeypox from handling
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infected bed linen. That all sounds pretty bad. So I
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asked Chloe about it. How do we think about that?
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Because on one hand, the fact that it can survive
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on bed sheets, clothes.
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When you tell people, oh, it could survive.
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On surfaces, then everyone's like, it could be everywhere.
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Yeah, and that's right.
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There's a fear of that, theoretically, but that would be
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very unlucky, you know, in terms of spread to people
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who weren't having sexual contact.
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It was vanishingly rare in our trial. Almost nobody got
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it that way.
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Right.
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In Chloe's study of hundreds of people, they think that
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the vast majority of them didn't get this through surfaces
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or just talking to someone.
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There was a much clearer explanation.
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Chloe reckons that 95% of the people in her study
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probably got monkeypox through close sexual contact.
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95%.
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I think if we think about how it's transmitted, it's
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transmitted from contact.
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It's skin-to-skin contact. with a lesion. The lesions are very,
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very infectious.
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The virus is in those lesions, so when they break open,
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the virus can get into someone else's body, say, through
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broken skin or fleshy, moist bits, like a mouth or
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a butt. But it's not just the lesions that might
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be able to spread this when we have sex. Something
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else might be going on here. Chloe's team tested 32
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samples of semen and found DNA from the monkeypox virus
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in 29 of them.
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Now, that doesn't mean that it is transmitting that way
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because we don't know that the virus is infectious and
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can transmit from semen. But based on other viruses like Zika,
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once you find it in the semen, it's quite likely
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that it can transmit. And indeed, what we're finding is
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we're finding lesions which appear to be at the site
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of inoculation, like where the virus is actually entering the body.
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For example, if someone ejaculated right into the back of
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your throat.
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Chloe says it's too early to know for sure if
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this is being spread through semen. But big picture, what
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does all of this tell us? Well, while it's possible
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to get infected through surfaces like sharing bed linen or
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even someone's clothes... and maybe even talking really closely to someone.
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And we do think that three people in Chloe's study
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and a couple of kids in the US got this
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through household transmission.
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Generally speaking, though.
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Unless you're having sexual activity, you are at very, very,
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very low risk.
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Still, though, out of an abundance of caution, if you've
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got monkeypox, the CDC recommends isolating and avoiding all personal
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close contact until the symptoms have fully cleared up.
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Which could be several weeks. Okay, next up.
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If you are infected, when do you start to get
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contagious and when do you stop? Well, Chloe has started
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piecing together an answer for this because for around two
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dozen people in her study, they were able to basically
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pinpoint when they got it and who they got it from.
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Because there was an absolute description of I went to
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a party, I had sex with three people. After that,
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I had no sex with anybody. Five days later, I
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noticed X. And then I took a photo of it
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and then I showed it to the doctor. And then
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the next day I experienced this and the next day
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I experienced this and the next day I experienced this.
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And we have some doctors who actually was able to
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send serial photographs and they took samples, PCR samples from
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the lesions on day one, day three, day five, whatever.
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So it was quite clear what the evolution was.
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So with this level of detail, they saw that the
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average time between getting infected and showing symptoms was about
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seven days. But it was pretty variable, like the shortest
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time was just three days and the longest was almost
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three weeks. And based on the evidence that we have now,
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Chloe doesn't think that you're infectious before you've got symptoms.
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As far as we know, it becomes infectious at the
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time of the first lesion.
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And that's different from COVID.
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The bad news is that because some people just have
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mild symptoms, say only a few lesions.
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That means that if people have got very few symptoms,
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they're able to pass it on because they don't know
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they're unwell and there's no reason to just stop behaving
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as normal.
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Right.
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And then, curiously, in your study, there was this time
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lag between the first lesion to getting more.
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which surprised me it was.
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On average five days because you really might miss one
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little bump.
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What's happening there? Why is there that time lag?
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It's possibly the inoculum, the place where the virus goes
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in and then it sort of spreads inside the lymph
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nodes and then you get subsequent lesions.
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Oh, so once it hits, so say it starts whatever
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on your arm, once it gets to the lymph nodes,
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that's really... When it starts hitting the rest of your body, okay.
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Once you start getting lesions, you are infectious. When do
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you stop being infectious?
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Once the scabs have fallen off.
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Is it certain that people aren't infectious after the scabs
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fall off?
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That's what we currently think.
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To the best of my current knowledge and my understanding,
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once the lesions fall off, you're no longer infectious.
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That's what we currently know. Right.
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And then what if in the semen, do we know
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when it stops being in the semen?
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Yeah, that's really difficult.
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We don't know how long it lasts in semen and
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we don't know if it's infectious in semen.
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So if you've been infected, when can you start having
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sex again?
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Once all of the lesions have fallen off.
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And if you, you know, at this point in terms
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of the semen, I would suggest people use condoms for
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a while, at least 12 weeks.
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Yeah, that's 12 weeks after the lesions fall off. This
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number doesn't really come from cold, hard data, but It's
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what the World Health Organization is recommending right now.
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And a big question that's.
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Been popping up is who's most at risk of getting
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a really serious case here? At first, Chloe was really
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worried about her patients with HIV, but she actually found
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that in her study for the men with HIV who
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were taking medication and had their condition under control, they
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ended up doing just as well as the men who
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didn't have HIV. But if you do have HIV and
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it's not well controlled, getting monkeypox could be really bad.
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There are other groups that doctors are concerned about too,
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like other people who are immunocompromised, children and pregnant people.
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For pregnancy, it's thought that monkeypox can cross the placenta
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and infect a growing fetus. And in the past, pregnant
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people who have gotten monkeypox have sometimes lost their babies.
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So experts are watching this super closely. But the thing
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to keep in mind is that a lot of the
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data that we have on this comes from a different
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version of monkeypox to the one that's now spreading around
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the US and Europe. And we know just generally that
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that version is nastier than the one we've got. So
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bottom line here at Science Versus, we think it's just
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too early to know how dangerous this outbreak is going
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to be. We do know that one pregnant woman in
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the US did get infected and had a healthy baby.
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Two kids in the US that got this about a
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week ago were treated and are doing well. We just
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heard about two more kids that have been infected. We
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don't yet know how they're going. So here's where we're at.
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This virus is spreading, mainly through sexual contact right now,
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and mostly among gay and bisexual men.
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But it may not stay that way. Because, you know,
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a lot of us have sex.
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And Chloe says that this could very possibly start spreading
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fast in straight people.
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For example, if it enters into the commercial sex worker population,
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that is quite an active heterosexual network. If it enters
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into sort of swinger groups, you know, people, heterosexual groups
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that are having multiple sexual partners, it could spread through
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those groups as well.
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It's a disease of humans. It's not a disease of Africans.
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It's not a disease of gay people.
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It's a disease that's spreading within the gay community at
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the moment. And if you get some strange lesion, bear
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in mind that there's a global pandemic of monkeypox.
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00:18:46.490 --> 00:18:51.930
After the break, this virus is mutating. Should we be worried?
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00:19:02.170 --> 00:19:04.690
Hey, it's Wendy from Science Versus, and I want to
342
00:19:04.730 --> 00:19:08.059
tell you about a podcast that I love, Science Friday.
343
00:19:08.230 --> 00:19:10.779
They cover all sorts of amazing things in the weird
344
00:19:10.819 --> 00:19:14.859
and wonderful world of science, from how concussions affect our
345
00:19:14.900 --> 00:19:17.960
brain to the inner secrets of a snake with a
346
00:19:18.059 --> 00:19:19.480
spider on its tail.
347
00:19:19.579 --> 00:19:21.890
It's a lot of news that you can use and
348
00:19:21.910 --> 00:19:23.970
some that you can't, but you're going to love anyway.
349
00:19:24.210 --> 00:19:27.349
It's hosted by Ira Flatto and it Flora Lichtman.
350
00:19:27.509 --> 00:19:30.230
Who is an old friend of the show and loves
351
00:19:30.309 --> 00:19:31.730
a pun as much as we do.
352
00:19:31.750 --> 00:19:35.559
Science Friday is on every day wherever you get your podcasts.
353
00:19:42.900 --> 00:19:43.369
Welcome back.
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00:19:43.980 --> 00:19:48.009
Today we're looking at this big monkeypox outbreak. Our next
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00:19:48.069 --> 00:19:52.690
question is why is is this happening now? Because as
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we mentioned, this virus has been around for a long time,
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mostly popping up in Central and Western Africa. And yet,
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we've never seen an outbreak like this. So to find
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00:20:04.000 --> 00:20:06.559
out what's going on, we called up a guy who
360
00:20:06.599 --> 00:20:11.700
knows this virus super well. So meet Yan Xiang. a
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00:20:11.740 --> 00:20:15.460
microbiology professor at UT Health San Antonio. And he's been
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studying pox viruses for over 20 years. He says of
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00:20:19.920 --> 00:20:23.450
all the viruses, monkeypox is actually his favorite.
364
00:20:24.829 --> 00:20:26.890
Why is it your favorite virus?
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00:20:27.529 --> 00:20:32.069
Everything I know about immunology, I learned from study viruses.
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So that's why it's my favorite virus.
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And all we want to talk about is how they
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scare the crap out of us.
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That's right.
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00:20:40.880 --> 00:20:41.420
That's right.
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Yan's been studying monkeypox for so long that he remembers
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the first time it hit the US.
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It was in 2003. Oh, yeah, that's a.
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00:20:53.890 --> 00:20:57.740
Very interesting story, actually. At that time, there was an
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importation of African rodent as exotic animals, including Gambian giant rat.
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The Gambian pouched rat.
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00:21:10.240 --> 00:21:10.539
Yeah.
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Oh, my gosh, it's huge.
379
00:21:12.390 --> 00:21:13.009
Yeah.
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00:21:13.069 --> 00:21:14.349
It is a giant rat.
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Giant rats, yes.
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00:21:15.750 --> 00:21:17.470
It's, like, bigger than someone's head.
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Yeah, yeah.
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So these mammoth rats that got imported into the US, well,
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some of them had monkey pox.
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00:21:25.539 --> 00:21:27.539
The rats were put into an exotic.
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Pet facility near some prairie dogs, which got infected too.
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00:21:31.279 --> 00:21:33.599
The prairie dogs were then sold to some families in
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00:21:33.619 --> 00:21:34.940
the Midwest as pets.
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And here's where the infections happened.
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00:21:38.180 --> 00:21:43.000
So those kids actually got infected with monkeypox. Oh.
392
00:21:43.160 --> 00:21:43.640
Yeah.
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Did it spread to school friends or anything?
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00:21:46.869 --> 00:21:51.049
There are no sustained human-to-human transmission in that case.
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00:21:51.910 --> 00:21:54.910
The virus didn't really spread from person to person.
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00:21:55.670 --> 00:21:58.880
Basically, everyone who got sick from that outbreak got it
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00:21:58.930 --> 00:22:03.740
directly from their infected prairie dog. And this is generally
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how monkeypox has been acting in Africa too. So when
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00:22:07.519 --> 00:22:10.880
Jan started hearing about all these people getting monkeypox that
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00:22:11.019 --> 00:22:13.819
hadn't travelled to Africa, he was like.
401
00:22:14.839 --> 00:22:20.390
That is really strange. And it looks like there's a
402
00:22:20.460 --> 00:22:24.589
sustained human-to-human transmission. That is also unusual.
403
00:22:25.289 --> 00:22:28.910
So what's changed? Why is it spreading all over?
404
00:22:30.450 --> 00:22:32.789
There's a lot of talk online that this virus has
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00:22:32.849 --> 00:22:36.630
mutated recently and that we're dealing with a radically new
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00:22:36.710 --> 00:22:41.640
form of monkeypox. And there is some science that backs
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00:22:41.660 --> 00:22:47.740
this up. This virus has been mutating a lot more
408
00:22:47.819 --> 00:22:51.579
in recent years. In one study from Nigeria, they found
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00:22:51.660 --> 00:22:54.890
that over the last five years, the mutation rate is
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00:22:54.890 --> 00:22:57.910
10 times higher than what we'd normally expect for a
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00:22:58.029 --> 00:23:03.170
monkeypox virus. And researchers have genetically analysed the virus that
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00:23:03.250 --> 00:23:06.150
is swimming around the US and Europe right now.
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And Jan has seen that there are some changes that
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00:23:11.009 --> 00:23:12.069
could be concerning.
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00:23:13.130 --> 00:23:17.029
Like, we know that if pox viruses lose certain genes,
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00:23:17.450 --> 00:23:21.279
they can become more dangerous. And with this monkeypox that's
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00:23:21.299 --> 00:23:22.640
been circulating right now.
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We have started to see some gene loss in the
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00:23:27.640 --> 00:23:31.799
new variant. But our current understanding of the pox virus
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00:23:31.859 --> 00:23:36.630
biology will not allow us to predict what kind of
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00:23:36.769 --> 00:23:41.670
gene loss in monkeypox can lead to a more dangerous virus.
422
00:23:41.849 --> 00:23:42.410
We don't know.
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00:23:46.819 --> 00:23:49.240
Yan says it's way too early to know whether these
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mutations are a real problem. From what he's seen, though,
425
00:23:53.539 --> 00:23:56.700
he doesn't think they're responsible for this new global outbreak.
426
00:23:58.299 --> 00:24:05.160
I'm not totally convinced. There are mutations, but we don't
427
00:24:05.240 --> 00:24:07.130
know the meaning of those mutations.
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00:24:07.970 --> 00:24:11.910
Plus, Jan says that there's a simpler explanation for why
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00:24:11.970 --> 00:24:12.950
this is happening now.
430
00:24:13.890 --> 00:24:14.890
It's a one-two punch.
431
00:24:15.910 --> 00:24:19.160
The first is that monkeypox is close cousins with the
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00:24:19.279 --> 00:24:20.500
smallpox virus.
433
00:24:21.140 --> 00:24:25.160
Yes, that smallpox virus that killed millions of people.
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00:24:26.440 --> 00:24:27.940
Well, the thing is, a ton of us used to
435
00:24:27.980 --> 00:24:32.819
have immunity against smallpox because we vaccinated against it. After
436
00:24:32.859 --> 00:24:38.390
we eradicated smallpox, though, around 1980, we basically stopped doing this,
437
00:24:39.109 --> 00:24:39.529
which means.
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00:24:40.470 --> 00:24:43.710
And new generation of people, they don't have the vaccine.
439
00:24:43.789 --> 00:24:47.170
They never received the vaccine for smallpox. So they don't
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00:24:47.210 --> 00:24:51.539
have the immunity against those virus. You know, we thought
441
00:24:51.599 --> 00:24:55.420
pox virus is all under control. You know, we got
442
00:24:55.500 --> 00:25:00.240
rid of the smallpox. But then suddenly, you know, monkeypox
443
00:25:00.359 --> 00:25:01.039
kind of emerged.
444
00:25:02.200 --> 00:25:03.460
Okay, so that's the first thing.
445
00:25:03.980 --> 00:25:08.299
Waning immunity to smallpox, which we think also means waning
446
00:25:08.359 --> 00:25:15.690
immunity to monkeypox. Second punch, super spreader events. So people
447
00:25:15.750 --> 00:25:18.130
have started traveling and partying again.
448
00:25:18.150 --> 00:25:19.230
And Dr.
449
00:25:19.250 --> 00:25:23.970
Carlton Thomas said that as monkeypox cases were just ticking up,
450
00:25:24.759 --> 00:25:27.680
there were a bunch of big parties where this thing
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00:25:27.700 --> 00:25:28.960
could have easily spread.
452
00:25:28.980 --> 00:25:34.289
There was a fetish festival in Belgium called Dark Lands.
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00:25:34.819 --> 00:25:36.759
which is a leather and fetish festival where a lot
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00:25:36.779 --> 00:25:41.380
of gay and bi men go. They reported on May
455
00:25:41.819 --> 00:25:46.569
20th that there were three positive cases of monkeypox from Darklands, Belgium.
456
00:25:47.269 --> 00:25:49.809
The same people that go to this fetish festival in
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00:25:49.849 --> 00:25:54.549
Belgium go to a similar fetish festival at the end
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00:25:54.589 --> 00:25:58.769
of May in Chicago, Illinois called International Mr. Leather. I
459
00:25:59.829 --> 00:26:04.660
am a very sex positive person, but this really concerned me.
460
00:26:05.369 --> 00:26:07.890
After the festivals in May, there were a bunch of
461
00:26:08.009 --> 00:26:10.329
pride celebrations where folks got together.
462
00:26:10.349 --> 00:26:15.900
I said, oh, oh, you know, this is this has
463
00:26:15.960 --> 00:26:18.500
a potential to explode. And lo and behold, it has.
464
00:26:19.099 --> 00:26:22.599
So here's what scientists think happened. A few people got
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00:26:22.660 --> 00:26:26.049
monkey pox in a country where this is endemic. And
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00:26:26.069 --> 00:26:28.630
then they either went to one of these parties or
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00:26:28.710 --> 00:26:30.670
passed it to someone else who went to one of
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00:26:30.710 --> 00:26:36.059
those parties. There was some canoodling and bam. And the
469
00:26:36.079 --> 00:26:39.319
fact that this is spreading through sexual contact, it actually
470
00:26:39.420 --> 00:26:43.410
isn't that surprising. Because we already knew that lesions were
471
00:26:43.549 --> 00:26:47.069
turning up on genitals. Doctors in Nigeria had seen this
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00:26:47.170 --> 00:26:50.130
for years. It's something that we talked about with Jan.
473
00:26:51.109 --> 00:26:56.170
Oh, yeah, yeah. No, it has been published. They have described,
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00:26:56.190 --> 00:26:59.059
you know, lesion around genital areas.
475
00:26:59.299 --> 00:27:00.430
Before this outbreak?
476
00:27:00.490 --> 00:27:02.200
Yeah, before this outbreak.
477
00:27:03.000 --> 00:27:08.710
Okay, our final question. What can we do about it? Well,
478
00:27:09.089 --> 00:27:12.410
if you're infected, for most people, this will clear up
479
00:27:12.470 --> 00:27:15.299
on its own. The CDC told us that it's looking
480
00:27:15.339 --> 00:27:18.519
like the lesions take about two or three weeks to heal.
481
00:27:19.119 --> 00:27:22.500
And in Chloe's study, 95% of the people didn't get
482
00:27:22.599 --> 00:27:26.799
anything other than pain meds. There is an antiviral, though,
483
00:27:27.019 --> 00:27:30.900
that was made for smallpox. It's called tecovirimat or TPOX.
484
00:27:31.599 --> 00:27:34.329
Eight people in Chloe's study got it and ended up
485
00:27:34.349 --> 00:27:34.789
doing well.
486
00:27:35.740 --> 00:27:36.180
Here's Chloe.
487
00:27:37.279 --> 00:27:38.779
It's hard to know whether it would have turned the
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00:27:38.819 --> 00:27:42.930
corner anyway. But clinicians are saying that they think it's
489
00:27:42.970 --> 00:27:44.029
reducing the severity.
490
00:27:45.730 --> 00:27:47.069
So that's important.
491
00:27:47.230 --> 00:27:50.049
But it's been quite difficult to actually get these released
492
00:27:50.190 --> 00:27:50.890
to treat people.
493
00:27:51.089 --> 00:27:54.740
Yes, a doctor told me yesterday that in the US,
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00:27:54.880 --> 00:27:57.839
if you need TPOX, they have to call the CDC.
495
00:27:58.039 --> 00:27:59.900
It's not just at your local pharmacy.
496
00:28:00.140 --> 00:28:01.039
Yeah, that's right.
497
00:28:02.299 --> 00:28:04.480
We're hearing from the CDC that it's about to get
498
00:28:04.700 --> 00:28:08.609
easier to access. And something that people are worried about
499
00:28:09.210 --> 00:28:12.170
is that the monkeypox lesions could leave their mark for
500
00:28:12.190 --> 00:28:16.220
a long time. When people get lesions on their face,
501
00:28:16.519 --> 00:28:18.440
a big concern is scarring.
502
00:28:18.990 --> 00:28:20.869
How often does scarring happen?
503
00:28:20.890 --> 00:28:24.130
I think the scarring can happen, but what we are
504
00:28:24.170 --> 00:28:26.289
seeing is that the lesions scab over and then when
505
00:28:26.309 --> 00:28:29.089
the scabs fall off, you can often get a scar
506
00:28:29.130 --> 00:28:31.440
for a period of time, but that tends to resolve
507
00:28:31.500 --> 00:28:34.200
like chickenpox. I can't guarantee it will be in every
508
00:28:34.240 --> 00:28:36.380
single person, but in general, that's what we would expect.
509
00:28:36.599 --> 00:28:39.380
Is there something people should do to try to avoid scarring?
510
00:28:39.400 --> 00:28:42.380
I mean, you shouldn't go and sunbathe when you've got
511
00:28:42.440 --> 00:28:44.849
scars because then they can make it worse.
512
00:28:46.500 --> 00:28:49.759
And the fact that monkeypox can be so awful has
513
00:28:49.819 --> 00:28:52.799
made folks desperate for anything that might help stop it.
514
00:28:53.539 --> 00:28:55.089
In particular, vaccines.
515
00:28:56.230 --> 00:29:00.650
Now, unlike when COVID broke out, we actually have vaccines.
516
00:29:01.309 --> 00:29:04.769
These jabs weren't meant to protect us from monkeypox. They
517
00:29:04.809 --> 00:29:08.460
were made for smallpox. The government started developing them after
518
00:29:08.519 --> 00:29:12.200
September 11 in case terrorists used smallpox in an attack.
519
00:29:13.210 --> 00:29:16.089
And it seems that they can help us against monkeypox.
520
00:29:16.809 --> 00:29:19.859
One study found that those who were vaccinated against smallpox
521
00:29:20.299 --> 00:29:23.599
were five times less likely to get monkeypox than those
522
00:29:23.640 --> 00:29:27.720
who weren't. But these vaccines that we've got, they are
523
00:29:27.799 --> 00:29:32.880
not a chastity belt against monkeypox. In fact, we don't
524
00:29:32.970 --> 00:29:37.329
even know how well they work. I talked to Carlton
525
00:29:37.369 --> 00:29:40.700
about this. He's the doctor who's been talking all about
526
00:29:40.759 --> 00:29:42.200
monkeypox on social media.
527
00:29:43.039 --> 00:29:46.539
Now what remains to be seen is, is it going
528
00:29:46.559 --> 00:29:48.839
to be effective? This is one of the first times
529
00:29:48.859 --> 00:29:53.569
we've ever preventatively vaccinated a group of people for monkeypox.
530
00:29:54.869 --> 00:29:57.049
So is it going to work? And when are the
531
00:29:57.130 --> 00:30:00.740
antibody levels enough after that one shot to say, okay,
532
00:30:00.759 --> 00:30:02.220
go have sex again and do your thing.
533
00:30:02.900 --> 00:30:05.859
A number that's being quoted over and over again is
534
00:30:05.880 --> 00:30:10.079
that the vaccines are 85% effective. But that actually comes
535
00:30:10.119 --> 00:30:13.059
from a study that wasn't even using the vaccines that
536
00:30:13.079 --> 00:30:17.660
we have now, just a similar one. So the vaccine
537
00:30:17.759 --> 00:30:21.009
that people are mainly getting now is called Jinius, and
538
00:30:21.089 --> 00:30:24.890
it's a weakened version of a virus that's related to monkeypox.
539
00:30:25.230 --> 00:30:27.630
It's kind of been hacked away so it doesn't replicate
540
00:30:27.670 --> 00:30:31.450
in your body. Now, we actually don't have results from
541
00:30:31.549 --> 00:30:35.170
big clinical trials where it's been tested against monkeypox, the
542
00:30:35.210 --> 00:30:39.200
kind of thing that we had for our COVID vaccines. Instead,
543
00:30:39.599 --> 00:30:42.440
scientists reckon that this is going to help here because
544
00:30:42.480 --> 00:30:45.160
they've looked at this vaccine in the lab, doing stuff
545
00:30:45.200 --> 00:30:49.039
like trying it on animals or measuring people's antibodies after
546
00:30:49.059 --> 00:30:54.029
they get the jab. And they've also been tested for safety. Now,
547
00:30:54.069 --> 00:30:56.809
the other thing to note here is that Jinius normally
548
00:30:56.849 --> 00:31:00.470
needs two doses. But for now, lots of places are
549
00:31:00.569 --> 00:31:03.769
only doing one for the simple reason that there's just
550
00:31:03.809 --> 00:31:08.049
not enough to go around. Even with all of these caveats, though,
551
00:31:08.069 --> 00:31:11.769
it does seem like the vaccines can help you if
552
00:31:12.269 --> 00:31:15.769
you're at risk. In fact, even if you've been exposed
553
00:31:15.809 --> 00:31:18.910
to monkeypox, we think the shot can help soon after.
554
00:31:20.579 --> 00:31:25.240
The only problem now is getting one. What is it
555
00:31:25.279 --> 00:31:28.579
like to get a vaccine right now in America?
556
00:31:30.190 --> 00:31:34.029
It's like getting a gold circle Beyonce ticket. Oh, wow.
557
00:31:34.890 --> 00:31:36.809
I mean, I don't know exactly what that means, but
558
00:31:36.849 --> 00:31:38.750
it sounds hard.
559
00:31:39.329 --> 00:31:42.859
It's really, really hard. So it's like winning the lottery.
560
00:31:44.099 --> 00:31:47.779
Rollout of this vaccine has been super frustrating. The U.S.
561
00:31:47.880 --> 00:31:50.579
Used to have millions of it in its national stockpile,
562
00:31:51.259 --> 00:31:54.160
but they expired, which meant that at the start of
563
00:31:54.200 --> 00:31:59.349
this monkeypox outbreak, there were only some 2,400 doses on
564
00:31:59.470 --> 00:32:05.269
US soil. By July 27th, they'd shipped out just over 300,000 doses,
565
00:32:05.670 --> 00:32:09.069
which is not meant for everyone in the US. For example,
566
00:32:09.170 --> 00:32:12.470
they're focusing on people who think they've been exposed or
567
00:32:12.509 --> 00:32:15.890
those who are having sex with multiple partners. The government
568
00:32:15.930 --> 00:32:19.450
says that it's got a lot more coming. But for now,
569
00:32:20.230 --> 00:32:24.339
it's been very difficult to get these vaccines. When Carlton
570
00:32:24.380 --> 00:32:27.420
heard about one becoming available in his area in San Diego,
571
00:32:27.880 --> 00:32:28.599
he jumped on it.
572
00:32:29.359 --> 00:32:32.299
I texted my husband. I texted all my friends. I
573
00:32:32.339 --> 00:32:34.240
put it up on social media all at the same
574
00:32:34.279 --> 00:32:37.660
time to just try to get it out there. And
575
00:32:38.079 --> 00:32:41.700
I was on hold for two hours. And I finally
576
00:32:42.200 --> 00:32:43.359
got through and got an appointment.
577
00:32:43.839 --> 00:32:45.160
So you got vaccinated?
578
00:32:45.180 --> 00:32:48.880
Yeah. Yeah, I got vaccinated. Yeah, I got vaccinated in
579
00:32:48.900 --> 00:32:50.119
my tricep right here.
580
00:32:50.569 --> 00:32:53.750
Since we think these vaccines are going to work, but
581
00:32:53.789 --> 00:32:58.690
don't know exactly how well. Carlton is being careful right now.
582
00:32:59.789 --> 00:33:02.619
At the moment, he's in Greece for his 50th birthday.
583
00:33:03.279 --> 00:33:06.339
Well, I went to a gay nude beach today in Mykonos,
584
00:33:06.400 --> 00:33:09.740
surrounded by the most beautiful men in the world. And
585
00:33:09.759 --> 00:33:14.259
I just smiled and looked. Didn't touch a soul. Didn't
586
00:33:14.299 --> 00:33:18.430
come close to anybody. And it's just not worth it.
587
00:33:19.609 --> 00:33:22.450
Because I'm telling people, hey, don't do this, don't do that.
588
00:33:22.529 --> 00:33:25.230
So while I'm in Mykonos, I'm in my room on
589
00:33:25.269 --> 00:33:26.950
Friday night at 845 right now.
590
00:33:27.069 --> 00:33:28.329
And you're talking to me.
591
00:33:28.349 --> 00:33:31.859
Talking to you rather than going out and partying because
592
00:33:31.990 --> 00:33:34.960
it's honestly not worth it. It's not worth the risk
593
00:33:35.019 --> 00:33:39.220
for me. Mykonos will always be here. But right now
594
00:33:39.339 --> 00:33:41.940
I need to focus on setting an example and keeping
595
00:33:41.980 --> 00:33:44.990
myself and my family protected. So that's what I'm doing.
596
00:33:45.720 --> 00:33:48.319
And by the way, if you got a smallpox vaccination
597
00:33:48.500 --> 00:33:52.420
decades ago, while you are not totally protected from getting this,
598
00:33:52.980 --> 00:33:59.390
it might help you. But chickenpox is a totally different virus.
599
00:33:59.529 --> 00:34:03.410
Don't be fooled by the word pox. As Carlton and
600
00:34:03.529 --> 00:34:06.170
I were finishing up our chat, we got to talking
601
00:34:06.269 --> 00:34:10.210
about how people often put these morals on top of viruses.
602
00:34:11.329 --> 00:34:13.269
This happened through the HIV AIDS epidemic.
603
00:34:13.980 --> 00:34:17.179
A lot of gay men just experienced a ton of stigma.
604
00:34:18.440 --> 00:34:21.239
And for some of the people that Carlton is talking
605
00:34:21.260 --> 00:34:24.480
to right now, well, they just feel like we're right
606
00:34:24.519 --> 00:34:25.059
back there.
607
00:34:26.500 --> 00:34:32.039
There's a whole stigmatization and shame, a lot of shaming
608
00:34:33.940 --> 00:34:36.519
coming at these people for having monkeypox because they're being
609
00:34:36.559 --> 00:34:41.019
labeled as a whore that deserved it. And nobody deserves monkeypox.
610
00:34:42.239 --> 00:34:42.400
Mm-mm.
611
00:34:43.030 --> 00:34:48.150
It's just a virus. It's just an infection. Viruses and
612
00:34:48.170 --> 00:34:51.139
infections are not meant to punish people. They just happen.
613
00:34:52.199 --> 00:34:53.989
I mean, I was doing some of the same things
614
00:34:54.050 --> 00:34:56.940
that the people that got monkeypox were doing when they
615
00:34:56.980 --> 00:34:59.380
got monkeypox. I just happened to be a couple of
616
00:34:59.420 --> 00:35:01.920
weeks behind them. And then I realized what was happening
617
00:35:01.940 --> 00:35:02.639
and I stopped.
618
00:35:03.760 --> 00:35:05.059
They're just having sex.
619
00:35:06.079 --> 00:35:12.300
They're just having sex. Sex is natural and normal and healthy. Yes.
620
00:35:12.420 --> 00:35:15.699
And you don't deserve to be punished for that in
621
00:35:16.219 --> 00:35:16.659
any way.
622
00:35:16.679 --> 00:35:18.230
Okay.
623
00:35:18.969 --> 00:35:22.730
So here's where we're at with this monkeypox outbreak. These
624
00:35:22.809 --> 00:35:25.889
early cases caught us off guard and left a lot
625
00:35:25.909 --> 00:35:29.090
of people worried about how to stay safe. Right now,
626
00:35:29.260 --> 00:35:32.800
the science is suggesting that this can be serious and painful.
627
00:35:33.619 --> 00:35:35.909
But for a lot of cases... They will clear up
628
00:35:35.989 --> 00:35:36.510
on their own.
629
00:35:36.530 --> 00:35:39.389
And it sounds like the tools that we have to
630
00:35:39.449 --> 00:35:41.809
fight this, teapots, are vaccines.
631
00:35:42.690 --> 00:35:44.170
They should be easier to get soon.
632
00:35:45.780 --> 00:35:48.260
Tomorrow, we're going to release an interview with Dr Anthony
633
00:35:48.320 --> 00:35:52.639
Fauci about what went wrong here, why it felt like
634
00:35:52.659 --> 00:35:55.840
the response was so slow, and where he thinks this
635
00:35:55.920 --> 00:35:57.039
outbreak is going next.
636
00:35:58.420 --> 00:36:02.599
That's Science Versus. Your call has been forwarded to an
637
00:36:02.739 --> 00:36:04.340
automatic voice message system.
638
00:36:04.940 --> 00:36:07.079
At the tone, please record your message.
639
00:36:08.380 --> 00:36:08.860
Hey, Meryl.
640
00:36:09.039 --> 00:36:10.500
I called you about the citations.
641
00:36:11.820 --> 00:36:12.090
Okay.
642
00:36:12.570 --> 00:36:12.860
Thanks.
643
00:36:16.269 --> 00:36:16.630
Hello?
644
00:36:17.050 --> 00:36:19.690
Hi, Meryl Hawn, producer at Science Versus.
645
00:36:20.449 --> 00:36:21.050
Hi, Wendy.
646
00:36:21.889 --> 00:36:25.909
I just left a message about the citations.
647
00:36:27.340 --> 00:36:28.670
I know, it didn't ring.
648
00:36:28.889 --> 00:36:29.730
I don't know what happened.
649
00:36:29.750 --> 00:36:33.429
Oh no, did I leave a message about citations on
650
00:36:33.630 --> 00:36:35.530
someone else's voicemail?
651
00:36:36.570 --> 00:36:37.289
I think so.
652
00:36:37.309 --> 00:36:38.610
Oh well.
653
00:36:38.630 --> 00:36:40.650
So how many citations are there, Meryl? Oh, well, there
654
00:36:40.690 --> 00:36:41.429
are 147 citations.
655
00:36:41.429 --> 00:36:41.570
147.
656
00:36:41.570 --> 00:36:42.769
And if people want.
657
00:36:42.429 --> 00:36:45.230
To find them, where should they go?
658
00:36:55.880 --> 00:36:58.019
They can look at our show notes and then follow
659
00:36:58.079 --> 00:36:58.699
the links.
660
00:36:58.500 --> 00:36:59.360
To the transcript.
661
00:37:00.159 --> 00:37:04.960
Excellent. Thank you. I think that's all.
662
00:37:05.219 --> 00:37:05.440
Yeah.
663
00:37:06.360 --> 00:37:06.940
All right.
664
00:37:07.300 --> 00:37:07.679
Great.
665
00:37:07.900 --> 00:37:08.920
Thanks so much, Meryl.
666
00:37:09.219 --> 00:37:09.500
Thanks.
667
00:37:09.880 --> 00:37:10.420
Bye, Wendy.
668
00:37:10.559 --> 00:37:10.800
Bye.
669
00:37:11.920 --> 00:37:14.079
If you want to hear more about monkey parks, then
670
00:37:14.119 --> 00:37:17.599
we really, really recommend this podcast called A Bumpy Ride.
671
00:37:18.139 --> 00:37:22.219
It's by Leo Herrera, and it's just really beautiful. So
672
00:37:22.619 --> 00:37:31.650
check it out, A Bumpy Ride. This episode was produced
673
00:37:31.690 --> 00:37:35.050
by me, Wendy Zuckerman, Michelle Dang, Meryl Horne, Courtney Gilbert,
674
00:37:35.210 --> 00:37:38.929
Rose Rimler, Nick Delrose and Disha Bhagat. Additional help from
675
00:37:38.949 --> 00:37:43.550
McKeddy Foster-Keys. We're edited by Blythe Terrell. Fact-checking by Erica
676
00:37:43.570 --> 00:37:47.199
Akiko Howard. Mix and sound design by Sam Baer. Music
677
00:37:47.239 --> 00:37:50.739
written by Bumi Hidaka, Emma Munger, Bobby Lord, Peter Leonard
678
00:37:50.860 --> 00:37:53.719
and Sir Wiley. Thanks to the researchers we got in
679
00:37:53.739 --> 00:37:57.039
touch with for this episode. Really appreciate you jumping on
680
00:37:57.079 --> 00:37:58.659
the phone at the last minute.
681
00:37:59.340 --> 00:38:01.239
A big thanks to Dr.
682
00:38:01.500 --> 00:38:06.760
Agam Rao, Professor Asma Khalil, Professor Siddhartha Birareddy, Professor Preeti
683
00:38:06.800 --> 00:38:08.050
Malani and Dr.
684
00:38:08.070 --> 00:38:08.690
Hugh Adler.
685
00:38:09.269 --> 00:38:13.050
And a special thanks to Leroy G. Robinson Jr., Randy Teague,
686
00:38:13.389 --> 00:38:16.849
Nick Lem, the Zuckerman family and Joseph Lavelle Wilson. I'm
687
00:38:16.889 --> 00:38:17.510
Wendy Zuckerman.
688
00:38:18.190 --> 00:38:18.710
Back to you later.