Monkeypox symptoms may reduce with antiviral drugs: Study

New Delhi, May 25: Some antiviral medications may have the potential to reduce the symptoms of monkeypox. These medications also can reduce the amount of time a patient is contagious says a study of seven patients diagnosed with the rate viral disease in the United Kingdom between 2018 and 2021.

The study was published on Tuesday in the Lancet Infectious Diseases Journal. Hugh Adler of the Liverpool University Hospitals NHS Foundation Trust, UK said as public health officials are trying to understand what is causing the May 2022 monkeypox outbreaks in Europe and North America, which have affected several patients who reported neither travel nor an identified link to a previously known case our study offers some of the first insights into the use of antivirals for the treatment of monkeypox in humans.

Adler the lead author of the paper said, 'although this latest outbreak has affected more patients than we had previously encountered in the UK, historically monkeypox has not transmitted very efficiently between people, and overall the risk to public health is low.'

Out of the seven monkeypox cases analysed in the study, four were imported from West Africa with three further cases occurring due to human to human transmission.

Currently there are no licensed treatments for monkeypox and there is limited data on the duration of the contagiousness. The incubation period ranges from 5 to 21 days.

The study authors observed clinical data alongside laboratory results from blood tests and nose-and-throat swabs to describe the duration and clinical features of monkeypox in a high-income setting.
Researchers also reported patient response to antiviral medications developed to treat smallpox -- brincidofovir and tecovirimat -- which have previously demonstrated some efficacy against monkeypox in animals.

Between 2018 and 2019, four patients observed in the study were treated for monkeypox in HCID units in England. Three of these cases were imported from West Africa.

The fourth case occurred in a healthcare worker 18 days after initial exposure to the virus and was the first example of monkeypox transmission in a hospital setting outside of Africa.

The initial three patients were treated with brincidofovir seven days after the initial onset of the rash.

The study found that brincidofovir did not have any convincing clinical benefit in treating monkeypox and alterations in liver blood tests were observed.

The researchers noted that it is not known whether brincidofovir administration earlier in the course of the disease or at a different dosing schedule would have yielded different clinical outcomes.
Despite this, all three patients, plus the fourth hospital transmission patient, made a full recovery, they said.

Three further cases of monkeypox were reported in the UK in 2021 in a family travelling from Nigeria, with two of these cases being the first examples of household transmission outside of Africa.

One of the 2021 UK patients was treated with tecovirimat and experienced a shorter duration of symptoms and upper respiratory tract viral shedding than the other cases in this cluster, the researchers said.

However, they note that conclusions are unable to be drawn on antiviral effectiveness against monkeypox in such a small cohort, calling for further research into antivirals to treat this neglected tropical disease.

"During previous outbreaks of monkeypox, patients were considered infectious until all lesions crusted over," said Catherine Houlihan, of the UK Health Security Agency and University College London, one of the co-authors of the paper.

"In these seven UK cases, viral shedding was observed for at least three weeks following infection.

However, data on infectivity remains limited, and is an important area for future study," said Houlihan.

The authors acknowledge some limitations with this study, primarily its observational nature and the small number of cases analysed.

They were also unable to confirm positive monkeypox PCR test results with laboratory samples of the virus, meaning that ongoing shedding of contagious virus was unable to be verified.

(PTI)