Poliovirus: Still a Threat

First U.S. polio case in nearly a decade.

Henderson respirator 20th century. Credit: Wellcome Library, London, via Wikipedia Creative Commons.

Last month, an unvaccinated 20-year-old in Rockland County, New York, was diagnosed with paralytic polio. He had not traveled in the previous month; he was infected by an (unknown) individual who had travelled and acquired the infection abroad.

According to the CDC, poliovirus was also found in wastewater from Rockland and a neighboring county—coincidentally sampled in May, June, and July as part of SARS-CoV-2 surveillance—and some of the positive samples were genetically linked to virus from the patient. This reflects ongoing community transmission and ongoing risk to unvaccinated residents. Because most poliovirus infections […]

2022-08-23T08:43:27-04:00August 23rd, 2022|infectious diseases, Nursing, Public health|0 Comments
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The Monkeypox Vaccine: What Nurses Need to Know

Colorized transmission electron micrograph of monkeypox particles (red) found within an infected cell, cultured in the laboratory. Credit: NIAID. (Wikimedia Commons)

In the current monkeypox outbreak, the pandemic-strained U.S. public health system is once again faced with a major threat. This time, a vaccine is already available, but only in limited quantities. Here’s what nurses need to know. It will remain important to keep up with new developments as they occur.

The Jynneos vaccine

Jynneos is a live but nonreplicating vaccine for the prevention of both monkeypox and smallpox. It is made from vaccinia virus, a less virulent relative of these two viruses. The vaccine is given subcutaneously in two separate doses administered at least 28 days apart, and a person is considered fully vaccinated two weeks after the second dose.

The most common vaccine side effects are pain, redness, induration, swelling, or itching at the vaccination site. (People with HIV infection or atopic dermatitis do not seem to experience additional or more severe side […]

2022-08-17T06:34:29-04:00August 17th, 2022|infection control, infectious diseases, Nursing|0 Comments
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Monkeypox Update: As Knowledge Increases, More to Be Learned

Colorized transmission electron micrograph of monkeypox particles (red) found within an infected cell (blue), cultured in the laboratory. Credit: NIAID. (Wikimedia Commons)

It seems impossible that we have to confront the rapid spread of a new virus when we’re still dealing with the effects of COVID-19. But for monkeypox, we didn’t have to respond “from scratch.” After decades of research and clinical work on smallpox, a related but considerably more lethal virus, testing protocols and vaccines were already available for use in monkeypox.

Nearly 20,000 cases of monkeypox have been reported around the world since May, with more than 5,000 infections reported in the U.S. There are probably many more undiagnosed and unreported cases.

Variations in presentation.

In New York City, where more than 1,000 cases of monkeypox have been reported, clinicians are seeing variations from “classic” presentations of monkeypox. The NYC Department of Health and Mental Hygiene reports that many people with monkeypox are not experiencing prodromal symptoms […]

2022-08-01T14:17:20-04:00August 1st, 2022|infection control, infectious diseases, Nursing, Public health|0 Comments
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Monkeypox: The Basics for Nurses

In the past, cases of monkeypox only occasionally occurred outside of central and western Africa, where the disease is endemic, and it was virtually always related to travel or to the inappropriate relocation of wild animals. (In the US in 2003, 71 cases of monkeypox in six states were traced to pet prairie dogs that had been imported in the “exotic animals” trade.) What should we make of the outbreaks this year in 23 countries where the disease is rarely seen?

Current cases of monkeypox are occurring in people without a history of travel to endemic areas, and in some cases without obvious contact to known cases. Most of these people have had mild disease, though monkeypox can cause severe disease in young children, pregnant women, and immunosuppressed individuals. While monkeypox usually is not highly transmissible nor deadly, it has never spread to so many countries seemingly simultaneously.

A close relative of smallpox.

Monkeypox is a close relative of smallpox, and the smallpox vaccine also prevents monkeypox infection.  Many experts point to the end of mass smallpox vaccination campaigns as a factor in the emergence of cases at this time. Forty years ago, about 80% of the population was vaccinated against smallpox; today that figure is only about 30%. Monkeypox cases have been on the rise since smallpox was declared to be eradicated in 1980. In one monkeypox-endemic region, cases had increased twentyfold in recent decades. At the same […]

2022-06-02T10:14:45-04:00June 2nd, 2022|infectious diseases, Public health|0 Comments
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States Seek to Limit Health Officials’ Powers to Act

Since the COVID-19 pandemic began, public health measures to control the spread of the virus have provoked fierce debate. In recent months, at least 15 state legislatures have passed or are considering bills to limit the legal authority of public health agencies, according to the Network for Public Health Law, which has partnered with the National Association of County and City Health Officials to document the situation. In addition, lawmakers in at least 46 states have introduced bills to rein in the power of governors to take action in public health and other emergencies.

The anger fueling these actions stems from the perceived overreach by health officials, resulting in a backlash of legislative attempts to limit their authority. These include measures to prevent the closure of businesses or allow lawmakers to rescind mask mandates.

In addition, some state courts have limited the emergency and regulatory powers that governors used to respond to the pandemic. Demands for “individual freedom” spurred some of these state actions, though their consequences are likely to be more far reaching. […]

2021-11-18T10:25:06-05:00November 18th, 2021|infection control, infectious diseases, Nursing, Public health|0 Comments
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