DEAR READERS: In early May, the United States government purchased $119 million worth of Jynneos monkeypox vaccines from the Danish biotechnology company Bavarian Nordic. The news followed the first confirmed case in the U.S.
According to the Centers for Disease Control and Prevention, Jynneos is administered as two subcutaneous injections four weeks apart. People who receive Jynneos are not considered vaccinated until they receive both doses.
In recent weeks, more than 120 confirmed or suspected cases of monkeypox have been reported in over a dozen non-endemic countries, including the United Kingdom, the U.S. and Spain. According to the World Health Organization (who.int/news-room/fact-sheets/detail/monkeypox), various animal species have been identified as susceptible to the monkeypox virus. These include rope squirrels, tree squirrels, Gambian pouched rats, dormice, nonhuman primates and other species.
The U.S. reported an outbreak in 2003, when a shipment of rodents from Ghana spread the virus to pet prairie dogs in Illinois and infected more than 70 people. My concern at present is the potential for the virus to spread to indigenous wildlife here in the U.S., where some species could become reservoirs for the future infection of humans.
There are probably several sources of the current wave of monekypox infections: Infected monkeys could have been poached from the wild for "bush meat" and/or for export to biomedical and pharmaceutical laboratories for experimentation and the development of new vaccines and drugs. Some consider the possibility of a lapse in biosecurity in one of these facilities.
Whatever the source of this virus, against which the smallpox vaccine gives us some protection, these outbreaks are a clarion call to back off from wildlife exploitation. Habitat encroachment, poaching, live markets and international wildlife traffic must cease, since many animal species can be a source of zoonotic diseases -- infectious and variously contagious diseases transmissible to people -- who then spread such diseases within their own communities. Wildlife habitats need to be protected, restored and extended to ensure optimal, health-sustaining biodiversity.
We should also revisit the bioethical question of using primates in biomedical research and the development and testing of drugs and vaccines.
International collaboration to better reduce climate change is urgently needed to reduce the rising incidence of insect-borne diseases. Mosquitoes, ticks and other vectors of zoonoses are proliferating under the warmer and wetter conditions now prevailing in many regions of the world.
DEAR DR. FOX: I've reached out to you before, when my 17-year-old Chihuahua was in the end stages of his life. You really helped me put the decision into perspective. I am now facing another dilemma with my 16-year-old Yorkie.
His health has declined dramatically over this past month, but I am not ready to give him his wings. I learned from an ER visit a week ago that he has a mass on one kidney and cysts on the other; both adrenal glands are enlarged, and possibly have tumors; the liver is enlarged; the kidneys are failing; and it appears he has pancreatitis.
He was a fairly healthy, if aging, dog before this started. It all began with diarrhea due to giardia, which was treated with two rounds of Panacur and three rounds of Flagyl. The diarrhea cleared, but then he began vomiting every night. On the third night, we took him to the ER, where they ran the labs and ultrasound. He was given Clavamox, Cerenia and omeprazole. He was in the ICU overnight and had two grand mal seizures, which he had never had before. They said it was time to let him go.
We took him home and have been giving him subcutaneous fluids daily. He has been refusing his food and water, except for an occasional sip or bite. I can't let him go because I keep thinking the pancreatitis can be controlled with more antibiotics, and if he has Cushing's, that can be treated as well.
I don't understand how all this happened and was just now discovered. The mass and cysts didn't just appear overnight. I want him to live comfortably and for his kidneys to be as healthy as they can be with what little function he has left. I really feel like this is an acute situation and that some things can be corrected. -- D.M., Fort Myers, Florida
DEAR D.M.: I am so sorry to hear about what you and your old dog have gone through. Don't blame yourself or the attending veterinarians for not diagnosing these chronic underlying conditions earlier; the giardia probably aggravated them to the point where compensatory mechanisms failed. It is remarkable how animals continue to act normally even when various internal organs are beginning to fail.
Considering all the organs involved, I would make your old Yorkie as comfortable as possible, offer him good-quality baby food (chicken, turkey and vegetables) and anything he likes to eat. Give him gentle massage therapy as per my book "The Healing Touch for Dogs," and prepare yourself to say goodbye. He may die in your arms, but if he shows evidence of pain and distress, do consider in-home euthanasia. Many veterinarians provide this humane service at a reasonable cost. I send my condolences.
(Send all mail to animaldocfox@gmail.com or to Dr. Michael Fox in care of Andrews McMeel Syndication, 1130 Walnut St., Kansas City, MO 64106. The volume of mail received prohibits personal replies, but questions and comments of general interest will be discussed in future columns.
Visit Dr. Fox’s website at DrFoxOneHealth.com.)