(Tribune News Service) — Although monkeypox only recently began dominating U.S. headlines, scientists at Fort Detrick have long been familiar with the virus.
It's closely related to the virus that causes smallpox. And even though smallpox was eradicated in 1979, the U.S. Army still considers it a threat, since it could be used as a biological weapon.
Over the years, researchers at the U.S. Army Medical Research Institute of Infectious Diseases have helped develop vaccines and therapeutics that can be used for both monkeypox and smallpox.
With monkeypox now spreading in countries where it isn't usually detected — including the United States — scientists at the institute are working to develop better ways to diagnose, prevent and treat the disease.
Jay Hooper, molecular virology branch chief for USAMRIID, spoke on Friday about some of the research being conducted.
It's been two-and-a-half years since the first COVID-19 infections were reported, and more money is now being spent on preparing for and preventing future pandemics, Hooper said in an interview in his office.
Public health experts around the world are talking to each other more frequently, he said. And it's becoming increasingly obvious that countries need to be prepared to fight infectious diseases transmitted from animals to humans.
But, in some ways, Hooper said, it doesn't feel like much has changed.
"We had the Ebola outbreak. And then we had the Zika outbreak. And then we had the SARS outbreak," he said. "And after each one of them, people basically said, 'We can't let this happen again.'"
"Meanwhile, monkeypox was smoldering in Africa."
Research in progress
An article published nearly two decades ago hangs on the wall of Hooper's office.
It documents a big win for a team of USAMRIID scientists he had been working with to develop a safer smallpox vaccine for immunocompromised people. A study had shown the gene-based vaccine was effective in protecting monkeys from monkeypox.
USAMRIID doesn't work with the smallpox virus at Fort Detrick, Hooper said. There are only two stocks of the virus in the world sanctioned by the World Health Organization: one at the Centers for Disease Control and Prevention headquarters in Atlanta and one in Russia.
In the years that followed, Hooper said, his team kept working on the vaccine, but their progress was constrained by the funding they could get. The vaccine has yet to advance further than the "proof of concept" stage, he said.
There were about 9,600 monkeypox cases around the world as of Monday, including 865 in the United States, according to the CDC. Especially in light of the outbreak, the lull in the team's work was unfortunate, Hooper said.
If they had continued "at full speed," they would be further along in developing the DNA vaccine than they are now.
"We continue to try and push things forward, but it's just a slower pace than what it was," he said.
But Hooper and his USAMRIID colleagues recently had another victory. They've been working with a biopharmaceutical company to develop a new class of drugs based on mRNA, a type of molecule that uses genetic information to create a kind of blueprint for making proteins.
Their eventual goal is to use mRNA to deliver information to the body that it can use to ward off disease. When they tested the technology in a rabbit, they saw promising results, according to a USAMRIID news release published this month.
Although the drugs are "definitely not ready for prime time," Hooper said, he hopes they one day could be used with a vaccine to fight monkeypox and similar diseases. The mRNA treatment would help the body confront an infection in the short-term, while the vaccine would help protect it in the long-term.
"That's the vision," Hooper said. The recent research published was "one little baby step in proof of concept of, like, 'Could that work?'"
USAMRIID link to smallpox vaccine
The two vaccines licensed in the United States to prevent smallpox have been found to also be effective at protecting people against monkeypox, according to the Centers for Disease Control and Prevention.
USAMRIID had ties to the development of both.
A former USAMRIID division chief helped create one — ACAM2000 — after leaving the institute, Hooper said.
It was a "cleaned-up" version of an earlier smallpox vaccine, which was a big force behind the global push to eradicate the virus.
But ACAM2000, similar to its predecessor, contains live virus. The vaccine can be dangerous for people with suppressed immune systems, including those with HIV.
Another vaccine was needed that could be administered to everyone, including people who were immunocompromised, Hooper said.
Luckily, he said, one had already started being developed in the 1960s: the vaccine known in America today as Jynneos.
Using animal models and other types of tests, scientists began comparing the vaccine's effectiveness with the effectiveness of ACAM2000.
But they had a problem. For the FDA to OK the vaccine, scientists needed to prove it could work on a large scale — a process that usually involves thousands of people who agree to participate in a trial.
By this time, smallpox had been eradicated. There weren't enough monkeypox cases to test the vaccine, either.
So, researchers got creative, Hooper said. They decided to administer the Jynneos vaccine to people who had already received ACAM2000, to see if the newer vaccine would effectively fight the live virus present in the older one.
Led by Phillip Pittman, chief of the department of clinical research at USAMRIID, scientists conducted a clinical trial of the vaccine in Korea, where 440 U.S. military troops who had been vaccinated with ACAM2000 were stationed.
The trial found the vaccine to be effective. And in 2019, the FDA approved Jynneos to be used to protect people from smallpox and monkeypox.
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With monkeypox now spreading in countries where it isn’t usually detected — including the United States — scientists at the U.S. Army Medical Research Institute of Infectious Diseases are working to develop better ways to diagnose, prevent and treat the disease. (U.S. Army Medical Research Institute of Infectious Diseases - USAMRIID/Facebook)
