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Catala A, Riera J, Fuertes I. [Translated article] Mpox - Formerly Monkey Pox - in Dermatology: A Review of Epidemiologic Features, Clinical Presentation, Diagnosis, and Treatment. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:T318-T326. [PMID: 36848956 PMCID: PMC9972588 DOI: 10.1016/j.ad.2023.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 01/08/2023] [Indexed: 02/27/2023] Open
Abstract
Mpox is an emerging zoonotic disease that has spread rapidly around the world. It has been declared a public health emergency of international concern by the World Health Organization. This review is an update for dermatologists on the epidemiology, clinical presentation, diagnosis, and treatment of Mpox. The primary mode of transmission in the current outbreak is close physical contact during sexual activity. Although most of the initial cases were reported in men who have sex with men, anyone who has close contact with an infected person or contaminated fomites is at risk. Classic prodromal features of Mpox include subclinical manifestations and a mild rash. Complications are common but rarely require hospitalization. Polymerase chain reaction analysis of mucocutaneous lesions is the test of choice for a definitive diagnosis. In the absence of specific treatments, management focuses on symptomatic relief.
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Affiliation(s)
- A Catala
- Servicio de Dermatología y Venereología, Hospital Clínic, Barcelona, Spain.
| | - J Riera
- Servicio de Dermatología y Venereología, Hospital Clínic, Barcelona, Spain
| | - I Fuertes
- Servicio de Dermatología y Venereología, Hospital Clínic, Barcelona, Spain
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202
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Javelle E, Ficko C, Savini H, Mura M, Ferraris O, Tournier JN, de Laval F. Monkeypox clinical disease: Literature review and a tool proposal for the monitoring of cases and contacts. Travel Med Infect Dis 2023; 52:102559. [PMID: 36809829 PMCID: PMC9946014 DOI: 10.1016/j.tmaid.2023.102559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 10/26/2022] [Accepted: 02/17/2023] [Indexed: 02/24/2023]
Abstract
The human monkeypox disease has mainly been described in Western and Central Africa. Since May 2022, the monkeypox virus has been spreading worldwide in a new epidemiological pattern, where cases result from person-to-person transmission, and develop clinically milder or less typical illness than during previous outbreaks in endemic areas. The newly-emerging monkeypox disease needs to be described over the long term, to improve cases definitions, to implement prompt control measures against epidemics, and to provide supportive care. Hence, we first conducted a review of historical and recent outbreaks to define the full clinical spectrum of the monkeypox disease and its course known so far. Then, we built a self-administrated questionnaire collecting daily symptoms of the monkeypox infection to follow cases and their contacts, even remotely. This tool will assist in the management of cases, the surveillance of contacts, and the conduct of clinical studies.
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Affiliation(s)
- Emilie Javelle
- Institut de Recherche Biomédicale des Armées IRBA, Microbiology and Infectious Diseases Department, Marseille, France; Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; Laveran Military Teaching Hospital, Marseille, France.
| | - Cécile Ficko
- Bégin Military Teaching Hospital, Saint-Mandé, France; Ecole Du Val-de-Grâce, Paris, France
| | - Hélène Savini
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; Laveran Military Teaching Hospital, Marseille, France
| | - Marie Mura
- Institut de Recherche Biomédicale des Armées IRBA, Microbiology and Infectious Diseases Department, Brétigny-sur-Orge, France; Institut Pasteur, Innovation Lab: Vaccines, Paris, France
| | - Olivier Ferraris
- Institut de Recherche Biomédicale des Armées IRBA, Microbiology and Infectious Diseases Department, Brétigny-sur-Orge, France; CNR-LE National Reference Center-expert Laboratory Orthopoxvirus, IRBA, Brétigny-sur-Orge, France
| | - Jean Nicolas Tournier
- Ecole Du Val-de-Grâce, Paris, France; Institut de Recherche Biomédicale des Armées IRBA, Microbiology and Infectious Diseases Department, Brétigny-sur-Orge, France; Institut Pasteur, Innovation Lab: Vaccines, Paris, France
| | - Franck de Laval
- Service de Santé des Armées SSA, French Armed Forces Center for Epidemiology and Public Health CESPA, Marseille, France; Aix Marseille University, INSERM, IRD, Sciences Economiques Sociales de La Santé & Traitement de L'Information Médicale SESSTIM, Marseille, France
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203
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Orthopoxvirus Zoonoses—Do We Still Remember and Are Ready to Fight? Pathogens 2023; 12:pathogens12030363. [PMID: 36986285 PMCID: PMC10052541 DOI: 10.3390/pathogens12030363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/13/2023] [Accepted: 02/16/2023] [Indexed: 02/24/2023] Open
Abstract
The eradication of smallpox was an enormous achievement due to the global vaccination program launched by World Health Organization. The cessation of the vaccination program led to steadily declining herd immunity against smallpox, causing a health emergency of global concern. The smallpox vaccines induced strong, humoral, and cell-mediated immune responses, protecting for decades after immunization, not only against smallpox but also against other zoonotic orthopoxviruses that now represent a significant threat to public health. Here we review the major aspects regarding orthopoxviruses’ zoonotic infections, factors responsible for viral transmissions, as well as the emerging problem of the increased number of monkeypox cases recently reported. The development of prophylactic measures against poxvirus infections, especially the current threat caused by the monkeypox virus, requires a profound understanding of poxvirus immunobiology. The utilization of animal and cell line models has provided good insight into host antiviral defenses as well as orthopoxvirus evasion mechanisms. To survive within a host, orthopoxviruses encode a large number of proteins that subvert inflammatory and immune pathways. The circumvention of viral evasion strategies and the enhancement of major host defenses are key in designing novel, safer vaccines, and should become the targets of antiviral therapies in treating poxvirus infections.
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204
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Ngungu M, Addai E, Adeniji A, Adam UM, Oshinubi K. Mathematical epidemiological modeling and analysis of monkeypox dynamism with non-pharmaceutical intervention using real data from United Kingdom. Front Public Health 2023; 11:1101436. [PMID: 36875378 PMCID: PMC9982733 DOI: 10.3389/fpubh.2023.1101436] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 01/16/2023] [Indexed: 02/19/2023] Open
Abstract
In this study, a mathematical model for studying the dynamics of monkeypox virus transmission with non-pharmaceutical intervention is created, examined, and simulated using real-time data. Positiveness, invariance, and boundedness of the solutions are thus examined as fundamental features of mathematical models. The equilibrium points and the prerequisites for their stability are achieved. The basic reproduction number and thus the virus transmission coefficient ℜ0 were determined and quantitatively used to study the global stability of the model's steady state. Furthermore, this study considered the sensitivity analysis of the parameters according to ℜ0. The most sensitive variables that are important for infection control are determined using the normalized forward sensitivity index. Data from the United Kingdom collected between May and August 2022, which also aid in demonstrating the usefulness and practical application of the model to the spread of the disease in the United Kingdom, were used. In addition, using the Caputo-Fabrizio operator, Krasnoselskii's fixed point theorem has been used to analyze the existence and uniqueness of the solutions to the suggested model. The numerical simulations are presented to assess the system dynamic behavior. More vulnerability was observed when monkeypox virus cases first appeared recently as a result of numerical calculations. We advise the policymakers to consider these elements to control monkeypox transmission. Based on these findings, we hypothesized that another control parameter could be the memory index or fractional order.
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Affiliation(s)
- Mercy Ngungu
- Human Sciences Research Council (HSRC), Pretoria, South Africa
| | - Emmanuel Addai
- Department of Biomedical Engineering, College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, China
- Department of Mathematics, Taiyuan University of Technology, Taiyuan, China
| | - Adejimi Adeniji
- Department of Mathematics, Tshwane University of Technology, Pretoria, South Africa
| | | | - Kayode Oshinubi
- AGEIS Laboratory, University Grenoble Alpes, Saint Martin d'Hères, France
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205
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Nanomedicine as a Potential Tool against Monkeypox. Vaccines (Basel) 2023; 11:vaccines11020428. [PMID: 36851305 PMCID: PMC9963669 DOI: 10.3390/vaccines11020428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/24/2023] [Accepted: 02/06/2023] [Indexed: 02/16/2023] Open
Abstract
Human monkeypox is a rare viral zoonosis that was first identified in 1970; since then, this infectious disease has been marked as endemic in central and western Africa. The disease has always been considered rare and self-limiting; however, recent worldwide reports of several cases suggest otherwise. Especially with monkeypox being recognized as the most important orthopoxvirus infection in humans in the smallpox post-eradication era, its spread across the globe marks a new epidemic. Currently, there is no proven treatment for human monkeypox, and questions about the necessity of developing a vaccine persist. Notably, if we are to take lessons from the COVID-19 pandemic, developing a nanomedicine-based preventative strategy might be prudent, particularly with the rapid growth of the use of nanotechnology and nanomaterials in medical research. Unfortunately, the collected data in this area is limited, dispersed, and often incomplete. Therefore, this review aims to trace all reported nanomedicine approaches made in the monkeypox area and to suggest possible directions that could be further investigated to develop a counteractive strategy against emerging and existing viruses that could diminish this epidemic and prevent it from becoming a potential pandemic, especially with the world still recovering from the COVID-19 pandemic.
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206
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Stafford A, Rimmer S, Gilchrist M, Sun K, Davies EP, Waddington CS, Chiu C, Armstrong-James D, Swaine T, Davies F, Gómez CHM, Kumar V, ElHaddad A, Awad Z, Smart C, Mora-Peris B, Muir D, Randell P, Peters J, Chand M, Warrell CE, Rampling T, Cooke G, Dhanji S, Campbell V, Davies C, Osman S, Abbara A. Use of cidofovir in a patient with severe mpox and uncontrolled HIV infection. THE LANCET. INFECTIOUS DISEASES 2023; 23:e218-e226. [PMID: 36773621 PMCID: PMC9908088 DOI: 10.1016/s1473-3099(23)00044-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/20/2022] [Accepted: 12/29/2022] [Indexed: 02/11/2023]
Abstract
A 48-year-old man with poorly controlled HIV presented with severe human monkeypox virus (hMPXV) infection, having completed 2 weeks of tecovirimat at another hospital. He had painful, ulcerating skin lesions on most of his body and oropharyngeal cavity, with subsequent Ludwig's angina requiring repeated surgical interventions. Despite commencing a second, prolonged course of tecovirimat, he did not objectively improve, and new lesions were still noted at day 24. Discussion at the UK National Health Service England High Consequence Infectious Diseases Network recommended the use of 3% topical and then intravenous cidofovir, which was given at 5 mg/kg; the patient made a noticeable improvement after the first intravenous dose. He received further intravenous doses at 7 days and 21 days after the dose and was discharged at day 52. Cidofovir is not licensed for use in treatment of hMPXV infection. Data for cidofovir use in hMPXV are restricted to studies in animals. Four other documented cases of cidofovir use against hMPXV have been reported in the USA in 2022, but we present its first use in the UK. The scarcity of studies into the use of cidofovir in this condition clearly shows the need for robust studies to assess efficacy, optimum dosage, timing, and route of administration.
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Affiliation(s)
- Adam Stafford
- Department of Infectious Diseases, Imperial College NHS Healthcare Trust, St Mary's Hospital, London, UK
| | - Stephanie Rimmer
- Department of Infectious Diseases, Imperial College NHS Healthcare Trust, St Mary's Hospital, London, UK
| | - Mark Gilchrist
- Department of Infectious Diseases, Imperial College NHS Healthcare Trust, St Mary's Hospital, London, UK,Department of Infectious Diseases, Imperial College London, London, UK
| | - Kristi Sun
- Department of Infectious Diseases, Imperial College NHS Healthcare Trust, St Mary's Hospital, London, UK
| | - Ella P Davies
- Department of Infectious Diseases, Imperial College NHS Healthcare Trust, St Mary's Hospital, London, UK
| | - Claire S Waddington
- Department of Infectious Diseases, Imperial College NHS Healthcare Trust, St Mary's Hospital, London, UK
| | - Christopher Chiu
- Department of Infectious Diseases, Imperial College NHS Healthcare Trust, St Mary's Hospital, London, UK,Department of Infectious Diseases, Imperial College London, London, UK
| | - Darius Armstrong-James
- Department of Infectious Diseases, Imperial College NHS Healthcare Trust, St Mary's Hospital, London, UK,Department of Infectious Diseases, Imperial College London, London, UK
| | - Thomas Swaine
- Department of Infectious Diseases, Imperial College NHS Healthcare Trust, St Mary's Hospital, London, UK
| | - Frances Davies
- Department of Infectious Diseases, Imperial College NHS Healthcare Trust, St Mary's Hospital, London, UK,Department of Infectious Diseases, Imperial College London, London, UK
| | - Carlos H M Gómez
- Department of Intensive Care Medicine, Imperial College NHS Healthcare Trust, St Mary's Hospital, London, UK
| | - Vagish Kumar
- Department of Intensive Care Medicine, Imperial College NHS Healthcare Trust, St Mary's Hospital, London, UK
| | - Ahmad ElHaddad
- Department of Intensive Care Medicine, Imperial College NHS Healthcare Trust, St Mary's Hospital, London, UK
| | - Zaid Awad
- Department of Ear, Nose and Throat, Imperial College NHS Healthcare Trust, St Mary's Hospital, London, UK
| | - Christopher Smart
- Department of Intensive Care Medicine, Imperial College NHS Healthcare Trust, St Mary's Hospital, London, UK
| | - Borja Mora-Peris
- Department of HIV, Imperial College NHS Healthcare Trust, St Mary's Hospital, London, UK,Department of Infectious Diseases, Imperial College London, London, UK
| | - David Muir
- Department of Infectious Diseases, Imperial College NHS Healthcare Trust, St Mary's Hospital, London, UK,Department of Infectious Diseases, Imperial College London, London, UK
| | - Paul Randell
- Department of Infectious Diseases, Imperial College NHS Healthcare Trust, St Mary's Hospital, London, UK,Department of Infectious Diseases, Imperial College London, London, UK
| | - Joanna Peters
- Department of Infectious Diseases, Imperial College NHS Healthcare Trust, St Mary's Hospital, London, UK
| | - Meera Chand
- United Kingdom Health Security Agency, Colindale, UK
| | | | | | - Graham Cooke
- Department of Infectious Diseases, Imperial College NHS Healthcare Trust, St Mary's Hospital, London, UK,Department of Infectious Diseases, Imperial College London, London, UK
| | - Sara Dhanji
- Department of Intensive Care Medicine, Imperial College NHS Healthcare Trust, St Mary's Hospital, London, UK
| | - Vivienne Campbell
- Department of Speech and Language Therapy, Imperial College NHS Healthcare Trust, St Mary's Hospital, London, UK
| | - Carys Davies
- Department of Intensive Care Medicine, Imperial College NHS Healthcare Trust, St Mary's Hospital, London, UK
| | - Sana Osman
- Department of Intensive Care Medicine, Imperial College NHS Healthcare Trust, St Mary's Hospital, London, UK
| | - Aula Abbara
- Department of Infectious Diseases, Imperial College NHS Healthcare Trust, St Mary's Hospital, London, UK; Department of Infectious Diseases, Imperial College London, London, UK.
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207
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Lim EY, Whitehorn J, Rivett L. Monkeypox: a review of the 2022 outbreak. Br Med Bull 2023; 145:17-29. [PMID: 36751952 DOI: 10.1093/bmb/ldad002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/11/2023] [Indexed: 02/09/2023]
Abstract
INTRODUCTION In May 2022, the World Health Organisation declared a multi-country monkeypox outbreak in non-endemic countries following cases reported from 12 member states that were not endemic for monkeypox virus. SOURCES OF DATA Pubmed search. AREAS OF AGREEMENT The virology, epidemiology, transmission, incubation and aspects of infection control are described. Clinical features of previous and current outbreaks are described, with growing observations that the current outbreak presents with clinical features distinct from previous outbreaks. AREAS OF CONTROVERSY There are variations in clinical presentations seen in the current outbreak that have not been seen in prior outbreaks. More research is needed to investigate the reasons for these differences. GROWING POINTS The higher numbers of HIV-positive patients in the current outbreak has allowed better description of the disease in patients co-infected with HIV and monkeypox. The absence of more severe symptoms in HIV-positive patients in the current outbreak could possibly be due to the fact that most of these patients had well-controlled HIV, although further characterization of this cohort of patients would be useful. AREAS FOR DEVELOPING RESEARCH Current treatment and vaccination options have been extrapolated from studies of other Orthopox viruses. There remains a need for more data on the safety and efficacy of these options in the context of monkeypox infections.
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Affiliation(s)
- Eleanor Y Lim
- Department of Infectious Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
| | - James Whitehorn
- Department of Infectious Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK.,Clinical Microbiology and Public Health Laboratory, Public Health England, Cambridge CB21 5XA, UK
| | - Lucy Rivett
- Department of Infectious Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK.,Clinical Microbiology and Public Health Laboratory, Public Health England, Cambridge CB21 5XA, UK
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208
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Khattak S, Rauf MA, Ali Y, Yousaf MT, Liu Z, Wu DD, Ji XY. The monkeypox diagnosis, treatments and prevention: A review. Front Cell Infect Microbiol 2023; 12:1088471. [PMID: 36814644 PMCID: PMC9939471 DOI: 10.3389/fcimb.2022.1088471] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 12/30/2022] [Indexed: 02/08/2023] Open
Abstract
The world is currently dealing with a second viral outbreak, monkeypox, which has the potential to become an epidemic after the COVID-19 pandemic. People who reside in or close to forest might be exposed indirectly or at a low level, resulting in subclinical disease. However, the disease has lately emerged in shipped African wild mice in the United States. Smallpox can cause similar signs and symptoms to monkeypox, such as malaise, fever, flu-like signs, headache, distinctive rash, and back pain. Because Smallpox has been eliminated, similar symptoms in a monkeypox endemic zone should be treated cautiously. Monkeypox is transmitted to humans primarily via interaction with diseased animals. Infection through inoculation via interaction with skin or scratches and mucosal lesions on the animals is conceivable significantly once the skin barrier is disrupted by scratches, bites, or other disturbances or trauma. Even though it is clinically unclear from other pox-like infections, laboratory diagnosis is essential. There is no approved treatment for human monkeypox virus infection, however, smallpox vaccination can defend counter to the disease. Human sensitivity to monkeypox virus infection has grown after mass vaccination was discontinued in the 1980s. Infection may be prevented by reducing interaction with sick patients or animals and reducing respiratory exposure among people who are infected.
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Affiliation(s)
- Saadullah Khattak
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, Henan University, Kaifeng, Henan, China
| | - Mohd Ahmar Rauf
- School of Pharmaceutical Sciences, Wayne State University, Detroit, MI, United States
| | - Yasir Ali
- National Center for Bioinformatics, Quaid-e-Azam University, Islamabad, Pakistan
| | - Muhammad Tufail Yousaf
- Institute of Microbiology, Faculty of Veterinary and Animal Sciences, Gomal University, Dera Ismail Khan, Pakistan
| | - Zhihui Liu
- Department of General Practice, Henan Provincial Peoples Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China,*Correspondence: Zhihui Liu, ; Dong-Dong Wu, ; Xin-Ying Ji,
| | - Dong-Dong Wu
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, Henan University, Kaifeng, Henan, China,School of Stomatology, Henan University, Kaifeng, Henan, China,*Correspondence: Zhihui Liu, ; Dong-Dong Wu, ; Xin-Ying Ji,
| | - Xin-Ying Ji
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, Henan University, Kaifeng, Henan, China,*Correspondence: Zhihui Liu, ; Dong-Dong Wu, ; Xin-Ying Ji,
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209
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Ford ES, Papanicolaou GA, Dadwal SS, Pergam S, Spallone A. Frequently Asked Questions about Mpox (Formerly Monkeypox Disease) for Hematopoietic Cell Transplantation and Chimeric Antigen Receptor T Cell Recipients from the American Society for Transplantation and Cellular Therapy. Transplant Cell Ther 2023; 29:289-292. [PMID: 36746374 PMCID: PMC9899127 DOI: 10.1016/j.jtct.2023.01.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 02/08/2023]
Affiliation(s)
- Emily S Ford
- Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Center, Seattle, Washington; Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington
| | | | - Sanjeet S Dadwal
- Division of Infectious Diseases, City of Hope National Medical Center, Duarte, California
| | - Steve Pergam
- Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Center, Seattle, Washington; Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington
| | - Amy Spallone
- Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas.
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210
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Ahmed SK, Mohamed MG, Dabou EA, Abuijlan I, Chandran D, El-Shall NA, Chopra H, Dhama K. Monkeypox (mpox) in immunosuppressed patients. F1000Res 2023; 12:127. [PMID: 37089133 PMCID: PMC10113800 DOI: 10.12688/f1000research.130272.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/27/2023] [Indexed: 02/05/2023] Open
Abstract
The World Health Assembly declared that smallpox had been completely eradicated from the human population in 1980. Monkeypox, a zoonosis native to damp forested regions in West and Central Africa, is the illness that is most comparable to smallpox clinically and immunologically. Both illnesses could be prevented by the smallpox vaccine. Although the monkeypox virus is a less effective human disease than the smallpox virus, it could now spread among human populations if smallpox had not been eradicated and population-wide immunity had not been developed. A health warning on severe monkeypox in people who are immunocompromised due to Human Immunodeficiency virus (HIV) and other illnesses was released by the U.S. Centers for Disease Control and Prevention (CDC) on September 29, 2022. The advise does not specifically include primary immunodeficiency, but it does define other immunocompromising disorders as “having autoimmune disease with immunodeficiency as a clinical component”. The documented severe signs of monkeypox include widespread rashes with secondary fungal or bacterial skin infections or tissue death (necrosis), intestine obstruction, and difficulties with the heart, lungs, urinary system, and nervous system. Both those with healthy immune systems and those with weakened immune systems, such as those who are immunosuppressed, older people, children, etc., have encountered serious health issues, but the latter group is more likely to do so. According to the advisory, “of the people with severe monkeypox manifestations for whom CDC has been consulted, the majority have had HIV with CD4 counts 200 cells/ml, indicating substantial immunosuppression”. The current article goes into great detail about monkeypox disease occurring in immunocompromised patients and preventive guidelines.
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Affiliation(s)
- Sirwan Khalid Ahmed
- Department of Pediatrics, Rania Pediatric & Maternity Teaching Hospital, Rania, Sulaymaniyah, Kurdistan Region, 46012, Iraq
| | - Mona Gamal Mohamed
- RAK College of Nursing, RAK Medical and Health Sciences University, Ras Al Khiamah, United Arab Emirates
| | - Eman Abdelaziz Dabou
- RAK College of Nursing, RAK Medical and Health Sciences University, Ras Al Khiamah, United Arab Emirates
| | - Israa Abuijlan
- RAK College of Nursing, RAK Medical and Health Sciences University, Ras Al Khiamah, United Arab Emirates
| | - Deepak Chandran
- Department of Veterinary Sciences and Animal Husbandry, Amrita School of Agricultural Sciences, Amrita Vishwa Vidyapeetham University, Coimbatore, Tamil Nadu, 642109, India
| | - Nahed A. El-Shall
- Department of Poultry and Fish Diseases, Faculty of Veterinary Medicine, Alexandria University, Edfina, El-Beheira, 22758, Egypt
| | - Hitesh Chopra
- Chitkara College of Pharmacy, Chitkara University, Punjab, 140401, India
| | - Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Bareilly, Uttar Pradesh, 243122, India
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211
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Pan D, Nazareth J, Sze S, Martin CA, Decker J, Fletcher E, Déirdre Hollingsworth T, Barer MR, Pareek M, Tang JW. Transmission of monkeypox/mpox virus: A narrative review of environmental, viral, host, and population factors in relation to the 2022 international outbreak. J Med Virol 2023; 95:e28534. [PMID: 36708091 PMCID: PMC10107822 DOI: 10.1002/jmv.28534] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/05/2022] [Accepted: 01/24/2023] [Indexed: 01/29/2023]
Abstract
Monkeypox virus (MPXV) has spread globally. Emerging studies have now provided evidence regarding MPXV transmission, that can inform rational evidence-based policies and reduce misinformation on this topic. We aimed to review the evidence on transmission of the virus. Real-world studies have isolated viable viruses from high-touch surfaces for as long as 15 days. Strong evidence suggests that the current circulating monkeypox (mpox) has evolved from previous outbreaks outside of Africa, but it is yet unknown whether these mutations may lead to an inherently increased infectivity of the virus. Strong evidence also suggests that the main route of current MPXV transmission is sexual; through either close contact or directly, with detection of culturable virus in saliva, nasopharynx, and sperm for prolonged periods and the presence of rashes mainly in genital areas. The milder clinical presentations and the potential presence of presymptomatic transmission in the current circulating variant compared to previous clades, as well as the dominance of spread amongst men who have sex with men (MSMs) suggests that mpox has a developed distinct clinical phenotype that has increased its transmissibility. Increased public awareness of MPXV transmission modalities may lead to earlier detection of the spillover of new cases into other groups.
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Affiliation(s)
- Daniel Pan
- Department of Respiratory SciencesUniversity of LeicesterLeicesterUK
- Department of Infectious Diseases and HIV MedicineUniversity Hospitals of Leicester NHS TrustLeicesterUK
- Li Ka Shing Centre for Health Information and Discovery, Big Data InstituteUniversity of OxfordOxfordUK
- NIHR Leicester Biomedical Research CentreLiecesterUK
| | - Joshua Nazareth
- Department of Respiratory SciencesUniversity of LeicesterLeicesterUK
- Department of Infectious Diseases and HIV MedicineUniversity Hospitals of Leicester NHS TrustLeicesterUK
- NIHR Leicester Biomedical Research CentreLiecesterUK
| | - Shirley Sze
- Department of Cardiovascular SciencesUniversity of LeicesterLeicesterUK
| | - Christopher A. Martin
- Department of Respiratory SciencesUniversity of LeicesterLeicesterUK
- Department of Infectious Diseases and HIV MedicineUniversity Hospitals of Leicester NHS TrustLeicesterUK
- NIHR Leicester Biomedical Research CentreLiecesterUK
| | - Jonathan Decker
- Department of Respiratory SciencesUniversity of LeicesterLeicesterUK
| | - Eve Fletcher
- Department of Respiratory SciencesUniversity of LeicesterLeicesterUK
| | - T. Déirdre Hollingsworth
- Li Ka Shing Centre for Health Information and Discovery, Big Data InstituteUniversity of OxfordOxfordUK
| | - Michael R. Barer
- Department of Respiratory SciencesUniversity of LeicesterLeicesterUK
- Department of Clinical MicrobiologyUniversity Hospitals of Leicester NHS TrustLeicesterUK
| | - Manish Pareek
- Department of Respiratory SciencesUniversity of LeicesterLeicesterUK
- Department of Infectious Diseases and HIV MedicineUniversity Hospitals of Leicester NHS TrustLeicesterUK
- NIHR Leicester Biomedical Research CentreLiecesterUK
| | - Julian W. Tang
- Department of Respiratory SciencesUniversity of LeicesterLeicesterUK
- Department of VirologyUniversity Hospitals of Leicester NHS TrustLeicesterUK
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Lack of clinical evidence of antiviral therapy for human monkeypox: A scoping review. J Infect Chemother 2023; 29:228-231. [PMID: 36283609 PMCID: PMC9598785 DOI: 10.1016/j.jiac.2022.10.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/08/2022] [Accepted: 10/17/2022] [Indexed: 11/05/2022]
Abstract
Since May 2022, many human monkeypox cases have been reported from non-endemic countries. This systematic review aimed to evaluate and summarize the existing research on the efficacy and safety of tecovirimat, brincidofovir, and cidofovir for patients with monkeypox. We searched studies that reported the efficacy and adverse events of tecovirimat, brincidofovir, or cidofovir for patients with human monkeypox in several databases including preprint servers. Only five studies were included. The efficacy and adverse events were assessed in only five and four patients, respectively. Regarding tecovirimat, all two patients recovered from monkeypox. One had no adverse event and the other has no description of an adverse event. Regarding brincidofovir, all three patients recovered from monkeypox but all of them had increased alanine transaminase, and one had nausea and abdominal discomfort. There was no study on treatment with cidofovir. Based on past studies and our results, tecovirimat might be the best choice due to ease of administration (oral drug), fewer side effects, and past treatment results for human monkeypox administration. However, very few studies were included in this scoping review. Therefore, further studies are needed to assess their efficacy and safety as possible treatments for human monkeypox.
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213
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Gandhi P A, Patro SK, Sandeep M, Satapathy P, Shamim MA, Kumar V, Aggarwal AK, Padhi BK, Sah R. Oral manifestation of the monkeypox virus: a systematic review and meta-analysis. EClinicalMedicine 2023; 56:101817. [PMID: 36628187 PMCID: PMC9815964 DOI: 10.1016/j.eclinm.2022.101817] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/16/2022] [Accepted: 12/20/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Mpox (formerly known as monkeypox) is a global public health concern, given the recent outbreaks in non-endemic countries where little scientific evidence exists on the disease epidemiology. Oral lesions among mpox cases have been poorly reported. Our aim was to estimate the overall prevalence of oral manifestations among patients with mpox globally. METHODS In this systematic review and meta-analysis, an extensive literature search in PubMed, Scopus, Web of Science, Embase, Cochrane, and preprint servers (medRxiv, arXiv, bioRxiv, BioRN, ChiRxiv, ChiRN, and SSRN) and assessment of all published articles, conducted across the world, until Nov 15 2022 as per the PROSPERO registration protocol (CRD42022371249), was undertaken. Primary studies (case series, cross-sectional, retrospective, prospective designs) that reported the oral/oropharyngeal symptoms among laboratory-confirmed mpox cases were included. The characteristics of the study, information on the number of cases, and symptomatic status were extracted from the included studies. The quality of the included studies was assessed for bias. Random-effects meta-regression with DerSimonian & Laird estimator, and subgroup analyses were conducted using STATA (v17.0). The degree of funnel plot asymmetry was assessed using Egger's test when at least 10 estimates were available. The heterogeneity between studies was assessed using the I2 statistic. The primary outcome was the pooled prevalence of oral manifestations in the examined population. FINDINGS 19 studies were included with 4042 laboratory-confirmed patients with mpox for qualitative and quantitative synthesis. The pooled prevalence of oral manifestations in the investigated population was 36.75% (95% confidence interval [CI]: 23.77-50.65). Heterogeneity was found to be high in the current meta-analysis (I2 = 98.24%; p < 0.001). Subgroup analysis revealed a pooled prevalence of 39.96% (95% CI: 21.42-59.91) of sore throat, 24.80% (95% CI: 8.14-46.32) of mouth sore, 18.24% (95% CI: 0.34-52.54) of tonsillitis and 17.99% (95% CI: 15.66-20.43) of mouth rash from the included studies. INTERPRETATION Oral manifestations are common in patients with mpox, with variations in prevalence across the sites within the oral cavity, and geography of the studies. Healthcare workers should be wary of the oral signs and symptoms of mpox in endemic and high-risk areas. FUNDING None.
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Affiliation(s)
- Aravind Gandhi P
- Department of Community Medicine, ESIC Medical College & Hospital, Sanathnagar, Hyderabad, India
| | - Sourabha Kumar Patro
- Department of Otolaryngology and Head and Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Prakasini Satapathy
- Department of Virology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Vinay Kumar
- Unit of Orthodontics, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Arun Kumar Aggarwal
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Bijaya Kumar Padhi
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
- Corresponding author. Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India.
| | - Ranjit Sah
- Tribhuvan University Teaching Hospital, Kathmandu, Nepal
- Dr. D.Y Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pune, Maharashtra, India
- Harvard Medical School, Boston, MA, USA
- Corresponding author. Tribhuvan University Teaching Hospital, Kathmandu, 44613 Nepal.
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Kopanou Taliaka P, Tsantes AG, Konstantinidi A, Liakou P, Tavoulari EF, Piovani D, Bonovas S, Iacovidou N, Tsantes AE, Sokou R. Monkeypox disease and pregnancy. Where are we today? A review of literature. J Perinatol 2023; 43:417-423. [PMID: 36725987 DOI: 10.1038/s41372-023-01629-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/23/2023] [Accepted: 01/25/2023] [Indexed: 02/03/2023]
Abstract
Monkeypox has emerged as a significant human pathogen, posing severe risks in vulnerable populations. At present, there is not enough data available as to whether pregnant women are more vulnerable to monkeypox infection, or they suffer more severe symptoms, and studies on this issue as well as to the possible adverse effects on the developing fetus are limited. The aim of this review, was to bring together what is known so far about monkeypox virus transmission, the clinical course of the disease, and associated maternal-fetal outcomes. Furthermore, to summarize the current available recommendations on the prevention and management of monkeypox infection during pregnancy, in order to help obstetricians and neonatologists navigate through this new challenging area and provide the best available care to their patients.
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Affiliation(s)
| | - Andreas G Tsantes
- Microbiology Department, "Saint Savvas" Oncology Hospital, Athens, Greece
| | | | - Paraskevi Liakou
- Neonatal Intensive Care Unit, "Agios Panteleimon" General Hospital of Nikea, Piraeus, Greece
| | | | - Daniele Piovani
- IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Stefanos Bonovas
- IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Nicoletta Iacovidou
- Neonatal Department, National and Kapodistrian University of Athens, Aretaieio Hospital, Athens, Greece
| | - Argirios E Tsantes
- Laboratory of Haematology and Blood Bank Unit, "Attiko" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Rozeta Sokou
- Neonatal Intensive Care Unit, "Agios Panteleimon" General Hospital of Nikea, Piraeus, Greece. .,Neonatal Department, National and Kapodistrian University of Athens, Aretaieio Hospital, Athens, Greece.
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Hallo-Carrasco A, Hunt CL, Prusinski CC, Eldrige JS, McVeigh KH, Hurdle MFB, Prokop LJ, Gupta S. Pain Associated With Monkeypox Virus: A Rapid Review. Cureus 2023; 15:e34697. [PMID: 36909034 PMCID: PMC9995223 DOI: 10.7759/cureus.34697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2023] [Indexed: 02/08/2023] Open
Abstract
International concerns for another pandemic arose after emerging reports of an ongoing outbreak of the monkeypox virus (MPXV) in Europe and the United States in 2022. Severe pain is one of the most distressing complications for patients in the current outbreak, but there is a general paucity of relevant peer-reviewed medical literature from which to draw clear recommendations on appropriate pain therapies. The Centers for Disease Control recently published a letter in July 2022 urging providers to conduct further studies concerning pain management. Thus, a rapid literature search was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search of several databases from inception until August 19, 2022, was conducted. All published studies describing pain in patients who tested positive for MPXV with original data and written in English were included. Sixty-nine studies were initially identified for screening. After initial screening, 27 papers were considered for full-text review, and 15 papers met the inclusion criteria. A total of 1043 positive cases were included in this study. Most patients were men. Treatment options proposed by the authors include acetaminophen, ibuprofen, opioids, lidocaine gel, metamizole, and rectal suppositories containing emollients or steroids with oral laxatives for severe anal pain. Although most cases were mild requiring outpatient treatment, a considerable number of patients were admitted due to serious complications. Severe pain was often the reason to seek medical attention and hospital admission for pain control. Analgesic plans included oral and topical analgesia. In severe cases, pain was managed with opioids. To our knowledge, this rapid review is the first study to comprehensively summarize proposed treatments for pain associated with MPXV. Guidelines may be needed to help direct the best management to avoid morbidity in patients, particularly as adjuvants may play a key role but are not commonly utilized in published reports.
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Affiliation(s)
| | | | | | | | | | | | | | - Sahil Gupta
- Pain Medicine, Mayo Clinic, Jacksonville, USA
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216
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217
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Galán-Huerta KA, Paz-Infanzon M, Nuzzolo-Shihadeh L, Ruiz-Higareda AF, Bocanegra-Ibarias P, Villareal-Martínez DZ, Muñoz-Garza FZ, Guerrero-Putz MD, Sáenz-Ibarra B, Barboza-Quintana O, Ocampo-Candiani J, Rivas-Estilla AM, Camacho-Ortiz A. Metagenomic Sequencing of Monkeypox Virus, Northern Mexico. Emerg Infect Dis 2023; 29:448-450. [PMID: 36648111 PMCID: PMC9881790 DOI: 10.3201/eid2902.221199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Monkeypox virus (MPXV) has gained interest because of a multicountry outbreak of mpox (formerly monkeypox) cases with no epidemiologic link to MPXV-endemic regions. We sequenced the complete genome of MPXV isolated from a patient in northern Mexico. Phylogenetic analysis grouped the virus with isolates from Germany.
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218
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Monkeypox and the Prevalence of Human Immunodeficiency Virus and Other Sexually Transmitted Infections. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2023. [DOI: 10.5812/archcid-135151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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219
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Zhou J, Xiao F, Fu J, Jia N, Huang X, Sun C, Liu C, Huan H, Wang Y. Rapid detection of monkeypox virus by multiple cross displacement amplification combined with nanoparticle-based biosensor platform. J Med Virol 2023; 95:e28479. [PMID: 36609918 DOI: 10.1002/jmv.28479] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/29/2022] [Accepted: 01/04/2023] [Indexed: 01/09/2023]
Abstract
The current outbreak of monkeypox virus (MPXV) has become a public health emergency of international concern that highlights the need for rapid, sensitive MPXV diagnostic assays. Here, we combined isothermal multiple cross displacement amplification (MCDA) with nanoparticle-based lateral flow biosensor (LFB) to devise a diagnostic test for the diagnosis of MPXV infection (called MPXV-MCDA-LFB) and differentiation of West and Central African MPXV isolates. The MPXV-MCDA-LFB protocol conducts isothermal MCDA reaction for DNA templates followed by LFB detection of preamplification target sequences. Two MCDA primer sets were designed targeting the D41L and ATI genes of Central and West African MPXV isolates, respectively, and the optimal condition of two MCDA reactions was 64°C for 30 min. The two MCDA reactions were decoded by LFB, which was devised for detecting three targets, including two amplicons yielded from two MCDA reactions and a chromatography control. Thus, the MPXV-MCDA-LFB assay could be completed within 50 min including rapid template preparation (15 min), MCDA reaction (30 min) and reporting of result (<5 min). The MPXV-MCDA-LFB method is very sensitive and can detect the target genes (D14L and ATI) with as low as five copies of plasmid template per reaction and 12.5 copies of pseudotyped virus in human blood samples. The MPXV-MCDA-LFB assay does not cross-react with non-MPXV templates, validating its specificity. Therefore, the MPXV-MCDA-LFB assay developed here is a useful tool for rapid and reliable diagnosis of MPXV infection.
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Affiliation(s)
- Juan Zhou
- Experimental Research Center, Capital Institute of Pediatrics, Beijing, People's Republic of China
| | - Fei Xiao
- Experimental Research Center, Capital Institute of Pediatrics, Beijing, People's Republic of China
| | - Jin Fu
- Experimental Research Center, Capital Institute of Pediatrics, Beijing, People's Republic of China
| | - Nan Jia
- Experimental Research Center, Capital Institute of Pediatrics, Beijing, People's Republic of China
| | - Xiaolan Huang
- Experimental Research Center, Capital Institute of Pediatrics, Beijing, People's Republic of China
| | - Chunrong Sun
- Experimental Research Center, Capital Institute of Pediatrics, Beijing, People's Republic of China
| | - Chunyan Liu
- Experimental Research Center, Capital Institute of Pediatrics, Beijing, People's Republic of China
| | - Hui Huan
- Department of Infectious Diseases, Affiliated Children's Hospital, Capital Institute of Pediatrics, Beijing, People's Republic of China
| | - Yi Wang
- Experimental Research Center, Capital Institute of Pediatrics, Beijing, People's Republic of China
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220
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Wolf JM, Wolf LM, Fagundes PP, Tomm DMS, Petek H, Brenner A, Maccari JG, Nasi LA. Molecular evolution of the human monkeypox virus. J Med Virol 2023; 95:e28533. [PMID: 36708096 DOI: 10.1002/jmv.28533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/17/2022] [Accepted: 01/24/2023] [Indexed: 01/29/2023]
Abstract
Recently, in 2022, new cases of human monkeypox virus (hMPXV) occurred in Europe and North America. The first case was reported in Europe in May 2022, and subsequently, more than 50 000 new cases were confirmed in 100 countries. Currently, the classification of hMPXV according to the nextstrain occurs in five big clades (1A, A.1, A.2, A.1.1, and B.1). According to the resurgence of smallpox-like disease caused by hMPXV and the spread of the virus to the European and American continents, in the present study, we review and summarize the molecular evolution of the hMPXV, determining the molecular evolution of the main clades. A total of 442 hMPXV whole-genome sequences with available information from the country and sampling date (between October 2017 and 2022), were obtained and evaluated using the Bayesian method. The clade B.1 which is currently circulating was the most frequent (n = 415; 93.9%). The other clades presented the following frequencies: 1A (n = 13; 2.9%), A.1 (n = 10; 2.3%), A.2 (n = 3; 0.7%) and A.1.1 (n = 1; 0.2%) The overall nucleotide divergence of hMPXV was 5.590e-5. The 1A clade was detected between 2017 and 2020. A.1 was observed, and between 2019 and 2022 some A.2 sequences were detected. In 2022, the great predominance of B.1 was observed. The common ancestor of the hMPXV belongs to the clade 1A and the time to the Most Recent Common Ancestor (tMRCA) was 2017-04-04 (Highest Posterior Density 95% (HPD95%): 2017-03-09; 2017-08-04) on the West African continent. The tMRCA of A.1 was 2018-05-21 (HPD95%: 2018-05-20; 2018-07-04) with divergence of 6.885e-5 substitutions per site per year. This clade was of West African origin but was eventually detected in European countries. Also, A.2 was detected with sequences of North America and showed tMRCA of 2019-07-15 (HPD95%: 2018-11-18; 2020-02-24). A.1.1 showed tMRCA from 2021 to 06-05 (HPD95%: 2021-06-05; 2021-11-26) and this clade was detected in North America and was the precursor for the globally spreading B.1 which tMRCA was 2022-04-26 (HPD95%: 2022-02-27; 2022-04-26). hMPXV has been spread from West Africa to the United Kingdom, Israel, Singapore, the USA, Canada, Portugal, Spain, Ireland, France, Belgium, the Netherlands, Switzerland, Germany, Italy, Slovenia, Austria, the Republic Czech, Sweden, and Finland. hMPXV also reached countries such as Brazil, Mexico, Australia, and Taiwan. The common ancestor of the hMPXV belongs to the clade 1A with origin in the West African continent. Clade B.1 was responsible for the recent widespread worldwide. Immunization to prevent the spread of hMPXV is not yet available to the public, future studies should focus on the development of effective vaccines to contain the spread of this virus.
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Affiliation(s)
- Jonas Michel Wolf
- Clinical Practice Management and Health Value Office, Medical Manager at Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
| | - Lucas Michel Wolf
- UFRGS, (Universidade Federal do Rio Grande do Sul), Porto Alegre, Rio Grande do Sul, Brasil
| | - Pamela Pereira Fagundes
- PUCRS (Pontifícia Universidade Católica do Rio Grande do Sul), Porto Alegre, Rio Grande do Sul, Brasil
| | | | - Helena Petek
- Clinical Practice Management and Health Value Office, Medical Manager at Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
| | - Aline Brenner
- Clinical Practice Management and Health Value Office, Medical Manager at Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
| | - Juçara Gasparetto Maccari
- Clinical Practice Management and Health Value Office, Medical Manager at Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
| | - Luiz Antonio Nasi
- Clinical Practice Management and Health Value Office, Medical Manager at Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
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221
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Hoarau G, Vauloup Fellous C, Haigh O, Labetoulle M, Rousseau A. [Monkeypox: Important facts for the ophthalmologist]. J Fr Ophtalmol 2023; 46:185-193. [PMID: 36639339 PMCID: PMC9832348 DOI: 10.1016/j.jfo.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 01/13/2023]
Abstract
The current monkeypox virus (MPXV) outbreak, raging since May 2022, is the largest ever observed on a world-wide scale. Despite previously being endemic in west and central Africa with a mortality rate of up to 10%, it remained a neglected tropical disease. Along with other recent pandemics gaining much attention, this MPXV outbreak has provided an opportunity to improve our understanding of its physiopathology and better define management strategies, particularly in patients with more serious disease. From the ophthalmologist's perspective, eyelid involvement and conjunctivitis or keratoconjunctivitis are frequently observed and may precede systemic signs or even remain the major site of involvement. While the course of MPXV keratoconjunctivitis is most often favorable, severe cases pose a functional threat, in particular for immunocompromised patients. This review provides an overview of MPXV pathophysiology, diagnosis and treatment, as well as considerations for prevention of transmission. During such an epidemic, the ophthalmologist can be the first to diagnose MPXV, treat the ocular involvement, and set up adequate preventative measures in collaboration with infectious disease specialists.
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Affiliation(s)
- G. Hoarau
- Service d’ophtalmologie, réseau OPHTARA, CHU Bicêtre Paris-Saclay, université Paris Saclay, AP–HP, Kremlin-Bicêtre, France
| | - C. Vauloup Fellous
- Service de virologie, HU Paul Brousse Paris Saclay, université Paris Saclay, AP–HP, Villejuif, France,Département d’immunologie des maladies virales, auto-immunes, hématologiques et bactériennes, UMR1184, CEA Fontenay-Aux-Roses, France
| | - O. Haigh
- Département d’immunologie des maladies virales, auto-immunes, hématologiques et bactériennes, UMR1184, CEA Fontenay-Aux-Roses, France
| | - M. Labetoulle
- Service d’ophtalmologie, réseau OPHTARA, CHU Bicêtre Paris-Saclay, université Paris Saclay, AP–HP, Kremlin-Bicêtre, France,Département d’immunologie des maladies virales, auto-immunes, hématologiques et bactériennes, UMR1184, CEA Fontenay-Aux-Roses, France
| | - A. Rousseau
- Service d’ophtalmologie, réseau OPHTARA, CHU Bicêtre Paris-Saclay, université Paris Saclay, AP–HP, Kremlin-Bicêtre, France,Département d’immunologie des maladies virales, auto-immunes, hématologiques et bactériennes, UMR1184, CEA Fontenay-Aux-Roses, France,Auteur correspondant. Service d’ophtalmologie, CHU Bicêtre, 78, rue du Général Leclerc, 94275 Le Kremlin-Bicêtre, France
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222
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Cao Y, Li M, Haihambo N, Wang X, Zhao X, Wang B, Sun M, Guo M, Han C. Temporal dynamic characteristics of human monkeypox epidemic in 2022 around the world under the COVID-19 pandemic background. Front Public Health 2023; 11:1120470. [PMID: 36778555 PMCID: PMC9909487 DOI: 10.3389/fpubh.2023.1120470] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 01/09/2023] [Indexed: 01/27/2023] Open
Abstract
Background The reemergence of the monkeypox epidemic has aroused great concern internationally. Concurrently, the COVID-19 epidemic is still ongoing. It is essential to understand the temporal dynamics of the monkeypox epidemic in 2022 and its relationship with the dynamics of the COVID-19 epidemic. In this study, we aimed to explore the temporal dynamic characteristics of the human monkeypox epidemic in 2022 and its relationship with those of the COVID-19 epidemic. Methods We used publicly available data of cumulative monkeypox cases and COVID-19 in 2022 and COVID-19 at the beginning of 2020 for model validation and further analyses. The time series data were fitted with a descriptive model using the sigmoid function. Two important indices (logistic growth rate and semi-saturation period) could be obtained from the model to evaluate the temporal characteristics of the epidemic. Results As for the monkeypox epidemic, the growth rate of infection and semi-saturation period showed a negative correlation (r = 0.47, p = 0.034). The growth rate also showed a significant relationship with the locations of the country in which it occurs [latitude (r = -0.45, p = 0.038)]. The development of the monkeypox epidemic did not show significant correlation compared with the that of COVID-19 in 2020 and 2022. When comparing the COVID-19 epidemic with that of monkeypox, a significantly longer semi-saturation period was observed for monkeypox, while a significant larger growth rate was found in COVID-19 in 2020. Conclusions This novel study investigates the temporal dynamics of the human monkeypox epidemic and its relationship with the ongoing COVID-19 epidemic, which could provide more appropriate guidance for local governments to plan and implement further fit-for-purpose epidemic prevention policies.
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Affiliation(s)
- Yanxiang Cao
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Meijia Li
- Faculty of Psychology and Center for Neuroscience, Vrije Universiteit Brussel, Brussels, Belgium
| | - Naem Haihambo
- Faculty of Psychology and Center for Neuroscience, Vrije Universiteit Brussel, Brussels, Belgium
| | - Xinni Wang
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Xixi Zhao
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Bin Wang
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Meirong Sun
- School of Psychology, Beijing Sport University, Beijing, China
| | - Mingrou Guo
- Shenzhen Key Laboratory of Neuropsychiatric Modulation and Collaborative Innovation Center for Brain Science, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Center for Excellence in Brain Science and Intelligence Technology, Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen–Hong Kong Institute of Brain Science, Shenzhen Fundamental Research Institutions, Shenzhen, China
| | - Chuanliang Han
- Shenzhen Key Laboratory of Neuropsychiatric Modulation and Collaborative Innovation Center for Brain Science, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Center for Excellence in Brain Science and Intelligence Technology, Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen–Hong Kong Institute of Brain Science, Shenzhen Fundamental Research Institutions, Shenzhen, China,*Correspondence: Chuanliang Han ✉
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223
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Skin Manifestation of Human Monkeypox. J Clin Med 2023; 12:jcm12030914. [PMID: 36769562 PMCID: PMC9918194 DOI: 10.3390/jcm12030914] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 01/03/2023] [Accepted: 01/10/2023] [Indexed: 01/26/2023] Open
Abstract
Monkeypox is a zoonotic infectious disease caused by the monkeypox virus (MPXV) infection, which is mainly manifested as characteristic rashes. It spreads mainly through direct skin-to-skin contact. In some cases, respiratory transmission occurs through contact with respiratory droplets when in close contact with an infected person for a long time. The monkeypox outbreak in 2022 frequently occurred in the MSM (men who have sex with men) population, raising concerns about whether monkeypox could be transmitted through sexual behavior. This article mainly reviews the research progress of skin manifestations of monkeypox, including typical and atypical rashes of monkeypox, and different skin manifestations in some special groups, such as children, pregnant women and individuals co-infected with HIV (human immunodeficiency virus) and MPXV. At present, dermatologists are not very familiar with the diagnosis and treatment of monkeypox, it is therefore necessary to review the skin manifestations of monkeypox, which can help clinicians diagnose the sporadic cases and monitor the occurrence of monkeypox early, particularly in people at higher risk of infection. Early clinical diagnosis and treatment can largely avoid serious complications and death from monkeypox.
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Gao J, Zhou C, Liang H, Jiao R, Wheelock ÅM, Jiao K, Ma J, Zhang C, Guo Y, Luo S, Liang W, Xu L. Monkeypox outbreaks in the context of the COVID-19 pandemic: Network and clustering analyses of global risks and modified SEIR prediction of epidemic trends. Front Public Health 2023; 11:1052946. [PMID: 36761122 PMCID: PMC9902715 DOI: 10.3389/fpubh.2023.1052946] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 01/04/2023] [Indexed: 01/25/2023] Open
Abstract
Background Ninety-eight percent of documented cases of the zoonotic disease human monkeypox (MPX) were reported after 2001, with especially dramatic global spread in 2022. This longitudinal study aimed to assess spatiotemporal risk factors of MPX infection and predict global epidemiological trends. Method Twenty-one potential risk factors were evaluated by correlation-based network analysis and multivariate regression. Country-level risk was assessed using a modified Susceptible-Exposed-Infectious-Removed (SEIR) model and a risk-factor-driven k-means clustering analysis. Results Between historical cases and the 2022 outbreak, MPX infection risk factors changed from relatively simple [human immunodeficiency virus (HIV) infection and population density] to multiple [human mobility, population of men who have sex with men, coronavirus disease 2019 (COVID-19) infection, and socioeconomic factors], with human mobility in the context of COVID-19 being especially key. The 141 included countries classified into three risk clusters: 24 high-risk countries mainly in West Europe and Northern America, 70 medium-risk countries mainly in Latin America and Asia, and 47 low-risk countries mainly in Africa and South Asia. The modified SEIR model predicted declining transmission rates, with basic reproduction numbers ranging 1.61-7.84 in the early stage and 0.70-4.13 in the current stage. The estimated cumulative cases in Northern and Latin America may overtake the number in Europe in autumn 2022. Conclusions In the current outbreak, risk factors for MPX infection have changed and expanded. Forecasts of epidemiological trends from our modified SEIR models suggest that Northern America and Latin America are at greater risk of MPX infection in the future.
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Affiliation(s)
- Jing Gao
- Vanke School of Public Health, Tsinghua University, Beijing, China,Institute for Healthy China, Tsinghua University, Beijing, China,Respiratory Medicine Unit, Department of Medicine and Centre for Molecular Medicine, Karolinska Institute, Stockholm, Sweden,Heart and Lung Centre, Department of Pulmonary Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Cui Zhou
- Vanke School of Public Health, Tsinghua University, Beijing, China,Institute for Healthy China, Tsinghua University, Beijing, China
| | - Hanwei Liang
- Vanke School of Public Health, Tsinghua University, Beijing, China,Institute for Healthy China, Tsinghua University, Beijing, China
| | - Rao Jiao
- Department of Mathematical Science, Tsinghua University, Beijing, China
| | - Åsa M. Wheelock
- Heart and Lung Centre, Department of Pulmonary Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Kedi Jiao
- Vanke School of Public Health, Tsinghua University, Beijing, China,Institute for Healthy China, Tsinghua University, Beijing, China
| | - Jian Ma
- Vanke School of Public Health, Tsinghua University, Beijing, China,Institute for Healthy China, Tsinghua University, Beijing, China
| | - Chutian Zhang
- Vanke School of Public Health, Tsinghua University, Beijing, China,Institute for Healthy China, Tsinghua University, Beijing, China
| | - Yongman Guo
- Vanke School of Public Health, Tsinghua University, Beijing, China,Institute for Healthy China, Tsinghua University, Beijing, China
| | - Sitong Luo
- Vanke School of Public Health, Tsinghua University, Beijing, China,Institute for Healthy China, Tsinghua University, Beijing, China,Sitong Luo ✉
| | - Wannian Liang
- Vanke School of Public Health, Tsinghua University, Beijing, China,Institute for Healthy China, Tsinghua University, Beijing, China,Wannian Liang ✉
| | - Lei Xu
- Vanke School of Public Health, Tsinghua University, Beijing, China,Institute for Healthy China, Tsinghua University, Beijing, China,*Correspondence: Lei Xu ✉
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225
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Català A, Riera J, Fuertes I. Mpox - Formerly Monkey Pox - in Dermatology: A Review of Epidemiologic Features, Clinical Presentation, Diagnosis, and Treatment. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:318-326. [PMID: 36682683 PMCID: PMC9854265 DOI: 10.1016/j.ad.2023.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/27/2022] [Accepted: 01/08/2023] [Indexed: 01/22/2023] Open
Abstract
Mpox is an emerging zoonotic disease that has spread rapidly around the world. It has been declared a public health emergency of international concern by the World Health Organization. This review is an update for dermatologists on the epidemiology, clinical presentation, diagnosis, and treatment of Mpox. The primary mode of transmission in the current outbreak is close physical contact during sexual activity. Although most of the initial cases were reported in men who have sex with men, anyone who has close contact with an infected person or contaminated fomites is at risk. Classic prodromal features of Mpox include subclinical manifestations and a mild rash. Complications are common but rarely require hospitalization. Polymerase chain reaction analysis of mucocutaneous lesions is the test of choice for a definitive diagnosis. In the absence of specific treatments, management focuses on symptomatic relief.
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226
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Mpox, Caused by the MPXV of the Clade IIb Lineage, Goes Global. Trop Med Infect Dis 2023; 8:tropicalmed8020076. [PMID: 36828492 PMCID: PMC9966881 DOI: 10.3390/tropicalmed8020076] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/12/2023] [Accepted: 01/16/2023] [Indexed: 01/22/2023] Open
Abstract
Mpox is a great public health concern worldwide currently; thus, a global primary epidemiological analysis of mpox and a phylogenetic analysis of currently circulating MPXV strains based on open-source data is necessary. A total of 83,419 confirmed cases with 72 deaths were reported from 7 May to 23 December 2022, representing an ongoing increasing trend. Mpox was largely restricted to being endemic in children in West Africa (WA) before 2022, and it mainly spread from animals to humans. Our analysis highlights that mpox has not only spread across regions within Africa but has also led to most infection events outside Africa. Currently, mpox has been dominated by human-to-human spread in 110 countries, with the majority of cases distributed in the non-endemic regions of Europe and North America. These data indicate that the geographic range, transmission route, vulnerable populations, and clinical manifestations of mpox have changed, which suggests that the niche of mpox has the potential to change. Remarkably, approximately 38,025 suspected mpox cases were recorded in West and Central Africa during 1970-2022, which implied that the epidemiology of mpox in the two regions remained cryptic, suggesting that strengthening the accuracy of molecular diagnosis on this continent is a priority. Moreover, 617 mpox genomes have been obtained from 12 different hosts; these data imply that the high host diversity may contribute to its ongoing circulation and global outbreak. Furthermore, a phylogenetic analysis of 175 MPXV genome sequences from 38 countries (regions) showed that the current global mpox outbreak was caused by multiple sub-clades in the clade IIb lineage. These data suggest that MPXV strains from the clade IIb lineage may play a predominated role in the spread of mpox worldwide, implying that the current mpox outbreak has a single infection source. However, further investigations into the origin of the new global mpox outbreak are necessary. Therefore, our analysis highlights that adjusted timely interventive measures and surveillance programs, especially using cheap and quick strategies such as wastewater monitoring the DNA of MPXV in Africa (WA), are important for uncovering this disease's transmission source and chain, which will help curb its further spread.
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227
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Du M, Sun H, Zhang S, Yuan J, Yan W, Liu Q, Qin C, Liu M, Liu J. Global Epidemiological Features of Human Monkeypox Cases and Their Associations With Social-Economic Level and International Travel Arrivals: A Systematic Review and Ecological Study. Int J Public Health 2023; 68:1605426. [PMID: 36743344 PMCID: PMC9894882 DOI: 10.3389/ijph.2023.1605426] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 01/12/2023] [Indexed: 01/22/2023] Open
Abstract
Objectives: We aimed to evaluate global epidemiological features of human monkeypox (mpox) cases and their associations with social-economic level and international travel arrivals. Methods: We estimated the pooled value by random-effects models. Then, we conducted an ecological study to evaluate the relationship of confirmed cases with social-economic indices and international travel arrivals using correlation analyses. Results: The average age (2022: 35.52, 95% CI [28.09, 42.94] vs. before 2022: 18.38, 95% CI [14.74, 22.02]) and comorbidity rate (2022: 15.7%, 95% CI [8.9%, 22.4%] vs. before 2022: 14.9%, 95% CI [8.5%, 21.3%]) of mpox cases in the 2022 human mpox outbreak were significantly higher than those of cases before 2022. During the 2022 mpox outbreak, the proportion of men who have sex with men (MSM) was high (79.8%, 95% CI [65.5%, 94.2%]). The number of confirmed mpox cases in 2022 significantly correlated with high social-economic levels and international travel arrivals (all p < 0.05). Conclusion: Our findings highlighted the importance of early surveillance and timely detection in high-risk populations, including older people, MSM, and travelers, which is crucial to curb the wide transmission of mpox.
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Affiliation(s)
- Min Du
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Huimin Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Shimo Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jie Yuan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Wenxing Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Qiao Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Chenyuan Qin
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Min Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China,Global Center for Infectious Disease and Policy Research, Global Health and Infectious Diseases Group, Peking University, Beijing, China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China,Global Center for Infectious Disease and Policy Research, Global Health and Infectious Diseases Group, Peking University, Beijing, China,Institute for Global Health and Development, Peking University, Beijing, China,*Correspondence: Jue Liu,
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McCollum AM, Shelus V, Hill A, Traore T, Onoja B, Nakazawa Y, Doty JB, Yinka-Ogunleye A, Petersen BW, Hutson CL, Lewis R. Epidemiology of Human Mpox - Worldwide, 2018-2021. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2023; 72:68-72. [PMID: 36656790 PMCID: PMC9869741 DOI: 10.15585/mmwr.mm7203a4] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Monkeypox (mpox) is a zoonotic disease caused by Monkeypox virus (MPXV), an Orthopoxvirus; the wild mammalian reservoir species is not known. There are two genetic clades of MPXV: clade I and clade II (historically found in central and west Africa, respectively), with only Cameroon reporting both clades (1). Human cases have historically been reported from 1) mostly rural, forested areas in some central and west African countries; 2) countries reporting cases related to population migration or travel of infected persons; and 3) exposure to imported infected mammals (2). The annual number of cases in Africa has risen since 2014 and cumulatively surpassed reports from the previous 40 years for most countries. This reemergence of mpox might be due to a combination of environmental and ecological changes, animal or human movement, the cessation of routine smallpox vaccination since its eradication in 1980, improvements in disease detection and diagnosis, and genetic changes in the virus (2). This report describes the epidemiology of mpox since 1970 and during 2018-2021, using data from national surveillance programs, World Health Organization (WHO) bulletins, and case reports, and addresses current diagnostic and treatment challenges in countries with endemic disease. During 2018-2021, human cases were recognized and confirmed in six African countries, with most detected in the Democratic Republic of the Congo (DRC) and Nigeria. The reemergence and increase in cases resulted in its being listed in 2019 as a priority disease for immediate and routine reporting through the Integrated Disease Surveillance and Response strategy in the WHO African region.* In eight instances, patients with mpox were identified in four countries outside of Africa after travel from Nigeria. Since 2018, introductory and intermediate training courses on prevention and control of mpox for public health and health care providers have been available online at OpenWHO.†,§ The global outbreak that began in May 2022¶ has further highlighted the need for improvements in laboratory-based surveillance and access to treatments and vaccines to prevent and contain the infection, including in areas of Africa with endemic mpox.
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229
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A Review on Zoonotic Pathogens Associated with Non-Human Primates: Understanding the Potential Threats to Humans. Microorganisms 2023; 11:microorganisms11020246. [PMID: 36838210 PMCID: PMC9964884 DOI: 10.3390/microorganisms11020246] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/07/2023] [Accepted: 01/16/2023] [Indexed: 01/21/2023] Open
Abstract
Non-human primates (NHP) share a close relationship with humans due to a genetic homology of 75-98.5%. NHP and humans have highly similar tissue structures, immunity, physiology, and metabolism and thus often can act as hosts to the same pathogens. Agriculture, meat consumption habits, tourism development, religious beliefs, and biological research have led to more extensive and frequent contact between NHPs and humans. Deadly viruses, such as rabies virus, herpes B virus, Marburg virus, Ebola virus, human immunodeficiency virus, and monkeypox virus can be transferred from NHP to humans. Similarly, herpes simplex virus, influenza virus, and yellow fever virus can be transmitted to NHP from humans. Infectious pathogens, including viruses, bacteria, and parasites, can affect the health of both primates and humans. A vast number of NHP-carrying pathogens exhibit a risk of transmission to humans. Therefore, zoonotic infectious diseases should be evaluated in future research. This article reviews the research evidence, diagnostic methods, prevention, and treatment measures that may be useful in limiting the spread of several common viral pathogens via NHP and providing ideas for preventing zoonotic diseases with epidemic potential.
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230
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Tiwari A, Adhikari S, Kaya D, Islam MA, Malla B, Sherchan SP, Al-Mustapha AI, Kumar M, Aggarwal S, Bhattacharya P, Bibby K, Halden RU, Bivins A, Haramoto E, Oikarinen S, Heikinheimo A, Pitkänen T. Monkeypox outbreak: Wastewater and environmental surveillance perspective. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 856:159166. [PMID: 36202364 PMCID: PMC9534267 DOI: 10.1016/j.scitotenv.2022.159166] [Citation(s) in RCA: 44] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 09/22/2022] [Accepted: 09/28/2022] [Indexed: 04/13/2023]
Abstract
Monkeypox disease (MPXD), a viral disease caused by the monkeypox virus (MPXV), is an emerging zoonotic disease endemic in some countries of Central and Western Africa but seldom reported outside the affected region. Since May 2022, MPXD has been reported at least in 74 countries globally, prompting the World Health Organization to declare the MPXD outbreak a Public Health Emergency of International Concern. As of July 24, 2022; 92 % (68/74) of the countries with reported MPXD cases had no historical MPXD case reports. From the One Health perspective, the spread of MPXV in the environment poses a risk not only to humans but also to small mammals and may, ultimately, spread to potent novel host populations. Wastewater-based surveillance (WBS) has been extensively utilized to monitor communicable diseases, particularly during the ongoing COVID-19 pandemic. It helped in monitoring infectious disease caseloads as well as specific viral variants circulating in communities. The detection of MPXV DNA in lesion materials (e.g. skin, vesicle fluid, crusts), skin rashes, and various body fluids, including respiratory and nasal secretions, saliva, urine, feces, and semen of infected individuals, supports the possibility of using WBS as an early proxy for the detection of MPXV infections. WBS of MPXV DNA can be used to monitor MPXV activity/trends in sewerage network areas even before detecting laboratory-confirmed clinical cases within a community. However, several factors affect the detection of MPXV in wastewater including, but not limited to, routes and duration time of virus shedding by infected individuals, infection rates in the relevant affected population, environmental persistence, the processes and analytical sensitivity of the used methods. Further research is needed to identify the key factors that impact the detection of MPXV biomarkers in wastewater and improve the utility of WBS of MPXV as an early warning and monitoring tool for safeguarding human health. In this review, we shortly summarize aspects of the MPXV outbreak relevant to wastewater monitoring and discuss the challenges associated with WBS.
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Affiliation(s)
- Ananda Tiwari
- Department of Food Hygiene and Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, Finland; Department of Health Security, Expert Microbiology Research Unit, Finnish Institute for Health and Welfare, Finland.
| | - Sangeet Adhikari
- Biodesign Center for Environmental Health Engineering, Biodesign Institute, Arizona State University, Tempe, AZ 85287, USA
| | - Devrim Kaya
- School of Chemical, Biological, and Environmental Engineering, Oregon State University (OSU), Corvallis, OR, USA
| | - Md Aminul Islam
- COVID-19 Diagnostic Laboratory, Department of Microbiology, Noakhali Science and Technology University, Noakhali, 3814, Bangladesh; Advanced Molecular Laboratory, Department of Microbiology, President Abdul Hamid Medical College, Karimganj, Kishoreganj, Bangladesh
| | - Bikash Malla
- Interdisciplinary Center for River Basin Environment, University of Yamanashi, 4-3-11 Takeda, Kofu, Yamanashi 400-8511, Japan
| | - Samendra P Sherchan
- Department of Biology, Morgan State University, Baltimore, MD, USA; Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Ahmad I Al-Mustapha
- Department of Food Hygiene and Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, Finland; Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, University of Ibadan, Oyo State, Nigeria; Department of Veterinary Services, Kwara State Ministry of Agriculture and Rural Development, Ilorin, Kwara State, Nigeria
| | - Manish Kumar
- Sustainability Cluster, School of Engineering, University of Petroleum & Energy Studies, Dehradun, Uttarakhand 248007, India
| | - Srijan Aggarwal
- Department of Civil, Geological and Environmental Engineering, College of Engineering and Mines, University of Alaska Fairbanks, PO Box 755900, Fairbanks, AK 99775, USA
| | - Prosun Bhattacharya
- Department of Sustainable Development, Environmental Science and Engineering, KTH Royal Institute of Technology, SE-10044 Stockholm, Sweden
| | - Kyle Bibby
- Department of Civil and Environmental Engineering and Earth Sciences, University of Notre Dame, IN 46556, USA
| | - Rolf U Halden
- Biodesign Center for Environmental Health Engineering, Biodesign Institute, Arizona State University, Tempe, AZ 85287, USA
| | - Aaron Bivins
- Department of Civil & Environmental Engineering, Louisiana State University, LA, USA
| | - Eiji Haramoto
- Interdisciplinary Center for River Basin Environment, University of Yamanashi, 4-3-11 Takeda, Kofu, Yamanashi 400-8511, Japan
| | - Sami Oikarinen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Annamari Heikinheimo
- Department of Food Hygiene and Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, Finland; Finnish Food Authority, Seinäjoki, Finland
| | - Tarja Pitkänen
- Department of Food Hygiene and Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, Finland; Department of Health Security, Expert Microbiology Research Unit, Finnish Institute for Health and Welfare, Finland
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231
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Monkeypox 2022 Outbreak: How Alarming Is the Situation? Epidemiological and Clinical Review. Clin Pract 2023; 13:102-115. [PMID: 36648850 PMCID: PMC9844383 DOI: 10.3390/clinpract13010010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/20/2022] [Accepted: 12/28/2022] [Indexed: 01/15/2023] Open
Abstract
Monkeypox is a disease caused by Orthopoxvirus, which also includes the smallpox virus. Several endemics have been reported on the African continent, typically in the western and central regions. However, since 13 May 2022, there have been several cases reported from different member states; the number of confirmed cases in 1 month exceeded the total number of cases reported outside the African continent since the first case in 1970. The World Health Organization (WHO) and Centers for Disease Control (CDC) consider monkeypox as an important disease for global public health. The clinical manifestations and laboratory findings in patients with monkeypox remain unclear. In this brief review, we investigated and compared the different characteristics already reported in cases of monkeypox.
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232
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Diatta KLES, Faye O, Sall AA, Faye O, Faye M. Useful public health countermeasures to control the current multicountry outbreak of Monkeypox disease. Front Public Health 2023; 10:1060678. [PMID: 36711326 PMCID: PMC9878340 DOI: 10.3389/fpubh.2022.1060678] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 12/21/2022] [Indexed: 01/15/2023] Open
Abstract
Monkeypox is a viral disease endemic to some countries in Central and Western Africa. However, sporadic human cases have also been reported outside of Africa. The first human case was reported in 1970 in the Democratic Republic of Congo. Very similar to the eradicated smallpox regarding its clinical representation, the Monkeypox disease is most common in children aged between 5 and 9 years with a fatality rate ranging from 1 to 11% in Africa. During the past decade, the number of countries that reported human cases of the disease grew significantly, while experts still sought knowledge on the characteristics of the virus. The recent increase in Monkeypox cases in many countries raises the concern about a possible global health threat. There is a need to subsequently provide insights into the incidence of Monkeypox disease and come up with mechanisms to prevent its emergence and contain its spread. Furthermore, it is crucial to have a better view of the global diagnostic capacity of the Monkeypox virus. This review aims to assess useful public health countermeasures to control the current multicountry outbreak of Monkeypox disease. Articles were searched in PubMed and Google Scholar electronic databases on 30 June 2022, using selected keywords, without language and date restriction. A total of 44 scientific records were published between 1 January 1962 and 30 June 2022. Herein, we discuss the epidemiological and public health situation at a global scale, provide an updated overview and data of utility for a better understanding of knowledge and research gaps in the epidemiology of the Monkeypox disease, and give useful measures for controlling the current multicountry outbreak.
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233
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Mitjà O, Ogoina D, Titanji BK, Galvan C, Muyembe JJ, Marks M, Orkin CM. Monkeypox. Lancet 2023; 401:60-74. [PMID: 36403582 PMCID: PMC9671644 DOI: 10.1016/s0140-6736(22)02075-x] [Citation(s) in RCA: 161] [Impact Index Per Article: 161.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/12/2022] [Accepted: 10/19/2022] [Indexed: 11/19/2022]
Abstract
Monkeypox is a zoonotic illness caused by the monkeypox virus, an Orthopoxvirus in the same genus as the variola, vaccinia, and cowpox viruses. Since the detection of the first human case in the Democratic Republic of the Congo in 1970, the disease has caused sporadic infections and outbreaks, mainly restricted to some countries in west and central Africa. In July, 2022, WHO declared monkeypox a Public Health Emergency of International Concern, on account of the unprecedented global spread of the disease outside previously endemic countries in Africa and the need for global solidarity to address this previously neglected disease. The 2022 outbreak has been primarily associated with close intimate contact (including sexual activity) and most cases have been diagnosed among men who have sex with men, who often present with novel epidemiological and clinical characteristics. In the 2022 outbreak, the incubation period ranges from 7 days to 10 days and most patients present with a systemic illness that includes fever and myalgia and a characteristic rash, with papules that evolve to vesicles, pustules, and crusts in the genital, anal, or oral regions and often involve the mucosa. Complications that require medical treatment (eg, antiviral therapy, antibacterials, and pain control) occur in up to 40% of patients and include rectal pain, odynophagia, penile oedema, and skin and anorectal abscesses. Most patients have a self-limited illness; between 1% and 13% require hospital admission (for treatment or isolation), and the case-fatality rate is less than 0·1%. A diagnosis can be made through the presence of Orthopoxvirus DNA in PCRs from lesion swabs or body fluids. Patients with severe manifestations and people at risk of severe disease (eg, immunosuppressed people) could benefit from antiviral treatment (eg, tecovirimat). The current strategy for post-exposure prophylaxis or pre-exposure prophylaxis for people at high risk is vaccination with the non-replicating modified vaccinia Ankara. Antiviral treatment and vaccines are not yet available in endemic countries in Africa.
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Affiliation(s)
- Oriol Mitjà
- Skin Neglected Tropical Diseases and Sexually Transmitted Infections section, Hospital Universitari Germans Trías i Pujol, Badalona, Spain; Fight Infectious Diseases Foundation, Badalona, Spain; School of Medicine and Health Sciences, University of Papua New Guinea, Port Moresby, Papua New Guinea.
| | - Dimie Ogoina
- Department of Internal Medicine, Infectious Diseases Unit, Niger Delta University and Niger Delta University Teaching Hospital, Bayelsa, Nigeria
| | - Boghuma K Titanji
- Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA; Medecins du Cameroun (Medcamer), Yaoundé, Cameroon
| | | | - Jean-Jacques Muyembe
- Institut National de Recherche Biomedicale, Kinshasa, Democratic Republic of the Congo
| | - Michael Marks
- London School of Hygiene & Tropical Medicine, London, UK; Hospital for Tropical Diseases, University College London Hospital, London, UK; Division of Infection and Immunology, University College London, London, UK
| | - Chloe M Orkin
- Centre for Immunobiology, Blizard Institute, Queen Mary University, London, UK
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234
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Sabeena S. The changing epidemiology of monkeypox and preventive measures: an update. Arch Virol 2023; 168:31. [PMID: 36604361 DOI: 10.1007/s00705-022-05677-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 10/14/2022] [Indexed: 01/07/2023]
Abstract
Monkeypox is a systemic exanthematous viral disease presenting with fever, lymphadenopathy, and vesicular rash. The zoonotic virus causing this disease is endemic to many sub-Saharan African countries, where a steady rise in cases has been witnessed for the past 30 years. However, monkeypox re-emerged as the largest outbreak of the West African clade (clade II) of monkeypox virus in Nigeria in 2017. This poxvirus received only minimal global attention until recently, when cases emerged in Europe and rapidly spread globally in certain sections of the community, such as men having sex with men or bisexuals, with human-to-human transmission. Monkeypox virus has established its presence in humans, crossing geographical boundaries, and clusters of infections may occur among individuals in close contact. All six WHO regions have reported monkeypox cases without any epidemiological association with endemic regions. The ongoing multicountry outbreak suggests that silent human-to-human transmission has been happening in Europe and the United States for a while. For containment of the outbreak, active surveillance and rapid identification of new cases are essential. The availability of vaccines is currently limited. Policymakers must focus on awareness programmes, primary preventive or post-exposure vaccination, and treatment with antivirals to control the ongoing outbreak.
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Mpox: Special Considerations in the Immunocompromised Host. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2023. [DOI: 10.1007/s40506-022-00260-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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236
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Lutz M, Hayney MS, Farraye FA, Caldera F. A Note on Monkeypox for Our Patients With Inflammatory Bowel Disease. Inflamm Bowel Dis 2023; 29:179-180. [PMID: 36200852 DOI: 10.1093/ibd/izac214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Megan Lutz
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin, Madison, School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Mary S Hayney
- School of Pharmacy, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Francis A Farraye
- Inflammatory Bowel Disease Center, Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA
| | - Freddy Caldera
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin, Madison, School of Medicine and Public Health, Madison, Wisconsin, USA
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Money KM, Barnett TA, Rapaka S, Osborn R, Kitani T, Fuguet D, Amjad F, Clark JR, Chakravarty D, Copeland MJ, Honce JM, Kumar PN, Kumar RN, Mousa-Ibrahim F, Sirdar B, Sobota R, Tang M, Bolon MK, Russell EJ, Wilson M, Tornatore C, Batra A, Tyler KL, Pastula DM. Monkeypox-Associated Central Nervous System Disease: A Case Series and Review. Ann Neurol 2023; 93:893-905. [PMID: 36602053 DOI: 10.1002/ana.26597] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/02/2023] [Accepted: 01/03/2023] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Monkeypox virus (MPXV) disease has been declared a public health emergency by the World Health Organization, creating an urgent need for neurologists to be able to recognize, diagnosis, and treat MPXV-associated neurologic disease. METHODS Three cases of MPXV-associated central nervous system (CNS) disease occurring during the 2022 outbreak, and their associated imaging findings are presented, with 2 cases previously published in a limited capacity in a public health bulletin. RESULTS Three previously healthy immunocompetent gay men in their 30s developed a febrile illness followed by progressive neurologic symptoms with presence of a vesiculopustular rash. MPXV nucleic acid was detected by polymerase chain reaction (PCR) from skin lesions of 2 patients, with the third patient having indeterminate testing but an epidemiologic link to a confirmed MPXV disease case. Cerebrospinal fluid demonstrated a lymphocytic pleocytosis, elevated protein, and negative MPXV-specific PCR. In 2 patients, magnetic resonance imaging of the brain and spine demonstrated partially enhancing, longitudinally extensive central spinal cord lesions with multifocal subcortical, basal ganglia, thalamic, cerebellar, and/or brainstem lesions. The third patient had thalamic and basal ganglia lesions. All patients received 14 days of tecovirimat, and 2 patients also received multiple forms of immunotherapy, including intravenous immunoglobulin, pulsed high-dose steroids, plasmapheresis, and/or rituximab. Good neurologic recovery was observed in all cases. INTERPRETATION MPXV can be associated with CNS disease. It is unclear whether this is from a parainfectious immune-mediated injury or direct CNS viral invasion. ANN NEUROL 2023.
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Affiliation(s)
- Kelli M Money
- Neuroinfectious Diseases Group, Departments of Neurology and Medicine (Infectious Diseases), University of Colorado School of Medicine, Aurora, Colorado, USA
| | - T Allen Barnett
- Ken & Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Samuel Rapaka
- Department of Infectious Diseases, Georgetown University Medical Center, Washington, District of Columbia, USA
| | - Rebecca Osborn
- Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Takashi Kitani
- Department of Neurology, Georgetown University Medical Center, Washington, District of Columbia, USA
| | - Daniel Fuguet
- Department of Radiology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Faria Amjad
- Department of Neurology, Georgetown University Medical Center, Washington, District of Columbia, USA
| | - Jeffrey R Clark
- Ken & Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Debanjana Chakravarty
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA.,Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | - Matthew J Copeland
- Department of Infectious Diseases, Georgetown University Medical Center, Washington, District of Columbia, USA
| | - Justin M Honce
- Department of Radiology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Princy N Kumar
- Department of Infectious Diseases, Georgetown University Medical Center, Washington, District of Columbia, USA
| | - Rebecca N Kumar
- Department of Infectious Diseases, Georgetown University Medical Center, Washington, District of Columbia, USA
| | - Fady Mousa-Ibrahim
- Ken & Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Bilaal Sirdar
- Department of Neurology, Georgetown University Medical Center, Washington, District of Columbia, USA
| | - Rafal Sobota
- Ken & Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Mengxuan Tang
- Ken & Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Maureen K Bolon
- Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Eric J Russell
- Ken & Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Michael Wilson
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA.,Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | - Carlo Tornatore
- Department of Neurology, Georgetown University Medical Center, Washington, District of Columbia, USA
| | - Ayush Batra
- Ken & Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Kenneth L Tyler
- Neuroinfectious Diseases Group, Departments of Neurology and Medicine (Infectious Diseases), University of Colorado School of Medicine, Aurora, Colorado, USA.,Department of Immunology and Microbiology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Daniel M Pastula
- Neuroinfectious Diseases Group, Departments of Neurology and Medicine (Infectious Diseases), University of Colorado School of Medicine, Aurora, Colorado, USA.,Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado, USA
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Onu HC, Golden O, Wali IA, Adedire BE, Balogun M, Chidinma E, Ayo SA, Emmanuel O. Epidemiology of human Monkey-pox cases in Rivers State, Nigeria January 2017-June 2022. Front Public Health 2023; 10:1039604. [PMID: 36684949 PMCID: PMC9846594 DOI: 10.3389/fpubh.2022.1039604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/23/2022] [Indexed: 01/06/2023] Open
Abstract
The resurgence in monkey pox disease has posed a global health threat. Nigeria recorded increased number of reported monkey pox cases in 2017, with cases occurring in subsequent years. Notably, cases of monkey pox had been reported in western countries from an epidemiologically linked traveler with a travel history to Nigeria. The highest burden of cases of monkey pox is recorded in River state, Nigeria. Consequently, there is the need to examine the epidemiology of monkey pox according to time, place, person and geography in Rivers state. A retrospective analysis of monkey pox cases was conducted based on the data obtained from the Rivers State Disease Surveillance and Notification unit from January 2017-June 2022. A total of 112 suspected cases were reported during this period of which 49 (44%) were confirmed by laboratory diagnosis. Obio-Akpor (29) and Port Harcourt (9) Local Government Areas which make up the urban centers of the state recorded most cases of monkey pox. More males (36) were affected than females (10), and the age group mostly affected was from 20 to 29 years, however increased cases of monkey pox was found in the months of September to November in most of the years reviewed. Monkey pox is prevalent in Rivers state, although the pattern follows a declining trend. Therefore, the state government should put appropriate mechanisms in place to eradicate the disease.
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Affiliation(s)
| | - Owhonda Golden
- Department of Public Health and Disease Control, Rivers State Ministry of Health, Port Harcourt, Rivers State, Nigeria
| | - I. Aaron Wali
- Department of Community Medicine, Rivers State University, Port Harcourt, Rivers State, Nigeria
| | | | | | - Eze Chidinma
- School of Public Health, University of Port Harcourt, Port Harcourt, Rivers State, Nigeria
| | - S. Adebowale Ayo
- Department of Epidemiology and Medical Biostatistics, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Okolocha Emmanuel
- Department of Veterinary Public Health and Preventive Medicine, Ahmadu Bello University, Zaria, Kaduna, Nigeria
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Mishra S, Rout M, Panda S, Singh SK, Sinha R, Dehury B, Pati S. An immunoinformatic approach towards development of a potent and effective multi-epitope vaccine against monkeypox virus (MPXV). J Biomol Struct Dyn 2023; 41:11714-11727. [PMID: 36591724 DOI: 10.1080/07391102.2022.2163426] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 12/22/2022] [Indexed: 01/03/2023]
Abstract
Monkeypox is a viral zoonotic disease, often transmitted to humans from animals. While the whole world is haggling with the COVID-19 pandemic, the emergence of the monkeypox virus (MPXV) arose as a new challenge to mankind. Till date, numerous cases related to the MPXV have been reported in several countries across the globe, but, its momentary distribution in the current time has left everyone in fright with increasing mortality and limited clinically approved treatments. Therefore, it is of immense importance to develop a potent and highly effective vaccine capable of inducing desired immunogenic responses against the highly contagious MPXV. Herein, using various immunoinformatic and computational biology tools, we made an attempt to develop a multi-epitope vaccine construct against the MPXV which is antigenic, non-allergen and non-toxic in nature and capable of exhibiting immunogenic behavior. The sequence of vaccine construct was designed using the proposed 4 MHC-I, 3 MHC-II and 4 B-cell epitopes linked with suitable adjuvant and linkers. The modeled structure of the vaccine construct was used to assess its interaction with the Toll-like Receptor 4 (TLR4) using ClusPro and HADDOCK. All-atoms molecular dynamics simulation of the MPXV vaccine construct-TLR4 complex followed by a high level of gene expression of the construct within the bacterial system affirmed its stability along with induction of immunogenic response within the host cell. Altogether, our immunoinformatic approach aid in the development of a stable chimeric vaccine construct against MPXV and needs further experimental validation for its immunological relevance and usefulness as a vaccine candidate.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Sarbani Mishra
- Bioinformatics Division, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Madhusmita Rout
- Bioinformatics Division, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Sunita Panda
- Mycology Laboratory, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Susheel Kumar Singh
- Vaccine and Diagnostic Laboratory, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Rohan Sinha
- Department of Computer Science and Engineering, National Institute of Technology Patna, Patna, Bihar, India
| | - Budheswar Dehury
- Bioinformatics Division, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Sanghamitra Pati
- Bioinformatics Division, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
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The clinical presentation of monkeypox: a retrospective case-control study of patients with possible or probable monkeypox in a West London cohort. Int J Infect Dis 2023; 126:48-53. [PMID: 36410691 PMCID: PMC9674568 DOI: 10.1016/j.ijid.2022.11.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/21/2022] [Accepted: 11/14/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES Since May 2022, cases of human monkeypox virus (hMPXV) with human-to-human cross-transmission have significantly increased in nonendemic countries. Our aim was to characterize diagnostic features of patients with confirmed and possible monkeypox to guide future risk stratification and to describe a virtual care model. METHODS We performed a retrospective case-control study of 140 patients assessed and screened for suspected monkeypox; on hMPXV polymerase chain reaction testing, 70 were confirmed positive, and 70 were negative. Data were compared to generate odds ratios of demographic and clinical features. RESULTS Patients who tested positive were predominantly cis-male (99%) and self-identified as gay, bisexual, and other men who have sex with men (94%). Lymphadenopathy at presentation was associated with a higher likelihood of a positive result (odds ratio [OR] 7.69 [95% confidence interval (CI) 3.58, 16.51]). Patients who tested positive were more likely to have a rash affecting the genital (OR 5.38 [95% CI 2.57, 11.23]) or buttocks/perianal region (OR 3.79 [1.70, 8.45]) than negative controls. A total of 79% of patients were engaged with a virtual ward follow-up. CONCLUSION These data can inform a risk-based approach to the management of suspected monkeypox in gay, bisexual, and other men who have sex with men populations. Lymphadenopathy at presentation and the location of the rash were more associated with a positive hMPXV result. Health authorities can consider a virtual ward approach in the hMPHXV outbreak.
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Monkeypox virus from neurological complications to neuroinvasive properties: current status and future perspectives. J Neurol 2023; 270:101-108. [PMID: 35989372 PMCID: PMC9393054 DOI: 10.1007/s00415-022-11339-w] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/13/2022] [Accepted: 08/14/2022] [Indexed: 01/07/2023]
Abstract
Cases of monkeypox (MPV) are sharply rising around the world. While most efforts are being focused on the management of the first symptoms of monkeypox, such as cutaneous lesions and flu-like symptoms, the effect of the monkeypox virus (MPXV) on multiple organs still remains unclear. Recently, several neurological manifestations, such as headache, myalgia, malaise, fatigue, altered consciousness, agitation, anorexia, nausea, and vomiting, have been reported in patients with MPV. In addition, data from experimental studies have indicated that MPXV can gain access to the central nervous system (CNS) through the olfactory epithelium and infected circulatory monocytes/macrophages as two probable neuroinvasive mechanisms. Therefore, there are growing concerns about the long-term effect of MPXV on the CNS and subsequent neurological complications. This paper highlights the importance of the neuroinvasive potential of MPXV, coupled with neurological manifestations.
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242
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Harrison LB, Bergeron G, Cadieux G, Charest H, Fafard J, Levade I, Blais AC, Huchet E, Trottier B, Vlad D, Szabo J, Thomas R, Poulin S, Greenaway C, Zaharatos GJ, Oughton M, Chakravarti A, Pilarski R, Bui-Nguyen A, Benomar K, Libman MD, Vinh DC, Duggan AT, Graham M, Klein MB, Barkati S. Monkeypox in Montréal: Epidemiology, Phylogenomics, and Public Health Response to a Large North American Outbreak. Ann Intern Med 2023; 176:67-76. [PMID: 36508736 DOI: 10.7326/m22-2699] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Monkeypox, a viral zoonotic disease, is causing a global outbreak outside of endemic areas. OBJECTIVE To characterize the outbreak of monkeypox in Montréal, the first large outbreak in North America. DESIGN Epidemiologic and laboratory surveillance data and a phylogenomic analysis were used to describe and place the outbreak in a global context. SETTING Montréal, Canada. PATIENTS Probable or confirmed cases of monkeypox. MEASUREMENTS Epidemiologic, clinical, and demographic data were aggregated. Whole-genome sequencing and phylogenetic analysis were performed for a set of outbreak sequences. The public health response and its evolution are described. RESULTS Up to 18 October 2022, a total of 402 cases of monkeypox were reported mostly among men who have sex with men (MSM), most of which were suspected to be acquired through sexual contact. All monkeypox genomes nested within the B.1 lineage. Montréal Public Health worked closely with the affected communities to control the outbreak, becoming the first jurisdiction to offer 1 dose of the Modified Vaccinia Ankara-Bavarian Nordic vaccine as preexposure prophylaxis (PrEP) to those at risk in early June 2022. Two peaks of cases were seen in early June and July (43 and 44 cases per week, respectively) followed by a decline toward near resolution of the outbreak in October. Reasons for the biphasic peak are not fully elucidated but may represent the tempo of vaccination and/or several factors related to transmission dynamics and case ascertainment. LIMITATIONS Clinical data are self-reported. Limited divergence among sequences limited genomic epidemiologic conclusions. CONCLUSION A large outbreak of monkeypox occurred in Montréal, primarily among MSM. Successful control of the outbreak rested on early and sustained engagement with the affected communities and rapid offer of PrEP vaccination to at-risk persons. PRIMARY FUNDING SOURCE None.
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Affiliation(s)
- Luke B Harrison
- Department of Medicine, Division of Infectious Diseases, McGill University Health Centre, Montréal, Québec, Canada (L.B.H.)
| | - Geneviève Bergeron
- Direction régionale de santé publique de Montréal, Montréal, Québec, Canada (G.B.)
| | - Geneviève Cadieux
- Direction régionale de santé publique de Montréal and Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada (G.C.)
| | - Hugues Charest
- Laboratoire de santé publique du Québec, INSPQ, Sainte-Anne-de-Bellevue, and Département de microbiologie, infectiologie et immunologie, Université de Montréal, Montréal, Québec, Canada (H.C., J.F.)
| | - Judith Fafard
- Laboratoire de santé publique du Québec, INSPQ, Sainte-Anne-de-Bellevue, and Département de microbiologie, infectiologie et immunologie, Université de Montréal, Montréal, Québec, Canada (H.C., J.F.)
| | - Inès Levade
- Laboratoire de Santé publique du Québec, INSPQ, Sainte-Anne-de-Bellevue, Québec, Canada (I.L.)
| | | | | | - Benoît Trottier
- Clinique Médicale du Quartier Latin, Montréal, Québec, Canada (B.T., D.V.)
| | - Dragos Vlad
- Clinique Médicale du Quartier Latin, Montréal, Québec, Canada (B.T., D.V.)
| | - Jason Szabo
- Clinique Médicale l'Actuel, Montréal, Québec, Canada (J.S., R.T.)
| | - Réjean Thomas
- Clinique Médicale l'Actuel, Montréal, Québec, Canada (J.S., R.T.)
| | | | - Christina Greenaway
- Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Department of Medicine, Division of Infectious Diseases, Jewish General Hospital, and J.D. MacLean Centre for Tropical Diseases at McGill University, Montréal, Québec, Canada (C.G.)
| | - Gerasimos J Zaharatos
- Department of Medicine, Division of Infectious Diseases, Jewish General Hospital, Montréal, Québec, Canada (G.J.Z., M.O.)
| | - Matthew Oughton
- Department of Medicine, Division of Infectious Diseases, Jewish General Hospital, Montréal, Québec, Canada (G.J.Z., M.O.)
| | - Arpita Chakravarti
- Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada (A.C.)
| | - Robert Pilarski
- Clinique Médicale La Licorne, Montréal, Québec, Canada (R.P.)
| | | | | | - Michael D Libman
- Department of Medicine, Division of Infectious Diseases, McGill University Health Centre, J.D. MacLean Centre for Tropical Diseases at McGill University, and Research Institute of the McGill University Health Centre, Montréal, Québec, Canada (M.D.L., S.B.)
| | - Donald C Vinh
- Department of Medicine, Division of Infectious Diseases, McGill University Health Centre, and Research Institute of the McGill University Health Centre, Montréal, Québec, Canada (D.C.V.)
| | - Ana T Duggan
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada (A.T.D.)
| | - Morag Graham
- National Microbiology Laboratory, Public Health Agency of Canada, and Department of Medical Microbiology & Infectious Diseases, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada (M.G.)
| | - Marina B Klein
- Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, and Research Institute of the McGill University Health Centre, Montréal, Québec, Canada (M.B.K.)
| | - Sapha Barkati
- Department of Medicine, Division of Infectious Diseases, McGill University Health Centre, J.D. MacLean Centre for Tropical Diseases at McGill University, and Research Institute of the McGill University Health Centre, Montréal, Québec, Canada (M.D.L., S.B.)
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Saxena SK, Ansari S, Maurya VK, Kumar S, Jain A, Paweska JT, Tripathi AK, Abdel-Moneim AS. Re-emerging human monkeypox: A major public-health debacle. J Med Virol 2023; 95:e27902. [PMID: 35652133 DOI: 10.1002/jmv.27902] [Citation(s) in RCA: 56] [Impact Index Per Article: 56.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 05/28/2022] [Accepted: 05/30/2022] [Indexed: 01/11/2023]
Abstract
A multicountry outbreak of the monkeypox virus has gained global attention. As of May 25, 250 confirmed human monkeypox cases have been reported globally. Monkeypox is caused by the Monkeypox virus, which belongs to the Orthopoxvirus genus and Poxviridae family. Monkeypox is often a self-limiting infection, with symptoms lasting 2-4 weeks with the case fatality ratio around 3%-6%. Monkeypox is transmitted to humans by direct contact with an infected person or animal or contact with virus-contaminated material. Human monkeypox infections may lead to various medical complications such as fever, rash, and lymphadenopathies. Pneumonitis, encephalitis, sight-threatening keratitis, and subsequent bacterial infections are all possible complications of monkeypox. An antiviral agent developed to treat smallpox has also been approved for use in the treatment of monkeypox in the United States. Vaccines used in the smallpox eradication program also provided immunity to monkeypox. Newer vaccines have been developed, one of which has been approved for monkeypox prevention. In this study, we provide information about the recent outbreaks of human monkeypox, epidemiology, transmission pattern, possible diagnosis techniques, therapeutics, and available preventive strategies.
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Affiliation(s)
- Shailendra K Saxena
- Centre for Advanced Research, Faculty of Medicine, King George's Medical University, Lucknow, India
- World Society for Virology, Massachusetts, USA
- The Indian Virological Society, New Delhi, India
| | - Saniya Ansari
- Centre for Advanced Research, Faculty of Medicine, King George's Medical University, Lucknow, India
- World Society for Virology, Massachusetts, USA
| | - Vimal K Maurya
- Centre for Advanced Research, Faculty of Medicine, King George's Medical University, Lucknow, India
- World Society for Virology, Massachusetts, USA
| | - Swatantra Kumar
- Centre for Advanced Research, Faculty of Medicine, King George's Medical University, Lucknow, India
- World Society for Virology, Massachusetts, USA
| | - Amita Jain
- Centre for Advanced Research, Faculty of Medicine, King George's Medical University, Lucknow, India
- Department of Microbiology, King George's Medical University, Lucknow, India
| | - Janusz T Paweska
- World Society for Virology, Massachusetts, USA
- Centre for Emerging Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases of the National Health Laboratory Service, Sandringham-Johannesburg, South Africa
| | - Anil K Tripathi
- Centre for Advanced Research, Faculty of Medicine, King George's Medical University, Lucknow, India
| | - Ahmed S Abdel-Moneim
- World Society for Virology, Massachusetts, USA
- Department of Microbiology, Taif University, Al-Taif, Saudi Arabia
- Department of Virology, Beni-Suef University, Beni-Suef, Egypt
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Canakis A, Kim RE, Sinha P, Raufman JP. Addressing the risk of monkeypox exposure during gastrointestinal endoscopy. Ann Gastroenterol 2023; 36:1-5. [PMID: 36593811 PMCID: PMC9756032 DOI: 10.20524/aog.2022.0770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 10/25/2022] [Indexed: 12/12/2022] Open
Abstract
The current monkeypox virus (MPV) outbreak is now a global health concern. MPV, a zoonotic double-stranded DNA virus, may be transmitted from human to human or by contaminated surfaces. Understanding the clinical characteristics and risks of MPV transmission are important, especially for health care workers, who may unknowingly encounter the virus while fulfilling their clinical responsibilities. The World Health Organization has recognized this orthopoxvirus outbreak as a public health emergency and the knowledge gaps regarding MPV's transmission are likely to have contributed to its spread. Instituting proper infection controls in all settings, including the endoscopy suite, is critical to stemming this developing epidemic. Direct contact with skin lesions is the primary mode of transmission, and anorectal lesions are the most common skin manifestation. Hence, gastroenterologists and endoscopists are very likely to see patients with MPV infection. In this context, patients may present with symptoms of proctitis, or lesions may be encountered unexpectedly during anoscopy, sigmoidoscopy, or colonoscopy. In consequence, preprocedural exams and endoscopic procedures may increase exposure risk, especially if characteristic lesions go unrecognized. In this review, we provide background epidemiological and virological information, but focus on the potential risk of MPV exposure during gastrointestinal endoscopy and evaluate current practices regarding personal protective equipment and post-procedure instrument and endoscopy suite decontamination.
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Affiliation(s)
- Andrew Canakis
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD (Andrew Canakis, Raymond E. Kim, Jean-Pierre Raufman)
| | - Raymond E. Kim
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD (Andrew Canakis, Raymond E. Kim, Jean-Pierre Raufman)
| | - Pranay Sinha
- Section of Infectious Diseases, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, MA (Pranay Sinha), USA
| | - Jean-Pierre Raufman
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD (Andrew Canakis, Raymond E. Kim, Jean-Pierre Raufman)
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Epidemiological and clinical characteristics of patients with human monkeypox infection in Mexico: a nationwide observational study. LANCET REGIONAL HEALTH. AMERICAS 2023; 17:100392. [PMID: 36405887 PMCID: PMC9646405 DOI: 10.1016/j.lana.2022.100392] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/11/2022] [Accepted: 10/21/2022] [Indexed: 11/11/2022]
Abstract
Background Human monkeypox, a zoonosis historically endemic to West and South Africa, has led to a worldwide outbreak driven by human-to-human transmission resulting in an international public health emergency. Endemic and outbreak monkeypox cases may differ in their affected populations, clinical features, and outcomes. Thus, profiling cases of the current monkeypox outbreak worldwide is crucial. Methods We performed a nationwide observational surveillance-based study from May 24 to September 5, 2022. Patients that met the operational clinical definition of monkeypox or symptomatic close contacts of confirmed cases were tested by real-time polymerase chain reaction. Clinical data were collected with a standardized case-report form. We report epidemiologic, sociodemographic, and clinical characteristics of confirmed cases. Findings Five-hundred and sixty-five human monkeypox confirmed cases were analysed; 97.2% were men, of whom 59.5% identified as men who have sex with men, and 54.5% had human immunodeficiency virus infection. The median age was 34 years. All patients but one had rash (99.8%), 78.9% had fever, and 47.8% reported myalgia. The anogenital area was the most commonly affected one by rash (49.6%), and proctitis occurred in 6.2% of patients. Six patients required hospitalization, of which one died due to causes unrelated to monkeypox. Interpretation The 2022 monkeypox outbreak in Mexico is mainly driven by middle-aged men who have sex with men, of which a large proportion are persons who live with human immunodeficiency virus infection. Clinical features such as the high proportion of anogenital lesions suggest sexual contact is a pivotal transmission mechanism in this outbreak. Funding This research was supported by grant A1-S-18342 from Consejo Nacional de Ciencia y Tecnología (CONACyT), Mexico (to S.I.V.-F.).
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Low N, Bachmann LH, Ogoina D, McDonald R, Ipekci AM, Quilter LAS, Cevik M. Mpox virus and transmission through sexual contact: Defining the research agenda. PLoS Med 2023; 20:e1004163. [PMID: 36649325 PMCID: PMC9888714 DOI: 10.1371/journal.pmed.1004163] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Revised: 01/31/2023] [Indexed: 01/18/2023] Open
Abstract
In a Policy Forum piece, Dr. Nicola Low and colleagues define the research agenda for Mpox virus and transmission through sexual contact.
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Affiliation(s)
- Nicola Low
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- * E-mail:
| | - Laura H. Bachmann
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Dimie Ogoina
- Infectious Diseases Unit, Department of Internal Medicine, Niger Delta University/Niger Delta University Teaching Hospital, Bayelsa, Nigeria
| | - Robert McDonald
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Aziz Mert Ipekci
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Laura A. S. Quilter
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Muge Cevik
- Division of Infection and Global Health Research, School of Medicine, University of St. Andrews, St. Andrews, Scotland, United Kingdom
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Kabir A, Nazaret I. Action to prevent monkeypox in Iran: special attention to men who have sex with men. Clin Microbiol Infect 2023; 29:118-119. [PMID: 36245143 PMCID: PMC9556979 DOI: 10.1016/j.cmi.2022.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/13/2022] [Accepted: 09/13/2022] [Indexed: 01/26/2023]
Affiliation(s)
- Amir Kabir
- Independent Researcher, Washington, D.C., USA,Corresponding author. Amir Kabir, Washington, D.C., USA
| | - Irwin Nazaret
- Primary Care and Population Sciences, University College London, Royal Free Campus, Rowland Hill Street, London, United Kingdom
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Mungmunpuntipantip R, Wiwanitkit V. Laboratory Diagnosis for Monkeypox: Clinical Practice and Important Points to Be Recognized. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1410:13-20. [PMID: 36396924 DOI: 10.1007/5584_2022_741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Monkeypox is a unique variety of pox infection. WHO has already acknowledged the seriousness of the large monkeypox outbreak in 2022. The disease commonly presents as acute febrile illness with skin lesion. However, a fever or a skin lesion, however, is sometimes not detectable. Without the peculiar appearance, the physician might have missed the problem and made a false diagnosis. Basically, the clinical diagnosis is the simplest procedure and must be used by practitioners. Laboratory methods can help confirm diagnosis. The gold standard for diagnosis is the molecular-based diagnosis. There are also other available approaches such as point of care testing. In this article, we also summarize and discuss important practical points in laboratory diagnosis for monkeypox.
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Affiliation(s)
| | - Viroj Wiwanitkit
- Joseph Ayobabalola University, Ikeji-Arakeji, Nigeria
- Dr DY Patil University, Pune, India
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Muacevic A, Adler JR, Gupta AK, Gupta H, Sonkar SK, Atam V, Chaudhary SC. As the World Struggles With the COVID-19 Pandemic, Another Emergency Threat Arrives on the Horizon, the Monkeypox: A Systematic Review. Cureus 2023; 15:e33596. [PMID: 36655160 PMCID: PMC9838594 DOI: 10.7759/cureus.33596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2023] [Indexed: 01/12/2023] Open
Abstract
The whole world got threatened by COVID-19, which made a significant loss in various sectors and pushed the world into a deep valley. Now a new threat, the emerging outbreak of monkeypox is rapidly spreading across the globe and is currently being observed in more than 110 countries with 79,473 confirmed cases and 50 deaths. Data were collected from PubMed, EMBASE, MEDLINE, Cochrane, Scopus database, African Journals OnLine, internet library sub-Saharan Africa, and Google Scholar. Most data were taken from the democratic Republic of Congo, the Central African Republic, Cameroon, the Republic of Congo, Liberia, Nigeria, the US, and the UK. Case reports, outbreak investigations, epidemiological studies, and surveillance studies were reviewed to find epidemiological details about the outbreak. A total of 50 peer-reviewed articles and 20 grey literature articles, including 9050 cases, were identified for data extraction. Our systematic review revealed that the group most affected is male (95.5%), with a median age of 33.8 years. A total of 55% of the transmission was sexually transmitted. The most commonly reported symptoms such as vesicular-pustular rashes (97.54%), fever (55.25%), inguinal lymphadenopathy (53.6%), exanthema (40.21%), fatigue, headache, asthenia (26.32%), myalgia (16.33%), vesicles and ulcers (30.61%) in the anogenital regions were some of the significant findings. The case fatality rate was observed to be up to 8.65%. The most affected country was the USA, which has the most fatalities in younger ages involved in homosexuality, suffering from HIV or sexually transmitted diseases (STDs).
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Lee MS, Chao YC, Hu BS, Liu C. Breakthrough monkeypox infection in a Taiwanese male with human immunodeficiency virus 6 days after vaccination. DERMATOL SIN 2023. [DOI: 10.4103/ds.ds-d-22-00136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
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