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Cuetos-Suárez D, Gan RK, Cuetos-Suárez D, Arcos González P, Castro-Delgado R. A Review of Mpox Outbreak and Public Health Response in Spain. Risk Manag Healthc Policy 2024; 17:297-310. [PMID: 38328470 PMCID: PMC10849094 DOI: 10.2147/rmhp.s440035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/12/2023] [Indexed: 02/09/2024] Open
Abstract
Objective In May 2022, an unprecedented Mpox outbreak was reported in several non-endemic countries with unknown epidemiological links. Since May 2022, more than 20,000 cases have been reported in Europe. Spain has been the most affected country in Europe. We aim to describe the Mpox epidemiological profile in Spain, identify its outbreak risks, and describe public health interventions implemented by the Spanish authorities. Methods A literature review was conducted, using specific selection criteria to obtain relevant publications describing Mpox clinical presentation and risk factors and the public health response in Spain to the ongoing outbreak. Results 63.1% of the cases presented an anogenital rash, considered a specific and early symptom in this outbreak. Low case fatality rate is observed, mainly in risk groups, such as the immunocompromised population. Patients evolution was generally favorable, although 3-8% required hospitalization and two deaths occurred; 40% of patients were previously diagnosed with HIV infection. Most of the cases were seen among young population and concentrated in men who had sex with other men, mainly with multiple sexual partners, who did not practice safe sex such as using condoms, and those attending mass event parties. Conclusion To date, the Mpox outbreak is not considered a public health emergency of international concern. The epidemiological trend of the virus in Spain shows that public health response interventions (health education, contact tracing, vaccination, etc.) have adequately controlled the epidemic curve in high-risk populations and avoided spreading the virus to other groups within the community.
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Affiliation(s)
- Daniel Cuetos-Suárez
- Unit for Research in Emergency and Disaster, Public Health Area, Department of Medicine, University of Oviedo, Oviedo, Asturias, Spain
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Rick Kye Gan
- Unit for Research in Emergency and Disaster, Public Health Area, Department of Medicine, University of Oviedo, Oviedo, Asturias, Spain
| | - David Cuetos-Suárez
- Emergency Medicine Department, Spanish Central Defense Academy, Madrid, Spain
| | - Pedro Arcos González
- Unit for Research in Emergency and Disaster, Public Health Area, Department of Medicine, University of Oviedo, Oviedo, Asturias, Spain
| | - Rafael Castro-Delgado
- Health Service Principality of Asturias (SAMU-Asturias), Health Research Institute of Asturias, ISPA (Prehospital Care and Disasters Research Group, GIAPREDE)Oviedo, Asturias, Spain
- Department of Medicine, University of Oviedo, Oviedo, Asturias, Spain
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Jain N, Umar TP, Sayad R, Mokresh ME, Tandarto K, Siburian R, Liana P, Laivacuma S, Reinis A. Monkeypox Diagnosis in Clinical Settings: A Comprehensive Review of Best Laboratory Practices. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1451:253-271. [PMID: 38801583 DOI: 10.1007/978-3-031-57165-7_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
An outbreak of monkeypox (Mpox) was reported in more than 40 countries in early 2022. Accurate diagnosis of Mpox can be challenging, but history, clinical findings, and laboratory diagnosis can establish the diagnosis. The pre-analytic phase of testing includes collecting, storing, and transporting specimens. It is advised to swab the lesion site with virus transport medium (VTM) containing Dacron or polyester flock swabs from two different sites. Blood, urine, and semen samples may also be used. Timely sampling is necessary to obtain a sufficient amount of virus or antibodies. The analytical phase of infectious disease control involves diagnostic tools to determine the presence of the virus. While polymerase chain reaction (PCR) is the gold standard for detecting Mpox, genome sequencing is for identifying new or modified viruses. As a complement to these methods, isothermal amplification methods have been designed. ELISA assays are also available for the determination of antibodies. Electron microscopy is another effective diagnostic method for tissue identification of the virus. Wastewater fingerprinting provides some of the most effective diagnostic methods for virus identification at the community level. The advantages and disadvantages of these methods are further discussed. Post-analytic phase requires proper interpretation of test results and the preparation of accurate patient reports that include relevant medical history, clinical guidelines, and recommendations for follow-up testing or treatment.
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Affiliation(s)
- Nityanand Jain
- Faculty of Medicine, Riga Stradiņš University, Dzirciema Street 16, Riga, 1007, Latvia.
- Joint Microbiology Laboratory, Pauls Stradins Clinical University Hospital, Pilsonu Street 13, Riga, 1002, Latvia.
| | - Tungki Pratama Umar
- Faculty of Medicine, Sriwijaya University, Dr. Mohammad Ali Street-RSMH Complex, Palembang, 30126, Indonesia.
| | - Reem Sayad
- Faculty of Medicine, Assiut University, Saad Zaghloul, Assiut, 71515, Egypt
| | - Muhammed Edib Mokresh
- Faculty of International Medicine, University of Health Sciences, Tibbiye, Istanbul, 34668, Turkey
| | - Kevin Tandarto
- Faculty of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Pluit Raya Street No. 2, North Jakarta, Special Capital Region of Jakarta, 14440, Indonesia
| | - Reynold Siburian
- Faculty of Medicine, Sriwijaya University, Dr. Mohammad Ali Street-RSMH Complex, Palembang, 30126, Indonesia
| | - Phey Liana
- Department of Clinical Pathology, Faculty of Medicine, Sriwijaya University-Mohammad Hoesin General Hospital, Palembang, 30126, Indonesia
| | - Sniedze Laivacuma
- Faculty of Medicine, Riga Stradiņš University, Dzirciema Street 16, Riga, 1007, Latvia
- Department of Infectious Diseases, Riga East Clinical University Hospital, Hipokrata Street 2, Riga, 1038, Latvia
| | - Aigars Reinis
- Faculty of Medicine, Riga Stradiņš University, Dzirciema Street 16, Riga, 1007, Latvia
- Joint Microbiology Laboratory, Pauls Stradins Clinical University Hospital, Pilsonu Street 13, Riga, 1002, Latvia
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3
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Marín-Sánchez O, Pesantes-Grados P, Pérez-Timaná L, Marín-Machuca O, Sánchez-Llatas CJ, Chacón RD. Comparative Epidemiological Assessment of Monkeypox Infections on a Global and Continental Scale Using Logistic and Gompertz Mathematical Models. Vaccines (Basel) 2023; 11:1765. [PMID: 38140170 PMCID: PMC10747842 DOI: 10.3390/vaccines11121765] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/16/2023] [Accepted: 11/21/2023] [Indexed: 12/24/2023] Open
Abstract
The monkeypox virus (MPXV) has caused an unusual epidemiological scenario-an epidemic within a pandemic (COVID-19). Despite the inherent evolutionary and adaptive capacity of poxviruses, one of the potential triggers for the emergence of this epidemic was the change in the status of orthopoxvirus vaccination and eradication programs. This epidemic outbreak of HMPX spread worldwide, with a notable frequency in Europe, North America, and South America. Due to these particularities, the objective of the present study was to assess and compare cases of HMPX in these geographical regions through logistic and Gompertz mathematical modeling over one year since its inception. We estimated the highest contagion rates (people per day) of 690, 230, 278, and 206 for the world, Europe, North America, and South America, respectively, in the logistic model. The equivalent values for the Gompertz model were 696, 268, 308, and 202 for the highest contagion rates. The Kruskal-Wallis Test indicated different means among the geographical regions affected by HMPX regarding case velocity, and the Wilcoxon pairwise test indicated the absence of significant differences between the case velocity means between Europe and South America. The coefficient of determination (R2) values in the logistic model varied from 0.8720 to 0.9023, and in the Gompertz model, they ranged from 0.9881 to 0.9988, indicating a better fit to the actual data when using the Gompertz model. The estimated basic reproduction numbers (R0) were more consistent in the logistic model, varying from 1.71 to 1.94 in the graphical method and from 1.75 to 1.95 in the analytical method. The comparative assessment of these mathematical modeling approaches permitted the establishment of the Gompertz model as the better-fitting model for the data and the logistic model for the R0. However, both models successfully represented the actual HMPX case data. The present study estimated relevant epidemiological data to understand better the geographic similarities and differences in the dynamics of HMPX.
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Affiliation(s)
- Obert Marín-Sánchez
- Departamento Académico de Microbiología Médica, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Av. Carlos Germán Amezaga 375, Lima 15081, Peru;
| | - Pedro Pesantes-Grados
- Unidad de Posgrado, Facultad de Ciencias Matemáticas, Universidad Nacional Mayor de San Marcos, Av. Carlos Germán Amezaga 375, Lima 15081, Peru;
| | - Luis Pérez-Timaná
- Escuela Profesional de Genética y Biotecnología, Facultad de Ciencias Biológicas, Universidad Nacional Mayor de San Marcos, Av. Carlos Germán Amezaga 375, Lima 15081, Peru;
| | - Olegario Marín-Machuca
- Departamento Académico de Ciencias Alimentarias, Facultad de Oceanografía, Pesquería, Ciencias Alimentarias y Acuicultura, Universidad Nacional Federico Villarreal, Calle Roma 350, Miraflores 15074, Peru;
| | - Christian J. Sánchez-Llatas
- Department of Genetics, Physiology, and Microbiology, School of Biology, Complutense University of Madrid (U.C.M.), C. de José Antonio Nováis, 12, 28040 Madrid, Spain;
| | - Ruy D. Chacón
- Department of Pathology, School of Veterinary Medicine, University of São Paulo, Av. Prof. Orlando M. Paiva, 87, São Paulo 05508-270, Brazil
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Dubey T, Chakole S, Agrawal S, Gupta A, Munjewar PK, Sharma R, Yelne S. Enhancing Nursing Care in Monkeypox (Mpox) Patients: Differential Diagnoses, Prevention Measures, and Therapeutic Interventions. Cureus 2023; 15:e44687. [PMID: 37809174 PMCID: PMC10551575 DOI: 10.7759/cureus.44687] [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: 08/04/2023] [Accepted: 09/04/2023] [Indexed: 10/10/2023] Open
Abstract
Monkeypox (Mpox), a rare zoonotic viral infection caused by the monkeypox virus, has been gaining attention due to its potential for human-to-human transmission and its clinical resemblance to other poxvirus infections, such as smallpox and chickenpox. Enhancing nursing care for monkeypox patients is imperative to manage and contain its spread effectively. This review analyzes the key aspects of enhancing nursing care in monkeypox patients, focusing on differential diagnoses, prevention measures, and therapeutic interventions. Differential diagnosis is crucial in terms of the early recognition and management of monkeypox. Given its similarity to other poxvirus infections, a thorough assessment of clinical symptoms, travel history, and exposure to potential reservoir hosts is essential. Nursing professionals play a pivotal role in eliciting comprehensive patient histories and relaying this information to the medical team for accurate diagnosis. Prevention measures constitute a vital component of nursing care in monkeypox management. Implementing stringent infection prevention and control practices, including isolation protocols, personal protective equipment (PPE) usage, and hand hygiene, is imperative to curbing nosocomial transmission. Nurses are at the forefront of enforcing these measures, educating patients, families, and healthcare staff about their significance, and ensuring strict adherence. Therapeutic interventions in monkeypox largely focus on supportive care and symptom management. Nurses occupy a central role in administering antiviral medications, providing wound care for skin lesions, and monitoring patients for potential complications such as secondary bacterial infections. Psychosocial support is equally important, as patients often experience fear and anxiety due to the disease's contagious nature. Nursing professionals offer compassionate care, address patients' emotional needs, and facilitate communication between patients and their families. Enhancing nursing care for monkeypox entails a multifaceted approach involving differential diagnoses, prevention measures, and therapeutic interventions. Nursing professionals serve as frontline caregivers, pivotal in early diagnosis, effective prevention strategies, and comprehensive patient management. As the global healthcare community faces an influx of emerging infectious diseases, the lessons learned from managing monkeypox can contribute to the creation of a more resilient and responsive nursing workforce capable of effectively addressing future health challenges.
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Affiliation(s)
- Tanishq Dubey
- General Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Swarupa Chakole
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Suyash Agrawal
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Anannya Gupta
- Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pratiksha K Munjewar
- Medical Surgical Nursing, Smt. Radhikabai Meghe Memorial College of Nursing, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Ranjana Sharma
- Medical Surgical Nursing, Smt. Radhikabai Meghe Memorial College of Nursing, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Seema Yelne
- Nursing, Shalinitai Meghe College of Nursing, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Khan SA, Parajuli SB, Rauniyar VK. Neurological manifestations of an emerging zoonosis-Human monkeypox virus: A systematic review. Medicine (Baltimore) 2023; 102:e34664. [PMID: 37657009 PMCID: PMC10476717 DOI: 10.1097/md.0000000000034664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 07/19/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND The last few decades have witnessed an appalling rise in several emerging and re-emerging viral and zoonotic outbreaks. Amongst those emerging zoonosis, one of the diseases which is gaining popularity these days and has been declared as public health emergency of international concern by the world health organization, is human monkeypox virus (HMPX). Proper understanding of the clinical spectrum of the disease is of paramount importance for early diagnosis and treatment. In this review, we aimed to study and quantify the neurological manifestations of HMPX virus infection. METHODS Any study, released prior to April 13, 2023, that reported neurological manifestations in patients infected by HMPX virus were reviewed systematically on PubMed, Scopus, Google Scholar, and Cochrane Library using the PRISMA (Preferred Reporting Items for Systematic review and Meta-Analysis) statement. RESULTS Our systematic review included data from 22 eligible studies: 10 cohort studies, 3 cross sectional studies, one retrospective study, 5 case series, and 2 case reports. The most commonly reported neurological manifestations of HMPX were headache (48.84%), myalgia (27.50%), fatigue (17.73%), and photophobia (4.43%). Uncommonly, HMPX can also present with visual deficit (0.57%), seizure (0.34%), encephalitis (0.8%), dizziness (0.34%), encephalomyelitis (0.23%), coma (0.11%), and transverse myelitis (0.11%). DISCUSSIONS Monkeypox virus usually presents with self-limiting painful rash, lymphadenitis, and fever, complications like secondary skin infection, eye problems and pneumonia can be life threatening, carrying a case fatality rate of 1% to 10%. Neurological manifestations are not uncommon and can further add-on to morbidity and mortality.
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Affiliation(s)
| | - Surya Bahadur Parajuli
- Department of Community Medicine, Birat Medical College Teaching Hospital, Morang, Nepal
| | - Vivek K. Rauniyar
- Department of Clinical Neurology, Birat Medical College Teaching Hospital, Morang, Nepal
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6
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Spirito F, Guida A, Caponio VCA, Lo Muzio L. Monkeypox: A New Challenge for Global Health System? Life (Basel) 2023; 13:1250. [PMID: 37374034 DOI: 10.3390/life13061250] [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: 04/14/2023] [Revised: 05/16/2023] [Accepted: 05/23/2023] [Indexed: 06/29/2023] Open
Abstract
The COVID-19 pandemic, starting in 2020, has presented a major challenge in terms of early diagnosis and the subsequent containment and management of severe cases. The spread of viruses such as monkeypox in non-endemic countries is now creating new difficulties for healthcare professionals. Proper case definition and clinical examination are crucial for the early identification of suspected cases. For this reason, we performed a review of the literature in order to report the first signs, which are useful for healthcare providers for early case identification. Since 2022 to date, 86,930 laboratory-confirmed cases and 1051 probable cases have been reported worldwide, and of these, 116 were fatal cases and, for the first time, most of the cases were registered in countries that have not historically reported monkeypox and that lack direct or immediate epidemiological links to areas of West or Central Africa where the disease is endemic. Patients with Monkeypox experience prodromal symptoms, such as fever, fatigue, headache, muscle aches, and a rash after an incubation period of 5-21 days. The disease is usually self-limiting within 2-4 weeks but can lead to complications, such as pneumonia, encephalitis, kidney injury, and myocarditis in children, pregnant individuals, and those with weakened immune systems. The case-fatality ratio is between 1 and 10%. Today, prevention campaigns and the control of human monkeypox are the best weapons to prevent infection and stop transmission. Prevention strategies, such as avoiding contact with sick or dead animals, and the proper preparation of all foods containing animal meat or parts, should be adopted. Furthermore, close contact with infected people or contaminated materials should be avoided to prevent human-to-human transmission.
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Affiliation(s)
- Francesca Spirito
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli, 71122 Foggia, Italy
| | - Agostino Guida
- U.O.C. Odontostomatologia, A.O.R.N. "A. Cardarelli", 80131 Naples, Italy
| | - Vito Carlo Alberto Caponio
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli, 71122 Foggia, Italy
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli, 71122 Foggia, Italy
- Consorzio Interuniversitario Nazionale per la Bio-Oncologia, 66100 Chieti, Italy
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Saadh MJ, Ghadimkhani T, Soltani N, Abbassioun A, Daniel Cosme Pecho R, Taha A, Jwad Kazem T, Yasamineh S, Gholizadeh O. Progress and prospects on vaccine development against Monkeypox Infection. Microb Pathog 2023; 180:106156. [PMID: 37201635 DOI: 10.1016/j.micpath.2023.106156] [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: 02/12/2023] [Revised: 05/11/2023] [Accepted: 05/15/2023] [Indexed: 05/20/2023]
Abstract
The monkeypox virus (MPOX) is an uncommon zoonotic illness brought on by an orthopoxvirus (OPXV). MPOX can occur with symptoms similar to smallpox. Since April 25, 2023, 110 nations have reported 87,113 confirmed cases and 111 fatalities. Moreover, the outspread prevalence of MPOX in Africa and a current outbreak of MPOX in the U.S. have made it clear that naturally occurring zoonotic OPXV infections remain a public health concern. Existing vaccines, though they provide cross-protection to MPOX, are not specific for the causative virus, and their effectiveness in the light of the current multi-country outbreak is still to be verified. Furthermore, as a sequel of the eradication and cessation of smallpox vaccination for four decades, MPOX found a possibility to re-emerge, but with distinct characteristics. The World Health Organization (WHO) suggested that nations use affordable MPOX vaccines within a framework of coordinated clinical effectiveness and safety evaluations. Vaccines administered in the smallpox control program and conferred immunity against MPOX. Currently, vaccines approved by WHO for use against MPOX are replicating (ACAM2000), low replicating (LC16m8), and non-replicating (MVA-BN). Although vaccines are accessible, investigations have demonstrated that smallpox vaccination is approximately 85% efficient in inhibiting MPOX. In addition, developing new vaccine methods against MPOX can help prevent this infection. To recognize the most efficient vaccine, it is essential to assess effects, including reactogenicity, safety, cytotoxicity effect, and vaccine-associated side effects, especially for high-risk and vulnerable people. Recently, several orthopoxvirus vaccines have been produced and are being evaluated. Hence, this review aims to provide an overview of the efforts dedicated to several types of vaccine candidates with different strategies for MPOX, including inactivated, live-attenuated, virus-like particles (VLPs), recombinant protein, nucleic acid, and nanoparticle-based vaccines, which are being developed and launched.
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Affiliation(s)
- Mohamed J Saadh
- Faculty of Pharmacy, Middle East University, Amman, 11831, Jordan; Applied Science Research Center, Applied Science Private University, Amman, Jordan
| | | | - Narges Soltani
- School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Arian Abbassioun
- Department of Virology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | | | - Ali Taha
- Medical Technical College, Al-Farahidi University, Iraq
| | - Tareq Jwad Kazem
- Scientific Affairs Department, Al-Mustaqbal University, 51001, Hillah, Babylon, Iraq
| | - Saman Yasamineh
- Research Center for Clinical Virology, Tehran University of Medical Sciences, Tehran, Iran.
| | - Omid Gholizadeh
- Research Center for Clinical Virology, Tehran University of Medical Sciences, Tehran, Iran.
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8
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Ullah M, Li Y, Munib K, Zhang Z. Epidemiology, host range, and associated risk factors of monkeypox: an emerging global public health threat. Front Microbiol 2023; 14:1160984. [PMID: 37213509 PMCID: PMC10196482 DOI: 10.3389/fmicb.2023.1160984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 03/27/2023] [Indexed: 05/23/2023] Open
Abstract
Based on recent multiregional epidemiological investigations of Monkeypox (MPX), on 24 July 2022, the World Health Organization declared it a global public health threat. Retrospectively MPX was an ignored zoonotic endemic infection to tropical rainforest regions of Western and Central African rural communities until a worldwide epidemic in May 2022 verified the potential threat of monkeypox virus (MPXV) to be propagated across the contemporary world via transnational tourism and animal movements. During 2018-2022, different cases of MPX diagnosed in Nigerian travelers have been documented in Israel, the United Kingdom, Singapore, and the United States. More recently, on 27 September 2022, 66,000 MPX cases have been confirmed in more than 100 non-endemic countries, with fluctuating epidemiological footprinting from retrospective epidemics. Particular disease-associated risk factors fluctuate among different epidemics. The unpredicted appearance of MPX in non-endemic regions suggests some invisible transmission dynamic. Hence, broad-minded and vigilant epidemiological attention to the current MPX epidemic is mandatory. Therefore, this review was compiled to highlight the epidemiological dynamic, global host ranges, and associated risk factors of MPX, concentrating on its epidemic potential and global public health threat.
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Affiliation(s)
- Munib Ullah
- State Key Laboratory of Veterinary Etiological Biology, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China
- Department of Clinical Studies, Faculty of Veterinary and Animal Sciences, PMAS-Arid Agriculture University Rawalpindi, Rawalpindi, Pakistan
| | - Yanmin Li
- College of Animal Husbandry and Veterinary Medicine, Southwest Minzu University, Chengdu, China
| | - Kainat Munib
- Department of Sociology, Allama Iqbal Open University Islamabad, Islamabad, Pakistan
| | - Zhidong Zhang
- College of Animal Husbandry and Veterinary Medicine, Southwest Minzu University, Chengdu, China
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9
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Alrasheedy AA, Aldawsari AH, Alqasir MI, Alsawyan OA, Alalwan OA, Alwaker SA, Almutairi MS, Godman B. Knowledge of Community Pharmacists in Saudi Arabia Regarding Human Monkeypox, Its Management, Prevention, and Vaccination: Findings and Implications. Vaccines (Basel) 2023; 11:vaccines11040878. [PMID: 37112790 PMCID: PMC10143221 DOI: 10.3390/vaccines11040878] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/17/2023] [Accepted: 04/19/2023] [Indexed: 04/29/2023] Open
Abstract
Many cases of monkeypox have recently been reported in countries where this disease is not endemic, raising a global health concern. Consequently, healthcare professionals (HCPs), including pharmacists, need to be aware of the disease, its prevention, including the role of vaccines, and its management to reduce transmission. A cross-sectional, questionnaire-based study was conducted among conveniently sampled community pharmacists in the Qassim region of Saudi Arabia. A total of 189 community pharmacists participated in the study, giving a response rate of 72.97%. From these, 86.77% were male, 51.32% were ≤30 years old, 36.51% were aged between 31-40 years, and 43.39% had 1-5 years of experience as community pharmacists. Their overall knowledge was 17.72 ± 5.56 out of a maximum of 28. The overall rate of correct answers for the knowledge statements was 63.29%, with 52.4% answering ≥50-<75% of the knowledge questions correctly and 31.2% answering ≥75% of the questions correctly. The knowledge subdomain related to diagnosis and clinical characteristics recorded the highest score, with the subdomain relating to causative pathogens and epidemiology recording a lower score. Overall, community pharmacists had moderate knowledge of monkeypox and its clinical management, prevention, and the role of vaccines, which is a concern for the future. Consequently, tailored, flexible, and timely educational interventions are needed to ensure that HCPs, including community pharmacists, are fully equipped with the latest evidence-based knowledge regarding this viral disease to reduce transmission and improve care.
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Affiliation(s)
- Alian A Alrasheedy
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim 51452, Saudi Arabia
| | - Abdulrahman H Aldawsari
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim 51452, Saudi Arabia
| | - Munyib I Alqasir
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim 51452, Saudi Arabia
| | - Omar A Alsawyan
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim 51452, Saudi Arabia
| | - Osama A Alalwan
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim 51452, Saudi Arabia
| | - Saleh A Alwaker
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim 51452, Saudi Arabia
| | - Masaad S Almutairi
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim 51452, Saudi Arabia
| | - Brian Godman
- Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Molotlegi Street, Garankuwa, Pretoria 0208, South Africa
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman P.O. Box 346, United Arab Emirates
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10
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Kandeel M. Current Clinical Trials for the Monkeypox Virus. DR. SULAIMAN AL HABIB MEDICAL JOURNAL 2023. [PMCID: PMC9990049 DOI: 10.1007/s44229-023-00029-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background Monkeypox (MPX) is a zoonotic Orthopoxvirus causing smallpox-like symptoms. Before April 2022, MPX cases outside Africa were rare. The virus can spread through skin-to-skin contact, sexual contact, respiratory droplets, and household items such as towels and blankets. Aim This study was aimed at highlighting the dire need for vaccination and treatment against this infection. Several in-process clinical trials that may help overcome MPX infection are discussed. Methods A search for recent clinical studies was conducted in the clinicaltrials.gov database. Results A total of 15 trials were identified. After February 2022, 14 new trials were launched. Of the 15 trials, 9 were observational studies, 3 were treatment studies and 3 were preventive studies. MPX clinical trial topics were classified into four broad categories: MPX virus shedding and clearance; response to MPX vaccine; antiviral treatment for MPX; and awareness regarding MPX. One medication, tecovirimat, and two vaccines are currently in clinical trials. Conclusions Few treatments and vaccines are under evaluation. Although multiple trials have been conducted, evidence to determine the present state of MPX infection is currently insufficient. Global collaboration is required to achieve complete understanding of the epidemiology, prevention and control of MPX.
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Affiliation(s)
- Mahmoud Kandeel
- Department of Biomedical Sciences, College of Veterinary Medicine, King Faisal University, Al-Hofuf, 31982 Al-Ahsa Saudi Arabia
- Department of Pharmacology, Faculty of Veterinary Medicine, Kafrelshikh University, Kafrelshikh, 33516 Egypt
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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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Attallah O. MonDiaL-CAD: Monkeypox diagnosis via selected hybrid CNNs unified with feature selection and ensemble learning. Digit Health 2023; 9:20552076231180054. [PMID: 37312961 PMCID: PMC10259124 DOI: 10.1177/20552076231180054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 05/18/2023] [Indexed: 06/15/2023] Open
Abstract
Objective Recently, monkeypox virus is slowly evolving and there are fears it will spread as COVID-19. Computer-aided diagnosis (CAD) based on deep learning approaches especially convolutional neural network (CNN) can assist in the rapid determination of reported incidents. The current CADs were mostly based on an individual CNN. Few CADs employed multiple CNNs but did not investigate which combination of CNNs has a greater impact on the performance. Furthermore, they relied on only spatial information of deep features to train their models. This study aims to construct a CAD tool named "Monkey-CAD" that can address the previous limitations and automatically diagnose monkeypox rapidly and accurately. Methods Monkey-CAD extracts features from eight CNNs and then examines the best possible combination of deep features that influence classification. It employs discrete wavelet transform (DWT) to merge features which diminishes fused features' size and provides a time-frequency demonstration. These deep features' sizes are then further reduced via an entropy-based feature selection approach. These reduced fused features are finally used to deliver a better representation of the input features and feed three ensemble classifiers. Results Two freely accessible datasets called Monkeypox skin image (MSID) and Monkeypox skin lesion (MSLD) are employed in this study. Monkey-CAD could discriminate among cases with and without Monkeypox achieving an accuracy of 97.1% for MSID and 98.7% for MSLD datasets respectively. Conclusions Such promising results demonstrate that the Monkey-CAD can be employed to assist health practitioners. They also verify that fusing deep features from selected CNNs can boost performance.
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Affiliation(s)
- Omneya Attallah
- Department of Electronics and Communications Engineering, College of Engineering and Technology, Arab Academy for Science, Technology and Maritime Transport, Alexandria, Egypt
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