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Kamaratos-Sevdalis N, Kourampi I, Ozturk NB, Mavromanoli AC, Tsagkaris C. Mpox and Surgery: Protocols, Precautions, and Recommendations. Microorganisms 2024; 12:1900. [PMID: 39338574 PMCID: PMC11434558 DOI: 10.3390/microorganisms12091900] [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: 08/06/2024] [Revised: 09/11/2024] [Accepted: 09/13/2024] [Indexed: 09/30/2024] Open
Abstract
Mpox, also known as Monkeypox, is an infectious disease known to spread via direct contact and fomites, which poses a significant contagion risk in surgical settings and may increase the challenges already posed by COVID-19. Within the three years following the outbreak of Mpox, we conducted a review of the impact of Mpox on surgical practice. We searched Pubmed/Medline and Scopus, focusing on original studies and case reports in English or German. Our search terms included "Mpox", "Monkeypox", and "Surgery". Out of 60 clinical or epidemiological studies, as well as expert opinions, brief reports, and pertinent literature reviews, eight were included after full-text assessment. We also incorporated two pertinent literature reviews, including a total of 10 papers, in this analysis. The main topics addressed by the literature are 1. manifestations of Mpox for surgical consideration or urgent management, for which it is important to consider whether a surgical approach is needed to address long-term Mpox-related lesions and 2. infection control in surgical settings, especially considering its impact on elective surgery and the well-being of healthcare workers. Mpox could affect surgical services and access to operating theaters. Unlike COVID-19, Mpox, compared to initial concerns, has not substantially compromised surgical delivery. However, limited reports exist on the surgical impact of Mpox. It is crucial to involve surgeons in Mpox diagnosis, educate surgical practitioners on its mimicry of common surgical conditions, enhance infection control during surgery, and ensure access to corrective surgery as a means of tackling the stigmatization associated with Mpox and sexually transmitted diseases in general.
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Affiliation(s)
| | - Islam Kourampi
- Faculty of Medicine, National and Kapodistrian University of Athens, 157 72 Athens, Greece
| | - Nazli Begum Ozturk
- Department of Internal Medicine, Beaumont Health, Royal Oak, MI 48073, USA;
| | - Anna C. Mavromanoli
- European Student Think Tank, Public Health and Policy Working Group, 1058 Amsterdam, The Netherlands;
| | - Christos Tsagkaris
- European Student Think Tank, Public Health and Policy Working Group, 1058 Amsterdam, The Netherlands;
- Faculty of Medicine, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
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Betsy J, George S, George N, Kv B, Sukumaran A. Perceptions of Indian Healthcare Practitioners Regarding the 2022 Outbreak of Monkeypox Disease. Cureus 2023; 15:e35157. [PMID: 36950001 PMCID: PMC10027578 DOI: 10.7759/cureus.35157] [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: 02/18/2023] [Indexed: 02/20/2023] Open
Abstract
Introduction Although only a few cases of monkeypox have been reported in India so far, it is vital for healthcare practitioners to have sufficient knowledge about its epidemiology, clinical presentation, diagnosis, and management. Therefore, this study aimed to understand the perception of Indian healthcare practitioners regarding the 2022 outbreak of monkeypox disease. Methods A cross-sectional survey was conducted among 500 medical and dental practitioners from various regions of Kerala, India. The Chi-squared test for proportion was used to determine the significant difference in the knowledge levels of the participants. Binary logistic regression (multivariate) was used to understand the knowledge of healthcare professionals regarding the 2022 outbreak of monkeypox disease. Results A total of 424 healthcare professionals completed this survey. Overall, the level of knowledge was good in 64.9% and poor in 35.1% of the participants (p<0.01). Binary logistic regression analysis did not show any statistical significance (p > 0.05) in terms of demographic characteristics. However, in this sample, participants with 6-10 years of work experience were more likely to have improved knowledge scores (odd's ratio OR 1.764). Similarly, participants between the age of 30-40 years were also likely to have improved knowledge scores (OR: 1.065). Conclusions Indian healthcare professionals had an overall good level of knowledge regarding the 2022 outbreak of monkeypox. However, a low level of knowledge was found related to the clinical presentation and immunization of monkeypox. This may be due to the low prevalence of monkeypox in this region.
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Affiliation(s)
- Joseph Betsy
- Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
- Dentistry, Pushpagiri Research Centre, Pushpagiri Institute of Medical Sciences and Research Centre, Thiruvalla, IND
| | - Sherin George
- Pediatric and Preventive Dentistry, Pushpagiri College of Dental Sciences, Thiruvalla, India, Thiruvalla, IND
| | - Nebu George
- Periodontics, Pushpagiri College of Dental Sciences, Thiruvalla, IND
| | - Baiju Kv
- Statistics, Government College for Women, Thiruvananthapuram, IND
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Human Monkeypox: Oral Implications and Recommendations for Oral Screening and Infection Control in Dental Practice. J Pers Med 2022; 12:jpm12122000. [PMID: 36556221 PMCID: PMC9788482 DOI: 10.3390/jpm12122000] [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: 11/17/2022] [Revised: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 12/11/2022] Open
Abstract
The World Health Organization declared the spread of the human monkeypox virus (MPXV) an "emerging threat of moderate health concern" on 23 June 2022. Although about 20,000 cases of Monkeypox (MPX) were recorded in Europe and more than 28,000 in the United States from May to October 2022, their number is still small compared to the number of dental patients treated annually. Therefore, the likelihood of oral healthcare workers encountering an MPX case is relatively low in not endemic regions. In addition, MPX-positive individuals are considered contagious only during the prodromal or acute phase. However, the exact shedding and transmission routes of MPX and the associated risk of transmission in the dental setting remain unclear. Moreover, infected subjects whose disease is confined to the head and neck may require oral and dental care because they complain of lymphadenopathy involving the cervical lymph nodes. Furthermore, MPX lesions may first appear in the oral cavity or perioral area. Therefore, given the recent spread of MPXV in non-endemic areas where dentists are not used to considering this disease in the differential diagnosis and taking appropriate preventive measures, all oral healthcare providers nowadays should be aware of the oral presentation of MPX for adequate oral screening and appropriate preventive measures for infection control in the dental practice.
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Pandya VS, Mehta V, Miraj M, Alasiry SM, Alanazy W, Uthup TT, Shaik RA, D’Amico C, Mancini M, Gorassini F, Fiorillo L, Meto A. Monkeypox: An Unfamiliar Virus-Clinical and Epidemiological Characteristics, Diagnosis, and Treatment with Special Emphasis on Oral Health. Diagnostics (Basel) 2022; 12:2749. [PMID: 36359593 PMCID: PMC9689609 DOI: 10.3390/diagnostics12112749] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 10/04/2022] [Accepted: 10/06/2022] [Indexed: 10/13/2023] Open
Abstract
With the recent increased prevalence of human outbreaks, monkeypox has been recognized for decades as an infectious disease with substantial pandemic potential. The majority of cases of this virus have been observed in the European region (11,865), with few cases in the Western Pacific (54). Various governing health agencies are striving to restrain the fatal monkeypox virus (MPXV). Health practitioners around the world are learning about the many clinical manifestations of this infection, and its potential therapies. Despite the plethora of new evidence and rising cases, the essential questions remain unsolved. Thus, in this review, we have modernized the outlook for monkeypox, which will be helpful for various medical practitioners. In the light of continuing outbreaks around the world, we have also presented our assessment of the readiness of India against this outbreak, with a special focus on its effects on oral health.
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Affiliation(s)
- Visha Shailesh Pandya
- Department of Public Health Dentistry, Vaidik Dental College & Research Centre, Dadra and Nagar Haveli and Daman and Diu 396210, India
| | - Vini Mehta
- Department of Public Health Dentistry, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune 411018, India
| | - Mohammas Miraj
- Department of Physical Therapy and Rehabilitation, College of Applied Medical Sciences, Majmaah University, Al-Majmaah 11952, Saudi Arabia
| | - Sharifa M. Alasiry
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Al-Majmaah 11952, Saudi Arabia
| | - Wdad Alanazy
- Department of Maternity Nursing, Faculty of Nursing, College of Applied Medical Sciences, Majmaah University, Al-Majmaah 11952, Saudi Arabia
| | - Tintu Thomas Uthup
- Department of Public Health, College of Health Sciences, Saudi Electronic University, Riyadh 13316, Saudi Arabia
| | - Riyaz Ahamed Shaik
- Department of Family and Community Medicine, College of Medicine, Majmaah University, Al-Majmaah 11952, Saudi Arabia
| | - Cesare D’Amico
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98100 Messina, Italy
| | - Maura Mancini
- Unit of Ophthalmology, Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98125 Messina, Italy
| | - Francesca Gorassini
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98100 Messina, Italy
| | - Luca Fiorillo
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98100 Messina, Italy
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania “Luigi Vanvitelli”, 80121 Naples, Italy
- Department of Dentistry, Faculty of Dental Sciences, University of Aldent, 1007 Tirana, Albania
| | - Aida Meto
- Department of Dentistry, Faculty of Dental Sciences, University of Aldent, 1007 Tirana, Albania
- Clinical Microbiology, School of Dentistry, University of Modena and Reggio Emilia, 41125 Modena, Italy
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Gouel-Cheron A, Kantor E, Rioux C, Kerneis S, Montravers P. Monkeypox-infected patients in the perioperative context: Recommendations from an expert centre. Anaesth Crit Care Pain Med 2022; 41:101122. [PMID: 35803574 PMCID: PMC9400400 DOI: 10.1016/j.accpm.2022.101122] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 06/30/2022] [Accepted: 06/30/2022] [Indexed: 11/24/2022]
Affiliation(s)
- Aurélie Gouel-Cheron
- Département d'Anesthésie-Réanimation, CHU Bichat-Claude Bernard, DMU PARABOL, AP-HP, Nord, Paris, France; Institut Pasteur, Antibodies in Therapy and Pathology, Inserm UMR 1222, Paris, France; National Institute of Allergy and Infectious Diseases, National Institutes of Health, Biostatistics Research Branch, Division of Clinical Research, Bethesda, MD, USA.
| | - Elie Kantor
- Département d'Anesthésie-Réanimation, CHU Bichat-Claude Bernard, DMU PARABOL, AP-HP, Nord, Paris, France
| | - Christophe Rioux
- Service de Maladies Infectieuses et Tropicales, Hôpital Bichat Claude Bernard, AP-HP, Paris, France
| | - Solen Kerneis
- Université Paris Cité, INSERM, IAME, F-75018 Paris, France; Equipe de Prévention du Risque Infectieux (EPRI), AP-HP, Hôpital Bichat, F-75018 Paris, France
| | - Philippe Montravers
- Département d'Anesthésie-Réanimation, CHU Bichat-Claude Bernard, DMU PARABOL, AP-HP, Nord, Paris, France; Université Paris Cité, INSERM, IAME, F-75018 Paris, France; INSERM UMR 1152, Université de Paris, Paris, France
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Organisation du parcours périopératoire du patient infecté par le virus Monkeypox nécessitant une prise en charge chirurgicale urgente. ANESTHÉSIE & RÉANIMATION 2022. [PMCID: PMC9300055 DOI: 10.1016/j.anrea.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Advancing surgical setting: A paradigm for healthcare workers during the monkeypox outbreak. Ann Med Surg (Lond) 2022; 81:104343. [PMID: 36035596 PMCID: PMC9399141 DOI: 10.1016/j.amsu.2022.104343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 07/31/2022] [Indexed: 11/23/2022] Open
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Samaranayake L, Anil S. The Monkeypox Outbreak and Implications for Dental Practice. Int Dent J 2022; 72:589-596. [PMID: 35934521 PMCID: PMC9485535 DOI: 10.1016/j.identj.2022.07.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/12/2022] [Accepted: 07/13/2022] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Monkeypox (MPX) caused by the MPX virus, is a contagious disease confined mainly to African regions, and is currently making multiple appearances outside of disease-endemic countries. World Health Organization (WHO) very recently declared the current monkeypox outbreak a Public Health Emergency of International Concern. We review here the salient features of MPX and its possible impact on dentistry. METHODS The data on the aetiology, transmission modes, signs and symptoms, diagnosis, and management, including the risk of its occupational transmission in dental settings, were garnered from the current literature, mainly from the World Health Organization and Centers for Disease Control and Prevention databases. RESULTS Over recent months, MPX has reemerged in more than 88 countries in Europe, North America, and Australia, with some 22000 case reports to date (as of July 2022). The initial signs of MPX appear during the prodromal period, in the oral cavity as single or multiple macular lesions on the oral mucosa, accompanied by generalised lymphadenopathy. Subsequently, the characteristic rash appears on the skin and spreads centripetally from the trunk towards the palms and soles. MPX is a self-limiting disease with very low mortality and may last from 2 to 4 weeks. Although MPX is similar to chickenpox, there are a number of differentiating signs, the main element being lymphadenopathy. Strict adherence to standard, contact, and droplet infection control precautions, including wearing N95 masks, FFP3 respirators, fluid-resistant attire, and eye protection, is necessary to prevent its spread. CONCLUSIONS MPX appears to be a significant travel-related disease. Dental care workers should note that premonitory signs of the disease usually appear on the oral mucosa as macules and ulcers prior to the characteristic skin lesions. Implementing standard, contact, and droplet infection control measures, patient isolation, and referral are important, particularly during a local outbreak. A vaccine specific for MPX is under development, although the smallpox vaccine appears to be effective.
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Affiliation(s)
- Lakshman Samaranayake
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Sukumaran Anil
- Department of Dentistry, Oral Health Institute, Hamad Medical Corporation, Doha, Qatar; College of Dental Medicine, Qatar University, Doha, Qatar.
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