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Hemati S, Mohammadi-Moghadam F. A systematic review on environmental perspectives of monkeypox virus. REVIEWS ON ENVIRONMENTAL HEALTH 2024; 39:363-370. [PMID: 36593124 DOI: 10.1515/reveh-2022-0221] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
Monkeypox (MPX) is one of the common infections between humans and animals that caused by a virus belonging to the Orthopoxvirus genus. The Monkeypox virus (MPXV) outbreak is a global crisis triggered by environmental factors (virus, wastewater, surface, air) and amplified by the decisions of government officials and communities. The aim of this systematic review is to describe the environmental perspectives of MPXV with emphasis on risk assessment to prevent and control a new pandemic. Five online databases including Web of Science, PubMed, Scopus, Science Direct and Google Scholar were searched from 1990 to October 2022. Among 120 records, after the screening, four studies were included in the systematic review. The systematic review revealed that the possibility of MPXV transmission through wastewater, air, and the contaminated surfaces is a significant concern and its detection and destroying will play a major role in controlling the spread of the virus. Poxviruses have a high environmental stability, but are sensitive to all common chemical disinfectants. In conclusion, this study revealed that the environmental surveillance can be used as a complementary tool for detecting pathogens circulation in communities. This implies that the monitoring of environmental perspectives of MPXV can provide new awareness into virus transmission routes as well as the role of stakeholders and public health policies in MPXV risk management.
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Affiliation(s)
- Sara Hemati
- Department of Environmental Health Engineering, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Fazel Mohammadi-Moghadam
- Department of Environmental Health Engineering, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
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2
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Yu L, Shen Y, Liu M, Ma J, Long J, Zheng D. Evaluation of monkeypox knowledge and attitudes among Chinese medical students. BMC Public Health 2024; 24:745. [PMID: 38459436 PMCID: PMC10921768 DOI: 10.1186/s12889-024-18259-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 03/03/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Monkeypox is a zoonotic disease caused by the monkeypox virus and is increasingly recognized as a serious public health concern worldwide. Our aim was to investigate the knowledge and attitudes of Chinese medical students regarding monkeypox. METHODS A cross-sectional study was conducted among 8,897 college students from China. An e-questionnaire was used to collect data on knowledge (17 items), attitudes (12 items), and baseline criteria. The relationships between a range of factors and knowledge and attitudes were studied using univariate and multivariate analyses. RESULTS A total of 79.33% of the study participants were female, 89.10% were of Han ethnicity, 72.50% were from rural areas, 50.39% were in their first year, and 80.65% were medical majors. A total of 50.88% had good knowledge of monkeypox, and 57.11% had a positive attitude towards monkeypox knowledge. Univariate analysis revealed that origin and major were the factors affecting the knowledge level of monkeypox among participants. Rural students had more knowledge of monkeypox than urban students, and nonmedical students had greater awareness of monkeypox than did medical students. Moreover, sex and grade were the factors influencing participants' attitudes towards monkeypox; men had more positive attitudes than women did, and senior students had more positive attitudes than junior students did. Multivariate analysis revealed that major and the origin of the students independently influenced the monkeypox knowledge of Chinese medical students, while sex, grade and monkeypox knowledge were significantly related to attitudes towards monkeypox. CONCLUSION This study revealed that nearly half of the Chinese medical students had good knowledge and a positive attitude towards monkeypox. Student origin and major independently influenced the knowledge of Chinese medical students of monkeypox, while sex, grade and knowledge were independently related to the attitudes of Chinese medical students towards monkeypox.
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Affiliation(s)
- Liliang Yu
- Chongqing Three Gorges Medical College, Chongqing, China
| | - Yan Shen
- Chongqing Three Gorges Medical College, Chongqing, China
| | - Min Liu
- Chongqing Three Gorges Medical College, Chongqing, China
| | - Junchun Ma
- Wanzhou District Center for Disease Control and Prevention, Chongqing, China
| | - Jiang Long
- Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Daikun Zheng
- Chongqing Three Gorges Medical College, Chongqing, China.
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Ghazy RM, Elrewany E, Gebreal A, ElMakhzangy R, Fadl N, Elbanna EH, Tolba MM, Hammad EM, Youssef N, Abosheaishaa H, Hamouda EEM, Mehana ZEE, Al Zomia AS, A Alnami RA, Salma EAS, Alqahtani AS, Alshehri AF, Hussein M. Systematic Review on the Efficacy, Effectiveness, Safety, and Immunogenicity of Monkeypox Vaccine. Vaccines (Basel) 2023; 11:1708. [PMID: 38006040 PMCID: PMC10674429 DOI: 10.3390/vaccines11111708] [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: 09/22/2023] [Revised: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND The variation in the reported vaccine safety and effectiveness could contribute to the high rates of vaccine hesitancy among the general population and healthcare workers in areas where monkeypox (mpox) is circulating. In this review, our objective was to evaluate the safety, immunogenicity, effectiveness, and efficacy of the mpox vaccines. METHODS An extensive search for articles across multiple databases was performed, including searching six databases (PubMed Central, PubMed Medline, Scopus, Web of Science, Cochrane, ProQuest), two pre-print databases (European PMC Preprint and MedRxiv), and Google Scholar. RESULTS A total of 4290 citations were retrieved from the included databases. Following the removal of duplicates and the initial screening of records, a total of 36 studies were included into the analysis. Additionally, we identified five more studies through manual searches, resulting in a total of 41 eligible articles for qualitative synthesis. The study findings revealed that mpox vaccines demonstrate the ability to generate adequate antibodies; however, their effectiveness may decrease over time, exhibiting varying safety profiles. Most of the included studies consistently reported substantial levels of effectiveness and efficacy against mpox. Interestingly, the number of vaccine doses administered was found to influence the degree of immunogenicity, subsequently impacting the overall effectiveness and efficacy of the vaccines. Furthermore, we found that smallpox vaccines exhibited a form of cross-protection against mpox. CONCLUSIONS Vaccines can be used to prevent mpox and effectively control its spread.
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Affiliation(s)
- Ramy Mohamed Ghazy
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria 21561, Egypt; (R.M.G.); (E.E.)
| | - Ehab Elrewany
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria 21561, Egypt; (R.M.G.); (E.E.)
| | - Assem Gebreal
- Alexandria Faculty of Medicine, Alexandria University, Alexandria 21561, Egypt; (A.G.); (E.M.H.); (Z.E.E.M.)
| | - Rony ElMakhzangy
- Family Health Department, High Institute of Public Health, Alexandria University, Alexandria 21561, Egypt; (R.E.); (N.F.)
| | - Noha Fadl
- Family Health Department, High Institute of Public Health, Alexandria University, Alexandria 21561, Egypt; (R.E.); (N.F.)
| | - Eman Hassan Elbanna
- Health Administration and Behavioral Sciences Department, High Institute of Public Health, Alexandria University, Alexandria 21561, Egypt;
| | - Mahmoud M. Tolba
- Pharmaceutical Division, Ministry of Health and Population, Faiyum City 63723, Egypt;
| | - Elsayed Mohamed Hammad
- Alexandria Faculty of Medicine, Alexandria University, Alexandria 21561, Egypt; (A.G.); (E.M.H.); (Z.E.E.M.)
| | - Naglaa Youssef
- Medical-Surgical Nursing, Faculty of Nursing, Cairo University, Cairo 11562, Egypt;
| | | | | | - Zeyad Elsayed Eldeeb Mehana
- Alexandria Faculty of Medicine, Alexandria University, Alexandria 21561, Egypt; (A.G.); (E.M.H.); (Z.E.E.M.)
| | - Ahmed Saad Al Zomia
- College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (A.S.A.Z.); (R.A.A.A.); (E.A.S.S.); (A.S.A.); (A.F.A.)
| | - Raad Ahmed A Alnami
- College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (A.S.A.Z.); (R.A.A.A.); (E.A.S.S.); (A.S.A.); (A.F.A.)
| | - Emad Ali Saeed Salma
- College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (A.S.A.Z.); (R.A.A.A.); (E.A.S.S.); (A.S.A.); (A.F.A.)
| | - Abdulaziz Saleh Alqahtani
- College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (A.S.A.Z.); (R.A.A.A.); (E.A.S.S.); (A.S.A.); (A.F.A.)
| | - Abdulaziz Fayez Alshehri
- College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (A.S.A.Z.); (R.A.A.A.); (E.A.S.S.); (A.S.A.); (A.F.A.)
| | - Mai Hussein
- Clinical Research Administration, Alexandria Directorate of Health Affairs, Alexandria 21561, Egypt
- Egyptian Ministry of Health and Population, Cairo 11562, Egypt
- Master of Medical Science in Clinical Investigation, Harvard Medical School, Boston, MA 02115, USA
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Sham S, Sapna F, Anjali F, Kumar S, Podder V, Jaladi S, Bendari A, Al-Refai R, Baloch MM, Abdelwahed M, Kiran N, Geetha SD, Laharwani H. The Changing Global Epidemiology of Re-emerging Human Monkeypox Virus Infection: A Systematic Review. Cureus 2023; 15:e45123. [PMID: 37842498 PMCID: PMC10569669 DOI: 10.7759/cureus.45123] [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: 09/12/2023] [Indexed: 10/17/2023] Open
Abstract
Human monkeypox virus (MPVX) infection represents an emerging zoonotic disease caused by an orthopoxvirus, resulting in a condition reminiscent of smallpox. More recent developments have witnessed a notable surge in global MPVX outbreaks, eliciting significant concerns. We aimed to investigate the epidemiological factors of the emerging human monkeypox virus infection, including the number of suspected, confirmed, and fatal cases, as well as the risk factors for contracting monkeypox infection. We performed a systematic review of peer-reviewed literature by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. An electronic database search (PubMed, Wiley Online Library, and Science Direct) was undertaken. For monkeypox-related studies, we included 25 peer-reviewed articles from 2018 and 2022, and data were extracted on the current evidence on the cases and the risk factors for MPVX infection, to develop public health advisories. Our reports show a rapid rise of MPVX cases in the highly endemic African regions after the 1970s, spread to other countries, and an increase in the median age from young children to young adults. The cessation of smallpox vaccination might have been one of the factors responsible for these findings. As of 2022, the genomic sequences of ten MPVX strains associated with the recent countrywide outbreak have been determined. While the West African Clade has been primarily implicated in the recent viral surge, data were insufficient to determine which mutation contributed to increased transmissibility. In the Democratic Republic of the Congo (DRC), sleeping on the floor was significantly associated with contracting MPVX, while eating or processing of animal foods was not a significant risk factor. In the United States, cleaning the cages and bedding of sick animals, touching infected animals, and daily exposure to sick animals were associated with an increased probability of contracting the MPVX infection. Recent global outbreaks and the rising incidence of MPVX infections among young adults in the endemic zones might be a result of the cessation of the smallpox vaccine. The increased risk associated with exposure to sick animals or sleeping on the floor suggests high infectivity from animal excretions. Increasing awareness, strict surveillance, and contact tracing can help contain global outbreaks. The ring vaccination approach for exposed individuals is another potential disease containment strategy. Future studies should investigate measures for rapid laboratory diagnosis, maintaining lab safety, and transmissibility.
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Affiliation(s)
- Sunder Sham
- Pathology and Laboratory Medicine, Lenox Hill Hospital, Northwell Health, New York, USA
| | - Fnu Sapna
- Pathology and Laboratory Medicine, Albert Einstein College of Medicine, Bronx, USA
| | - Fnu Anjali
- Internal Medicine, Sakhi Baba General Hospital, Sukkur, PAK
| | - Sanjay Kumar
- Gastroentrology, Bahria University of Health Sciences, Karachi, PAK
| | - Vivek Podder
- General Medicine, Tairunnessa Memorial Medical College and Hospital, Gazipur, BGD
| | - Soumya Jaladi
- Pathology and Laboratory Medicine, University of Louisville, Louisville, USA
| | - Ahmed Bendari
- Pathology and Laboratory Medicine, Lenox Hill Hospital, Northwell Health, New York, USA
| | - Reham Al-Refai
- Pathology and Laboratory Medicine, Lenox Hill Hospital, Northwell Health, New York, USA
| | - Manal M Baloch
- Internal Medicine, Bahria University of Health Sciences, Karachi, PAK
| | - Mohammed Abdelwahed
- Pathology and Laboratory Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Uniondale, USA
| | - Nfn Kiran
- Pathology and Laboratory Medicine, Staten Island University Hospital, Staten Island, USA
| | - Saroja Devi Geetha
- Pathology and Laboratory Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Uniondale, USA
| | - Hansini Laharwani
- Pathology and Laboratory Medicine, Washington University School of Medicine, St. Louis, USA
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Delamonica B, Davalos L, Larijani M, Anthony SJ, Liu J, MacCarthy T. Evolutionary potential of the monkeypox genome arising from interactions with human APOBEC3 enzymes. Virus Evol 2023; 9:vead047. [PMID: 37577211 PMCID: PMC10422979 DOI: 10.1093/ve/vead047] [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: 03/22/2023] [Revised: 06/27/2023] [Accepted: 07/26/2023] [Indexed: 08/15/2023] Open
Abstract
APOBEC3, an enzyme subfamily that plays a role in virus restriction by generating mutations at particular DNA motifs or mutational 'hotspots', can drive viral mutagenesis with host-specific preferential hotspot mutations contributing to pathogen variation. While previous analysis of viral genomes from the 2022 Mpox (formerly Monkeypox) disease outbreak has shown a high frequency of C>T mutations at TC motifs, suggesting recent mutations are human APOBEC3-mediated, how emerging monkeypox virus (MPXV) strains will evolve as a consequence of APOBEC3-mediated mutations remains unknown. By measuring hotspot under-representation, depletion at synonymous sites, and a combination of the two, we analyzed APOBEC3-driven evolution in human poxvirus genomes, finding varying hotspot under-representation patterns. While the native poxvirus molluscum contagiosum exhibits a signature consistent with extensive coevolution with human APOBEC3, including depletion of TC hotspots, variola virus shows an intermediate effect consistent with ongoing evolution at the time of eradication. MPXV, likely the result of recent zoonosis, showed many genes with more TC hotspots than expected by chance (over-representation) and fewer GC hotspots than expected (under-representation). These results suggest the MPXV genome: (1) may have evolved in a host with a particular APOBEC GC hotspot preference, (2) has inverted terminal repeat (ITR) regions-which may be exposed to APOBEC3 for longer during viral replication-and longer genes likely to evolve faster, and therefore (3) has a heightened potential for future human APOBEC3-meditated evolution as the virus spreads in the human population. Our predictions of MPXV mutational potential can both help guide future vaccine development and identification of putative drug targets and add urgency to the task of containing human Mpox disease transmission and uncovering the ecology of the virus in its reservoir host.
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Affiliation(s)
- Brenda Delamonica
- Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY 11794, USA
| | - Liliana Davalos
- Department of Ecology and Evolution, Stony Brook University, Stony Brook, NY 11794, USA
- Consortium for Inter-Disciplinary Environmental Research, Stony Brook University, Stony Brook, NY 11794, USA
| | - Mani Larijani
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
- Department of Pathology, Microbiology, and Immunology, University of California-Davis School of Veterinary Medicine, Davis, CA 95616, USA
| | - Simon J Anthony
- Department of Pathology, Microbiology, and Immunology, University of California-Davis School of Veterinary Medicine, Davis, CA 95616, USA
| | - Jia Liu
- Department of Microbiology and Immunology, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR 72205, USA
| | - Thomas MacCarthy
- Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY 11794, USA
- Laufer Center for Physical and Quantitative Biology, Stony Brook University, Stony Brook, NY 11794, USA
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Abd ElHafeez S, Gebreal A, Khalil MA, Youssef N, Sallam M, Elshabrawy A, Abdel-Rahman S, Mahboob AS, Yazbek S, Elbanna EH, Adhyaru R, Rodoshi ZN, Kih YS, Jawad H, Kolotouros E, Jaworski A, AlQarni G, Gablan M, Condurat A, Elden AESSN, Bennani O, Rawat K, Ismail A, Al-Hajj Y, Elehamer NMK, Nagi J, Admassu H, Al Asaad SH, Duvuru R, Ogunlana O, Alosaimi B, Ghazy RM. Assessing disparities in medical students' knowledge and attitude about monkeypox: a cross-sectional study of 27 countries across three continents. Front Public Health 2023; 11:1192542. [PMID: 37575128 PMCID: PMC10415161 DOI: 10.3389/fpubh.2023.1192542] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/16/2023] [Indexed: 08/15/2023] Open
Abstract
Background and aims The recent monkeypox (Mpox) outbreak confirmed by the World Health Organization (WHO) underscores the importance of evaluating the knowledge and attitude of medical students toward emerging diseases, given their potential roles as healthcare professionals and sources of public information during outbreaks. This study aimed to assess medical students' knowledge and attitude about Mpox and to identify factors affecting their level of knowledge and attitude in low-income and high-income countries. Methods A cross-sectional study was conducted on 11,919 medical students from 27 countries. A newly-developed validated questionnaire was used to collect data on knowledge (14 items), attitude (12 items), and baseline criteria. The relationship between a range of factors with knowledge and attitude was studied using univariate and multivariate analyses. Results 46% of the study participants were males; 10.7% were in their sixth year; 54.6% knew about smallpox; 84% received the coronavirus disease 2019 (COVID-19) vaccine; and 12.5% had training on Mpox. 55.3% had good knowledge of Mpox and 51.7% had a positive attitude towards it. Medical students in their third, fifth, or sixth year high- income countries who obtained information on Mpox from friends, research articles, social media and scientific websites were positive predictors for good knowledge. Conversely, being male or coming from high-income countries showed a negative relation with good knowledge about Mpox. Additionally, a positive attitude was directly influenced by residing in urban areas, being in the fifth year of medical education, having knowledge about smallpox and a history of receiving the coronavirus disease 2019 (COVID-19) vaccine. Receiving information about Mpox from social media or scientific websites and possessing good knowledge about Mpox were also predictors of a positive attitude. On the other hand, being male, employed, or receiving a training program about Mpox were inversely predicting positive attitude about Mpox. Conclusion There were differences in knowledge and attitude towards Mpox between medical students in low and high-income countries, emphasizing the need for incorporating epidemiology of re-emerging diseases like Mpox into the medical curriculum to improve disease prevention and control.
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Affiliation(s)
- Samar Abd ElHafeez
- Department of Epidemiology, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Assem Gebreal
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Mohammad Adnan Khalil
- Department of Basic Medical Sciences, Faculty of Medicine, King Fahad Medical City, Riyadh Second Health Cluster, Riyadh, Saudi Arabia
| | - Naglaa Youssef
- Department of Medical-Surgical Nursing, College of Nursing, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
- Medical-Surgical Nursing Department, Faculty of Nursing, Cairo University, Cairo, Egypt
| | - Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman, Jordan
| | - Abdelhamid Elshabrawy
- Department of Biostatistics and Demography, Faculty of Graduate Studies for Statistical Research, Cairo University, Cairo, Egypt
| | - Suzan Abdel-Rahman
- Department of Biostatistics and Demography, Faculty of Graduate Studies for Statistical Research, Cairo University, Cairo, Egypt
| | - Amira Saad Mahboob
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Saja Yazbek
- Faculty of Public Health, Lebanese University, Beirut, Lebanon
| | - Eman H. Elbanna
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | | | | | - Yap Siew Kih
- Taylor’s University School of Medicine, Subang Jaya, Malaysia
| | - Huda Jawad
- College of Health and Sport Sciences, University of Bahrain, Manama, Bahrain
| | - Evangelos Kolotouros
- Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Ghadah AlQarni
- College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia
| | | | | | | | - Oumayma Bennani
- Faculty Mohammed VI of Medicine and Pharmacy, Oujda, Morocco
| | - Kamna Rawat
- Government Doon Medical College, Dehradun, India
| | - Areeba Ismail
- Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Yasser Al-Hajj
- Faculty of Medicine, Beirut Arab University, Beirut, Lebanon
| | | | - Jasleen Nagi
- Faculty of Medicine, Imperial College London, London, United Kingdom
| | | | | | - Ruthwik Duvuru
- College of Medicine, Mohammed Bin Rashid University, Dubai, United Arab Emirates
| | | | - Bandar Alosaimi
- Research Center, King Fahad Medical City, Riyadh Second Health Cluster, Riyadh, Saudi Arabia
| | - Ramy Mohamed Ghazy
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
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Delamonica B, Davalos L, Larijani M, Anthony SJ, Liu J, MacCarthy T. Evolutionary potential of the monkeypox genome arising from interactions with human APOBEC3 enzymes. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.06.27.546779. [PMID: 37425914 PMCID: PMC10326987 DOI: 10.1101/2023.06.27.546779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
APOBEC3, an enzyme subfamily that plays a role in virus restriction by generating mutations at particular DNA motifs or mutational "hotspots," can drive viral mutagenesis with host-specific preferential hotspot mutations contributing to pathogen variation. While previous analysis of viral genomes from the 2022 Mpox (formerly Monkeypox) disease outbreak has shown a high frequency of C>T mutations at T C motifs, suggesting recent mutations are human APOBEC3-mediated, how emerging monkeypox virus (MPXV) strains will evolve as a consequence of APOBEC3-mediated mutations remains unknown. By measuring hotspot under-representation, depletion at synonymous sites, and a combination of the two, we analyzed APOBEC3-driven evolution in human poxvirus genomes, finding varying hotspot under-representation patterns. While the native poxvirus molluscum contagiosum exhibits a signature consistent with extensive coevolution with human APOBEC3, including depletion of T C hotspots, variola virus shows an intermediate effect consistent with ongoing evolution at the time of eradication. MPXV, likely the result of recent zoonosis, showed many genes with more T C hotspots than expected by chance (over-representation) and fewer G C hotspots than expected (under-representation). These results suggest the MPXV genome: 1) may have evolved in a host with a particular APOBEC G C hotspot preference, 2) has inverted terminal repeat (ITR) regions -which may be exposed to APOBEC3 for longer during viral replication- and longer genes likely to evolve faster, and therefore 3) has a heightened potential for future human APOBEC3-meditated evolution as the virus spreads in the human population. Our predictions of MPXV mutational potential can both help guide future vaccine development and identification of putative drug targets and add urgency to the task of containing human Mpox disease transmission and uncovering the ecology of the virus in its reservoir host.
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Affiliation(s)
- Brenda Delamonica
- Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY, 11794, USA
| | - Liliana Davalos
- Department of Ecology and Evolution, Stony Brook University, Stony Brook, NY, 11794, USA; Consortium for Inter-Disciplinary Environmental Research, Stony Brook University, Stony Brook, NY, 11794, USA
| | - Mani Larijani
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, Canada; Program in Immunology and Infectious Diseases, Division of Biomedical Sciences, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Canada
| | - Simon J Anthony
- Department of Pathology, Microbiology, and Immunology, University of California-Davis School of Veterinary Medicine, Davis, CA 95616, USA
| | - Jia Liu
- Department of Microbiology and Immunology, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA
| | - Thomas MacCarthy
- Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY 11794, USA; Laufer Center for Physical and Quantitative Biology, Stony Brook University, Stony Brook, NY 11794, USA
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Ghazy RM, Yazbek S, Gebreal A, Hussein M, Addai SA, Mensah E, Sarfo M, Kofi A, AL-Ahdal T, Eshun G. Monkeypox Vaccine Acceptance among Ghanaians: A Call for Action. Vaccines (Basel) 2023; 11:vaccines11020240. [PMID: 36851118 PMCID: PMC9959510 DOI: 10.3390/vaccines11020240] [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: 12/12/2022] [Revised: 01/13/2023] [Accepted: 01/18/2023] [Indexed: 01/26/2023] Open
Abstract
Background: Ghana ranked 31st worldwide and 3rd in Africa in the number of confirmed cases worldwide. We aimed to assess the intention to receive the monkeypox (MPOX) vaccine and its associated psychological antecedents among the Ghanaian population. Methods: A cross-sectional online survey was conducted in Ghana from November to December 2022. Snowball sampling was used to recruit participants via social media platforms, such as WhatsApp, LinkedIn, Telegram, and Facebook. The validated 5C scale was used to assess five psychological factors that influence vaccination behavior and intent: confidence, complacency, constraints, calculation, and collective responsibility. Results: The study drew 605 participants; their mean age was 30.0 ± 6.8; 68.1% were single; 60.8 % were males, and 51.9% were living in Greater Accra (The capital and largest city of Ghana). About 53.9% of the studied Ghanaian population did not intend to receive the MPOX vaccination. Vaccine acceptance among non-healthcare workers (non-HCWs) was significantly lower than among HCWs (41.7 vs. 55.3, p < 0.001). The determinants of vaccine acceptance were male gender (AOR = 1.48, 95% CI, 1.00-2.18, p = 0.049), urban residence (AOR = 0.63, 95% CI, 0.41-0.96, p = 0.033), refusal of coronavirus 2019 vaccine (AOR = 0.29, 95% CI, 0.16-0.52, p < 0.001), confidence in vaccination ((AOR = 2.45, 95% CI, 1.93-3.15, and p < 0.001), and collective responsibility (AOR = 1.34, 95% CI, 1.02-1.75, p = 0.034)). Conclusions: The participants in this study did not show high levels of intention to accept the MPOX vaccination. Consequently, tailoring the efforts aiming to promote MPOX vaccination is needed especially among non-HCWs through increasing their confidence in vaccine effectiveness and safety and promoting the importance of self-vaccination to protect others.
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Affiliation(s)
- Ramy Mohamed Ghazy
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria 21561, Egypt
- Correspondence: (R.M.G.); (T.A.-A.)
| | - Saja Yazbek
- Faculty of Public Health, Lebanese University, Beirut 6573, Lebanon
| | - Assem Gebreal
- Alexandria Faculty of Medicine, Alexandria University, Alexandria 21568, Egypt
| | - Mai Hussein
- Clinical Research Administration, Alexandria Directorate of Health Affairs, Alexandria 21554, Egypt
- Ministry of Health and Population, Cairo 71529, Egypt
| | - Sylvia Agyeman Addai
- Department of Science & Department of Educational Administration and Management, University of Education, Winneba CE-119-9961, Ghana
- Business School, Datalink University, Tema GN-03-266605, Ghana
- Human Resource & Marketing Department, Central University, Miotso-Prampram GT-001-5571, Ghana
| | - Ernestina Mensah
- Department of Midwifery, Seventh Day Adventist Nursing and Midwifery Training College, Agona-Asamang P.O. Box GN 37, Ghana
| | - Michael Sarfo
- School of Human and Health Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK
| | - Agyapong Kofi
- Manhyia Government Hospital, Kumasi AK-039-5028, Ghana
| | - Tareq AL-Ahdal
- Institute of Global Health (HIGH), Heidelberg University, Neuenheimer Feld 130/3, 69120 Heidelberg, Germany
- Correspondence: (R.M.G.); (T.A.-A.)
| | - Gilbert Eshun
- Seventh Day Adventist Hospital, Agona-Asamang AZ-0581-8540, Ghana
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Epidemiological, Clinical, and Virological Investigation of the First Four Cases of Monkeypox in Cartagena during the 2022 Outbreak. Pathogens 2023; 12:pathogens12020159. [PMID: 36839431 PMCID: PMC9961119 DOI: 10.3390/pathogens12020159] [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: 12/20/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 01/20/2023] Open
Abstract
Since early May 2022, numerous cases of Monkeypox (Mpox) have been reported globally in non-endemic areas. However, despite numerous reports worldwide, the epidemiological and genomic information related to the 2022 multi-country outbreak remains scarce in South America. By late June 2022, the first Mpox cases were detected in Colombia. Cartagena is a Colombian Caribbean city with high domestic and international connectivity, and, therefore, is vulnerable to the introduction of the Monkeypox virus (MPXV). This report provides an in-depth description of the epidemiological, clinical, and virological characteristics of the first four cases detected in Cartagena including three cases with no history of recent travel and one imported case. Using various laboratory tools based on PCR, next-generation sequencing, and viral isolation and quantification methods, the MPXV clade IIB was detected and isolated. Importantly, infectious viral particles were identified in lesion swabs collected from all cases and in oropharyngeal swabs collected from two cases. Blood samples tested negative using PCR and isolation. In summary, our work contributes complete genomic, clinical, and epidemiological information that will be useful for a number of studies going forward, and it also documents local information that contributes to our understanding of Mpox at the local level.
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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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Psychological Antecedents of Healthcare Workers towards Monkeypox Vaccination in Nigeria. Vaccines (Basel) 2022; 10:vaccines10122151. [PMID: 36560561 PMCID: PMC9783513 DOI: 10.3390/vaccines10122151] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 12/06/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
The ongoing monkeypox (MPX) outbreak has been declared a public health emergency of international concern. People in close contact with active MPX cases, including healthcare workers (HCWs), are at higher risk of virus acquisition since the MPX virus can be transmitted by skin contact or respiratory secretions. In this study, we aimed to assess the psychological antecedents of MPX vaccination among Nigerian HCWs using the 5C scale. We used an anonymous online cross-sectional survey to recruit potential participants using snowball sampling. The questionnaire aimed to assess the geo/socioeconomic features and the 5C psychological antecedents of vaccine acceptance (confidence, complacency, constraints, calculation, and collective responsibility). A total of 389 responses were included, with a median age of 37 years (IQR: 28−48), 55.5% males, and 60.7% married participants. Among the studied Nigerian HCWs, only 31.1% showed confidence in MPX vaccination, 58.4% expressed complacency towards vaccination, 63.8% perceived constraints towards MPX vaccination, 27.2% calculated the benefits and risks of vaccination, and 39.2% agreed to receive MPX vaccination to protect others. The determinants of MPX vaccine confidence were being single (OR = 5.07, 95% CI: 1.26−20.34, p = 0.022), a higher education level (with pre-college/high school as a reference, professional/technical: OR = 4.12, 95% CI: 1.57−10.73, p = 0.004, undergraduate: OR = 2.94, 95% CI: 1.32−6.55, p = 0.008, and postgraduate degree (OR = 3.48, 95% CI: 1.51−8.04, p = 0.003), and absence of chronic disease (OR = 2.57, 95% CI: 1.27−5.22, p = 0.009). The significant complacency predictors were having a middle-income (OR = 0.53, 95% CI: 0.33−0.89, p = 0.008), having a bachelor’s degree (OR = 2.37, 95% CI: 1.10−5.11, p = 0.027), and knowledge of someone who died due to MPX (OR = 0.20, 95% CI: 0.05−0.93, p = 0.040). Income was associated with perceived vaccination constraints (OR = 0.62, 95% CI: 0.39−0.99, p = 0.046). Participants aged 46−60 years had decreased odds in the calculation domain (OR = 0.52, 95% CI: 0.27−0.98, p = 0.044). Middle-income and bachelor degree/postgraduate education significantly influenced the collective responsibility domain (OR = 2.10, 95% CI: 1.19−3.69, p = 0.010; OR = 4.17, 95% CI: 1.85−9.38, p < 0.001; and OR = 3.45, 95% CI: 1.50−7.90, p = 0.003, respectively). An investigation of the 5C pattern-based psychological antecedents of MPX vaccination in a sample of Nigerian HCWs revealed low levels of vaccine confidence and collective responsibility with high levels of constraints and complacency. These psychological factors are recommended to be considered in any efforts aiming to promote MPX vaccination needed in a country where MPX is endemic.
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