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Cai Y, Zhang X, Zhang K, Liang J, Wang P, Cong J, Xu X, Li M, Liu K, Wei B. The global patent landscape of emerging infectious disease monkeypox. BMC Infect Dis 2024; 24:403. [PMID: 38622539 PMCID: PMC11017537 DOI: 10.1186/s12879-024-09252-w] [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: 09/04/2023] [Accepted: 03/24/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Monkeypox is an emerging infectious disease with confirmed cases and deaths in several parts of the world. In light of this crisis, this study aims to analyze the global knowledge pattern of monkeypox-related patents and explore current trends and future technical directions in the medical development of monkeypox to inform research and policy. METHODS A comprehensive study of 1,791 monkeypox-related patents worldwide was conducted using the Derwent patent database by descriptive statistics, social network method and linear regression analysis. RESULTS Since the 21st century, the number of monkeypox-related patents has increased rapidly, accompanied by increases in collaboration between commercial and academic patentees. Enterprises contributed the most in patent quantity, whereas the initial milestone patent was filed by academia. The core developments of technology related to the monkeypox include biological and chemical medicine. The innovations of vaccines and virus testing lack sufficient patent support in portfolios. CONCLUSIONS Monkeypox-related therapeutic innovation is geographically limited with strong international intellectual property right barriers though it has increased rapidly in recent years. The transparent licensing of patent knowledge is driven by the merger and acquisition model, and the venture capital, intellectual property and contract research organization model. Currently, the patent thicket phenomenon in the monkeypox field may slow the progress of efforts to combat monkeypox. Enterprises should pay more attention to the sharing of technical knowledge, make full use of drug repurposing strategies, and promote innovation of monkeypox-related technology in hotspots of antivirals (such as tecovirimat, cidofovir, brincidofovir), vaccines (JYNNEOS, ACAM2000), herbal medicine and gene therapy.
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Affiliation(s)
- Yuanqi Cai
- Center for Medical Artificial Intelligence, Qingdao Academy of Chinese Medical Sciences, Shandong University of Traditional Chinese Medicine, 266112, Qingdao, China
| | - Xiaoming Zhang
- Department of Cardiovascular Surgery, The Affiliated Hospital of Qingdao University, 266000, Qingdao, China
| | - Kuixing Zhang
- Center for Medical Artificial Intelligence, Qingdao Academy of Chinese Medical Sciences, Shandong University of Traditional Chinese Medicine, 266112, Qingdao, China
| | - Jingbo Liang
- Department of Biomedical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong SAR, China
| | - Pingping Wang
- Center for Medical Artificial Intelligence, Qingdao Academy of Chinese Medical Sciences, Shandong University of Traditional Chinese Medicine, 266112, Qingdao, China
| | - Jinyu Cong
- Center for Medical Artificial Intelligence, Qingdao Academy of Chinese Medical Sciences, Shandong University of Traditional Chinese Medicine, 266112, Qingdao, China
| | - Xin Xu
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, 999078, Taipa, Macau, China
| | - Mengyao Li
- Center for Medical Artificial Intelligence, Qingdao Academy of Chinese Medical Sciences, Shandong University of Traditional Chinese Medicine, 266112, Qingdao, China
| | - Kunmeng Liu
- Center for Medical Artificial Intelligence, Qingdao Academy of Chinese Medical Sciences, Shandong University of Traditional Chinese Medicine, 266112, Qingdao, China.
| | - Benzheng Wei
- Center for Medical Artificial Intelligence, Qingdao Academy of Chinese Medical Sciences, Shandong University of Traditional Chinese Medicine, 266112, Qingdao, China.
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Lucena-Neto FD, Falcão LFM, Vieira-Junior AS, Moraes ECS, David JPF, Silva CC, Sousa JR, Duarte MIS, Vasconcelos PFC, Quaresma JAS. Monkeypox Virus Immune Evasion and Eye Manifestation: Beyond Eyelid Implications. Viruses 2023; 15:2301. [PMID: 38140542 PMCID: PMC10747317 DOI: 10.3390/v15122301] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 12/24/2023] Open
Abstract
Monkeypox virus (MPXV), belonging to the Poxviridae family and Orthopoxvirus genus, is closely related to the smallpox virus. Initial prodromal symptoms typically include headache, fever, and lymphadenopathy. This review aims to detail various ocular manifestations and immune evasion associated with the monkeypox viral infection and its complications, making it appropriate as a narrative review. Common external ocular manifestations of MPXV typically involve a generalized pustular rash, keratitis, discharges, and dried secretions related to conjunctival pustules, photophobia, and lacrimation. Orthopoxviruses can evade host immune responses by secreting proteins that antagonize the functions of host IFNγ, CC and CXC chemokines, IL-1β, and the complement system. One of the most important transcription factors downstream of pattern recognition receptors binding is IRF3, which controls the expression of the crucial antiviral molecules IFNα and IFNβ. We strongly recommend that ophthalmologists include MPXV as part of their differential diagnosis when they encounter similar cases presenting with ophthalmic manifestations such as conjunctivitis, blepharitis, or corneal lesions. Furthermore, because non-vaccinated individuals are more likely to exhibit these symptoms, it is recommended that healthcare administrators prioritize smallpox vaccination for at-risk groups, including very young children, pregnant women, older adults, and immunocompromised individuals, especially those in close contact with MPXV cases.
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Affiliation(s)
- Francisco D. Lucena-Neto
- Department of Infectious Disease, School of Medicine, State University of Pará, Belém 66087-670, PA, Brazil; (F.D.L.-N.); (L.F.M.F.); (A.S.V.-J.); (C.C.S.); (J.R.S.); (P.F.C.V.)
| | - Luiz F. M. Falcão
- Department of Infectious Disease, School of Medicine, State University of Pará, Belém 66087-670, PA, Brazil; (F.D.L.-N.); (L.F.M.F.); (A.S.V.-J.); (C.C.S.); (J.R.S.); (P.F.C.V.)
| | - Adolfo S. Vieira-Junior
- Department of Infectious Disease, School of Medicine, State University of Pará, Belém 66087-670, PA, Brazil; (F.D.L.-N.); (L.F.M.F.); (A.S.V.-J.); (C.C.S.); (J.R.S.); (P.F.C.V.)
| | - Evelly C. S. Moraes
- Department of Infectious Disease, School of Medicine, Federal University of Pará, Belém 66075-110, PA, Brazil; (E.C.S.M.); (J.P.F.D.)
| | - Joacy P. F. David
- Department of Infectious Disease, School of Medicine, Federal University of Pará, Belém 66075-110, PA, Brazil; (E.C.S.M.); (J.P.F.D.)
| | - Camilla C. Silva
- Department of Infectious Disease, School of Medicine, State University of Pará, Belém 66087-670, PA, Brazil; (F.D.L.-N.); (L.F.M.F.); (A.S.V.-J.); (C.C.S.); (J.R.S.); (P.F.C.V.)
| | - Jorge R. Sousa
- Department of Infectious Disease, School of Medicine, State University of Pará, Belém 66087-670, PA, Brazil; (F.D.L.-N.); (L.F.M.F.); (A.S.V.-J.); (C.C.S.); (J.R.S.); (P.F.C.V.)
| | - Maria I. S. Duarte
- Department of Infectious Disease, School of Medicine, São Paulo University, São Paulo 01246-904, SP, Brazil;
| | - Pedro F. C. Vasconcelos
- Department of Infectious Disease, School of Medicine, State University of Pará, Belém 66087-670, PA, Brazil; (F.D.L.-N.); (L.F.M.F.); (A.S.V.-J.); (C.C.S.); (J.R.S.); (P.F.C.V.)
| | - Juarez A. S. Quaresma
- Department of Infectious Disease, School of Medicine, State University of Pará, Belém 66087-670, PA, Brazil; (F.D.L.-N.); (L.F.M.F.); (A.S.V.-J.); (C.C.S.); (J.R.S.); (P.F.C.V.)
- Department of Infectious Disease, School of Medicine, Federal University of Pará, Belém 66075-110, PA, Brazil; (E.C.S.M.); (J.P.F.D.)
- Department of Infectious Disease, School of Medicine, São Paulo University, São Paulo 01246-904, SP, Brazil;
- Virology Section, Evandro Chagas Institute, Ananindeua 67030-000, PA, Brazil
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Maru V, Ghaffar UB, Rawat A, Yunus M, Langaliya AK, Vyas S, Mehta D, Ojha A. Clinical and Epidemiological Interventions for Monkeypox Management in Children: A Systematic Review. Cureus 2023; 15:e38521. [PMID: 37288174 PMCID: PMC10241661 DOI: 10.7759/cureus.38521] [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: 04/11/2023] [Accepted: 05/03/2023] [Indexed: 06/09/2023] Open
Abstract
This review aims to compile the available literature on monkeypox, identify risk factors for developing the disease, and recommend effective preventative methods to reduce the number of reported cases and fatalities in children and pregnant women. In seeking out pertinent studies on monkeypox virus in children and pregnant women, we searched the literature using the databases Cochrane Library, Google Scholar, PubMed, EMBASE, Web of Science, and Scopus up to 1st February 2023. This study analyzed data from case studies of monkeypox in children and pregnant women. Clinical data and test findings of monkeypox patients less than 18 years old and pregnant women were analyzed. The Newcastle-Ottawa Scale was used to do the quality evaluation. Our record examination spanned the years 1985 to 2023 and found 17 children and five pregnant female patients treated with monkeypox in various hospitals/community centers. Zaire, Gabon, Chicago, Sierra Leone, Central African Republic, Northern DR Congo, Liberia, Cameroon, the Democratic Republic of the Congo, the United Kingdom, the Netherlands, and Florida all contributed to the 14 studies analyzed. There were no studies identified for meta-analysis of selected case studies of hospitalized children and pregnant women who were diagnosed with monkeypox. The incidence, prevalence, clinical characteristics, diagnosis, management, prevention, vaccinations, infant care, and care for expectant mothers are all discussed in this systematic review of monkeypox in children. Our research findings may provide a foundation for further focused research and the development of related recommendations or guidelines.
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Affiliation(s)
- Viral Maru
- Pediatric Dentistry, Government Dental College and Hospital, Mumbai, IND
| | | | - Anurag Rawat
- Interventional Cardiology, Himalayan Institute of Medical Sciences, Dehradun, IND
| | - Mohammed Yunus
- Pathology, Imam Abdulrahman Bin Faisal University, Dammam, SAU
| | - Akshayraj K Langaliya
- Conservative Dentistry and Endodontics, AMC Dental College and Hospital, Ahmedabad, IND
| | - Shubhangi Vyas
- Dentistry, AMC Dental College and Hospital, Ahmedabad, IND
| | - Dhaval Mehta
- Oral Medicine and Radiology, Narsinhbhai Patel Dental College and Hospital, Sankalchand Patel University, Visnagar, IND
| | - Akshaya Ojha
- Pediatric Dentistry, Private Practice, Jammu, IND
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Chandra Das R, Ratan ZA, Rahman MM, Runa NJ, Mondal S, Konstantinov K, Hosseinzadeh H, Cho JY. Antiviral activities of ginseng and its potential and putative benefits against monkeypox virus: A mini review. J Ginseng Res 2023; 47:S1226-8453(23)00028-3. [PMID: 37362081 PMCID: PMC10065872 DOI: 10.1016/j.jgr.2023.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/28/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
Due to the Covid-19 pandemic more than 6 million people have died, and it has bought unprecedented challenges to our lives. The recent outbreak of monkeypox virus (MPXV) has brought out new tensions among the scientific community. Currently, there is no specific treatment protocol for MPXV. Several antivirals, vaccinia immune globulin (VIG) and smallpox vaccines have been used to treat MPXV. Ginseng, one of the more famous among traditional medicines, has been used for infectious disease for thousands of years. It has shown promising antiviral effects. Ginseng could be used as a potential adaptogenic agent to help prevent infection by MPXV along with other drugs and vaccines. In this mini review, we explore the possible use of ginseng in MPXV prevention based on its antiviral activity.
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Affiliation(s)
- Rajib Chandra Das
- Institute for Superconducting and Electronics Materials (ISEM), University of Wollongong (UOW), Wollongong, NSW, Australia
- Department of Applied Chemistry and Chemical Engineering, Noakhali Science and Technology University, Noakhali, Bangladesh
| | - Zubair Ahmed Ratan
- Department of Biomedical Engineering, Khulna University of Engineering & Technology, Khulna, Bangladesh
- School of Health and Society, University of Wollongong, NSW, Australia
| | - Md Mustafizur Rahman
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh
| | | | - Susmita Mondal
- Institute for Superconducting and Electronics Materials (ISEM), University of Wollongong (UOW), Wollongong, NSW, Australia
| | - Konstantin Konstantinov
- Institute for Superconducting and Electronics Materials (ISEM), University of Wollongong (UOW), Wollongong, NSW, Australia
| | | | - Jae Youl Cho
- Department of Integrative Biotechnology, Sungkyunkwan University, Suwon, Republic of Korea
- Department of Biocosmetics, Sungkyunkwan University, Suwon, Republic of Korea
- Research Institute of Biomolecule Control and Biomedical Institute for Convergence at SKKU, Suwon, Republic of Korea
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Recent advances on human mpox. New Microbes New Infect 2022; 51:101066. [PMID: 36573212 PMCID: PMC9754762 DOI: 10.1016/j.nmni.2022.101066] [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: 08/04/2022] [Revised: 12/05/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
Mpox has been a concern of public health and travel caution. Using databases of WHO, CDC, google scholar, and PubMed, we searched recent literatures and reviewed the history, genomic mutation/evolution, host cell response pathways, regulation policy, vaccine and therapy development. Recent studies showed that current mpox has many genomic mutations related to regulation by APOBEC3. Current mpox has also been suggested to be associated with sexual transmission. Vaccination should be applied and anti-mpox drug should be urgently developed. More investigations are needed to ensure outbreak prevention.
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Gallè F, Bianco L, Da Molin G, Mancini R, Sciacchitano S, Ferracuti S, Liguori G, Orsi GB, Napoli C. "Monkeypox: What Do You Know about That?" Italian Adults' Awareness of a New Epidemic. Pathogens 2022; 11:1285. [PMID: 36365036 PMCID: PMC9696019 DOI: 10.3390/pathogens11111285] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/26/2022] [Accepted: 10/31/2022] [Indexed: 08/26/2023] Open
Abstract
In the course of 2022, an epidemic of monkeypox (MPX) arose worldwide. In order to assess the level of knowledge of the Italian adults regarding the new emerging disease, its prevention and their level of worrying and the acceptance of a possible vaccination, a web questionnaire was spread nationwide. A total of 1352 individuals (mean age 54.5 ± 13.4, 52.4% males) completed the questionnaire. Only 26. 7% of the sample wereaware of the burden of the epidemic at the moment of the investigation; 47.1% were not able to identify the transmission route, nor the main symptoms (48.9%); and 54.2% were hesitant toward a possible MPXV vaccination, mainly because of a lack of confident in vaccines (38.5%). A low level of worrying about the disease was registered (mean score 2.3 ± 1.2 on a 5-point scale). In the regression analysis performed considering MPX knowledge as outcome, a lower level of knowledge was associated with higher age (OR 1.378, CI95% 0.998-1.904), working or studying in a nonhealthcare setting (OR 0.046, CI95% 0.033-0.066), being single (OR 0.624, CI95% 0.455-0.856) and having mass media as the main source of information (OR 0.332, CI95% 0.158-0.696). These findings indicate as of the time of this investigation, the communication about the MPXV epidemic was not effective in determining a good level of knowledge about the disease and its transmission among Italian adults. This highlights the need to improve risk communication strategies.
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Affiliation(s)
- Francesca Gallè
- Department of Movement Sciences and Wellbeing, University of Naples “Parthenope”, Via Medina 40, 80133 Naples, Italy
| | - Lavinia Bianco
- Department of Public Health and Infectious Diseases, “Sapienza” University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Giovanna Da Molin
- Inter-University Research Centre “Population, Environment and Health”, University of Bari Aldo Moro, Piazza Cesare Battisti 1, 70121 Bari, Italy
| | - Rita Mancini
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Via di Grottarossa 1035/1039, 00189 Rome, Italy
| | - Salvatore Sciacchitano
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Via di Grottarossa 1035/1039, 00189 Rome, Italy
| | - Stefano Ferracuti
- Department of Human Neuroscience, “Sapienza” University of Rome, Piazzale Aldo Moro, 5, 00185 Rome, Italy
| | - Giorgio Liguori
- Department of Movement Sciences and Wellbeing, University of Naples “Parthenope”, Via Medina 40, 80133 Naples, Italy
| | - Giovanni Battista Orsi
- Department of Public Health and Infectious Diseases, “Sapienza” University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Christian Napoli
- Department of Medical Surgical Sciences and Translational Medicine, “Sapienza” University of Rome, Via di Grottarossa 1035/1039, 00189 Rome, Italy
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RACK1 Regulates Poxvirus Protein Synthesis Independently of Its Role in Ribosome-Based Stress Signaling. J Virol 2022; 96:e0109322. [PMID: 36098514 PMCID: PMC9517738 DOI: 10.1128/jvi.01093-22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Receptor for activated C kinase 1 (RACK1) is a small ribosomal subunit protein that is phosphorylated by vaccinia virus (VacV) to maximize translation of postreplicative (PR) mRNAs that harbor 5' polyA leaders. However, RACK1 is a multifunctional protein that both controls translation directly and acts as a scaffold for signaling to and from the ribosome. This includes stress signaling that is activated by ribosome-associated quality control (RQC) and ribotoxic stress response (RSR) pathways. As VacV infection activates RQC and stress signaling, whether RACK1 influences viral protein synthesis through its effects on translation, signaling, or both remains unclear. Examining the effects of genetic knockout of RACK1 on the phosphorylation of key mitogenic and stress-related kinases, we reveal that loss of RACK1 specifically blunts the activation of c-Jun N-terminal kinase/stress-activated protein kinase (JNK/SAPK) at late stages of infection. However, RACK1 was not required for JNK recruitment to ribosomes, and unlike RACK1 knockout, JNK inhibitors had no effect on viral protein synthesis. Moreover, reduced JNK activity during infection in RACK1 knockout cells contrasted with the absolute requirement for RACK1 in RSR-induced JNK phosphorylation. Comparing the effects of RACK1 knockout alongside inhibitors of late stage replication, our data suggest that JNK activation is only indirectly affected by the absence of RACK1 due to reduced viral protein accumulation. Cumulatively, our findings in the context of infection add further support for a model whereby RACK1 plays a specific and direct role in controlling translation of PR viral mRNAs that is independent of its role in ribosome-based stress signaling. IMPORTANCE Receptor for activated C kinase 1 (RACK1) is a multifunctional ribosomal protein that regulates translation directly and mediates signaling to and from the ribosome. While recent work has shown that RACK1 is phosphorylated by vaccinia virus (VacV) to stimulate translation of postreplicative viral mRNAs, whether RACK1 also contributes to VacV replication through its roles in ribosome-based stress signaling remains unclear. Here, we characterize the role of RACK1 in infected cells. In doing so, we find that RACK1 is essential for stress signal activation by ribotoxic stress responses but not by VacV infection. Moreover, although the loss of RACK1 reduces the level of stress-associated JNK activation in infected cells, this is an indirect consequence of RACK1's specific requirement for the synthesis of postreplicative viral proteins, the accumulation of which determines the level of cellular stress. Our findings reveal both the specific role of RACK1 and the complex downstream effects of its control of viral protein synthesis in the context of infection.
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Pipitò L, Cascio A. Monkeypox virus infection and creatine phosphokinase increase: A case from Italy. Travel Med Infect Dis 2022; 50:102412. [PMID: 35970435 PMCID: PMC9533948 DOI: 10.1016/j.tmaid.2022.102412] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 07/26/2022] [Accepted: 07/28/2022] [Indexed: 12/04/2022]
Affiliation(s)
- Luca Pipitò
- Infectious and Tropical Diseases Unit- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro,", University of Palermo, Palermo, Italy
| | - Antonio Cascio
- Infectious and Tropical Diseases Unit- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties "G D'Alessandro,", University of Palermo, Palermo, Italy.
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Català A, Clavo Escribano P, Riera J, Martín-Ezquerra G, Fernandez-Gonzalez P, Revelles Peñas L, Simón Gozalbo A, Rodríguez-Cuadrado FJ, Guilera Castells V, De la Torre Gomar FJ, Comunión Artieda A, Fuertes de Vega L, Blanco JL, Puig S, García Miñarro ÁM, Fiz Benito E, Muñoz-Santos C, Repiso-Jiménez JB, Ceballos-Rodriguez C, García Rodríguez V, Castaño Fernández JL, Sánchez-Gutiérrez I, Calvo López R, Berna-Rico E, de Nicolás-Ruanes B, Corella Vicente F, Tarín Vicente EJ, Fernández de la Fuente L, Riera-Martí N, Descalzo-Gallego MA, Grau-Perez M, García-Doval I, Fuertes I. Monkeypox outbreak in Spain: clinical and epidemiological findings in a prospective cross-sectional study of 185 cases. Br J Dermatol 2022; 187:765-772. [PMID: 35917191 DOI: 10.1111/bjd.21790] [Citation(s) in RCA: 148] [Impact Index Per Article: 74.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 07/22/2022] [Accepted: 07/22/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Since May 2022, a new outbreak of monkeypox has been reported in several countries, including Spain. The clinical and epidemiological characteristics of the cases in this outbreak may differ form earlier reports. METHODS We conducted a prospective cross-sectional study in multiple medical facilities in Spain to describe the cases of monkeypox in the 2022 outbreak. RESULTS In total, 185 patients were included. Most cases started with primarily localised homogeneous papules, not pustules, in the probable area of inoculation, whichcould be cutaneous or mucous, including single lesions. Generalised small pustules appeared later in some of them. Heterogeneous lesions occurred during this generalised phase. All patients had systemic symptoms. Less common lesions included mucosal ulcers (including pharyngeal ulcers and proctitis) and monkeypox whitlows. Four patients were hospitalised, none died. Smallpox vaccination and well-controlled HIV disease were not associated with markers of severity. Contact during sex is the most likely mechanism of transmission. In this outbreak, cases have been described in males having sex with males and are strongly associated with high-risk sexual behaviours. Seventy-six percent of the patients had other sexually transmitted diseases upon screening. CONCLUSIONS The clinical findings in this outbreak differ from previous findings and highly suggest contact transmission and initiation at the entry site. The characterisation of the epidemiology of this outbreak has implications for control.
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Affiliation(s)
- Alba Català
- Sexually Transmitted Diseases Clinic. Dermatology Department. Hospital Clinic. Barcelona, Spain
| | | | - Josep Riera
- Sexually Transmitted Diseases Clinic. Dermatology Department. Hospital Clinic. Barcelona, Spain
| | - Gemma Martín-Ezquerra
- Sexually Transmitted Diseases Clinic. Dermatology Department. Hospital Clinic. Barcelona, Spain
| | | | - Leonor Revelles Peñas
- Centro Sandoval. Dermatology Department. Hospital Clínico San Carlos. Madrid, Spain.,Dermatology Department. Complejo Asistencial Universitario de Salamanca. Salamanca, Spain
| | - Ana Simón Gozalbo
- Dermatology department. Hospital Universitario Infanta Leonor. Madrid, Spain
| | | | | | | | | | - Laura Fuertes de Vega
- Dermatology Department. Hospital Universitario Fundación Jiménez Díaz. Madrid, Spain
| | - José Luis Blanco
- Infectious Diseases & AIDS Unit. Hospital Clinic Barcelona., Spain
| | - Susana Puig
- Dermatology Department. Hospital Clinic. Barcelona, Spain
| | | | | | - Carlos Muñoz-Santos
- Dermatology Department. Hospital General de Granollers. Granollers, Barcelona, Spain
| | | | | | - Víctor García Rodríguez
- Dermatology Department. Hospital Universitari Sagrat Cor, Grupo Quirónsalud. Barcelona, Spain
| | | | | | | | | | | | | | | | | | - Nuria Riera-Martí
- Dermatology Department. Hospital Universitari Parc Tauli. Barcelona, Spain
| | | | - Mercè Grau-Perez
- Research Unit. Fundacion Piel Sana AEDV. Madrid, Spain. Dermatology Department. Hospital Universitario Puerta de Hierro Majadahonda. Madrid, Spain
| | - Ignacio García-Doval
- Research Unit. Fundacion Piel Sana AEDV. Madrid, Spain. Dermatology Department. Complexo Hospitalario Universitario de Vigo, Vigo, Spain
| | - Irene Fuertes
- Sexually Transmitted Diseases Clinic. Dermatology Department. Hospital Clinic. Barcelona, Spain
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Sookaromdee P, Wiwanitkti V. A commentary on "The 2022 monkeypox outbreak: Lessons from the 640 cases in 36 countries" (Int J Surg 2022;104:106712). Int J Surg 2022; 104:106769. [PMID: 35843593 PMCID: PMC9624142 DOI: 10.1016/j.ijsu.2022.106769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 07/05/2022] [Indexed: 11/12/2022]
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