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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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Mariotti D, Bettini A, Meschi S, Notari S, Francalancia M, Tartaglia E, Lapa D, Specchiarello E, Girardi E, Matusali G, Maggi F. Effect of chemical and physical agents on monkeypox virus infectivity and downstream research applications. Virology 2024; 592:109993. [PMID: 38244323 DOI: 10.1016/j.virol.2024.109993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/26/2023] [Accepted: 01/10/2024] [Indexed: 01/22/2024]
Abstract
The 2022 global spread of Monkeypox Virus (MPXV) underlined the need to investigate safe-handling procedures of clinical and research samples. Here we evaluated the efficiency in reducing MPXV infectious titer of Triton X-100 (0.1 and 0.2%), UV-C irradiation (15 or 30 min), and heat (56 °C 30 min or 70 °C 5 min). The treatment of MPXV at 70 °C resulted in the strongest decrease of MPXV infectious titer (5.4 Log TCID50/mL), 56 °C and UV-C had a lighter impact (3.9 and 4.3Log), Triton X-100 was less efficient (1.8-2.5Log). Notably, SARS-CoV-2 was much more susceptible to Triton X-100 (4.0 Log decrease). UV-C had the highest impact on MPXV DNA detection by PCR (2.2-4.3 Ct value increase); protein detection by ELISA was dramatically impaired by heating. Overall, UV-C and heating were more effective in lowering MPXV infectious titer but their impact on nucleic acids or protein detection assays must be considered.
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Affiliation(s)
- Davide Mariotti
- Laboratory of Virology and Biosafety Laboratories, National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense 292, 00149, Rome, Italy
| | - Aurora Bettini
- Laboratory of Virology and Biosafety Laboratories, National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense 292, 00149, Rome, Italy
| | - Silvia Meschi
- Laboratory of Virology and Biosafety Laboratories, National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense 292, 00149, Rome, Italy
| | - Stefania Notari
- Laboratory of Cellular Immunology and Pharmacology, National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense 292, 00149, Rome, Italy
| | - Massimo Francalancia
- Laboratory of Virology and Biosafety Laboratories, National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense 292, 00149, Rome, Italy
| | - Eleonora Tartaglia
- Laboratory of Cellular Immunology and Pharmacology, National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense 292, 00149, Rome, Italy
| | - Daniele Lapa
- Laboratory of Virology and Biosafety Laboratories, National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense 292, 00149, Rome, Italy
| | - Eliana Specchiarello
- Laboratory of Virology and Biosafety Laboratories, National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense 292, 00149, Rome, Italy
| | - Enrico Girardi
- Scientific Direction, National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense 292, 00149, Rome, Italy
| | - Giulia Matusali
- Laboratory of Virology and Biosafety Laboratories, National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense 292, 00149, Rome, Italy.
| | - Fabrizio Maggi
- Laboratory of Virology and Biosafety Laboratories, National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense 292, 00149, Rome, Italy
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Ahmed SK, Dabou EA, Ibrahim FM, Mohammed MG, Chandran D, Basit J, Chakraborty S, Emran TB, Islam R, Dhama K. Challenges and Counteracting Strategies Including Optimum Health Service Practices for Frontline Nurses During the Mpox Outbreak and Futuristic Vision. SAGE Open Nurs 2024; 10:23779608241256209. [PMID: 38784647 PMCID: PMC11113054 DOI: 10.1177/23779608241256209] [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: 07/29/2023] [Revised: 03/28/2024] [Accepted: 05/04/2024] [Indexed: 05/25/2024] Open
Abstract
Introduction Monkeypox (mpox) is an evolving infectious disease caused by the monkeypox virus (MPXV). On July 23, 2022, the WHO declared the recent mpox outbreaks a public health emergency of international concern (PHEIC), which terminated on May 11, 2023. As of July 11, 2023, 88,288 confirmed cases and 149 deaths have been reported from 112 countries and territories. Currently, mpox is not a PHEIC, as the outbreak and its impacts are nearly over. Nurses played significant roles during the mpox 2022 outbreak as frontline workers. Purpose In light of the impending mpox global outbreak in 2022, this brief report provides an update on the enormous difficulties faced by frontline nurses while playing a crucial role in handling the mpox outbreak and some potential solutions to these difficulties. The methodological framework employed in this narrative brief report involves conducting a comprehensive analysis and synthesis of relevant literature and hypothetical scenarios. The aim is to put forth practical strategies that can effectively tackle the difficulties encountered by frontline nurses in the context of the mpox outbreak. Additionally, the report seeks to envision a healthcare system that is more resilient in the face of future challenges. Conclusion It is important to understand the challenges the nurses face from their perspective. As frontline health care workers, the various health issues of nurses and their concerns must be taken care of appropriately by adopting optimum health service practices, adequate safety measures, recommended precautionary measures, and boosting them mentally while handling mpox patients. Counseling and the arrangement of workshops are required. Appropriate care should be taken to address the various health issues concerning nurses by adopting health service practices at optimum levels. Side by side, recommended safety and precautionary measures should be followed.
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Affiliation(s)
- Sirwan Khalid Ahmed
- College of Nursing, University of Raparin, Rania, Sulaymaniyah, Kurdistan Region, Iraq
- Ministry of Health, General Directorate of Health-Raparin, Rania, Sulaymaniyah, Kurdistan Region, Iraq
| | - Eman A. Dabou
- RAK College of Nursing, RAK Medical and Health Sciences University, Ras Al Khiamah, UAE
| | - Fatma M. Ibrahim
- RAK College of Nursing, RAK Medical and Health Sciences University, Ras Al Khiamah, UAE
| | - Mona G. Mohammed
- RAK College of Nursing, RAK Medical and Health Sciences University, Ras Al Khiamah, UAE
| | - Deepak Chandran
- (Department of Animal Husbandry, Government of Kerala, Palakkad, Kerala, India
| | - Jawad Basit
- Department of Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan
| | - Sandip Chakraborty
- State Disease Investigation Laboratory, ARDD, Abhoynagar, Agartala, West Tripura, India
| | - Talha Bin Emran
- Department of Pharmacy, BGC Trust University Bangladesh, Chittagong, Bangladesh
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka, Bangladesh
| | - Rabiul Islam
- School of Pharmacy, BRAC University, Dhaka, Bangladesh
| | - Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute (IVRI), Bareilly, Uttar Pradesh, India
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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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Li F, Shen X, Zhang H, Jin H, Zhang L, Lv B, Li W, Liang Z, Zhang X, Zhang D, Hou X, Pan Y, Kan B, Wang Q. Stability of mpox virus on different commonly contacted surfaces. J Med Virol 2023; 95:e29296. [PMID: 38054540 DOI: 10.1002/jmv.29296] [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: 10/19/2023] [Revised: 11/15/2023] [Accepted: 11/21/2023] [Indexed: 12/07/2023]
Abstract
Mpox is still spreading globally and is mostly reported to be transmitted by skin and mucosal contact. However, transmission through contact with fomites, contaminated objects, or surfaces has been reported in general population. Evaluation of the stability of mpox virus (MPXV) on different surfaces is important to minimize mpox transmission. In the study, the stability of MPXV on different kinds of commonly contacted surfaces was determined. MPXV was observed to have a surface-dependent stability pattern. Viable virus was detected on both glass and stainless steel for up to 5 days, and on plastic surfaces for up to 3 days. In contrast, no viable MPXV was detected on wooden board and cardboard, which are porous and water-absorbent surfaces, after 1 and 2 days of incubation, respectively. In addition, MPXV nucleic acids were more stable and showed better correlation with viral titers on stainless steel, plastic, and glass. The results indicate that fomite transmission of MPXV is plausible. Moreover, the stability of MPXV was highly surface-dependent and more stable on smooth surfaces, which could provide more information for minimizing the transmission of mpox and emphasize the significance of environmental disinfection in mpox prevention and control.
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Affiliation(s)
- Fu Li
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Xiaona Shen
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Huijuan Zhang
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Haoyuan Jin
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Lin Zhang
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Bing Lv
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Weihong Li
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Zhichao Liang
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Xin Zhang
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Daitao Zhang
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Xuexin Hou
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yang Pan
- Beijing Center for Disease Prevention and Control, Beijing, China
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Biao Kan
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Quanyi Wang
- Beijing Center for Disease Prevention and Control, Beijing, China
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
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Islam MA, Mumin J, Haque MM, Haque MA, Khan A, Bhattacharya P, Haque MA. Monkeypox virus (MPXV): A Brief account of global spread, epidemiology, virology, clinical features, pathogenesis, and therapeutic interventions. INFECTIOUS MEDICINE 2023; 2:262-272. [PMID: 38205182 PMCID: PMC10774656 DOI: 10.1016/j.imj.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 09/08/2023] [Accepted: 11/02/2023] [Indexed: 01/12/2024]
Abstract
The largest monkeypox virus (MPXV) outbreak of the 21st century occurred in 2022, which caused epidemics in many countries. According to WHO, physical contact with infected persons, contaminated surfaces, or affected animals might be a source of this virus transmission. A febrile sickness including few symptoms found in MPX disease. Skin rash, lesions, fever, headache, fatigue, and muscle aches symptoms were observed commonly for this disease. Animal and in vitro, studies have shown that the antiviral medications cidofovir and brincidofovir are effective against MPXV. The first-generation vaccinia virus vaccine was developed in 1960, and it helped to protect against MPXV with its side effects. A second-generation vaccination with limitations was launched in 2000. However, the CDC advised vaccinations for risk groups in endemic countries, including positive patients and hospital employees. The JYNNEOS vaccine, administered in 2 doses, also provides protection from MPX. This article presents concisely the most recent findings regarding epidemiology, genomic transmission, signs and symptoms, pathogenesis, diagnosis, and therapeutic interventions for MPXV, which may be helpful to researchers and practitioners. WHO declared that MPX was no longer a global health emergency due to its declining case rate, and a number of countries have reported new incidences. Further research-based investigations must be carried out based on the 2022 outbreak.
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Affiliation(s)
- Md Aminul Islam
- Advanced Molecular Lab, Department of Microbiology, President Abdul Hamid Medical College, Karimganj 2310, Bangladesh
- COVID-19 Diagnostic Lab, Department of Microbiology, Noakhali Science and Technology University, Noakhali 3814, Bangladesh
| | - Jubayer Mumin
- Department of Global Public Health, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Md Masudul Haque
- Department of Public Health, North South University, Dhaka 1229, Bangladesh
| | - Md. Azizul Haque
- Department of Biochemistry and Molecular Biology, Faculty of Agriculture, Hajee Mohammad Danesh Science and Technology University, Dinajpur 5200, Bangladesh
| | - Ahrar Khan
- Shandong Vocational Animal Science and Veterinary College, Weifang 261061, China
| | - Prosun Bhattacharya
- COVID-19 Research @KTH, Department of Sustainable Development, Environmental Science and Engineering, KTH Royal Institute of Technology, SE-100 44 Stockholm, Sweden
| | - Md Atiqul Haque
- Key Laboratory of Animal Epidemiology and Zoonoses of Ministry of Agriculture, College of Veterinary Medicine, China Agricultural University, Beijing 100019, China
- Department of Microbiology, Faculty of Veterinary and Animal Science, Hajee Mohammad Danesh Science and Technology University, Dinajpur 5200, Bangladesh
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Yinda CK, Morris DH, Fischer RJ, Gallogly S, Weishampel ZA, Port JR, Bushmaker T, Schulz JE, Bibby K, van Doremalen N, Lloyd-Smith JO, Munster VJ. Stability of Monkeypox Virus in Body Fluids and Wastewater. Emerg Infect Dis 2023; 29:2065-2072. [PMID: 37735747 PMCID: PMC10521604 DOI: 10.3201/eid2910.230824] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023] Open
Abstract
An outbreak of human mpox infection in nonendemic countries appears to have been driven largely by transmission through body fluids or skin-to-skin contact during sexual activity. We evaluated the stability of monkeypox virus (MPXV) in different environments and specific body fluids and tested the effectiveness of decontamination methodologies. MPXV decayed faster at higher temperatures, and rates varied considerably depending on the medium in which virus was suspended, both in solution and on surfaces. More proteinaceous fluids supported greater persistence. Chlorination was an effective decontamination technique, but only at higher concentrations. Wastewater was more difficult to decontaminate than plain deionized water; testing for infectious MPXV could be a helpful addition to PCR-based wastewater surveillance when high levels of viral DNA are detected. Our findings suggest that, because virus stability is sufficient to support environmental MPXV transmission in healthcare settings, exposure and dose-response will be limiting factors for those transmission routes.
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Alsaiari AA, Hakami MA, Alotaibi BS, Alkhalil SS, Alkhorayef N, Khan K, Jalal K. Delineating multi-epitopes vaccine designing from membrane protein CL5 against all monkeypox strains: a pangenome reverse vaccinology approach. J Biomol Struct Dyn 2023:1-22. [PMID: 37599459 DOI: 10.1080/07391102.2023.2248301] [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: 05/29/2023] [Accepted: 08/02/2023] [Indexed: 08/22/2023]
Abstract
The recently identified monkeypox virus (MPXV or mpox) is a zoonotic orthopox virus that infects humans and causes diseases with traits like smallpox. The world health organization (WHO) estimates that 3-6% of MPXV cases result in death. As it might impact everyone globally, like COVID, and become the next pandemic, the cure for this disease is important for global public health. The high incidence and disease ratio of MPXV necessitates immediate efforts to design a unique vaccine candidate capable of addressing MPXV diseases. Here, we used a computational pan-genome-based vaccine design strategy for all currently reported 19 MPXV strains acquired from different regions of the world. Thus, this study's objective was to develop a new and safe vaccine candidate against MPXV by targeting the membrane CL5 protein; identified after the pangenome analysis. Proteomics and reverse vaccinology have covered up all of the MPXV epitopes that would usually stimulate robust host immune responses. Following this, only two mapped (MHC-I, MHC-II, and B-cell) epitopes were observed to be extremely effective that can be used in the construction of CL5 protein vaccine candidates. The suggested vaccine (V5) candidate from eight vaccine models was shown to be antigenic, non-allergenic, and stable (with 213 amino acids). The vaccine's candidate efficacy was evaluated by using many in silico methods to predict, improve, and validate its 3D structure. Molecular docking and molecular dynamics simulations further reveal that the proposed vaccine candidate ensemble has a high interaction energy with the HLAs and TRL2/4 immunological receptors under study. Later, the vaccine sequence was used to generate an expression vector for the E. coli K12 strain. Further study uncovers that V5 was highly immunogenic because it produced robust primary, secondary, and tertiary immune responses. Eventually, the use of computer-aided vaccine designing may significantly reduce costs and speed up the process of developing vaccines. Although, the results of this research are promising, however, more research (experimental; in vivo, and in vitro studies) is needed to verify the biological efficacy of the proposed vaccine against MPXV.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Ahad Amer Alsaiari
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Mohammed Ageeli Hakami
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Al- Quwayiyah, Shaqra University, Riyadh, Saudi Arabia
| | - Bader S Alotaibi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Al- Quwayiyah, Shaqra University, Riyadh, Saudi Arabia
| | - Samia S Alkhalil
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Al- Quwayiyah, Shaqra University, Riyadh, Saudi Arabia
| | - Nada Alkhorayef
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Al- Quwayiyah, Shaqra University, Riyadh, Saudi Arabia
| | - Kanwal Khan
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan
| | - Khurshid Jalal
- HEJ Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan
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Saied AA, Chandran D, Chakraborty S, Emran TB, Dhama K. Mpox and healthcare workers — a minireview of our present knowledge. THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2023; 35:46. [DOI: 10.1186/s43162-023-00233-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/14/2023] [Indexed: 09/01/2023] Open
Abstract
Abstract
Introduction
Workers in the healthcare industry form the backbone of health systems everywhere. In the face of global health crises like the current monkeypox (mpox) outbreak, healthcare workers like doctors, dentists, pharmacists, nurses, midwives, paramedics, administrators, support staff, laboratory technicians, and community health workers all play crucial roles in providing care and containing the spread of the disease.
Aim
Therefore, in the wake of concerns about mpox recurrence, we seek to shed light on the occupational transmission of mpox infection and the possible risk to healthcare personnel.
Results
Contamination of the environment of the household of cases of mpox and environment of the patient care units with the viral DNA has been reported besides asymptomatic cases and detection of viral DNA in air samples; therefore, more research on non-lesion-based testing for human mpox infection for screening asymptomatic people, particularly among populations at high risk of infection, in the event of asymptomatic transmission and potential transmission via aerosols is necessary. Monitoring efforts can be aided by incorporating mpox testing into locations where people are more likely to contract illnesses and seek medical attention. We must take a precautionary infection control approach to control the spread of the virus while completing urgent research to understand better the human-to-human mpox transmission process.
Conclusions
In this minireview, we discuss the potential routes of mpox transmission to healthcare and preventative strategies and measures that should be taken and considered.
Graphical Abstract
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Rabaan AA, Al-Shwaikh SA, Alfouzan WA, Al-Bahar AM, Garout M, Halwani MA, Albayat H, Almutairi NB, Alsaeed M, Alestad JH, Al-Mozaini MA, Ashgar TMA, Alotaibi S, Abuzaid AA, Aldawood Y, Alsaleh AA, Al-Afghani HM, Altowaileb JA, Alshukairi AN, Arteaga-Livias K, Singh KKB, Imran M. A Comprehensive Review on Monkeypox Viral Disease with Potential Diagnostics and Therapeutic Options. Biomedicines 2023; 11:1826. [PMID: 37509466 PMCID: PMC10376530 DOI: 10.3390/biomedicines11071826] [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: 05/22/2023] [Revised: 06/20/2023] [Accepted: 06/23/2023] [Indexed: 07/30/2023] Open
Abstract
The purpose of this review is to give an up-to-date, thorough, and timely overview of monkeypox (Mpox), a severe infectious viral disease. Furthermore, this review provides an up-to-date treatment option for Mpox. The monkeypox virus (MPXV) has remained the most virulent poxvirus for humans since the elimination of smallpox approximately 41 years ago, with distribution mainly in central and west Africa. Mpox in humans is a zoonotically transferred disease that results in symptoms like those of smallpox. It had spread throughout west and central Africa when it was first diagnosed in the Republic of Congo in 1970. Mpox has become a major threat to global health security, necessitating a quick response by virologists, veterinarians, public health professionals, doctors, and researchers to create high-efficiency diagnostic tests, vaccinations, antivirals, and other infection control techniques. The emergence of epidemics outside of Africa emphasizes the disease's global significance. A better understanding of Mpox's dynamic epidemiology may be attained by increased surveillance and identification of cases.
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Affiliation(s)
- Ali A Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
- Department of Public Health and Nutrition, The University of Haripur, Haripur 22610, Pakistan
| | - Seham A Al-Shwaikh
- Department of Commitment Management, Directorate of Health Affairs in the Eastern Province, Dammam 31176, Saudi Arabia
| | - Wadha A Alfouzan
- Department of Microbiology, Faculty of Medicine, Kuwait University, Safat 13110, Kuwait
- Microbiology Unit, Department of Laboratories, Farwania Hospital, Farwania 85000, Kuwait
| | - Ali M Al-Bahar
- Department of Laboratory, Dhahran Long Term Care Hospital, Dhahran 34257, Saudi Arabia
| | - Mohammed Garout
- Department of Community Medicine and Health Care for Pilgrims, Faculty of Medicine, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Muhammad A Halwani
- Department of Medical Microbiology, Faculty of Medicine, Al Baha University, Al Baha 4781, Saudi Arabia
| | - Hawra Albayat
- Infectious Disease Department, King Saud Medical City, Riyadh 7790, Saudi Arabia
| | - Norah B Almutairi
- Infectious Disease Department, King Saud Medical City, Riyadh 7790, Saudi Arabia
| | - Mohammed Alsaeed
- Infectious Disease Division, Department of Medicine, Prince Sultan Military Medical City, Riyadh 11159, Saudi Arabia
| | - Jeehan H Alestad
- Immunology and Infectious Microbiology Department, University of Glasgow, Glasgow G1 1XQ, UK
- Microbiology Department, Collage of Medicine, Jabriya 46300, Kuwait
| | - Maha A Al-Mozaini
- Immunocompromsised Host Research Section, Department of Infection and Immunity, King Faisal, Specialist Hospital and Research Centre, Riyadh 11564, Saudi Arabia
| | - Tala M Al Ashgar
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11481, Saudi Arabia
| | - Sultan Alotaibi
- Molecular Microbiology Department, King Fahad Medical City, Riyadh 11525, Saudi Arabia
| | - Abdulmonem A Abuzaid
- Medical Microbiology Department, Security Forces Hospital Programme, Dammam 32314, Saudi Arabia
| | - Yahya Aldawood
- Clinical Laboratory Science Department, Mohammed Al-Mana College for Medical Sciences, Dammam 34222, Saudi Arabia
| | - Abdulmonem A Alsaleh
- Clinical Laboratory Science Department, Mohammed Al-Mana College for Medical Sciences, Dammam 34222, Saudi Arabia
| | - Hani M Al-Afghani
- Laboratory Department, Security Forces Hospital, Makkah 24269, Saudi Arabia
- iGene Center for Research and Training, Jeddah 2022, Saudi Arabia
| | - Jaffar A Altowaileb
- Microbiology Laboratory, Laboratory Department, Qatif Central Hospital, Qatif 32654, Saudi Arabia
| | - Abeer N Alshukairi
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
- Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah 22233, Saudi Arabia
| | - Kovy Arteaga-Livias
- Escuela de Medicina-Filial Ica, Universidad Privada San Juan Bautista, Ica 11000, Peru
- Escuela de Medicina, Universidad Nacional Hermilio Valdizán, Huanuco 10000, Peru
| | - Kirnpal Kaur Banga Singh
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia
| | - Mohd Imran
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Northern Border University, Rafha 91911, Saudi Arabia
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11
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Saied AA. Mpox virus Clade IIb detection in the air. J Med Virol 2023; 95:e28775. [PMID: 37212310 DOI: 10.1002/jmv.28775] [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: 02/06/2023] [Revised: 04/17/2023] [Accepted: 04/22/2023] [Indexed: 05/23/2023]
Abstract
Mpox is a viral zoonotic disease endemic in Central and West Africa that is caused by the Mpox virus, which belongs to the Orthopoxvirus genus and Poxviridae family. The clinical manifestations of mpox infection are milder than those of smallpox, and the incubation time of mpox varies from 5 to 21 days. Since May 2022, the mpox outbreak (formerly known as monkeypox) has suddenly and unexpectedly spread in non-endemic countries, suggesting that there may have been some undetected transmissions. Based on molecular analysis, there are two major genetic clades that represent the mpox virus: Clade I (formerly the Congo Basin clade OR the Central African clade) and Clade II (formerly the West African clade). It is believed that people who are asymptomatic or paucisymptomatic may spread the mpox virus. Infectious viruses cannot be distinguished by PCR testing; therefore, virus culture should be carried out. Recent evidence regarding the detection of the mpox virus (Clade IIb) in air samples collected from the patient's environment during the 2022 mpox outbreak was reviewed. Further studies are needed to evaluate the extent to which the presence of mpox virus DNA in the air could affect immunocompromised patients in healthcare facilities, and further epidemiological studies are crucial, especially in Africa.
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Affiliation(s)
- AbdulRahman A Saied
- National Food Safety Authority (NFSA), Aswan Branch, Aswan, Egypt
- Ministry of Tourism and Antiquities, Aswan Office, Aswan, Egypt
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12
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Beeson A, Styczynski A, Hutson CL, Whitehill F, Angelo KM, Minhaj FS, Morgan C, Ciampaglio K, Reynolds MG, McCollum AM, Guagliardo SAJ. Mpox respiratory transmission: the state of the evidence. THE LANCET. MICROBE 2023; 4:e277-e283. [PMID: 36898398 PMCID: PMC9991082 DOI: 10.1016/s2666-5247(23)00034-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 03/09/2023]
Abstract
The relative contribution of the respiratory route to transmission of mpox (formerly known as monkeypox) is unclear. We review the evidence for respiratory transmission of monkeypox virus (MPXV), examining key works from animal models, human outbreaks and case reports, and environmental studies. Laboratory experiments have initiated MPXV infection in animals via respiratory routes. Some animal-to-animal respiratory transmission has been shown in controlled studies, and environmental sampling studies have detected airborne MPXV. Reports from real-life outbreaks demonstrate that transmission is associated with close contact, and although it is difficult to infer the route of MPXV acquisition in individual case reports, so far respiratory transmission has not been specifically implicated. Based on the available evidence, the likelihood of human-to-human MPXV respiratory transmission appears to be low; however, studies should continue to assess this possibility.
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Affiliation(s)
- Amy Beeson
- Mpox Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ashley Styczynski
- Mpox Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Christina L Hutson
- Mpox Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Florence Whitehill
- Mpox Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kristina M Angelo
- Mpox Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Faisal S Minhaj
- Mpox Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Clint Morgan
- Mpox Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kaitlyn Ciampaglio
- Mpox Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mary G Reynolds
- Mpox Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Andrea M McCollum
- Mpox Response Team, Centers for Disease Control and Prevention, Atlanta, GA, USA
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13
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Lee BU. Airborne transmission of MPXV and its aerosol dynamics under different viral load conditions. THE LANCET. MICROBE 2023; 4:e288-e289. [PMID: 36870361 PMCID: PMC9977328 DOI: 10.1016/s2666-5247(23)00059-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/07/2023] [Indexed: 03/05/2023]
Affiliation(s)
- Byung Uk Lee
- Bioaerosol Laboratory, Konkuk University, Seoul 05029, South Korea.
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14
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Pan D, Nazareth J, Sze S, Martin CA, Decker J, Fletcher E, Déirdre Hollingsworth T, Barer MR, Pareek M, Tang JW. Transmission of monkeypox/mpox virus: A narrative review of environmental, viral, host, and population factors in relation to the 2022 international outbreak. J Med Virol 2023; 95:e28534. [PMID: 36708091 PMCID: PMC10107822 DOI: 10.1002/jmv.28534] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/05/2022] [Accepted: 01/24/2023] [Indexed: 01/29/2023]
Abstract
Monkeypox virus (MPXV) has spread globally. Emerging studies have now provided evidence regarding MPXV transmission, that can inform rational evidence-based policies and reduce misinformation on this topic. We aimed to review the evidence on transmission of the virus. Real-world studies have isolated viable viruses from high-touch surfaces for as long as 15 days. Strong evidence suggests that the current circulating monkeypox (mpox) has evolved from previous outbreaks outside of Africa, but it is yet unknown whether these mutations may lead to an inherently increased infectivity of the virus. Strong evidence also suggests that the main route of current MPXV transmission is sexual; through either close contact or directly, with detection of culturable virus in saliva, nasopharynx, and sperm for prolonged periods and the presence of rashes mainly in genital areas. The milder clinical presentations and the potential presence of presymptomatic transmission in the current circulating variant compared to previous clades, as well as the dominance of spread amongst men who have sex with men (MSMs) suggests that mpox has a developed distinct clinical phenotype that has increased its transmissibility. Increased public awareness of MPXV transmission modalities may lead to earlier detection of the spillover of new cases into other groups.
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Affiliation(s)
- Daniel Pan
- Department of Respiratory SciencesUniversity of LeicesterLeicesterUK
- Department of Infectious Diseases and HIV MedicineUniversity Hospitals of Leicester NHS TrustLeicesterUK
- Li Ka Shing Centre for Health Information and Discovery, Big Data InstituteUniversity of OxfordOxfordUK
- NIHR Leicester Biomedical Research CentreLiecesterUK
| | - Joshua Nazareth
- Department of Respiratory SciencesUniversity of LeicesterLeicesterUK
- Department of Infectious Diseases and HIV MedicineUniversity Hospitals of Leicester NHS TrustLeicesterUK
- NIHR Leicester Biomedical Research CentreLiecesterUK
| | - Shirley Sze
- Department of Cardiovascular SciencesUniversity of LeicesterLeicesterUK
| | - Christopher A. Martin
- Department of Respiratory SciencesUniversity of LeicesterLeicesterUK
- Department of Infectious Diseases and HIV MedicineUniversity Hospitals of Leicester NHS TrustLeicesterUK
- NIHR Leicester Biomedical Research CentreLiecesterUK
| | - Jonathan Decker
- Department of Respiratory SciencesUniversity of LeicesterLeicesterUK
| | - Eve Fletcher
- Department of Respiratory SciencesUniversity of LeicesterLeicesterUK
| | - T. Déirdre Hollingsworth
- Li Ka Shing Centre for Health Information and Discovery, Big Data InstituteUniversity of OxfordOxfordUK
| | - Michael R. Barer
- Department of Respiratory SciencesUniversity of LeicesterLeicesterUK
- Department of Clinical MicrobiologyUniversity Hospitals of Leicester NHS TrustLeicesterUK
| | - Manish Pareek
- Department of Respiratory SciencesUniversity of LeicesterLeicesterUK
- Department of Infectious Diseases and HIV MedicineUniversity Hospitals of Leicester NHS TrustLeicesterUK
- NIHR Leicester Biomedical Research CentreLiecesterUK
| | - Julian W. Tang
- Department of Respiratory SciencesUniversity of LeicesterLeicesterUK
- Department of VirologyUniversity Hospitals of Leicester NHS TrustLeicesterUK
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15
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Hernaez B, Muñoz-Gómez A, Sanchiz A, Orviz E, Valls-Carbo A, Sagastagoitia I, Ayerdi O, Martín R, Puerta T, Vera M, Cabello N, Vergas J, Prieto C, Pardo-Figuerez M, Negredo A, Lagarón JM, del Romero J, Estrada V, Alcamí A. Monitoring monkeypox virus in saliva and air samples in Spain: a cross-sectional study. THE LANCET. MICROBE 2023; 4:e21-e28. [PMID: 36436538 PMCID: PMC9691259 DOI: 10.1016/s2666-5247(22)00291-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 09/19/2022] [Accepted: 09/29/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND The transmission of monkeypox virus occurs through direct contact, but transmission through saliva or exhaled droplets and aerosols has not yet been investigated. We aimed to assess the presence of monkeypox virus DNA and infectious virus in saliva samples and droplets and aerosols exhaled from patients infected with monkeypox virus. METHODS We did a cross-sectional study in patients with monkeypox confirmed by PCR who attended two health centres in Madrid, Spain. For each patient, we collected samples of saliva, exhaled droplets within a mask, and aerosols captured by air filtration through newly developed nanofiber filters. We evaluated the presence of monkeypox virus in the samples by viral DNA detection by quantitative PCR (qPCR) and isolation of infectious viruses in cell cultures. FINDINGS Between May 18 and July 15, 2022, 44 patients with symptomatic monkeypox attended two health centres in Madrid and were included in the study. All were cisgender men, with a median age of 35·0 years (IQR 11·3). We identified high loads of monkeypox virus DNA by qPCR in 35 (85%) of 41 saliva samples. Infectious monkeypox virus was recovered from 22 (67%) of 33 saliva samples positive for monkeypox virus DNA. We also found a significant association between the number of affected cutaneous areas or general symptoms and the viral load present in saliva samples. Droplets exhaled from patients with monkeypox, detected inside a mask, contained monkeypox virus DNA in 32 (71%) of 45 samples, with two of the 32 positive samples showing the presence of the infectious virus. Monkeypox virus DNA in aerosols, collected from the medical consultation room, were detected in 27 (64%) of 42 samples, despite patients wearing an FFP2 mask during the visit. Infectious virus was not recovered from aerosol samples. High levels of monkeypox virus DNA were identified in aerosols collected from a hospital isolation room housing a patient with monkeypox. INTERPRETATION The identification of high viable monkeypox virus loads in saliva in most patients with monkeypox and the finding of monkeypox virus DNA in droplets and aerosols warrants further epidemiological studies to evaluate the potential relevance of the respiratory route of infection in the 2022 monkeypox virus outbreak. FUNDING EU, Consejo Superior de Investigaciones Científicas, and Ciberinfec.
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Affiliation(s)
- Bruno Hernaez
- Centro de Biología Molecular Severo Ochoa (Consejo Superior de Investigaciones Científicas and Universidad Autónoma de Madrid), Madrid, Spain
| | - Ana Muñoz-Gómez
- Centro Sandoval and Hospital Universitario Clínico de San Carlos, IdISSC, Madrid, Spain
| | - Africa Sanchiz
- Centro de Biología Molecular Severo Ochoa (Consejo Superior de Investigaciones Científicas and Universidad Autónoma de Madrid), Madrid, Spain
| | - Eva Orviz
- Centro Sandoval and Hospital Universitario Clínico de San Carlos, IdISSC, Madrid, Spain
| | | | - Iñigo Sagastagoitia
- Centro Sandoval and Hospital Universitario Clínico de San Carlos, IdISSC, Madrid, Spain,Ciber de Enfermedades Infecciosas, Madrid, Spain
| | - Oskar Ayerdi
- Centro Sandoval and Hospital Universitario Clínico de San Carlos, IdISSC, Madrid, Spain
| | - Rocío Martín
- Centro de Biología Molecular Severo Ochoa (Consejo Superior de Investigaciones Científicas and Universidad Autónoma de Madrid), Madrid, Spain
| | - Teresa Puerta
- Centro Sandoval and Hospital Universitario Clínico de San Carlos, IdISSC, Madrid, Spain
| | - Mar Vera
- Centro Sandoval and Hospital Universitario Clínico de San Carlos, IdISSC, Madrid, Spain
| | - Noemi Cabello
- Centro Sandoval and Hospital Universitario Clínico de San Carlos, IdISSC, Madrid, Spain,Ciber de Enfermedades Infecciosas, Madrid, Spain
| | - Jorge Vergas
- Centro Sandoval and Hospital Universitario Clínico de San Carlos, IdISSC, Madrid, Spain
| | - Cristina Prieto
- Instituto de Agroquímica y Tecnología de Alimentos, Valencia, Spain
| | | | - Anabel Negredo
- Ciber de Enfermedades Infecciosas, Madrid, Spain,Laboratorio de Arbovirus y Enfermedades Víricas Importadas, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Jorge del Romero
- Centro Sandoval and Hospital Universitario Clínico de San Carlos, IdISSC, Madrid, Spain
| | - Vicente Estrada
- Centro Sandoval and Hospital Universitario Clínico de San Carlos, IdISSC, Madrid, Spain; Ciber de Enfermedades Infecciosas, Madrid, Spain.
| | - Antonio Alcamí
- Centro de Biología Molecular Severo Ochoa (Consejo Superior de Investigaciones Científicas and Universidad Autónoma de Madrid), Madrid, Spain.
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16
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Abstract
Human monkeypox is a viral zoonosis endemic to West and Central Africa that has recently generated increased interest and concern on a global scale as an emerging infectious disease threat in the midst of the slowly relenting COVID-2019 disease pandemic. The hallmark of infection is the development of a flu-like prodrome followed by the appearance of a smallpox-like exanthem. Precipitous person-to-person transmission of the virus among residents of 100 countries where it is nonendemic has motivated the immediate and widespread implementation of public health countermeasures. In this review, we discuss the origins and virology of monkeypox virus, its link with smallpox eradication, its record of causing outbreaks of human disease in regions where it is endemic in wildlife, its association with outbreaks in areas where it is nonendemic, the clinical manifestations of disease, laboratory diagnostic methods, case management, public health interventions, and future directions.
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Affiliation(s)
- Sameer Elsayed
- Department of Medicine, Western University, London, Ontario, Canada
- Department of Pathology & Laboratory Medicine, Western University, London, Ontario, Canada
- Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada
| | - Lise Bondy
- Department of Medicine, Western University, London, Ontario, Canada
| | - William P. Hanage
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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17
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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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18
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Gould S, Atkinson B, Onianwa O, Spencer A, Furneaux J, Grieves J, Taylor C, Milligan I, Bennett A, Fletcher T, Dunning J. Air and surface sampling for monkeypox virus in a UK hospital: an observational study. THE LANCET. MICROBE 2022; 3:e904-e911. [PMID: 36215984 PMCID: PMC9546519 DOI: 10.1016/s2666-5247(22)00257-9] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/31/2022] [Accepted: 08/31/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND An outbreak of monkeypox virus infections in non-endemic countries was recognised on May 12, 2022. As of September 29, more than 67 000 infections have been reported globally, with more than 3400 confirmed cases in the UK by September 26. Monkeypox virus is believed to be predominantly transmitted through direct contact with lesions or infected body fluids, with possible involvement of fomites and large respiratory droplets. A case of monkeypox in a health-care worker in the UK in 2018 was suspected to be due to virus exposure while changing bedding. We aimed to measure the extent of environmental contamination in the isolation rooms of patients with symptomatic monkeypox. METHODS We investigated environmental contamination with monkeypox virus from infected patients admitted to isolation rooms at the Royal Free Hospital (London, UK) between May 24 and June 17, 2022. Surface swabs of high-touch areas in five isolation rooms, of the personal protective equipment (PPE) of health-care workers in doffing areas in three rooms, and from air samples collected before and during bedding changes in five rooms were analysed using quantitative PCR to assess monkeypox virus contamination levels. Virus isolation was performed to confirm presence of infectious virus in selected positive samples. FINDINGS We identified widespread surface contamination (56 [93%] of 60 samples were positive) in occupied patient rooms (monkeypox DNA cycle threshold [Ct] values 24·7-37·4), on health-care worker PPE after use (Ct 26·1-35·6), and in PPE doffing areas (Ct 26·3-36·8). Of 20 air samples taken, five (25%) were positive. Three (75%) of four air samples collected before and during a bedding change in one patient's room were positive (Ct 32·7-36·2). Replication-competent virus was identified in two (50%) of four samples selected for viral isolation, including from air samples collected during bedding change. INTERPRETATION These data show contamination in isolation facilities and potential for suspension of monkeypox virus into the air during specific activities. PPE contamination was observed after clinical contact and changing of bedding. Contamination of hard surfaces in doffing areas supports the importance of cleaning protocols, PPE use, and doffing procedures. FUNDING None.
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Affiliation(s)
- Susan Gould
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK,Tropical and Infectious Disease Unit, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK,Correspondence to: Dr Susan Gould, Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | | | | | | | | | | | - Caroline Taylor
- Department of Infectious Diseases, Royal Free London NHS Foundation Trust, London, UK
| | - Iain Milligan
- Department of Infectious Diseases, Royal Free London NHS Foundation Trust, London, UK
| | | | - Tom Fletcher
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK,Tropical and Infectious Disease Unit, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Jake Dunning
- Department of Infectious Diseases, Royal Free London NHS Foundation Trust, London, UK,NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Pandemic Sciences Institute, University of Oxford, Oxford, UK
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19
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Ogoina D, Ogunsola FT. Monkeypox and the health-care environment. THE LANCET. MICROBE 2022; 3:e889-e890. [PMID: 36215985 PMCID: PMC9546517 DOI: 10.1016/s2666-5247(22)00286-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Dimie Ogoina
- Department of Internal Medicine, Infectious Diseases Unit, Niger Delta University/Niger Delta University Teaching Hospital, Bayelsa PMB 100, Nigeria
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20
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Wang N, Zheng Y, Wang L. Can monkeypox virus be transmitted through the air? - Correspondence. Int J Surg 2022; 108:106995. [PMID: 36356826 PMCID: PMC9640216 DOI: 10.1016/j.ijsu.2022.106995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/06/2022] [Indexed: 11/09/2022]
Affiliation(s)
| | | | - Lichun Wang
- Corresponding author. West China Hospital of Sichuan University, 37 Guoxue Lane, Chengdu, 610041, PR China
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21
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Haruna UA, Musa SS, Manirambona E, Lucero-Prisno DE, Sarría-Santamera A. Monkeypox: Is the world ready for another pandemic? Front Public Health 2022; 10:1001155. [PMID: 36311631 PMCID: PMC9610551 DOI: 10.3389/fpubh.2022.1001155] [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: 07/22/2022] [Accepted: 09/21/2022] [Indexed: 01/26/2023] Open
Abstract
As the world continues to endure the impact of the COVID-19 pandemic, an outbreak of Monkeypox occurs and continues to spread unabatedly. The double-stranded DNA monkeypox virus is a sylvatic zoonosis, which occasionally infects humans and is a member of the genus Orthopoxviruses. Although scientists believed the virus to have low transmissibility, the speed and degree with which it spreads is alarming and could land one in a hospital or even kill one. Additionally, the fact that unusual transmissions are occurring among people without travel history to endemic regions suggests undetected transmissions, raising concerns about our preparedness for another pandemic. Contrary to the COVID-19 pandemic, there is a vaccine that could offer some protection against the monkeypox virus. Therefore, there is a need for coordinated efforts among authorities concerned and community-based organizations to raise awareness of the potential pandemic of monkeypox, activate surveillance systems and laboratory capacity, and heighten contact tracing and vaccination of at-risk individuals to stem the outbreak while there is still the opportunity to prevent it from becoming a pandemic.
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Affiliation(s)
- Usman Abubakar Haruna
- Department of Medicine, School of Medicine, Nazarbayev University, Astana, Kazakhstan,*Correspondence: Usman Abubakar Haruna
| | - Shuaibu Saidu Musa
- Global Health Focus Africa, Abuja, Nigeria,Department of Nursing Science, Ahmadu Bello University, Zaria, Nigeria
| | - Emery Manirambona
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Don Eliseo Lucero-Prisno
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
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22
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Endo A, Murayama H, Abbott S, Ratnayake R, Pearson CAB, Edmunds WJ, Fearon E, Funk S. Heavy-tailed sexual contact networks and monkeypox epidemiology in the global outbreak, 2022. Science 2022; 378:90-94. [PMID: 36137054 DOI: 10.1126/science.add4507] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The outbreak of monkeypox across non-endemic regions confirmed in May 2022 shows epidemiological features distinct from previously imported outbreaks, most notably its observed growth and predominance amongst men who have sex with men (MSM). We use a transmission model fitted to empirical sexual partnership data to show that the heavy-tailed sexual partnership distribution, in which a handful of individuals have disproportionately many partners, can explain the sustained growth of monkeypox among MSM despite the absence of such patterns previously. We suggest that the basic reproduction number (R0) for monkeypox over the MSM sexual network may be substantially above 1, which poses challenges to outbreak containment. Ensuring support and tailored messaging to facilitate prevention and early detection among MSM with high numbers of partners is warranted.
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Affiliation(s)
- Akira Endo
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- The Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Hiroaki Murayama
- School of Medicine, International University of Health and Welfare, Narita, Japan
| | - Sam Abbott
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- The Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Ruwan Ratnayake
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- The Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Carl A B Pearson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- The Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
- South African DSI-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, Republic of South Africa
| | - W John Edmunds
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- The Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Elizabeth Fearon
- The Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Sebastian Funk
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- The Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
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23
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Zemouri C, Beltrán EO, Holliday R, Jakubovics NS, Allison JR. Monkeypox: what do dental professionals need to know? Br Dent J 2022; 233:569-574. [PMID: 36241815 PMCID: PMC9568425 DOI: 10.1038/s41415-022-5079-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 08/31/2022] [Indexed: 11/09/2022]
Abstract
Infection control is critical for the safe delivery of dental care. Infection control practices must be responsive to emerging and re-emerging infectious diseases and outbreaks, as was clearly seen during the peak of the COVID-19 pandemic. An emerging global outbreak of the monkeypox virus has again raised potential challenges for infection control in dentistry. Monkeypox is an infectious disease, characterised by a rash affecting the skin and soft tissues, including the oral cavity. Previously, cases were mostly seen following contact with infected animals in Central and West Africa, with limited human-to-human transmission within and outside of these areas. However, since May 2022, sustained human-to-human transmission has occurred globally. Monkeypox can be transmitted via close contact with an infected person, contaminated objects and surfaces, or by droplets and possibly aerosols, which is therefore of potential importance to dental settings. This article discusses the relevance of monkeypox to dental professionals, the typical presentation of the disease, its potential impact on infection prevention and control practices and the delivery of dental services. The current monkeypox outbreak highlights the need for a more sustained programme of research into dental infection control that can provide a solid evidence base to underpin preparedness planning for future outbreaks and pandemics.
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Affiliation(s)
- Charifa Zemouri
- Zemouri Public Health Research and Consultancy, Amsterdam, The Netherlands
| | - Edgar O Beltrán
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Bogotá, Colombia
| | - Richard Holliday
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK; Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Nicholas S Jakubovics
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - James R Allison
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK; Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
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24
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Hemati S, Farhadkhani M, Sanami S, Mohammadi-Moghadam F. A review on insights and lessons from COVID-19 to the prevent of monkeypox pandemic. Travel Med Infect Dis 2022; 50:102441. [PMID: 36084881 PMCID: PMC9446553 DOI: 10.1016/j.tmaid.2022.102441] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 08/20/2022] [Accepted: 08/26/2022] [Indexed: 11/18/2022]
Abstract
Re-emerging of monkeypox virus (MPXV), a neglected viral zoonotic disease, is a potential global threat. In the current COVID-19 pandemic status, the increasing reporting of positive cases of human MPXV in most countries of the world is a major reason for concern. This paper aims to describe the insights and lessons from COVID-19 pandemic in preventing the impending danger MPXV. In order to prevent further outbreak of disease, identify and control of MPXV transmission routes is necessary. Public health authorities should be vigilant and applied of effective strategies to mitigate the potential spread of MPXV. To address research gaps related to MPX outbreaks, national, regional, and international collaborations are required in time. Finally, the lessons and insights put forward point to the fact that, like the COVID-19 pandemic, people's health by and large depends on the decisions of government officials and people must continue to adhere to health principles. Hence, governments and policymakers must take appropriate precautionary measures to prevent similar crises like COVID-19 in the world.
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Affiliation(s)
- Sara Hemati
- Department of Environmental Health Engineering, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran.
| | - Marzieh Farhadkhani
- Educational Development Center, Shahrekord University of Medical Sciences, Shahrekord, Iran.
| | - Samira Sanami
- Medical Plants Research Center, Basic Health Sciences Institute, 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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25
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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: 25] [Impact Index Per Article: 12.5] [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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26
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Monkeypox 2022: A Primer and Identify-Isolate-Inform (3I) Tool for Emergency Medical Services Professionals. Prehosp Disaster Med 2022; 37:687-692. [PMID: 35924712 PMCID: PMC9470524 DOI: 10.1017/s1049023x22001121] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Monkeypox 2022 exhibits unprecedented human-to-human transmission and presents with different clinical features than those observed in prior outbreaks. Previously endemic only to West and Central Africa, the monkeypox virus spread rapidly world-wide following confirmation of a case in the United Kingdom on May 7, 2022 of an individual that had traveled to Nigeria. Detection of cases with no travel history confirms on-going community spread. Emergency Medical Services (EMS) professionals will likely encounter patients suspected or confirmed to have monkeypox, previously a rare disease and therefore unfamiliar to most clinicians. Consequently, it is critical for EMS medical directors to immediately implement policies and procedures for EMS teams – including emergency medical dispatchers – to identify potential monkeypox cases. These must include direction on actions EMS professionals should take to protect themselves and others from virus transmission. Monkeypox 2022 may manifest more subtly than it has historically. Presentations include a subclinical prodrome and less dramatic skin lesions – potentially limited to genital or anal body regions – which can be easily confused with dermatologic manifestations of common sexually transmitted infections (STIs). While most readily spread by close contact with infectious skin lesions on a patient, it is also transmissible from fomites, such as bed sheets. Additionally, droplet transmission can occur, and the virus can be spread by aerosolization under certain conditions. The long incubation period could have profound negative consequences on EMS staffing if clinicians are exposed to monkeypox. This report summarizes crucial information needed for EMS professionals to understand and manage the monkeypox 2022 outbreak. It presents an innovative Identify-Isolate-Inform (3I) Tool for use by EMS policymakers, educators, and clinicians on the frontlines who may encounter monkeypox patients. Patients are identified as potentially exposed or infected after an initial assessment of risk factors with associated signs and symptoms. Prehospital workers must immediately don personal protective equipment (PPE) and isolate infectious patients. Also, EMS professionals must report exposures to their agency infection control officer and alert health authorities for non-transported patients. Prehospital professionals play a crucial role in emerging and re-emerging infectious disease mitigation. The monkeypox 2022 3I Tool includes knowledge essential for all clinicians, plus specific information to guide critical actions in the prehospital environment.
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27
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Saied AA. Should not airborne transmission be ignored in the 2022 monkeypox outbreak? Int J Surg 2022; 104:106762. [PMID: 35798203 PMCID: PMC9534014 DOI: 10.1016/j.ijsu.2022.106762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 07/02/2022] [Indexed: 11/02/2022]
Affiliation(s)
- AbdulRahman A Saied
- National Food Safety Authority (NFSA), Aswan Branch, Aswan, 81511, Egypt; Ministry of Tourism and Antiquities, Aswan Office, Aswan, 81511, Egypt.
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28
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Yeh KB, Setser B. Aerosol Test Chambers: Current State and Practice During the COVID-19 Pandemic. Front Bioeng Biotechnol 2022; 10:863954. [PMID: 35497330 PMCID: PMC9039174 DOI: 10.3389/fbioe.2022.863954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 03/25/2022] [Indexed: 11/13/2022] Open
Abstract
Respiratory infectious disease outbreaks such as those caused by coronaviruses and influenza, necessitate the use of specialized aerosol test chambers to study aspects of these causative agents including detection, efficacy of countermeasures, and aerosol survivability. The anthrax attacks from 2001 and earlier biowarfare and biodefense also influenced the study of biological aerosols to learn about how certain pathogens transmit either naturally or through artificial means. Some high containment biological laboratories, which work with Risk Group 3 and 4 agents in biosafety level -3, biosafety level-4 containment, are equipped with aerosol test chambers to enable the study of high-risk organisms in aerosolized form. Consequently, the biomedical, military and environmental sectors have specific applications when studying bioaerosols which may overlap while being different. There are countless aerosol test chambers worldwide and this number along with numerous high containment biological laboratories underscores the need for technical standards, regulatory and dual-use compliance. Here we survey common aerosol test chambers and their history, current use, and practice. Our findings reinforce the importance and need for continued collaboration among the multi-disciplinary fields studying aerobiology and biological aerosols.
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Affiliation(s)
- Kenneth B. Yeh
- MRIGlobal, Kansas City, MO, United States
- *Correspondence: Kenneth B. Yeh,
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29
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Richter WR, Sunderman MM, Mera TO, O’Brien KA, Morgan K, Streams S. Evaluation of environmental conditions as a decontamination approach for
SARS‐CoV
‐2 when applied to common library, archive, and museum related materials. J Appl Microbiol 2022; 132:3405-3415. [PMID: 35094472 PMCID: PMC9306959 DOI: 10.1111/jam.15468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 12/02/2022]
Abstract
Aims The purpose of this study was to evaluate the effects of ambient or altered environmental conditions on the inactivation of SARS‐CoV‐2 applied to materials common in libraries, archives and museums. Methods and Results Porous and non‐porous materials (e.g. paper, plastic protective book cover) were inoculated with approximately 1 × 105 TCID50 SARS CoV‐2 (USA‐WA1/2020), dried, placed within test chamber in either a stacked or unstacked configuration, and exposed to environmental conditions ranging from 4 to 29°C at 40 ± 10% relative humidity. The amount of infectious SARS‐CoV‐2 was then assessed at various timepoints from 0 to 10 days. Ambient conditions resulted in varying inactivation rates per material type. Virus inactivation rate decreased when materials were stacked or at colder temperatures. Virus inactivation rate increased when materials were unstacked or at warmer temperatures. Conclusions SARS‐CoV‐2 at ambient conditions resulted in the inactivation of virus below limit of quantitation (LOQ) for all materials by Day 8. Warmer temperatures, for a subset of materials, increased SARS‐CoV‐2 inactivation, and all were <LOQ by Day 3. Significance and Impact of the Study These results provide information for the library, archives and museum community regarding the inactivation of SARS‐CoV‐2, showing that inactivation is possible using prescribed environmental conditions and is a potential method of decontamination for items not compatible with common liquid disinfectants.
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Affiliation(s)
| | | | - T. O. Mera
- Battelle Memorial Institute Columbus OH USA
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30
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Fears AC, Klimstra WB, Duprex P, Hartman A, Weaver SC, Plante KS, Mirchandani D, Plante JA, Aguilar PV, Fernández D, Nalca A, Totura A, Dyer D, Kearney B, Lackemeyer M, Bohannon JK, Johnson R, Garry RF, Reed DS, Roy CJ. Persistence of Severe Acute Respiratory Syndrome Coronavirus 2 in Aerosol Suspensions. Emerg Infect Dis 2020; 26:2168-2171. [PMID: 32568661 PMCID: PMC7454081 DOI: 10.3201/eid2609.201806] [Citation(s) in RCA: 201] [Impact Index Per Article: 50.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
We aerosolized severe acute respiratory syndrome coronavirus 2 and determined that its dynamic aerosol efficiency surpassed those of severe acute respiratory syndrome coronavirus and Middle East respiratory syndrome. Although we performed experiment only once across several laboratories, our findings suggest retained infectivity and virion integrity for up to 16 hours in respirable-sized aerosols.
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Affiliation(s)
- Alyssa C. Fears
- Tulane University School of Medicine, New Orleans, Louisiana, USA (A.C. Fears, R.F. Garry, C.J. Roy):
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA (W.B. Klimstra, P. Duprex, A. Hartman, D.S. Reed)
- University of Texas Medical Branch, Galveston, Texas, USA (S.C. Weaver, K.S. Plante, D. Mirchandani, J.A. Plante, P.V. Aguilar, D. Fernández)
- U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, USA (A. Nalca, A. Totura, D. Dyer, B. Kearney)
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Maryland, USA (M. Lackemeyer, J.K. Bohannon, R. Johnson)
| | - William B. Klimstra
- Tulane University School of Medicine, New Orleans, Louisiana, USA (A.C. Fears, R.F. Garry, C.J. Roy):
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA (W.B. Klimstra, P. Duprex, A. Hartman, D.S. Reed)
- University of Texas Medical Branch, Galveston, Texas, USA (S.C. Weaver, K.S. Plante, D. Mirchandani, J.A. Plante, P.V. Aguilar, D. Fernández)
- U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, USA (A. Nalca, A. Totura, D. Dyer, B. Kearney)
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Maryland, USA (M. Lackemeyer, J.K. Bohannon, R. Johnson)
| | - Paul Duprex
- Tulane University School of Medicine, New Orleans, Louisiana, USA (A.C. Fears, R.F. Garry, C.J. Roy):
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA (W.B. Klimstra, P. Duprex, A. Hartman, D.S. Reed)
- University of Texas Medical Branch, Galveston, Texas, USA (S.C. Weaver, K.S. Plante, D. Mirchandani, J.A. Plante, P.V. Aguilar, D. Fernández)
- U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, USA (A. Nalca, A. Totura, D. Dyer, B. Kearney)
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Maryland, USA (M. Lackemeyer, J.K. Bohannon, R. Johnson)
| | - Amy Hartman
- Tulane University School of Medicine, New Orleans, Louisiana, USA (A.C. Fears, R.F. Garry, C.J. Roy):
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA (W.B. Klimstra, P. Duprex, A. Hartman, D.S. Reed)
- University of Texas Medical Branch, Galveston, Texas, USA (S.C. Weaver, K.S. Plante, D. Mirchandani, J.A. Plante, P.V. Aguilar, D. Fernández)
- U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, USA (A. Nalca, A. Totura, D. Dyer, B. Kearney)
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Maryland, USA (M. Lackemeyer, J.K. Bohannon, R. Johnson)
| | - Scott C. Weaver
- Tulane University School of Medicine, New Orleans, Louisiana, USA (A.C. Fears, R.F. Garry, C.J. Roy):
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA (W.B. Klimstra, P. Duprex, A. Hartman, D.S. Reed)
- University of Texas Medical Branch, Galveston, Texas, USA (S.C. Weaver, K.S. Plante, D. Mirchandani, J.A. Plante, P.V. Aguilar, D. Fernández)
- U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, USA (A. Nalca, A. Totura, D. Dyer, B. Kearney)
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Maryland, USA (M. Lackemeyer, J.K. Bohannon, R. Johnson)
| | - Kenneth S. Plante
- Tulane University School of Medicine, New Orleans, Louisiana, USA (A.C. Fears, R.F. Garry, C.J. Roy):
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA (W.B. Klimstra, P. Duprex, A. Hartman, D.S. Reed)
- University of Texas Medical Branch, Galveston, Texas, USA (S.C. Weaver, K.S. Plante, D. Mirchandani, J.A. Plante, P.V. Aguilar, D. Fernández)
- U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, USA (A. Nalca, A. Totura, D. Dyer, B. Kearney)
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Maryland, USA (M. Lackemeyer, J.K. Bohannon, R. Johnson)
| | - Divya Mirchandani
- Tulane University School of Medicine, New Orleans, Louisiana, USA (A.C. Fears, R.F. Garry, C.J. Roy):
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA (W.B. Klimstra, P. Duprex, A. Hartman, D.S. Reed)
- University of Texas Medical Branch, Galveston, Texas, USA (S.C. Weaver, K.S. Plante, D. Mirchandani, J.A. Plante, P.V. Aguilar, D. Fernández)
- U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, USA (A. Nalca, A. Totura, D. Dyer, B. Kearney)
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Maryland, USA (M. Lackemeyer, J.K. Bohannon, R. Johnson)
| | - Jessica Ann Plante
- Tulane University School of Medicine, New Orleans, Louisiana, USA (A.C. Fears, R.F. Garry, C.J. Roy):
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA (W.B. Klimstra, P. Duprex, A. Hartman, D.S. Reed)
- University of Texas Medical Branch, Galveston, Texas, USA (S.C. Weaver, K.S. Plante, D. Mirchandani, J.A. Plante, P.V. Aguilar, D. Fernández)
- U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, USA (A. Nalca, A. Totura, D. Dyer, B. Kearney)
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Maryland, USA (M. Lackemeyer, J.K. Bohannon, R. Johnson)
| | - Patricia V. Aguilar
- Tulane University School of Medicine, New Orleans, Louisiana, USA (A.C. Fears, R.F. Garry, C.J. Roy):
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA (W.B. Klimstra, P. Duprex, A. Hartman, D.S. Reed)
- University of Texas Medical Branch, Galveston, Texas, USA (S.C. Weaver, K.S. Plante, D. Mirchandani, J.A. Plante, P.V. Aguilar, D. Fernández)
- U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, USA (A. Nalca, A. Totura, D. Dyer, B. Kearney)
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Maryland, USA (M. Lackemeyer, J.K. Bohannon, R. Johnson)
| | - Diana Fernández
- Tulane University School of Medicine, New Orleans, Louisiana, USA (A.C. Fears, R.F. Garry, C.J. Roy):
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA (W.B. Klimstra, P. Duprex, A. Hartman, D.S. Reed)
- University of Texas Medical Branch, Galveston, Texas, USA (S.C. Weaver, K.S. Plante, D. Mirchandani, J.A. Plante, P.V. Aguilar, D. Fernández)
- U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, USA (A. Nalca, A. Totura, D. Dyer, B. Kearney)
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Maryland, USA (M. Lackemeyer, J.K. Bohannon, R. Johnson)
| | - Aysegul Nalca
- Tulane University School of Medicine, New Orleans, Louisiana, USA (A.C. Fears, R.F. Garry, C.J. Roy):
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA (W.B. Klimstra, P. Duprex, A. Hartman, D.S. Reed)
- University of Texas Medical Branch, Galveston, Texas, USA (S.C. Weaver, K.S. Plante, D. Mirchandani, J.A. Plante, P.V. Aguilar, D. Fernández)
- U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, USA (A. Nalca, A. Totura, D. Dyer, B. Kearney)
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Maryland, USA (M. Lackemeyer, J.K. Bohannon, R. Johnson)
| | - Aysegul Totura
- Tulane University School of Medicine, New Orleans, Louisiana, USA (A.C. Fears, R.F. Garry, C.J. Roy):
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA (W.B. Klimstra, P. Duprex, A. Hartman, D.S. Reed)
- University of Texas Medical Branch, Galveston, Texas, USA (S.C. Weaver, K.S. Plante, D. Mirchandani, J.A. Plante, P.V. Aguilar, D. Fernández)
- U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, USA (A. Nalca, A. Totura, D. Dyer, B. Kearney)
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Maryland, USA (M. Lackemeyer, J.K. Bohannon, R. Johnson)
| | - David Dyer
- Tulane University School of Medicine, New Orleans, Louisiana, USA (A.C. Fears, R.F. Garry, C.J. Roy):
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA (W.B. Klimstra, P. Duprex, A. Hartman, D.S. Reed)
- University of Texas Medical Branch, Galveston, Texas, USA (S.C. Weaver, K.S. Plante, D. Mirchandani, J.A. Plante, P.V. Aguilar, D. Fernández)
- U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, USA (A. Nalca, A. Totura, D. Dyer, B. Kearney)
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Maryland, USA (M. Lackemeyer, J.K. Bohannon, R. Johnson)
| | - Brian Kearney
- Tulane University School of Medicine, New Orleans, Louisiana, USA (A.C. Fears, R.F. Garry, C.J. Roy):
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA (W.B. Klimstra, P. Duprex, A. Hartman, D.S. Reed)
- University of Texas Medical Branch, Galveston, Texas, USA (S.C. Weaver, K.S. Plante, D. Mirchandani, J.A. Plante, P.V. Aguilar, D. Fernández)
- U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, USA (A. Nalca, A. Totura, D. Dyer, B. Kearney)
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Maryland, USA (M. Lackemeyer, J.K. Bohannon, R. Johnson)
| | - Matthew Lackemeyer
- Tulane University School of Medicine, New Orleans, Louisiana, USA (A.C. Fears, R.F. Garry, C.J. Roy):
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA (W.B. Klimstra, P. Duprex, A. Hartman, D.S. Reed)
- University of Texas Medical Branch, Galveston, Texas, USA (S.C. Weaver, K.S. Plante, D. Mirchandani, J.A. Plante, P.V. Aguilar, D. Fernández)
- U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, USA (A. Nalca, A. Totura, D. Dyer, B. Kearney)
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Maryland, USA (M. Lackemeyer, J.K. Bohannon, R. Johnson)
| | - J. Kyle Bohannon
- Tulane University School of Medicine, New Orleans, Louisiana, USA (A.C. Fears, R.F. Garry, C.J. Roy):
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA (W.B. Klimstra, P. Duprex, A. Hartman, D.S. Reed)
- University of Texas Medical Branch, Galveston, Texas, USA (S.C. Weaver, K.S. Plante, D. Mirchandani, J.A. Plante, P.V. Aguilar, D. Fernández)
- U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, USA (A. Nalca, A. Totura, D. Dyer, B. Kearney)
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Maryland, USA (M. Lackemeyer, J.K. Bohannon, R. Johnson)
| | - Reed Johnson
- Tulane University School of Medicine, New Orleans, Louisiana, USA (A.C. Fears, R.F. Garry, C.J. Roy):
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA (W.B. Klimstra, P. Duprex, A. Hartman, D.S. Reed)
- University of Texas Medical Branch, Galveston, Texas, USA (S.C. Weaver, K.S. Plante, D. Mirchandani, J.A. Plante, P.V. Aguilar, D. Fernández)
- U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, USA (A. Nalca, A. Totura, D. Dyer, B. Kearney)
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Maryland, USA (M. Lackemeyer, J.K. Bohannon, R. Johnson)
| | - Robert F. Garry
- Tulane University School of Medicine, New Orleans, Louisiana, USA (A.C. Fears, R.F. Garry, C.J. Roy):
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA (W.B. Klimstra, P. Duprex, A. Hartman, D.S. Reed)
- University of Texas Medical Branch, Galveston, Texas, USA (S.C. Weaver, K.S. Plante, D. Mirchandani, J.A. Plante, P.V. Aguilar, D. Fernández)
- U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, USA (A. Nalca, A. Totura, D. Dyer, B. Kearney)
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Maryland, USA (M. Lackemeyer, J.K. Bohannon, R. Johnson)
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Fears AC, Klimstra WB, Duprex P, Hartman A, Weaver SC, Plante KS, Mirchandani D, Plante JA, Aguilar PV, Fernández D, Nalca A, Totura A, Dyer D, Kearney B, Lackemeyer M, Bohannon JK, Johnson R, Garry RF, Reed DS, Roy CJ. Persistence of Severe Acute Respiratory Syndrome Coronavirus 2 in Aerosol Suspensions. Emerg Infect Dis 2020. [PMID: 32568661 DOI: 10.3201/eid2609.201806)] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
We aerosolized severe acute respiratory syndrome coronavirus 2 and determined that its dynamic aerosol efficiency surpassed those of severe acute respiratory syndrome coronavirus and Middle East respiratory syndrome. Although we performed experiment only once across several laboratories, our findings suggest retained infectivity and virion integrity for up to 16 hours in respirable-sized aerosols.
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Fears AC, Klimstra WB, Duprex P, Hartman A, Weaver SC, Plante KS, Mirchandani D, Plante JA, Aguilar PV, Fernández D, Nalca A, Totura A, Dyer D, Kearney B, Lackemeyer M, Bohannon JK, Johnson R, Garry RF, Reed DS, Roy CJ. Persistence of Severe Acute Respiratory Syndrome Coronavirus 2 in Aerosol Suspensions. Emerg Infect Dis 2020. [PMID: 32568661 DOI: 10.1101/2020.04.13.20063784v1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2023] Open
Abstract
We aerosolized severe acute respiratory syndrome coronavirus 2 and determined that its dynamic aerosol efficiency surpassed those of severe acute respiratory syndrome coronavirus and Middle East respiratory syndrome. Although we performed experiment only once across several laboratories, our findings suggest retained infectivity and virion integrity for up to 16 hours in respirable-sized aerosols.
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Fears AC, Klimstra WB, Duprex P, Hartman A, Weaver SC, Plante KC, Mirchandani D, Plante JA, Aguilar PV, Fernández D, Nalca A, Totura A, Dyer D, Kearney B, Lackemeyer M, Bohannon JK, Johnson R, Garry RF, Reed DS, Roy CJ. Comparative dynamic aerosol efficiencies of three emergent coronaviruses and the unusual persistence of SARS-CoV-2 in aerosol suspensions. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.04.13.20063784. [PMID: 32511433 PMCID: PMC7217084 DOI: 10.1101/2020.04.13.20063784] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The emergent coronavirus, designated severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is a zoonotic pathogen that has demonstrated remarkable transmissibility in the human population and is the etiological agent of a current global pandemic called COVID-191. We measured the dynamic (short-term) aerosol efficiencies of SARS-CoV-2 and compared the efficiencies with two other emerging coronaviruses, SARS-CoV (emerged in 2002) and Middle Eastern respiratory syndrome CoV (MERS-CoV; emerged starting in 2012). We also quantified the long-term persistence of SARS-CoV-2 and its ability to maintain infectivity when suspended in aerosols for up to 16 hours.
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Affiliation(s)
- A C Fears
- Tulane School of Medicine, Tulane National Primate Research Center, New Orleans, LA
| | - W B Klimstra
- Center for Vaccine Research, University of Pittsburgh, Pittsburgh, PA
| | - P Duprex
- Center for Vaccine Research, University of Pittsburgh, Pittsburgh, PA
| | - A Hartman
- Tulane School of Medicine, Tulane National Primate Research Center, New Orleans, LA
- Center for Vaccine Research, University of Pittsburgh, Pittsburgh, PA
- World Reference Center for Emerging Viruses and Arboviruses, Institute for Human Infections and Immunity, and Department of Pathology and Center for Tropical Diseases, University of Texas Medical Branch, Galveston, TX
- U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD
- National Institutes of Health, National Institute of Allergy and Infectious Diseases, Integrated Research Facility, Fort Detrick, MD
| | - S C Weaver
- World Reference Center for Emerging Viruses and Arboviruses, Institute for Human Infections and Immunity, and Department of Pathology and Center for Tropical Diseases, University of Texas Medical Branch, Galveston, TX
| | - K C Plante
- World Reference Center for Emerging Viruses and Arboviruses, Institute for Human Infections and Immunity, and Department of Pathology and Center for Tropical Diseases, University of Texas Medical Branch, Galveston, TX
| | - D Mirchandani
- World Reference Center for Emerging Viruses and Arboviruses, Institute for Human Infections and Immunity, and Department of Pathology and Center for Tropical Diseases, University of Texas Medical Branch, Galveston, TX
| | - J A Plante
- World Reference Center for Emerging Viruses and Arboviruses, Institute for Human Infections and Immunity, and Department of Pathology and Center for Tropical Diseases, University of Texas Medical Branch, Galveston, TX
| | - P V Aguilar
- World Reference Center for Emerging Viruses and Arboviruses, Institute for Human Infections and Immunity, and Department of Pathology and Center for Tropical Diseases, University of Texas Medical Branch, Galveston, TX
| | - D Fernández
- World Reference Center for Emerging Viruses and Arboviruses, Institute for Human Infections and Immunity, and Department of Pathology and Center for Tropical Diseases, University of Texas Medical Branch, Galveston, TX
| | - A Nalca
- U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD
| | - A Totura
- U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD
| | - D Dyer
- U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD
| | - B Kearney
- U.S. Army Medical Research Institute of Infectious Diseases, Fort Detrick, MD
| | - M Lackemeyer
- National Institutes of Health, National Institute of Allergy and Infectious Diseases, Integrated Research Facility, Fort Detrick, MD
| | - J K Bohannon
- National Institutes of Health, National Institute of Allergy and Infectious Diseases, Integrated Research Facility, Fort Detrick, MD
| | - R Johnson
- National Institutes of Health, National Institute of Allergy and Infectious Diseases, Integrated Research Facility, Fort Detrick, MD
| | - R F Garry
- Tulane School of Medicine, Tulane National Primate Research Center, New Orleans, LA
| | - D S Reed
- Center for Vaccine Research, University of Pittsburgh, Pittsburgh, PA
| | - C J Roy
- Tulane School of Medicine, Tulane National Primate Research Center, New Orleans, LA
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Richter WR, Sunderman MM, Wendling MQS, Serre S, Mickelsen L, Rupert R, Wood J, Choi Y, Willenberg Z, Calfee MW. Evaluation of altered environmental conditions as a decontamination approach for nonspore-forming biological agents. J Appl Microbiol 2020; 128:1050-1059. [PMID: 31782200 PMCID: PMC7323857 DOI: 10.1111/jam.14532] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 10/11/2019] [Accepted: 11/21/2019] [Indexed: 01/04/2023]
Abstract
AIMS The purpose of this study was to evaluate the effects of altered environmental conditions on the persistence of Francisella tularensis bacteria and Venezuelan equine encephalitis virus (VEEV), on two material types. METHODS AND RESULTS Francisella tularensis (F.t.) and VEEV were inoculated (c. 1 × 108 colony-forming units or PFU), dried onto porous and nonporous fomites (glass and paper), and exposed to combinations of altered environmental conditions ranging from 22 to 60°C and 30 to 75% relative humidity (RH). Viability of test organism was assessed after contact times ranging from 30 min to 10 days. Inactivation rates of F.t. and VEEV increased as both temperature and/or RH were increased. Greater efficacy was observed for paper as compared to glass for both test organisms. CONCLUSIONS The use of elevated temperature and RH increased rate of inactivation for both organisms and greater than six log reduction was accomplished in as little as 6 h by elevating temperature to approximately 60°C. SIGNIFICANCE AND IMPACT OF THE STUDY These results provide information for inactivation of nonspore-forming select agents using elevated temperature and humidity which may aid incident commanders following a biological contamination incident by providing alternative methods for remediation.
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Affiliation(s)
- W R Richter
- Battelle Memorial Institute, Columbus, OH, USA
| | | | | | - S Serre
- US Environmental Protection Agency, Research Triangle Park, NC, USA
| | - L Mickelsen
- US Environmental Protection Agency, Research Triangle Park, NC, USA
| | - R Rupert
- US Environmental Protection Agency, Philadelphia, PA, USA
| | - J Wood
- US Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Y Choi
- Battelle Memorial Institute, Columbus, OH, USA
| | | | - M W Calfee
- US Environmental Protection Agency, Research Triangle Park, NC, USA
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Mubareka S, Groulx N, Savory E, Cutts T, Theriault S, Scott JA, Roy CJ, Turgeon N, Bryce E, Astrakianakis G, Kirychuk S, Girard M, Kobinger G, Zhang C, Duchaine C. Bioaerosols and Transmission, a Diverse and Growing Community of Practice. Front Public Health 2019; 7:23. [PMID: 30847337 PMCID: PMC6394210 DOI: 10.3389/fpubh.2019.00023] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 01/25/2019] [Indexed: 12/20/2022] Open
Abstract
The transmission of infectious microbes via bioaerosols is of significant concern for both human and animal health. However, gaps in our understanding of respiratory pathogen transmission and methodological heterogeneity persist. New developments have enabled progress in this domain, and one of the major turning points has been the recognition that cross-disciplinary collaborations across spheres of human and animal health, microbiology, biophysics, engineering, aerobiology, infection control, public health, occupational health, and industrial hygiene are essential. Collaborative initiatives support advances in topics such as bioaerosol behavior, dispersion models, risk assessment, risk/exposure effects, and mitigation strategies in clinical, experimental, agricultural, and other field settings. There is a need to enhance the knowledge translation for researchers, stakeholders, and private partners to support a growing network of individuals and agencies to achieve common goals to mitigate inter- and intra-species pathogen transmission via bioaerosols.
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Affiliation(s)
- Samira Mubareka
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.,Sunnybrook Research Institute, Toronto, ON, Canada
| | | | - Eric Savory
- Department of Mechanical and Materials Engineering, University of Western Ontario, London, ON, Canada
| | - Todd Cutts
- Public Health Agency of Canada, Branch of Infectious Disease Prevention and Control, Applied Biosafety Research Program, Winnipeg, MB, Canada
| | - Steven Theriault
- Public Health Agency of Canada, Branch of Infectious Disease Prevention and Control, Applied Biosafety Research Program, Winnipeg, MB, Canada
| | - James A Scott
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Chad J Roy
- Department of Microbiology and Immunology, Tulane School of Medicine, Tulane University, New Orleans, LA, United States
| | - Nathalie Turgeon
- Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, and Département de Biochimie, de Microbiologie et de Bio-Informatique, Faculté des Sciences et de Génie, Université Laval, Québec, QC, Canada
| | - Elizabeth Bryce
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - George Astrakianakis
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Shelley Kirychuk
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada
| | - Matthieu Girard
- Institut de Recherche et de Développement en Agroenvironnement, Québec, QC, Canada
| | - Gary Kobinger
- Centre de Recherche en Infectiologie, Université Laval, Québec, QC, Canada
| | - Chao Zhang
- Department of Mechanical and Materials Engineering, University of Western Ontario, London, ON, Canada
| | - Caroline Duchaine
- Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, and Département de Biochimie, de Microbiologie et de Bio-Informatique, Faculté des Sciences et de Génie, Université Laval, Québec, QC, Canada
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Verreault D, Duchaine C, Marcoux-Voiselle M, Turgeon N, Roy CJ. Design of an environmentally controlled rotating chamber for bioaerosol aging studies. Inhal Toxicol 2015; 26:554-8. [PMID: 25055842 DOI: 10.3109/08958378.2014.928763] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
A chamber was designed and built to study the long-term effects of environmental conditions on air-borne microorganisms. The system consists of a 55.5-L cylindrical chamber, which can rotate at variable speeds on its axis. The chamber is placed within an insulated temperature controlled enclosure which can be either cooled or heated with piezoelectric units. A germicidal light located at the chamber center irradiates at a 360° angle. Access ports are located on the stationary sections on both ends of the chamber. Relative humidity (RH) is controlled by passing the aerosol through meshed tubes surrounded by desiccant. Validation assay indicates that the interior temperature is stable with less than 0.5 °C in variation when set between 18 and 30 °C with the UV light having no effect of temperature during operation. RH levels set at 20%, 50% and 80% varied by 2.2%, 3.3% and 3.3%, respectively, over a 14-h period. The remaining fraction of particles after 18 h of suspension was 8.8% at 1 rotation per minute (rpm) and 2.6% at 0 rpm with the mass median aerodynamic diameter (MMAD) changing from 1.21 ± 0.04 µm to 1.30 ± 0.02 µm at 1 rpm and from 1.21 ± 0.04 µm to 0.91 ± 0.01 µm at 0 rpm within the same time period. This chamber can be used to increase the time of particle suspension in an aerosol cloud and control the temperature, RH and UV exposure; the design facilitates stationary sampling to be performed while the chamber is rotating.
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Affiliation(s)
- Daniel Verreault
- Division of Microbiology, Infectious Disease Aerobiology, Tulane National Primate Research Center , Covington, LA , USA
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Lee KM, Chiu KB, Sansing HA, Didier PJ, Ficht TA, Arenas-Gamboa AM, Roy CJ, Maclean AG. Aerosol-induced brucellosis increases TLR-2 expression and increased complexity in the microanatomy of astroglia in rhesus macaques. Front Cell Infect Microbiol 2013; 3:86. [PMID: 24350061 PMCID: PMC3844859 DOI: 10.3389/fcimb.2013.00086] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 11/07/2013] [Indexed: 01/18/2023] Open
Abstract
Brucella melitensis, a bacterial pathogen and agent of epizootic abortion causes multiple pathologies in humans as well as a number of agriculturally important animal species. Clinical human brucellosis manifests as a non-specific, chronic debilitating disease characterized by undulant fever, arthropathies, cardiomyopathies and neurological sequelae. These symptoms can occur acutely for a few weeks or persist for months to years. Within the brain, endothelial and glial cells can be infected leading to downstream activation events including matrix metalloprotease (MMP) and cytokine secretion and Toll-like receptor (TLR) signaling. These events are likely to lead to tissue remodeling, including morphologic changes in neuronal and glial cells, which are linked to neurological complications including depressive behavior, immune activation and memory loss. Our hypothesis was that B. melitensis infection and neurobrucellosis would lead to activation of astrocytes through upregulation of TLR2 and stimulate concurrent changes in the microanatomy. All six animals were infected via inhalation route. TLR2 expression was approximately doubled in white matter astrocytes of infected rhesus macaques. There was also a 50% increase in the number of astrocytes per unit area in subcortical white matter tracts suggesting increased innate immune activation. This coincided with dramatic increases in the length and complexity of the cell arbor of hypertrophic astrocytes in both cortical gray and white matter. Thus, aerosol-induced brucellosis results in dramatically increased innate immune activation of astrocytes in the absence of widespread neuroinflammation.
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Affiliation(s)
- Kim M Lee
- Program in Biomedical Science, Tulane School of Medicine New Orleans, LA, USA ; Divisions of Comparative Pathology and Microbiology, Tulane National Primate Research Center Covington, LA, USA
| | - Kevin B Chiu
- Department of Biomedical Science, Tulane University New Orleans, LA, USA
| | - Hope A Sansing
- Divisions of Comparative Pathology and Microbiology, Tulane National Primate Research Center Covington, LA, USA
| | - Peter J Didier
- Divisions of Comparative Pathology and Microbiology, Tulane National Primate Research Center Covington, LA, USA
| | - Thomas A Ficht
- Veterinary Pathobiology, Texas A&M University College Station, TX, USA
| | | | - Chad J Roy
- Program in Biomedical Science, Tulane School of Medicine New Orleans, LA, USA ; Divisions of Comparative Pathology and Microbiology, Tulane National Primate Research Center Covington, LA, USA ; Department of Microbiology & Immunology, Tulane School of Medicine New Orleans, LA, USA
| | - Andrew G Maclean
- Program in Biomedical Science, Tulane School of Medicine New Orleans, LA, USA ; Divisions of Comparative Pathology and Microbiology, Tulane National Primate Research Center Covington, LA, USA ; Department of Microbiology & Immunology, Tulane School of Medicine New Orleans, LA, USA
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