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Haverkate MR, Willemstein IJ, van Ewijk CE, Adam PC, Lanooij SJ, Jonker-Jorna P, van Bokhoven C, van Rijckevorsel GG, Hoornenborg E, David S, Mollema L, Te Wierik MJ, Lange J, Franz E, de Melker HE, Op de Coul EL, Hahné SJ. Factors potentially contributing to the decline of the mpox outbreak in the Netherlands, 2022 and 2023. Euro Surveill 2024; 29:2300608. [PMID: 38785092 PMCID: PMC11128738 DOI: 10.2807/1560-7917.es.2024.29.21.2300608] [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: 11/03/2023] [Accepted: 03/18/2024] [Indexed: 05/25/2024] Open
Abstract
BackgroundIn 2022 and 2023, a global outbreak of mpox affected mostly gay, bisexual and other men having sex with men (GBMSM). Outbreak control in the Netherlands included isolation, quarantine, post-exposure prophylaxis vaccination and primary preventive vaccination (PPV).AimWe describe the course of the outbreak, the vaccination programme, vaccine effectiveness (VE) of full vaccination against symptomatic disease, and trends in behaviour to generate hypotheses about factors that influenced the outbreak's decline.MethodsIn this observational study, we collected data from public health services on notified cases, number of PPV invitations and PPV doses administered. We calculated PPV uptake and coverage. Trends in behavioural data of GBMSM visiting sexual health centres were analysed for all consultations in 2022. We estimated VE using the screening method.ResultsUntil 31 December 2023, 1,294 mpox cases were reported. The outbreak peaked in early July 2022 and then declined sharply. PPV started on 25 July 2022; in total 29,851 doses were administered, 45.8% received at least one dose, 35.4% were fully vaccinated. The estimated VE was 68.2% (95% CI 4.3-89.5%). We did not observe an evident decrease in high-risk behaviour.DiscussionIt is unlikely that PPV was a driver of the outbreak's decline, as incidence started to decline well before the start of the PPV programme. The possible impact of behavioural change could not be demonstrated with the available indicators, however, the data had limitations, hampering interpretation. We hypothesise that infection-induced immunity in high-risk groups was an important factor explaining the decline.
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Affiliation(s)
- Manon R Haverkate
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Inge Jm Willemstein
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Catharina E van Ewijk
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Philippe Cg Adam
- Institute for Prevention and Social Research, Utrecht, the Netherlands
- University of New South Wales Sydney, Sydney, Australia
| | - Susan J Lanooij
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | | | | | - Gini Gc van Rijckevorsel
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- Public Health Service Amsterdam, Amsterdam, the Netherlands
| | | | - Silke David
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Liesbeth Mollema
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Margreet J Te Wierik
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Jente Lange
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Eelco Franz
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Hester E de Melker
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Eline Lm Op de Coul
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Susan Jm Hahné
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
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Siddalingaiah N, Dhanya K, Lodha L, Pattanaik A, Mani RS, Ma A. Tracing the journey of poxviruses: insights from history. Arch Virol 2024; 169:37. [PMID: 38280957 DOI: 10.1007/s00705-024-05971-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/06/2023] [Indexed: 01/29/2024]
Abstract
The historical significance of the poxviruses is profound, largely due to the enduring impact left by smallpox virus across many centuries. The elimination of smallpox is a remarkable accomplishment in the history of science and medicine, with centuries of devoted efforts resulting in the development and widespread administration of smallpox vaccines. This review provides insight into the pivotal historical events involving medically significant poxviruses. Understanding the remarkable saga of combatting smallpox is crucial, serving as a guidepost for potential future encounters with poxvirus infections. There is a continual need for vigilant observation of poxvirus evolution and spillover from animals to humans, considering the expansive range of susceptible hosts. The recent occurrence of monkeypox cases in non-endemic countries stands as a stark reminder of the ease with which infections can be disseminated through international travel and trade. This backdrop encourages introspection about our journey and the current status of poxvirus research.
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Affiliation(s)
- Nayana Siddalingaiah
- Department of Neurovirology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, 560029, India
| | - K Dhanya
- Department of Neurovirology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, 560029, India
| | - Lonika Lodha
- Department of Neurovirology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, 560029, India
| | - Amrita Pattanaik
- Manipal Institute of Virology, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Reeta S Mani
- Department of Neurovirology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, 560029, India
| | - Ashwini Ma
- Department of Neurovirology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, 560029, India.
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Cornelisse VJ, Heath-Paynter D, Delpech V, Read P, Apostolellis A, Medland NA, MacIntyre CR, Giola M, Kidd M. How Australia and Aotearoa New Zealand avoided large-scale mpox (formerly monkeypox) outbreaks in 2022-2023. Intern Med J 2023; 53:1732-1738. [PMID: 37859543 DOI: 10.1111/imj.16236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 09/06/2023] [Indexed: 10/21/2023]
Affiliation(s)
- Vincent J Cornelisse
- Sydney Local Health District and Northern Sydney Local Health District, NSW Health, New South Wales, Sydney, Australia
- ASHM (the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine), Sydney, New South Wales, Australia
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
- Monash University, Melbourne, Victoria, Australia
| | - Dash Heath-Paynter
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
- Health Equity Matters, Sydney, New South Wales, Australia
| | - Valerie Delpech
- Mid North Coast Local Health District, Port Macquarie, New South Wales, Australia
| | - Phillip Read
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
- South Eastern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Alexis Apostolellis
- ASHM (the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine), Sydney, New South Wales, Australia
| | - Nicholas A Medland
- ASHM (the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine), Sydney, New South Wales, Australia
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - C Raina MacIntyre
- The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Massimo Giola
- Te Whatu Ora - Hauora a Toi and Lakes Districts, Aotearoa, New Zealand
| | - Michael Kidd
- Centre for Future Health Systems, University of New South Wales, Sydney, New South Wales, Australia
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia
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Carlson C, Katz R. WHO ends public health emergency designation for mpox. BMJ 2023; 381:p1190. [PMID: 37277145 DOI: 10.1136/bmj.p1190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Feng Y, Zhang Y, Liu S, Guo M, Huang H, Guo C, Wang W, Zhang W, Tang H, Wan Y. Unexpectedly higher levels of anti-orthopoxvirus neutralizing antibodies are observed among gay men than general adult population. BMC Med 2023; 21:183. [PMID: 37189197 DOI: 10.1186/s12916-023-02872-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 04/19/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND The confirmed cases in the current outbreak of Monkeypox are predominantly identified in the networks of men who have sex with men (MSM). The preexisting antibodies may profoundly impact the transmission of monkeypox virus (MPXV), however the current-day prevalence of antibodies against MPXV among gay men is not well characterized. METHODS A cohort of gay men (n = 326) and a cohort of the general adult population (n = 295) were enrolled in this study. Binding antibodies responses against MPXV/vaccinia and neutralizing antibody responses against vaccinia virus (Tiantan strain) were measured. The antibody responses of these two cohorts were then compared, as well as the responses of individuals born before and in/after 1981 (when the smallpox vaccination ceased in China). Finally, the correlation between the anti-MPXV antibody responses and the anti-vaccinia antibody responses, and the associations between preexisting anti-orthopoxvirus antibody responses and the diagnosed sexually transmitted infections (STIs) in the MSM cohort were analyzed separately. RESULTS Our data showed that binding antibodies against MPXV H3, A29, A35, E8, B6, M1 proteins and vaccinia whole-virus lysate could be detected in individuals born both before and in/after 1981, of which the prevalence of anti-vaccinia binding antibodies was significantly higher among individuals born before 1981 in the general population cohort. Moreover, we unexpectedly found that the positive rates of binding antibody responses against MPXV H3, A29, A35, E8 and M1 proteins were significantly lower among individuals of the MSM cohort born in/after 1981, but the positive rates of anti-MPXV B6 and anti-vaccinia neutralizing antibody responses were significantly higher among these individuals compared to those of age-matched participants in the general population cohort. Additionally, we demonstrated that the positive and negative rates of anti-MPXV antibody responses were associated with the anti-vaccinia antibody responses among individuals born before 1981 in the general population cohort, but no significant association was observed among individuals born in/after 1981 in both cohorts. The positive rates of both the binding and the neutralizing antibody responses were comparable between individuals with and without diagnosed STIs in the MSM cohort. CONCLUSIONS Anti-MPXV and anti-vaccinia antibodies could be readily detected in an MSM cohort and a general population cohort. And a higher level of anti-vaccinia neutralizing antibody responses was observed among individuals who did not get vaccinated against smallpox in the MSM cohort compared to age-matched individuals in the general population cohort.
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Affiliation(s)
- Yanmeng Feng
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430065, China
| | - Yifan Zhang
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China
- Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University, Key Laboratory of Laboratory Medicine of Henan Province, Zhengzhou, 450052, China
| | - Shengya Liu
- Shenzhen International Travel Health Care Center (Shenzhen Customs District Port Outpatient Clinics), Shenzhen Customs District, Shenzhen, 518033, China
| | - Meng Guo
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430065, China
| | - Haojie Huang
- Wuhan Pioneer Social Work Service Center, Wuhan, 430071, China
| | - Cuiyuan Guo
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China
- Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University, Key Laboratory of Laboratory Medicine of Henan Province, Zhengzhou, 450052, China
| | - Wanhai Wang
- Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University, Key Laboratory of Laboratory Medicine of Henan Province, Zhengzhou, 450052, China
| | - Wenhong Zhang
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China.
- Shanghai Huashen Institute of Microbes and Infections, 6 Lane 1220 Huashan Rd., Shanghai, 200052, NO, China.
| | - Heng Tang
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430065, China.
| | - Yanmin Wan
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China.
- Shanghai Huashen Institute of Microbes and Infections, 6 Lane 1220 Huashan Rd., Shanghai, 200052, NO, China.
- Department of Radiology, Shanghai Public Health Clinical Center, Shanghai, 201508, China.
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Zardi EM, Chello C. Human Monkeypox-A Global Public Health Emergency. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192416781. [PMID: 36554659 PMCID: PMC9779584 DOI: 10.3390/ijerph192416781] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/06/2022] [Accepted: 12/08/2022] [Indexed: 06/02/2023]
Abstract
Monkeypox, a viral zoonosis caused by an Orthopoxvirus, is clinically characterized by fever, headache, lymphadenopathy, myalgia, rash and burdened by some complications that can be severe and life threatening. Monkeypox, endemic in some central and west African countries, in tropical areas near equator, rose to the headlines following its recent outbreak in non-endemic countries of Europe and the USA. Thus, the World Health Organization, worried about the growing dimension of the problem, declared monkeypox a global public health emergency. Now, after months of careful observation, the western scientific research is drawing conclusion that African endemic countries represent a reserve pool able to feed, through travelers and sexual networks, the outbreak in non-endemic countries in which high-risk communities such as gay and bisexual men are the most affected. Prevention through vaccination and early diagnosis are the core to breaking the chain of diffusion of this epidemic. Particular attention should be paid to avoid the spread from endemic countries, also implementing the economic investments in their public health system. Information campaigns and assistance to high-risk classes in non-endemic countries are important priorities, however, assuming that specific treatments for this disease are still tentative.
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Affiliation(s)
- Enrico Maria Zardi
- Internistic Ultrasound Service, Department of Medicine and Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Rome, Italy
| | - Camilla Chello
- PhD Course, Department of Medicine and Surgery, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
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Pandey A, Galvani AP. Role of immunity landscape in global risk assessment of re-emerging diseases. THE LANCET. INFECTIOUS DISEASES 2022; 23:385-386. [PMID: 36455592 PMCID: PMC9704845 DOI: 10.1016/s1473-3099(22)00756-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 11/07/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Abhishek Pandey
- Center for Infectious Disease Modeling and Analysis (CIDMA), Yale School of Public Health, New Haven, CT 06520, USA
| | - Alison P Galvani
- Center for Infectious Disease Modeling and Analysis (CIDMA), Yale School of Public Health, New Haven, CT 06520, USA.
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