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Bonilla-Aldana DK, Bonilla-Aldana JL, Ulloque-Badaracco JR, Al-Kassab-Córdova A, Hernandez-Bustamante EA, Alarcon-Braga EA, Benites-Zapata VA, Copaja-Corzo C, Silva-Cajaleon K, Rodriguez-Morales AJ. Mpox infection in animals: A systematic review and meta-analysis. J Infect Public Health 2024; 17:102431. [PMID: 38820901 DOI: 10.1016/j.jiph.2024.04.015] [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: 02/05/2024] [Revised: 03/26/2024] [Accepted: 04/17/2024] [Indexed: 06/02/2024] Open
Abstract
Mpox is a zoonotic disease that became epidemic in multiple countries in 2022. There is a lack of published systematic reviews on natural animal infection due to Mpox. We performed a systematic literature review with meta-analysis to assess animal Mpox prevalence. We performed a random-effects model meta-analysis to calculate the pooled prevalence and 95% confidence interval (95%CI) for prevalence studies. After the screening, 15 reports were selected for full-text assessment and included in qualitative and quantitative analyses. Ten reports assessed Mpox infection by molecular or serological tests (n = 2680), yielding a pooled prevalence of 16.0% (95%CI: 3.0-29.0%) for non-human primates; 8.0% (95%CI: 4.0-12.0%) for rodents and 1.0% (95%CI: 0.0-3.0%) for shrews. Further studies in other animals are required to define the extent and importance of natural infection due to Mpox. These findings have implications for public human and animal health. OneHealth approach is critical for prevention and control.
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Affiliation(s)
| | - Jorge Luis Bonilla-Aldana
- Grupo de Investigación en Ciencias Animales Macagual, Universidad de La Amazonia, Florencia, Caquetá 180002, Colombia
| | | | - Ali Al-Kassab-Córdova
- Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Universidad San Ignacio de Loyola, Lima 15012, Peru
| | - Enrique A Hernandez-Bustamante
- Grupo Peruano de Investigación Epidemiológica, Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima 15012, Peru; Sociedad Científica de Estudiantes de Medicina de la Universidad Nacional de Trujillo, Trujillo 13011, Peru
| | | | | | - Cesar Copaja-Corzo
- Unidad de Investigación para la generación y síntesis de evidencias en salud, Universidad San Ignacio de Loyola, Lima 15012, Peru; Servicio de infectología, Hospital Nacional Edgardo Rebagliati Martins, EsSalud, Lima 15072, Peru
| | - Kenneth Silva-Cajaleon
- Faculties of Environmental and Health Sciences, Universidad Científica del Sur, Lima 4861, Peru
| | - Alfonso J Rodriguez-Morales
- Faculties of Environmental and Health Sciences, Universidad Científica del Sur, Lima 4861, Peru; Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas-Institución Universitaria Visión de las Américas, Pereira, 660003 Risaralda, Colombia; Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon
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2
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Abu-Hammad O, Arabiat D, Althagafi N, Eshky R, Abu-Hammad A, Jaber AR, Jaber AR, Dar-Odeh N. Sexually transmitted diseases and HIV co-infection among adult male patients in the 2022 monkeypox outbreak: a systematic review and meta-analysis. Dermatol Reports 2024; 16:9860. [PMID: 38957631 PMCID: PMC11216141 DOI: 10.4081/dr.2024.9860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 07/04/2024] Open
Abstract
This meta-analysis estimates sexually transmitted disease (STI) and HIV rates in male monkeypox patients during the 2022 outbreak. The study examines contextual factors that increase monkeypox risk. A systematic review of PubMed/Medline, Scopus, and Google Scholar was conducted to find observational studies on monkeypox patients' demographics and medical characteristics from the 2022 outbreak. This review's meta-analysis followed the System for the Unified Management, Assessment, and Review of Information - Joanna Briggs Institute (SUMARI JBI) guidelines. All HIV and STI prevalence data for male monkeypox patients was exported into the SUMARI JBI. For point prevalence of HIV and STIs, we used the Freeman-Tukey-type arcsine square root transformation to stabilize raw proportion variances. A fixed-effects model weighted and pooled all estimates by inverse variance. We then used a random model to account for sampling variation and reported fixed-effect model effect size heterogeneity across studies. Study heterogeneity was measured using the I2 test statistic and P-values. I2 test results were interpreted as low (25%), moderate (50%), and high (75%). Six Spanish and English studies qualified. These studies included 541 male monkeypox patients, 214 of whom had HIV and 255 with other STIs. HIV prevalence was estimated at 40% (95% CI = 0.31%, 0.50%; ᵡ2=15) and STIs at 43% (95% CI = 25%, 61%; ᵡ2=118). Overall, analyses showed moderate to high heterogeneity. Four in ten male monkeypox patients in 2022 had HIV or other STIs. To prevent HIV and other STIs, public health measures should target male and female monkeypox patients.
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Affiliation(s)
| | - Diana Arabiat
- School of Nursing, University of Jordan, Amman, Jordan
| | - Nebras Althagafi
- College of Dentistry, Taibah University, Al Madinah Al Munawara, Saudi Arabia
| | - Rawah Eshky
- College of Dentistry, Taibah University, Al Madinah Al Munawara, Saudi Arabia
| | | | | | | | - Najla Dar-Odeh
- School of Dentistry, University of Jordan, Amman, Jordan
- College of Dentistry, Taibah University, Al Madinah Al Munawara, Saudi Arabia
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3
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Lin M, Xin Y, Wang J, Nie P, Yan Q, Wang L, Wang L. Analysing monkeypox epidemic drivers: Policy simulation and multi-index modelling across 39 nations. J Glob Health 2024; 14:04037. [PMID: 38333932 PMCID: PMC10859682 DOI: 10.7189/jogh.14.04037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024] Open
Abstract
Background This study aimed to analyse the drivers of the monkeypox (Mpox) epidemic and policy simulation to support health care policies against the Mpox epidemic. Methods We established a three-round selection mechanism for 164 factors using Lasso and negative binomial regression to investigate the correlation between significant drivers and the cumulative confirmed cases of Mpox. Policy simulation for each driver was evaluated, and the varying effects of implementation at different times were examined. Results HIV/AIDS prevalence and air transport passengers carried were significant determinants of the risk of the Mpox epidemic across various countries, with regression coefficients of 1.417 and 0.766, respectively. A decrease in HIV/AIDS prevalence by 10, 20, 30, and 40% corresponded to reductions in the number of Mpox cases by 6.28, 6.55, 6.87, and 7.26%, respectively. Similarly, 20, 40, 60, and 80% travel restrictions led to reductions in Mpox cases by 7.16, 15.63, 26.28%, and 41.46%, respectively. Controlling air transport passengers carried in the first month could postpone outbreak onset by 0.5-2.0 months. Conclusions Mpox prevention and control policies should primarily focus on travel restrictions during high disease-risk periods and flight suspensions from high-risk nations in combination with regular HIV/AIDS prevention and treatment strategies.
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Affiliation(s)
- Mengxuan Lin
- Academy of Military Medical Sciences, Academy of Military Science of Chinese People’s Liberation Army, Beijing, China
| | - Yingrong Xin
- Chinese People’s Liberation Army Center for Disease Control and Prevention, Beijing, China
| | - Jiaojiao Wang
- State Key Laboratory of Multimodal Artificial Intelligence Systems, Institute of Automation Chinese Academy of Sciences, Beijing, China
| | - Pengyuan Nie
- Academy of Military Medical Sciences, Academy of Military Science of Chinese People’s Liberation Army, Beijing, China
| | - Qunjiao Yan
- Academy of Military Medical Sciences, Academy of Military Science of Chinese People’s Liberation Army, Beijing, China
| | - Ligui Wang
- Chinese People’s Liberation Army Center for Disease Control and Prevention, Beijing, China
| | - Lei Wang
- Academy of Military Medical Sciences, Academy of Military Science of Chinese People’s Liberation Army, Beijing, China
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4
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Maan I, Kohli M, Gilson R. Mpox in people living with HIV. Curr Opin Infect Dis 2024; 37:1-7. [PMID: 38112084 DOI: 10.1097/qco.0000000000000994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
PURPOSE OF REVIEW The 2022 global outbreak of mpox disproportionally affected people with HIV (PWH). We review the data on the presentation, treatment, and prevention of mpox in PWH. RECENT FINDINGS Most PWH with mpox had a mild and self-limiting illness, no different to people without HIV. A higher rate of rectal symptoms has been reported among PWH and those with advanced HIV disease were at higher risk of severe disease, hospitalization, and death. Treatment with antivirals was widely used in hospitalized patients without any randomized control trial data to support its use and without any data specifically in PWH. Use of smallpox vaccines to prevent mpox is safe in PWH regardless of CD4+ cell count. There is limited data on efficacy in those with lower CD4+ cell count and on long-term protective efficacy. SUMMARY PWH should be offered vaccination against mpox in line with national guidelines. PWH should be individually risk-assessed for severe mpox, based on their CD4+ cell count and co-morbidities and ideally recruited into treatment trials to build an evidence base on efficacy. HIV and other sexually transmitted infection testing should be offered to all people diagnosed with mpox.
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Affiliation(s)
- Irfaan Maan
- Institute for Global Health, University College London
- Mortimer Market Centre, Central and North West London NHS Foundation Trust, London, UK
| | - Manik Kohli
- Institute for Global Health, University College London
- Mortimer Market Centre, Central and North West London NHS Foundation Trust, London, UK
| | - Richard Gilson
- Institute for Global Health, University College London
- Mortimer Market Centre, Central and North West London NHS Foundation Trust, London, UK
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5
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Zeng GG, Jiang WL, Yu J, Nie GY, Lu YR, Xiao CK, Wang C, Zheng K. The Potential Relationship Between Cardiovascular Diseases and Monkeypox. Curr Probl Cardiol 2024; 49:102116. [PMID: 37802168 DOI: 10.1016/j.cpcardiol.2023.102116] [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: 09/28/2023] [Accepted: 09/30/2023] [Indexed: 10/08/2023]
Abstract
Mpox, a novel epidemic disease, has broken out the period of coronavirus disease 2019 since May 2022, which was caused by the mpox virus. Up to 12 September 2023, there are more than 90,439 confirmed mpox cases in over 115 countries all over the world. Moreover, the outbreak of mpox in 2022 was verified to be Clade II rather than Clade I. Highlighting the significance of this finding, a growing body of literature suggests that mpox may lead to a series of cardiovascular complications, including myocarditis and pericarditis. It is indeed crucial to acquire more knowledge about mpox from a perspective from the clinical cardiologist. In this review, we would discuss the epidemiological characteristics and primary treatments of mpox to attempt to provide a framework for cardiovascular physicians.
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Affiliation(s)
- Guang-Gui Zeng
- Department of Clinical Laboratory, Hengyang Central Hospital, Hengyang, Hunan, China; Institute of Pathogenic Biology, Hengyang Medical College, University of South China, Hengyang, Hunan, China; Institute of Cardiovascular Disease, Key Laboratory for Arteriosclerology of Hunan Province, 2020 Grade Excellent Doctor Class of Hengyang Medical College, University of South China, Hengyang, Hunan, China
| | - Wan-Li Jiang
- Institute of Cardiovascular Disease, Key Laboratory for Arteriosclerology of Hunan Province, 2020 Grade Excellent Doctor Class of Hengyang Medical College, University of South China, Hengyang, Hunan, China
| | - Jiang Yu
- Institute of Cardiovascular Disease, Key Laboratory for Arteriosclerology of Hunan Province, 2020 Grade Excellent Doctor Class of Hengyang Medical College, University of South China, Hengyang, Hunan, China
| | - Gui-Ying Nie
- Institute of Cardiovascular Disease, Key Laboratory for Arteriosclerology of Hunan Province, 2020 Grade Excellent Doctor Class of Hengyang Medical College, University of South China, Hengyang, Hunan, China
| | - Yu-Ru Lu
- Department of Emergency Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Department of Intensive Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chang-Kai Xiao
- Department of Urology, Hengyang Medical School, The First Affiliated Hospital, University of South China, Hengyang, Hunan, China
| | - Chuan Wang
- Institute of Pathogenic Biology, Hengyang Medical College, University of South China, Hengyang, Hunan, China.
| | - Kang Zheng
- Department of Clinical Laboratory, Hengyang Central Hospital, Hengyang, Hunan, China.
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6
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Guevara-Martínez J, La-Noire FP, Arteaga-Asensio P, Pascual-Miguelañez I, Moraes Souza R, Quiles M, Montes M, Fondevila C, Álvarez-Gallego M. Proctitis in patients with monkeypox infection: a single-center analysis of 42 consecutive cases from a multidisciplinary observational study on monkeypox proctitis. Tech Coloproctol 2023; 27:1211-1218. [PMID: 37086291 PMCID: PMC10638120 DOI: 10.1007/s10151-023-02782-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 03/07/2023] [Indexed: 04/23/2023]
Abstract
BACKGROUND The current monkeypox (MP) virus outbreak was declared an international emergency in July 2022. The aim of this report is to describe our initial experience with patients with MP, focusing on proctitis. METHODS We conducted an observational study between 20 May and 31 July 2022, on patients with MP at a reference tertiary center in Madrid, Spain. A descriptive analysis on MP was performed, focusing on its characteristics, symptoms, diagnosis, and outcomes. RESULTS A total of 143 positive MP cases were diagnosed in our center; 42 of them [all male, median age 39 years (range: 22-57 years)] had proctitis (29.37%), and 3 patients (2.09%/MP total cases and 7.14%/MP proctitis) required surgical drainage of a perianal abscess. CONCLUSIONS General and digestive surgeons must be aware of the presence of proctological impairment and complications due to MP virus.
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Affiliation(s)
- J Guevara-Martínez
- General and Digestive Surgery, Hospital Universitario La Paz. Universidad Autónoma de Madrid, Madrid, Spain
- Instituto de Investigación, Hospital Universitario La Paz, Madrid, Spain
| | - F Prieto La-Noire
- General and Digestive Surgery, Hospital Universitario La Paz. Universidad Autónoma de Madrid, Madrid, Spain
| | - P Arteaga-Asensio
- General and Digestive Surgery, Hospital Universitario La Paz. Universidad Autónoma de Madrid, Madrid, Spain
| | - I Pascual-Miguelañez
- General and Digestive Surgery, Hospital Universitario La Paz. Universidad Autónoma de Madrid, Madrid, Spain
- Instituto de Investigación, Hospital Universitario La Paz, Madrid, Spain
| | - R Moraes Souza
- Dermatology Department, Hospital Universitario La Paz, Madrid, Spain
| | - M Quiles
- Microbiology Department, Hospital Universitario La Paz, Madrid, Spain
| | - M Montes
- Internal Medicine Department, Hospital Universitario La Paz, Madrid, Spain
| | - C Fondevila
- General and Digestive Surgery, Hospital Universitario La Paz. Universidad Autónoma de Madrid, Madrid, Spain
- Instituto de Investigación, Hospital Universitario La Paz, Madrid, Spain
| | - M Álvarez-Gallego
- General and Digestive Surgery, Hospital Universitario La Paz. Universidad Autónoma de Madrid, Madrid, Spain.
- Instituto de Investigación, Hospital Universitario La Paz, Madrid, Spain.
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7
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Carrillo I, Velasco MJ, Fuertes de Vega L, Álvarez B. «When lack of protection brings us closer to our origins». The start of a pandemic. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2023; 41:577-578. [PMID: 37117144 DOI: 10.1016/j.eimce.2023.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/02/2022] [Accepted: 12/06/2022] [Indexed: 04/30/2023]
Affiliation(s)
- Irene Carrillo
- División de Enfermedades Infecciosas, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.
| | - Margarita Jo Velasco
- Servicio de Anatomía Patológica, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Laura Fuertes de Vega
- Servicio de Dermatología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Beatriz Álvarez
- División de Enfermedades Infecciosas, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
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8
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Estévez S, Vara M, Gamo M, Manzano S, Troya J, Botezat E, Jiménez E, Pedrero-Tomé R, Martin MÁ, de la Cueva P, Fernández E, Fernández B, Brown DE, Palma E, Simón A. Epidemiological and Clinical Characteristics of Patients Admitted to a Secondary Hospital with Suspected MPOX Virus Infection: Is HIV Playing a Role? J Clin Med 2023; 12:4124. [PMID: 37373818 DOI: 10.3390/jcm12124124] [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: 05/14/2023] [Revised: 06/09/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023] Open
Abstract
MPOX (monkeypox) is a zoonotic viral disease, endemic in some Central and West African countries. However, in May 2022, cases began to be reported in non-endemic countries, demonstrating community transmission. Since the beginning of the outbreak, different epidemiological and clinical behaviors have been observed. We conducted an observational study at a secondary hospital in Madrid to characterize suspected and confirmed cases of MPOX epidemiologically and clinically. Besides the general descriptive analysis, we compared data between HIV-positive and HIV-negative subjects; 133 patients were evaluated with suspected MPOX, of which 100 were confirmed. Regarding positive cases, 71.0% were HIV positive, and 99.0% were men with a mean age of 33. In the previous year, 97.6% reported having sex with men, 53.6% used apps for sexual encounters, 22.9% practiced chemsex, and 16.7% went to saunas. Inguinal adenopathies were significantly higher in MPOX cases (54.0% vs. 12.1%, p < 0.001), as the involvement of genital and perianal area (57.0% vs. 27.3% and 17.0% vs. 1.0%, p = 0.006 and p = 0.082 respectively). Pustules were the most common skin lesion (45.0%). In HIV-positive cases, only 6.9% had a detectable viral load, and the mean CD4 count was 607.0/mm3. No significant differences were observed in the disease course, except for a greater tendency towards the appearance of perianal lesions. In conclusion, the MPOX 2022 outbreak in our area has been related to sexual intercourse among MSM, with no severe clinical cases nor apparent differences in HIV and non-HIV patients.
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Affiliation(s)
- Samuel Estévez
- Department of Internal Medicine, Infanta Leonor University Hospital, 28031 Madrid, Spain
| | - Marta Vara
- Department of Preventive Medicine and Public Health, Infanta Leonor University Hospital, 28031 Madrid, Spain
| | - María Gamo
- Department of Dermatology, Infanta Leonor University Hospital, 28031 Madrid, Spain
| | - Samuel Manzano
- Department of Internal Medicine, Infanta Leonor University Hospital, 28031 Madrid, Spain
| | - Jesús Troya
- Department of Internal Medicine, Infanta Leonor University Hospital, 28031 Madrid, Spain
| | - Ekaterina Botezat
- Department of Preventive Medicine and Public Health, Infanta Leonor University Hospital, 28031 Madrid, Spain
| | - Eva Jiménez
- Department of Preventive Medicine and Public Health, Infanta Leonor University Hospital, 28031 Madrid, Spain
| | - Roberto Pedrero-Tomé
- Foundation for Biomedical Research and Innovation (FIIB), Infanta Leonor University Hospital, 28031 Madrid, Spain
| | - María Ángeles Martin
- Department of Dermatology, Infanta Leonor University Hospital, 28031 Madrid, Spain
| | - Pablo de la Cueva
- Department of Dermatology, Infanta Leonor University Hospital, 28031 Madrid, Spain
| | - Elisa Fernández
- Department of Internal Medicine, Infanta Leonor University Hospital, 28031 Madrid, Spain
| | - Beatriz Fernández
- Department of Internal Medicine, Infanta Leonor University Hospital, 28031 Madrid, Spain
| | - David Esteban Brown
- Department of Internal Medicine, Infanta Leonor University Hospital, 28031 Madrid, Spain
| | - Elena Palma
- Department of Internal Medicine, Infanta Leonor University Hospital, 28031 Madrid, Spain
| | - Ana Simón
- Department of Dermatology, Infanta Leonor University Hospital, 28031 Madrid, Spain
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9
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Ordoñez-González I, López-Zamora B, Medina G, Reyes-Navarro GV, Navarro AO, Cruz-Domínguez MP, Vera-Lastra O, Saavedra MÁ. Human monkeypox coinfection with syphilis in an immunocompromised patient. Dermatol Reports 2023; 15:9591. [PMID: 37397408 PMCID: PMC10312107 DOI: 10.4081/dr.2022.9591] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 09/22/2022] [Indexed: 07/04/2023] Open
Abstract
Monkeypox is a viral zoonosis from the Poxviridae family that spreads at an unprecedented rate. It is transmitted through contact with skin lesions, respiratory droplets, body fluids, and sexual contact. The diverse presentation of the disease leads to misdiagnosis. Thus, clinicians should have a high index of suspicion, mainly with diseases with skin lesions. The most vulnerable group to developing this disease are individuals with risky sexual relationships, sexually transmitted infections, or human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). To date, only one case of coinfection with the monkeypox virus, syphilis, and HIV has been reported; however, no cases have been revealed in the Mexican territory. Herein we describe an unusual case of syphilis-monkeypox coinfection in an immunocompromised patient; despite his coinfection, he had a favorable prognosis. Furthermore, we attach allusive pictures of the natural evolution of dermatological lesions.
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Affiliation(s)
| | | | - Gabriela Medina
- Unidad de Investigación de Medicina Translacional, Hospital de Especialidades Centro Médico Nacional La Raza, IMSS, Mexico City
- Universidad Nacional Autónoma de México, Mexico City
| | | | - Alberto Ordinola Navarro
- Universidad Nacional Autónoma de México, Mexico City
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City
| | - María Pilar Cruz-Domínguez
- Universidad Nacional Autónoma de México, Mexico City
- Dirección de Educación e Investigación, Hospital de Especialidades Centro Médico Nacional La Raza, IMSS, Mexico City
| | - Olga Vera-Lastra
- Universidad Nacional Autónoma de México, Mexico City
- Departamento de Medicina Interna, Hospital de Especialidades Centro Médico Nacional La Raza, IMSS, Mexico City
| | - Miguel Ángel Saavedra
- Universidad Nacional Autónoma de México, Mexico City
- División de Investigación, Hospital de Especialidades Centro Médico Nacional La Raza, IMSS, Mexico City, Mexico
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10
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Warner NC, Shishido A, Fulco PP, Sastry S. Immune reconstitution inflammatory syndrome due to monkeypox in two patients with AIDS. AIDS 2023; 37:1187-1188. [PMID: 37139659 DOI: 10.1097/qad.0000000000003541] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Affiliation(s)
- Nathaniel C Warner
- Department of Internal Medicine, Division of Infectious Diseases, Virginia Commonwealth University, Richmond, VA, USA
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11
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Ullah M, Li Y, Munib K, Zhang Z. Epidemiology, host range, and associated risk factors of monkeypox: an emerging global public health threat. Front Microbiol 2023; 14:1160984. [PMID: 37213509 PMCID: PMC10196482 DOI: 10.3389/fmicb.2023.1160984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 03/27/2023] [Indexed: 05/23/2023] Open
Abstract
Based on recent multiregional epidemiological investigations of Monkeypox (MPX), on 24 July 2022, the World Health Organization declared it a global public health threat. Retrospectively MPX was an ignored zoonotic endemic infection to tropical rainforest regions of Western and Central African rural communities until a worldwide epidemic in May 2022 verified the potential threat of monkeypox virus (MPXV) to be propagated across the contemporary world via transnational tourism and animal movements. During 2018-2022, different cases of MPX diagnosed in Nigerian travelers have been documented in Israel, the United Kingdom, Singapore, and the United States. More recently, on 27 September 2022, 66,000 MPX cases have been confirmed in more than 100 non-endemic countries, with fluctuating epidemiological footprinting from retrospective epidemics. Particular disease-associated risk factors fluctuate among different epidemics. The unpredicted appearance of MPX in non-endemic regions suggests some invisible transmission dynamic. Hence, broad-minded and vigilant epidemiological attention to the current MPX epidemic is mandatory. Therefore, this review was compiled to highlight the epidemiological dynamic, global host ranges, and associated risk factors of MPX, concentrating on its epidemic potential and global public health threat.
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Affiliation(s)
- Munib Ullah
- State Key Laboratory of Veterinary Etiological Biology, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China
- Department of Clinical Studies, Faculty of Veterinary and Animal Sciences, PMAS-Arid Agriculture University Rawalpindi, Rawalpindi, Pakistan
| | - Yanmin Li
- College of Animal Husbandry and Veterinary Medicine, Southwest Minzu University, Chengdu, China
| | - Kainat Munib
- Department of Sociology, Allama Iqbal Open University Islamabad, Islamabad, Pakistan
| | - Zhidong Zhang
- College of Animal Husbandry and Veterinary Medicine, Southwest Minzu University, Chengdu, China
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12
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Al-Mustapha AI, Ogundijo OA, Sikiru NA, Kolawole B, Oyewo M, El-Nadi H, Mustapha AM, Adebudo LI, Odukoya A, Asiegbu EC, Nanven MB, Lawal-Atolagbe T, Lawal-Lah F, Awoyale OD, Abubakar AT, Sahabi K, Babandi ZS. A cross-sectional survey of public knowledge of the monkeypox disease in Nigeria. BMC Public Health 2023; 23:591. [PMID: 36991417 PMCID: PMC10054201 DOI: 10.1186/s12889-023-15398-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 03/07/2023] [Indexed: 03/31/2023] Open
Abstract
The Monkeypox Disease (MPXD) gained attention due to its widened geographical distribution outside of Africa, Hence, a it was declared a global health emergency. The index case in Europe was from a Nigerian traveller. This study assessed public awareness and knowledge of the MPXD by conducting an online, cross-sectional survey of educated Nigerians. A total of 822 respondents were recruited using the snowball sampling method between the 16th to 29th of August 2022. More responses were retrieved from the Northeastern geopolitical region (30.1%, n=220) than other regions. Descriptive statistics revealed that 89% (n=731/822) of the study participants were aware of the MPXD but only 58.7% (n=429/731) of them had good knowledge of the disease with a mean knowledge score of 5.31±2.09. The main knowledge gaps were in the incubation period of the disease, the signs and symptoms, its mode of transmission, and preventive practices needed to curb the spread of the monkeypox virus (MPXV). Specifically, only 24.5% (n=179) of them knew that MPXV can be transmitted via sexual contact. Most of the study participants (79.2%, n=651) opined that we can prevent the occurrence of public health emergencies in the future. The multivariable logistic regression analysis revealed that of the socio-demographic variables, the male gender (OR: 1.69; 95% CI: 1.22,2.33); Ph.D. level education (1.44; 95% CI: 1.048,4.23); and being homosexual (OR:1.65; 95% CI: 1.07,3.78) were significantly associated with good knowledge of MPXD. Despite the varying prevalence across the country, the region of residence within Nigeria did not influence the knowledge of MPXD among the respondents. The knowledge gaps necessitate intensified public health risk communication with a focus on modes of transmission and the preventive measures needed to curb the spread of the MPXV.
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Affiliation(s)
- Ahmad Ibrahim Al-Mustapha
- Department of Food Hygiene and Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland.
- Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, University of Ibadan, Oyo State, Nigeria.
- Department of Veterinary Services, Kwara State Ministry of Agriculture and Rural Development, Ilorin, Kwara State, Nigeria.
| | - Oluwaseun Adeolu Ogundijo
- Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, University of Ibadan, Oyo State, Nigeria
| | - Nafisah Ayinde Sikiru
- Health Services Department, Federal University, Kashere, Kashere, Gombe State, Nigeria
| | - Barakat Kolawole
- Department of Public Health, Faculty of Basic Medical Sciences, Kwara State University, Malete, Kwara State, Nigeria
| | - Muftau Oyewo
- Department of Veterinary Services, Kwara State Ministry of Agriculture and Rural Development, Ilorin, Kwara State, Nigeria
- Nigerian Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
| | - Hager El-Nadi
- Infectious Diseases and One Health, Faculty of Pharmaceutical Sciences, Universite de Tours, Tours, France
| | | | | | - Adesoji Odukoya
- Nigerian Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
- Federal Department of Veterinary and Pest Control Services, Federal Ministry of Agriculture and Rural Development, Abuja, Nigeria
| | | | - Magdalene B Nanven
- Nigerian Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
| | | | | | | | - Ahmed Tijani Abubakar
- Department of Veterinary Services, Kwara State Ministry of Agriculture and Rural Development, Ilorin, Kwara State, Nigeria
- African Centers for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Kabiru Sahabi
- Department of Psychiatry, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria
| | - Zaharadeen S Babandi
- Department of Community Medicine, Ahmadu Bello University Teaching Hospital, Zaria, , Kaduna State, Nigeria
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Caria J, Vara-Luiz F, Maia I, Joosten A, Val-Flores L, Pinheiro H, Póvoas D, Germano N, Maltez F. Fatal Case of Progressive Mpox in a Patient with AIDS-Viral Enteropathy and Malabsorption Demanding the Use of Full Parenteral ARV and Endovenous Cidofovir. Infect Dis Rep 2023; 15:171-179. [PMID: 36960970 PMCID: PMC10037604 DOI: 10.3390/idr15020018] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/12/2023] [Accepted: 03/13/2023] [Indexed: 03/18/2023] Open
Abstract
We report a fatal case of disseminated mpox infection that progressed over more than three months in an HIV-infected patient with acquired immunodeficiency syndrome (AIDS). Mucocutaneous, pleuropulmonary, central nervous system, and gastrointestinal involvement was documented. This course of disease resembles progressive vaccinia, a formerly reported disease caused by uncontrolled replication of smallpox vaccination orthopoxviruses in immunosuppressed patients. Severe small bowel involvement jeopardized normal oral tecovirimat and antiretroviral therapy absorption. This problem prompted the use of full parenteral antiretrovirals and endovenous cidofovir. Although a remarkable decrease in HIV viral load occurred in six days, mpox infection continued to progress, and the patient died of septic shock. This case offers new clinical insights on the presentation of severe disease in AIDS patients. Moreover, this case alerts for the need for prompt therapy initiation in patients at risk of ominous clinical progression.
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Affiliation(s)
- João Caria
- Department of Infectious Diseases, Hospital de Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, 1069-166 Lisboa, Portugal
| | - Francisco Vara-Luiz
- Department of Gastroenterology, Hospital Garcia de Orta, 2805-267 Almada, Portugal
- Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), 2829-511 Almada, Portugal
| | - Inês Maia
- Department of Internal Medicine, Centro Hospitalar Barreiro-Montijo, 2830-003 Barreiro, Portugal
| | - Anneke Joosten
- Department of Internal Medicine, Centro Hospitalar Barreiro-Montijo, 2830-003 Barreiro, Portugal
| | - Luís Val-Flores
- Department of Intensive Care Medicine, Hospital de Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, 1069-166 Lisboa, Portugal
| | - Hélder Pinheiro
- Department of Infectious Diseases, Hospital de Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, 1069-166 Lisboa, Portugal
- Faculdade de Ciências Médica, Universidade Nova de Lisboa, 1169-056 Lisboa, Portugal
| | - Diana Póvoas
- Department of Infectious Diseases, Hospital de Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, 1069-166 Lisboa, Portugal
- Instituto Gulbenkian de Ciência, 2780-156 Oeiras, Portugal
| | - Nuno Germano
- Department of Intensive Care Medicine, Hospital de Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, 1069-166 Lisboa, Portugal
| | - Fernando Maltez
- Department of Infectious Diseases, Hospital de Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, 1069-166 Lisboa, Portugal
- Faculdade de Ciências Médica, Universidade Nova de Lisboa, 1169-056 Lisboa, Portugal
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1600-190 Lisboa, Portugal
- Laboratório Associado TERRA, Faculdade de Medicina, Universidade de Lisboa, 1600-190 Lisboa, Portugal
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Coşkun E, Soyak F, Öztürk-Deniz SS, Kutlu M, Sayın-Kutlu S. Four Human Mpox Cases from Turkey. INFECTIOUS DISEASES & CLINICAL MICROBIOLOGY 2023; 5:53-58. [PMID: 38633902 PMCID: PMC10986706 DOI: 10.36519/idcm.2023.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 02/04/2023] [Indexed: 04/19/2024]
Abstract
Human mpox (formerly monkeypox) disease has recently been reported in a number of European countries among individuals with no history of international travel or animal contact, causing global epidemic concerns. We describe the demographic, clinical characteristics, and laboratory data of four male patients with mpox disease, three of whom were human immunodeficiency virus (HIV)-positive, and one who was HIV-negative but had type 1 diabetes mellitus and a recent history of urological surgery. The HIV-negative patient attracted interest because he had no history of suspected sexual contact; however, he used shared bathrooms and towels at work, which could explain the potential transmission route. The remaining three male patients engaged in sexual activity with men recently. All four patients had prodromal symptoms such as short-term fever, myalgia, or fatigue, followed by a vesicular-pustular rash that began in the genital area, and two also had lesions on other parts of their bodies. Mpox is not generally considered in the differential diagnosis intitally because it is rare in Turkey; however, the diagnosis should be considered in patients with pustular umbilicated lesions and a history of risky sexual behavior.
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Affiliation(s)
- Emine Coşkun
- Department of Infectious Diseases and Clinical Microbiology, Pamukkale University School of Medicine, Denizli, Turkey
| | - Firuze Soyak
- Department of Infectious Diseases and Clinical Microbiology, Pamukkale University School of Medicine, Denizli, Turkey
| | - Suna Seçil Öztürk-Deniz
- Department of Infectious Diseases and Clinical Microbiology, Pamukkale University School of Medicine, Denizli, Turkey
| | - Murat Kutlu
- Department of Infectious Diseases and Clinical Microbiology, Pamukkale University School of Medicine, Denizli, Turkey
| | - Selda Sayın-Kutlu
- Department of Infectious Diseases and Clinical Microbiology, Pamukkale University School of Medicine, Denizli, Turkey
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15
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Carrillo I, Velasco MJ, Fuertes de Vega L, Álvarez B. «Cuando la falta de protección nos acerca a nuestros orígenes». El inicio de una pandemia. Enferm Infecc Microbiol Clin 2023. [DOI: 10.1016/j.eimc.2022.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Hoarau G, Vauloup Fellous C, Haigh O, Labetoulle M, Rousseau A. [Monkeypox: Important facts for the ophthalmologist]. J Fr Ophtalmol 2023; 46:185-193. [PMID: 36639339 PMCID: PMC9832348 DOI: 10.1016/j.jfo.2022.11.002] [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: 11/09/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 01/13/2023]
Abstract
The current monkeypox virus (MPXV) outbreak, raging since May 2022, is the largest ever observed on a world-wide scale. Despite previously being endemic in west and central Africa with a mortality rate of up to 10%, it remained a neglected tropical disease. Along with other recent pandemics gaining much attention, this MPXV outbreak has provided an opportunity to improve our understanding of its physiopathology and better define management strategies, particularly in patients with more serious disease. From the ophthalmologist's perspective, eyelid involvement and conjunctivitis or keratoconjunctivitis are frequently observed and may precede systemic signs or even remain the major site of involvement. While the course of MPXV keratoconjunctivitis is most often favorable, severe cases pose a functional threat, in particular for immunocompromised patients. This review provides an overview of MPXV pathophysiology, diagnosis and treatment, as well as considerations for prevention of transmission. During such an epidemic, the ophthalmologist can be the first to diagnose MPXV, treat the ocular involvement, and set up adequate preventative measures in collaboration with infectious disease specialists.
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Affiliation(s)
- G. Hoarau
- Service d’ophtalmologie, réseau OPHTARA, CHU Bicêtre Paris-Saclay, université Paris Saclay, AP–HP, Kremlin-Bicêtre, France
| | - C. Vauloup Fellous
- Service de virologie, HU Paul Brousse Paris Saclay, université Paris Saclay, AP–HP, Villejuif, France,Département d’immunologie des maladies virales, auto-immunes, hématologiques et bactériennes, UMR1184, CEA Fontenay-Aux-Roses, France
| | - O. Haigh
- Département d’immunologie des maladies virales, auto-immunes, hématologiques et bactériennes, UMR1184, CEA Fontenay-Aux-Roses, France
| | - M. Labetoulle
- Service d’ophtalmologie, réseau OPHTARA, CHU Bicêtre Paris-Saclay, université Paris Saclay, AP–HP, Kremlin-Bicêtre, France,Département d’immunologie des maladies virales, auto-immunes, hématologiques et bactériennes, UMR1184, CEA Fontenay-Aux-Roses, France
| | - A. Rousseau
- Service d’ophtalmologie, réseau OPHTARA, CHU Bicêtre Paris-Saclay, université Paris Saclay, AP–HP, Kremlin-Bicêtre, France,Département d’immunologie des maladies virales, auto-immunes, hématologiques et bactériennes, UMR1184, CEA Fontenay-Aux-Roses, France,Auteur correspondant. Service d’ophtalmologie, CHU Bicêtre, 78, rue du Général Leclerc, 94275 Le Kremlin-Bicêtre, France
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17
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Moretti M, Heymans B, Yin N, Kaur S, Libois A, Quoilin S, Martin C. Diagnostic approach to monkeypox outbreak, a case-control study. Int J STD AIDS 2023; 34:338-345. [PMID: 36688279 DOI: 10.1177/09564624231152789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND An international outbreak of the monkeypox (MPX) virus is ongoing with a different clinical presentation than previously reported. OBJECTIVE A monocentric retrospective study was designed to investigate clinical predictors of confirmed MPX cases among a group of patients referred for MPX screening. Furthermore, the additional value of performing a real-time polymerase chain reaction (RT-PCR) on multiple anatomical sites was analyzed. METHODS Between 28/05/2022 and 22/07/2022, the medical records of patients referred for MPX screening were investigated. Patients with positive RT-PCR were defined as cases, while the ones with negative RT-PCR as controls. Multivariable regression analysis was performed to estimate predictors of MPX diagnosis. RESULTS Among the 141 included patients, 85 (60%) had at least one positive RT-PCR for MPX. Carrying out RT-PCR only on the swab obtained by skin lesion sampling, 7 patients (7/85: 8%) would have been misdiagnosed. Multivariable regression analysis showed significant differences in the independent variables: "being men who have sex with men (MSM)", "living with HIV", "having multiple sexual partners in the last 3 weeks", and "having skin lesions in the anogenital area" for prediction of MPX diagnosis. These four discriminants were used to create a score to improve diagnosis in patients screened for MPX. CONCLUSION MPX diagnosis was associated with being MSM, living with HIV, having multiple sexual partners, and presenting with anogenital skin lesions. In this study, the derived score had good sensitivity and specificity to predict MPX diagnosis. Finally, performing multi-site swabs for MPX RT-PCR might lower false negative rates.
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Affiliation(s)
- Marco Moretti
- Department of internal medicine and infectious diseases, 81880CHU Saint Pierre, ULB, Brussels, Belgium.,Department of internal medicine and infectious disease, UZ Brussel, VUB, Brussels, Belgium
| | - Benjamin Heymans
- Department of internal medicine and infectious diseases, 81880CHU Saint Pierre, ULB, Brussels, Belgium
| | - Nicolas Yin
- Department of Microbiology, 26659Laboratoire Hospitalier Universitaire de Bruxelles - Universitair Laboratorium Brussel (LHUB-ULB), ULB, Brussels, Belgium
| | - Simran Kaur
- Department of internal medicine and infectious diseases, 81880CHU Saint Pierre, ULB, Brussels, Belgium
| | - Agnes Libois
- Department of internal medicine and infectious diseases, 81880CHU Saint Pierre, ULB, Brussels, Belgium
| | - Sophie Quoilin
- Department of hospital hygiene, 81880CHU Saint Pierre, ULB, Brussels, Belgium
| | - Charlotte Martin
- Department of internal medicine and infectious diseases, 81880CHU Saint Pierre, ULB, Brussels, Belgium
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18
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Ortiz-Saavedra B, Montes-Madariaga ES, Cabanillas-Ramirez C, Alva N, Ricardo-Martínez A, León-Figueroa DA, Barboza JJ, Mohanty A, Padhi BK, Sah R. Epidemiologic Situation of HIV and Monkeypox Coinfection: A Systematic Review. Vaccines (Basel) 2023; 11:246. [PMID: 36851124 PMCID: PMC9965118 DOI: 10.3390/vaccines11020246] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/13/2023] [Accepted: 01/19/2023] [Indexed: 01/26/2023] Open
Abstract
The most recent monkeypox (Mpox) outbreak is mostly affecting men who have sex with men (MSM) who participate in high-risk sexual behaviors, which is typically the case among human immunodeficiency virus (HIV) carriers, according to clinical and epidemiological statistics. The objective of this research is to determine the epidemiological situation of HIV and smallpox co-infection. Until 1 October 2022, a thorough evaluation of the literature was conducted utilizing the databases PubMed, Embase, Scopus, and Web of Science. Studies were evaluated based on the criteria for selection. Fifty-three studies met the selection criteria. A total of 6345 confirmed cases of monkeypox were recorded, and 40.32% (n = 2558) of these cases also had HIV co-infection. In addition, 51.36% (n = 3259) of the men (91.44%; n = 5802), whose ages ranged from 18 to 71 years, exhibited MSM-specific sexual behaviors. Co-infection with these two viruses can be especially dangerous because it can exacerbate the symptoms of both diseases and make them more difficult to treat. People with HIV are more vulnerable to certain infections, including monkeypox, because their immune systems are weakened. Therefore, it is important that they take measures to prevent infection, such as avoiding contact with infected animals, risky behaviors, and maintaining good hygiene.
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Affiliation(s)
- Brando Ortiz-Saavedra
- Universidad Nacional de San Agustín de Arequipa, Arequipa 04000, Peru
- Unidad de Revisiones Sistemáticas y Meta-Análisis, Tau-Relaped Group, Trujillo 13001, Peru
| | - Elizbet S. Montes-Madariaga
- Universidad Nacional de San Agustín de Arequipa, Arequipa 04000, Peru
- Unidad de Revisiones Sistemáticas y Meta-Análisis, Tau-Relaped Group, Trujillo 13001, Peru
| | | | - Niza Alva
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima 15023, Peru
| | | | - Darwin A. León-Figueroa
- Unidad de Revisiones Sistemáticas y Meta-Análisis, Tau-Relaped Group, Trujillo 13001, Peru
- Facultad de Medicina Humana, Universidad de San Martín de Porres, Chiclayo 14012, Peru
| | - Joshuan J. Barboza
- Vicerrectorado de Investigación, Universidad Norbert Wiener, Lima 15046, Peru
| | - Aroop Mohanty
- Department of Microbiology, All India Institute of Medical Sciences, Gorakhpur 273001, India
| | - Bijaya Kumar Padhi
- Department of Community Medicine, School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Ranjit Sah
- Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu 44600, Nepal
- Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune 411018, India
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Crosato V, Degli Antoni M, Izzo I, Cerini C, Pennati F, Gulletta M, Odolini S, Tomasoni LR, Matteelli A, Castelli F. Atypical monkeypox presentation in a previously vaccinated MSM HIV-positive adult. Infection 2023; 51:783-786. [PMID: 36639593 PMCID: PMC9839196 DOI: 10.1007/s15010-022-01967-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 12/15/2022] [Indexed: 01/14/2023]
Abstract
The outbreak of monkeypox virus (MPXV) in non-endemic countries is an international public health emergency, and the diversity in manifestations poses challenges for early diagnosis and isolation. We describe an atypical case of monkeypox (MPX) in a 46-year-old homosexual male living with HIV. He reported 1-day duration fever, a lesion on his chin that, over a period of 18 days, had gradually enlarged and ulcerated. Biopsy examination performed at an external centre revealed pyoderma gangrenosum, unconfirmed at a subsequent biopsy. When he reported to our hospital outpatients' clinic the chin lesion had a diameter of 5 × 5 cm, necrotic margins and ulcerated base and signs of superinfection. He was admitted for further investigations. Three swabs collected from pharynx, skin and chin lesion resulted positive for MPXV. He had a favourable clinical course and was discharged soon after. Pending the achievement of optimal vaccination coverage in at-risk groups, early identification and isolation of infectious patients represent the cornerstones of the containment strategy. Atypical cases of MPX manifestations are not uncommon, particularly in patients with HIV infection. A high level of suspicion should be maintained to identify infectious cases at an early stage and avoid further spread of the infection.
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Affiliation(s)
- Verena Crosato
- Unit of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
| | - Melania Degli Antoni
- Unit of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Ilaria Izzo
- Unit of Infectious and Tropical Diseases, ASST Spedali Civili, Brescia, Brescia, Italy
| | - Carlo Cerini
- Unit of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Francesca Pennati
- Unit of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Maurizio Gulletta
- Unit of Infectious and Tropical Diseases, ASST Spedali Civili, Brescia, Brescia, Italy
| | - Silvia Odolini
- Unit of Infectious and Tropical Diseases, ASST Spedali Civili, Brescia, Brescia, Italy
| | - Lina Rachele Tomasoni
- Unit of Infectious and Tropical Diseases, ASST Spedali Civili, Brescia, Brescia, Italy
| | - Alberto Matteelli
- Unit of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Francesco Castelli
- Unit of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
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20
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Strathdee SA, Crago AL, Shannon K. Harm reduction and rights-based approaches to reduce monkeypox transmission among sex workers. THE LANCET. INFECTIOUS DISEASES 2023; 23:e43-e46. [PMID: 36243028 PMCID: PMC9556054 DOI: 10.1016/s1473-3099(22)00661-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/19/2022] [Accepted: 09/21/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Steffanie A Strathdee
- Division of Infectious Diseases and Global Public Health, University of California San Diego School of Medicine, La Jolla, CA, USA.
| | | | - Kate Shannon
- Division of Social Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada; Centre for Gender and Sexual Health Equity, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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21
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Muacevic A, Adler JR, Tomsey AK. Non-painful, Non-itchy Monkeypox Virus Rash: A Case Report. Cureus 2022; 14:e32342. [PMID: 36632260 PMCID: PMC9828123 DOI: 10.7759/cureus.32342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2022] [Indexed: 12/13/2022] Open
Abstract
Monkeypox virus (MPVX) is a double-stranded deoxyribonucleic acid (DNA) virus from the genus Orthopoxvirus, family Poxviridae. Many cases of MPVX infection are currently seen worldwide. Although the majority of cases reported are not severe, basic precautionary measures are key to preventing this infection from turning into a catastrophic pandemic. We report a case of a 54-year-old male with no high-risk behavior who developed a sudden uncharacteristic monkeypox virus rash while on a flight from Nigeria.
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22
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Hatmal MM, Al-Hatamleh MAI, Olaimat AN, Ahmad S, Hasan H, Ahmad Suhaimi NA, Albakri KA, Abedalbaset A, Kadir R, Mohamud R. Comprehensive Literature Review of Monkeypox. Emerg Microbes Infect 2022; 11:2600-2631. [PMID: 36263798 DOI: 10.1080/22221751.2022.2132882] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The current outbreak of monkeypox (MPX) infection has emerged as a global matter of concern in the last few months. MPX is a zoonosis caused by the MPX virus (MPXV), which is one of the Orthopoxvirus species. Thus, it is similar to smallpox caused by the variola virus, and smallpox vaccines and drugs have been shown to be protective against MPX. Although MPX is not a new disease and is rarely fatal, the current multi-country MPX outbreak is unusual because it is occurring in countries that are not endemic for MPXV. In this work, we reviewed the extensive literature available on MPXV to summarize the available data on the major biological, clinical and epidemiological aspects of the virus and the important scientific findings. This review may be helpful in raising awareness of MPXV transmission, symptoms and signs, prevention and protective measures. It may also be of interest as a basis for performance of studies to further understand MPXV, with the goal of combating the current outbreak and boosting healthcare services and hygiene practices.Trial registration: ClinicalTrials.gov identifier: NCT02977715..Trial registration: ClinicalTrials.gov identifier: NCT03745131..Trial registration: ClinicalTrials.gov identifier: NCT00728689..Trial registration: ClinicalTrials.gov identifier: NCT02080767..
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Affiliation(s)
- Ma'mon M Hatmal
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan
| | - Mohammad A I Al-Hatamleh
- Department of Immunology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Amin N Olaimat
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan
| | - Suhana Ahmad
- Department of Immunology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Hanan Hasan
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan
| | | | | | | | - Ramlah Kadir
- Department of Immunology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Rohimah Mohamud
- Department of Immunology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
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Betancort-Plata C, Lopez-Delgado L, Jaén-Sanchez N, Tosco-Nuñez T, Suarez-Hormiga L, Lavilla-Salgado C, Pisos-Álamo E, Hernández-Betancor A, Hernández-Cabrera M, Carranza-Rodríguez C, Briega-Molina M, Pérez-Arellano JL. Monkeypox and HIV in the Canary Islands: A Different Pattern in a Mobile Population. Trop Med Infect Dis 2022; 7:318. [PMID: 36288059 PMCID: PMC9608065 DOI: 10.3390/tropicalmed7100318] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 10/11/2022] [Accepted: 10/14/2022] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND The clinical and epidemiological data of the recent outbreak of monkeypox (MPX) differ from previous reports. One difference is the epidemiological profile; the disease mainly affects a subgroup of MSM (men who have sex with men) with high-risk sexual behaviors, frequently persons living with human immunodeficiency virus (PLHIV). METHODS In this observational analysis, all patients with PCR (polymerase chain reaction)-confirmed MPX attending an Infectious Diseases and Tropical Medicine Unit in Gran Canaria (Spain) between May and July 2022 were considered. RESULTS In total, 42 men were included; 88% were identified as MSM, with a median age of 40 years. Only 43% were born in Spain. All the patients had systemic symptoms and skin lesions. The distribution of lesions was more frequent in the genital/anal region, and the involvement of hands and feet was less common. Fever and lymphadenopathies were less frequent than in other series. Other unusual manifestations were proctitis, pharyngitis and penile-scrotal edema. Half of the patients had other associated infections (mainly STIs, sexually transmitted infections), and 60% of the monkeypox patients had PLHIV (People Living with HIV). When comparing the clinical characteristics between HIV-positive and -negative patients, we found three main differences: (i) a higher frequency of perioral lesions, (ii) a higher frequency of pharyngitis and (iii) a higher number of sexually transmitted infections in HIV-positive patients. CONCLUSIONS The clinical findings in this outbreak of MPX had great variability in presentation. Several clinical differences were found in PLHIV-coinfected patients.
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Affiliation(s)
- Christian Betancort-Plata
- Unidad de Enfermedades Infecciosas y Medicina Tropical, Hospital Universitario Insular de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain
| | - Laura Lopez-Delgado
- Unidad de Enfermedades Infecciosas y Medicina Tropical, Hospital Universitario Insular de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain
| | - Nieves Jaén-Sanchez
- Unidad de Enfermedades Infecciosas y Medicina Tropical, Hospital Universitario Insular de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain
| | - Tomás Tosco-Nuñez
- Servicio de Microbiología y Parasitología, Hospital Universitario Insular de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain
| | - Laura Suarez-Hormiga
- Unidad de Enfermedades Infecciosas y Medicina Tropical, Hospital Universitario Insular de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain
| | - Carmen Lavilla-Salgado
- Unidad de Enfermedades Infecciosas y Medicina Tropical, Hospital Universitario Insular de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain
| | - Elena Pisos-Álamo
- Unidad de Enfermedades Infecciosas y Medicina Tropical, Hospital Universitario Insular de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain
- Departamento de Ciencias Médicas y Quirúrgicas, Universidad de Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain
| | - Araceli Hernández-Betancor
- Servicio de Microbiología y Parasitología, Hospital Universitario Insular de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain
| | - Michele Hernández-Cabrera
- Unidad de Enfermedades Infecciosas y Medicina Tropical, Hospital Universitario Insular de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain
- Departamento de Ciencias Médicas y Quirúrgicas, Universidad de Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain
| | - Cristina Carranza-Rodríguez
- Unidad de Enfermedades Infecciosas y Medicina Tropical, Hospital Universitario Insular de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain
- Departamento de Ciencias Médicas y Quirúrgicas, Universidad de Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain
| | - Marta Briega-Molina
- Unidad de Enfermedades Infecciosas y Medicina Tropical, Hospital Universitario Insular de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain
| | - José-Luis Pérez-Arellano
- Unidad de Enfermedades Infecciosas y Medicina Tropical, Hospital Universitario Insular de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain
- Departamento de Ciencias Médicas y Quirúrgicas, Universidad de Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain
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Tiecco G, Degli Antoni M, Storti S, Tomasoni LR, Castelli F, Quiros-Roldan E. Monkeypox, a Literature Review: What Is New and Where Does This concerning Virus Come From? Viruses 2022; 14:v14091894. [PMID: 36146705 PMCID: PMC9501516 DOI: 10.3390/v14091894] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 08/22/2022] [Accepted: 08/24/2022] [Indexed: 12/13/2022] Open
Abstract
Among the Poxviridae family, orthopoxvirus is the most notorious genus. Several DNA viruses belonging to this group are known to produce human disease from the life-threatening variola virus (VARV) (the causative agent of smallpox), monkeypox virus (MPXV), cowpox virus (CPXV), and vaccinia virus (VACV). These orthopoxviruses still remain a public health concern as VACV or CPXV still cause emerging endemic threads, especially in developing countries. MPXV is able to cause sporadic human outbreaks of a smallpox-like zoonotic disease and, in May 2022, hundreds of cases related to MPXV have been reported from more than 30 countries around the globe. At the end of July, monkeypox (MPX) outbreak was even declared a global health emergency by the World Health Organization (WHO). Many aspects remain unclear regarding this outbreak and a deep understanding of orthopoxvirus might have crucial and evident implications. During the era in which people under 45 years old are not protected against VACV, the potential use of orthopoxviruses as a biological weapon raises global concern considering the rapid spreading of the current MPX outbreak in vulnerable populations. Hence, we review the most recent evidence about phylogenesis, pathogenesis, prevention, and treatment for this concerning disease.
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Affiliation(s)
- Giorgio Tiecco
- Department of Clinical and Experimental Sciences, Unit of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Melania Degli Antoni
- Department of Clinical and Experimental Sciences, Unit of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Samuele Storti
- Department of Clinical and Experimental Sciences, Unit of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Lina Rachele Tomasoni
- Unit of Infectious and Tropical Diseases, ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Francesco Castelli
- Department of Clinical and Experimental Sciences, Unit of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Eugenia Quiros-Roldan
- Department of Clinical and Experimental Sciences, Unit of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy
- Correspondence: ; Tel.: +39-0303995677
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Benites-Zapata VA, Ulloque-Badaracco JR, Alarcon-Braga EA, Hernandez-Bustamante EA, Mosquera-Rojas MD, Bonilla-Aldana DK, Rodriguez-Morales AJ. Clinical features, hospitalisation and deaths associated with monkeypox: a systematic review and meta-analysis. Ann Clin Microbiol Antimicrob 2022; 21:36. [PMID: 35948973 PMCID: PMC9364300 DOI: 10.1186/s12941-022-00527-1] [Citation(s) in RCA: 72] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 08/01/2022] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION A multicountry monkeypox disease (MPX) outbreak began in May 2022 in Europe, leading to the assessment as a potential Public Health Emergency of International Concern (PHEIC) on June 23, 2022. Some observational studies have partially characterised clinical features, hospitalisations, and deaths. However, no systematic reviews of this MPX outbreak have been published. METHODS We performed a systematic review with meta-analysis, using five databases to assess clinical features, hospitalisations, complications and deaths of MPX confirmed or probable cases. Observational studies, case reports and case series, were included. We performed a random-effects model meta-analysis to calculate the pooled prevalence and 95% confidence interval (95% CI). In addition, we carried out a subgroup analysis according to the continents and a sensitivity analysis excluding studies classified as having a high risk of bias. RESULTS A total of 19 articles were included, using only 12 articles in the quantitative synthesis (meta-analysis). For 1958 patients, rash (93%, 95% CI 80-100%), fever (72%, 95% CI 30-99%), pruritus (65%, 95% CI 47-81%), and lymphadenopathy (62%, 47-76%), were the most prevalent manifestations. Among the patients, 35% (95% CI 14-59%) were hospitalised. Some 4% (95% CI 1-9%) of hospitalised patients had fatal outcomes (case fatality rate, CFR). CONCLUSION MPX is spreading rapidly, with a third of hospitalised patients, but less than 5% with fatal outcomes. As this zoonotic virus spreads globally, countries must urgently prepare human resources, infrastructure and facilities to treat patients according to the emerging guidelines and the most reliable clinical information.
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Affiliation(s)
| | | | - Esteban A Alarcon-Braga
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú
- Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima, Perú
| | - Enrique A Hernandez-Bustamante
- Sociedad Científica de Estudiantes de Medicina de la Universidad Nacional de Trujillo, Trujillo, Perú
- Grupo Peruano de Investigación Epidemiológica, Unidad Para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Perú
| | - Melany D Mosquera-Rojas
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú
- Sociedad Científica de Estudiantes de Medicina de la Universidad Peruana de Ciencias Aplicadas, Lima, Perú
| | - D Katterine Bonilla-Aldana
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas, Pereira, Risaralda, Colombia
- Latin American Network of MOnkeypox VIrus Research (LAMOVI), Pereira, Risaralda, Colombia
| | - Alfonso J Rodriguez-Morales
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas, Pereira, Risaralda, Colombia.
- Latin American Network of MOnkeypox VIrus Research (LAMOVI), Pereira, Risaralda, Colombia.
- Master of Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Perú.
- Faculty of Medicine, Institución Universitaria Visión de las Américas, Pereira, Risaralda, Colombia.
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