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Gao S, Zeng Z, Xin Q, Yang M, Feng X, Liu X, Kan W, Chen F, Chen Y, Chen Z. Global transboundary transmission path and risk of Mpox revealed with Least Cost Path model. Int J Infect Dis 2024; 146:107101. [PMID: 38777082 DOI: 10.1016/j.ijid.2024.107101] [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: 02/15/2024] [Revised: 04/18/2024] [Accepted: 05/16/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVES The recent surge of Mpox outbreaks in multiple countries has garnered global attention. As of July 12, 2023, there have been 88,288 reported cases of Mpox worldwide. Although genetic variation was not found to be the cause of the epidemic outbreak, the reasons for its rapid spread remain unclear. METHODS Using the niche method, this study identified high-risk regions for Mpox and determined that human factors are the primary contributors to global risks. To further investigate, a travel network resistance surface was created based on various modes of transportation and was combined with sea, airline, highway, and railway routes to construct the least cost path for human travel networks in different risk areas. RESULTS The results indicated that high-risk regions for Mpox are mainly concentrated in Europe and the United States, with large risk ranges and high-risk values. The least cost path revealed three primary transmission paths rely on developed transportation networks, including internal transmission in North America, Europe-Africa, and Europe-Asia-Africa. These findings suggest that human activities, facilitated by developed travel networks, remain the main contributing factor to the spread. CONCLUSIONS In summary, based on the Mpox epidemic report, this study conducted risk prediction and driving factor analysis on Mpox. The research results indicate that human use of transportation for long-distance activities is a key factor leading to the rapid spread of the virus. Subsequently, we focused on studying the global transmission pathways of Mpox and revealed several transmission pathways with high global population migration rates by constructing the LCPs between different high-risk areas. This study also emphasizes the importance of applying early monitoring data of Mpox to model risk prediction in controlling emerging infectious diseases, providing a new perspective for controlling Mpox and similar diseases.
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Affiliation(s)
- Shan Gao
- NMPA Key Laboratory for Quality Monitoring and Evaluation of Vaccines and Biological Products, One Health Center of Excellence for Research and Training, School of Public Health, Sun Yat-Sen University, Guangzhou, PR China
| | - Zan Zeng
- Department of Vascular Surgery, Third Affiliated Hospital of the Navy Medical University, Shanghai, PR China
| | - Qing Xin
- Key Laboratory of Livestock Infectious Diseases, Ministry of Education, Shenyang Agricultural University, Shenyang, Liaoning Province, PR China
| | - Mingwei Yang
- NMPA Key Laboratory for Quality Monitoring and Evaluation of Vaccines and Biological Products, One Health Center of Excellence for Research and Training, School of Public Health, Sun Yat-Sen University, Guangzhou, PR China
| | - Xiangning Feng
- NMPA Key Laboratory for Quality Monitoring and Evaluation of Vaccines and Biological Products, One Health Center of Excellence for Research and Training, School of Public Health, Sun Yat-Sen University, Guangzhou, PR China
| | - Xinrui Liu
- NMPA Key Laboratory for Quality Monitoring and Evaluation of Vaccines and Biological Products, One Health Center of Excellence for Research and Training, School of Public Health, Sun Yat-Sen University, Guangzhou, PR China
| | - Wei Kan
- Animal Disease Prevention and Control Center in Qinghai Province, Xining, China
| | - Fangyuan Chen
- The Second Geomatics Cartography Institute of National Administration of Ministry of Natural Resources, Harbin, Heilongjiang Province, PR China
| | - Yiyu Chen
- Department of Medical Administration, Guangdong Second Provincial General Hospital, Guangzhou, PR China
| | - Zeliang Chen
- NMPA Key Laboratory for Quality Monitoring and Evaluation of Vaccines and Biological Products, One Health Center of Excellence for Research and Training, School of Public Health, Sun Yat-Sen University, Guangzhou, PR China; Key Laboratory of Livestock Infectious Diseases, Ministry of Education, Shenyang Agricultural University, Shenyang, Liaoning Province, PR China; Key Laboratory of Zoonose Prevention and Control at Universities of Inner Mongolia Autonomous Region, Innovative Institute of Zoonoses, Inner Mongolia Minzu University, Tongliao, PR China.
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Reques L, Mercuriali L, Silué Y, Chazelle E, Spaccaferri G, Velter A, Mailles A, Frange P, Tarantola A. Mpox in children and adolescents and contact follow-up in school settings in greater Paris, France, May 2022 to July 2023. Euro Surveill 2024; 29:2300555. [PMID: 38785093 PMCID: PMC11128737 DOI: 10.2807/1560-7917.es.2024.29.21.2300555] [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: 10/13/2023] [Accepted: 01/23/2024] [Indexed: 05/25/2024] Open
Abstract
BackgroundDuring the 2022 mpox outbreak in Europe, primarily affecting men who have sex with men, a limited number of cases among children and adolescents were identified. Paediatric cases from outbreaks in endemic countries have been associated with a higher likelihood of severe illness. Detailed clinical case descriptions and interventions in school settings before 2022 are limited.AimTo describe clinical characteristics of mpox cases among children (< 15 years) and adolescents (15-17 years) in the greater Paris area in France, and infection control measures in schools.MethodsWe describe all notified laboratory-confirmed and non-laboratory-confirmed cases among children and adolescents identified from May 2022 to July 2023, including demographic and clinical characterisation and infection control measures in school settings, i.e. contact tracing, contact vaccination, secondary attack rate and post-exposure vaccination uptake.ResultsNineteen cases were notified (13 children, 6 adolescents). Four adolescent cases reported sexual contact before symptom onset. Ten child cases were secondary cases of adult patients; three cases were cryptic, with vesicles on hands, arms and/or legs and one case additionally presented with genitoanal lesions. Five cases attended school during their infectious period, with 160 at-risk contacts identified, and one secondary case. Five at-risk contacts were vaccinated following exposure.ConclusionCases among children and adolescents are infrequent but require a careful approach to identify the source of infection and ensure infection control measures. We advocate a 'contact warning' strategy vs 'contact tracing' in order to prevent alarm and stigma. Low post-exposure vaccination rates are expected.
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Affiliation(s)
- Laura Reques
- Health Surveillance and Safety Department, Regional Health Agency in the Île-de-France Region (Agence Régionale de Santé d'Île-de-France), Saint-Denis, France
| | - Lilas Mercuriali
- Health Surveillance and Safety Department, Regional Health Agency in the Île-de-France Region (Agence Régionale de Santé d'Île-de-France), Saint-Denis, France
| | | | - Emilie Chazelle
- Santé publique France, the national public health agency, Saint-Maurice, France
| | | | - Annie Velter
- Santé publique France, the national public health agency, Saint-Maurice, France
| | - Alexandra Mailles
- Santé publique France, the national public health agency, Saint-Maurice, France
| | - Pierre Frange
- Infection Control Unit, Laboratory of Clinical Microbiology, Necker - Enfants malades Hospital, AP-HP, Université Paris Cité, Paris, France
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Lucero-Obusan C, Oda G, Schirmer P, Edson C, Trevino C, Elbeik T, Holodniy M. Epidemiology of the 2022 Mpox Outbreak in the US Veterans Health Administration. J Infect Dis 2024; 229:S172-S180. [PMID: 38134309 DOI: 10.1093/infdis/jiad600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 12/15/2023] [Accepted: 12/20/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND In May 2022, mpox cases were reported in nonendemic countries, including the United States. We examined mpox infections in the Veterans Health Administration (VHA). METHODS Mpox diagnostic and whole genome sequencing (WGS) results, demographics, risk factors, hospitalizations, exposures, deaths, and pharmacy and immunization data were obtained from VHA data sources (23 May 2022-31 May 2023). RESULTS Of 1144 Veterans tested, 251 (21.9%) were presumptive positive for nonvariola orthopoxvirus (NVO) or confirmed positive for NVO and Monkeypox virus (MPXV). Incidence rate was 7.5 per 100 000 Veterans in care, with the highest rate observed in Veterans aged 25-34 years (13.83 cases per 100 000). Higher odds of NVO or NVO/MPXV positivity was associated with male sex; non-Hispanic Black race/ethnicity; syphilis or human immunodeficiency virus (HIV) positivity; or genital/rectal sample site, whereas older age and vaccination with JYNNEOS or vaccinia (smallpox) had lower odds. Among 209 with confirmatory testing, 90.4% reported intimate contact and/or an epidemiological link, 84.5% were men who have sex with men (MSM), 24.2% received tecovirimat, and 8.1% were hospitalized with 1 death. Eighty-six sequenced samples had evaluable WGS results. All were clade IIb, representing 10 different lineages from 20 states and the District of Columbia. CONCLUSIONS Mpox affected younger, MSM, non-Hispanic Black, and HIV/syphilis-positive men among US Veterans. Viral diversity was noted across geographic regions. At-risk Veterans would benefit from vaccination and risk reduction strategies for mpox and other sexually transmitted infections.
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Affiliation(s)
- Cynthia Lucero-Obusan
- Public Health National Program Office, US Department of Veterans Affairs, Washington, District of Columbia
- National Public Health Reference Laboratory, US Department of Veterans Affairs, Palo Alto, California
| | - Gina Oda
- Public Health National Program Office, US Department of Veterans Affairs, Washington, District of Columbia
- National Public Health Reference Laboratory, US Department of Veterans Affairs, Palo Alto, California
| | - Patricia Schirmer
- Public Health National Program Office, US Department of Veterans Affairs, Washington, District of Columbia
- National Public Health Reference Laboratory, US Department of Veterans Affairs, Palo Alto, California
| | - Connor Edson
- Public Health National Program Office, US Department of Veterans Affairs, Washington, District of Columbia
- National Public Health Reference Laboratory, US Department of Veterans Affairs, Palo Alto, California
| | - Christina Trevino
- Public Health National Program Office, US Department of Veterans Affairs, Washington, District of Columbia
- National Public Health Reference Laboratory, US Department of Veterans Affairs, Palo Alto, California
| | - Tarek Elbeik
- Public Health National Program Office, US Department of Veterans Affairs, Washington, District of Columbia
- National Public Health Reference Laboratory, US Department of Veterans Affairs, Palo Alto, California
| | - Mark Holodniy
- Public Health National Program Office, US Department of Veterans Affairs, Washington, District of Columbia
- National Public Health Reference Laboratory, US Department of Veterans Affairs, Palo Alto, California
- Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, California
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Ejaz M, Jabeen M, Sharif M, Syed MA, Shah PT, Faryal R. Human monkeypox: An updated appraisal on epidemiology, evolution, pathogenesis, clinical manifestations, and treatment strategies. J Basic Microbiol 2024; 64:e2300455. [PMID: 37867205 DOI: 10.1002/jobm.202300455] [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: 08/07/2023] [Revised: 09/13/2023] [Accepted: 10/04/2023] [Indexed: 10/24/2023]
Abstract
Monkeypox (Mpox) is a zoonotic viral disease caused by the monkeypox virus (MPXV), a member of the Orthopoxvirus genus. The recent occurrence of Mpox infections has become a significant global issue in recent months. Despite being an old disease with a low mortality rate, the ongoing multicountry outbreak is atypical due to its occurrence in nonendemic countries. The current review encompasses a comprehensive analysis of the literature pertaining to MPXV, with the aim of consolidating the existing data on the virus's epidemiological, biological, and clinical characteristics, as well as vaccination and treatment regimens against the virus.
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Affiliation(s)
- Mohammad Ejaz
- Department of Microbiology, Government Postgraduate College Mandian, Abbottabad, Pakistan
- Department of Microbiology, Quaid-i-Azam University, Islamabad, Pakistan
| | - Momina Jabeen
- National Center for Bioinformatics, Quaid-i-Azam University, Islamabad, Pakistan
| | - Mehmoona Sharif
- Department of Microbiology, Quaid-i-Azam University, Islamabad, Pakistan
| | - Muhammad Ali Syed
- Department of Microbiology, The University of Haripur, Haripur, Pakistan
| | - Pir T Shah
- Institute of Biomedical Sciences, Shanxi University, Taiyuan, Shanxi, China
| | - Rani Faryal
- Department of Microbiology, Quaid-i-Azam University, Islamabad, Pakistan
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Adam PCG, Op de Coul ELM, Zantkuijl P, Xiridou M, Bos H, Blom C, Ketsuwan I, te Wierik MJM, David S, de Wit JBF. A survey-based assessment of rates and covariates of mpox diagnosis and vaccination provides evidence to refine eligibility criteria for mpox vaccination among gay, bisexual and other men who have sex with men in the Netherlands. Front Public Health 2024; 12:1194844. [PMID: 38351958 PMCID: PMC10861664 DOI: 10.3389/fpubh.2024.1194844] [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: 03/27/2023] [Accepted: 01/04/2024] [Indexed: 02/16/2024] Open
Abstract
Background The 2022 multicountry mpox outbreaks predominantly affected gay, bisexual and other men who have sex with men (GBMSM) in non-endemic countries, including in the Netherlands. We conducted a survey-based assessment of the alignment between the risk factors associated with mpox diagnosis among GBMSM in the Netherlands and the eligibility criteria used in 2022 for vaccinating this group, with the aim to refine these criteria. Methods An online self-report survey was conducted among adult GBMSM in the Netherlands between 29 July and 30 August 2022, corresponding to the first month of the Dutch mpox vaccination campaign. GBMSM were recruited via advertisements on social media and gay dating apps. Participants reported on their sexual behaviour, mpox diagnosis, and/or (initial) mpox vaccination since the start of the outbreak. Covariables of mpox diagnosis and vaccination were assessed using logistic regression analyses. Results Of the 2,460 participants, 73 (3.0%, 95% CI 2.3-3.6%) were diagnosed with mpox and 485 (19.7%, 95% CI 18.1-21.3%) had received (initial) mpox vaccination. Using sample weighting, we estimated that, of the GBMSM population aged 18-80 years in the Netherlands, 1.1% (95% CI 0.7-1.6%) had been diagnosed with mpox and 7.8% (95% CI 6.8-8.9%) had received (initial) vaccination. HIV-PrEP use, living with HIV, reporting ≥20 sex partners in the past 12 months, and sex in sex venues/parties in the past 2 months were independent risk factors for mpox diagnosis. Except for sex in sex venues/parties, these variables were also independently associated with mpox vaccination. Conclusion This study provides novel evidence regarding the degree to which the 2022 eligibility criteria for mpox vaccination align with the risk factors for mpox among GBMSM in the Netherlands. The findings contribute to a refinement of the eligibility criteria for mpox vaccination, to which sex in sex venues/parties should be added.
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Affiliation(s)
- Philippe C. G. Adam
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, Australia
- Institute for Prevention and Social Research (IPSR Utrecht), Utrecht, Netherlands
- IPSR Bangkok, Bangkok, Thailand
| | | | | | - Maria Xiridou
- National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Hanna Bos
- Soa Aids Nederland, Amsterdam, Netherlands
| | - Cor Blom
- Soa Aids Nederland, Amsterdam, Netherlands
| | | | | | - Silke David
- National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - John B. F. de Wit
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, Netherlands
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Dou X, Li F, Ren Z, Zhang D, Li J, Li D, Sun Y, Jin H, Li R, Li W, Zhang X, Yang Y, Jia L, Han Y, Li W, Pan Y, Tan W, Yang P, Wang Q. Clinical, epidemiological, and virological features of Mpox in Beijing, China - May 31-June 21, 2023. Emerg Microbes Infect 2023; 12:2254407. [PMID: 37649257 PMCID: PMC10494722 DOI: 10.1080/22221751.2023.2254407] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/27/2023] [Accepted: 08/28/2023] [Indexed: 09/01/2023]
Abstract
The first locally acquired case in the Chinese mainland was reported on May 31, 2023, lagging behind other countries. In this study, we aimed to examine the early clinical and epidemiological characteristics of the earliest cases of Mpox in Beijing, China. Additionally, we investigated the sequence and transmission patterns of the Mpox virus (MPXV). We analyzed 37 reported cases of Mpox in Beijing from May 31, 2023 to June 21, 2023. The age range of the subjects was 24-51 years. Thirty-six cases (97.3%) were identified in men who have sex with men (MSM), and 19 cases (51.4%) tested positive for the human immunodeficiency virus. Thirty-three cases were symptomatic, while four were asymptomatic. Skin lesions were observed in 32 cases (97.0%), fever in 26 (78.8%), and swollen lymph nodes in 17 (51.5%). Rash typically appeared in the genital or perianal area 1-3 days before fever onset, with a minimum incubation period of 2 days. For individuals with skin rashes, the skin lesion samples showed 100% positivity and low Ct values. There were high oropharyngeal swab (75.8%) and blood (84.6%) positivity rates. All MPXV strains belonged to the B.1.3 branch of the West African lineage. These strains carried 76-86 nucleotide substitutions compared with the reference human MPXV genome, and genetic diversity was observed. Our findings provide the first insights into the landscape of early transmission of Mpox in Beijing and help inform policy formulation in the Chinese mainland.
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Affiliation(s)
- Xiangfeng Dou
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, People’s Republic of China
| | - Fu Li
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, People’s Republic of China
| | - Zhenyong Ren
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, People’s Republic of China
| | - Daitao Zhang
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, People’s Republic of China
| | - Jia Li
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, People’s Republic of China
| | - Dan Li
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, People’s Republic of China
| | - Yulan Sun
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, People’s Republic of China
| | - Haoyuan Jin
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, People’s Republic of China
| | - Renqing Li
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, People’s Republic of China
| | - Weihong Li
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, People’s Republic of China
| | - Xin Zhang
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, People’s Republic of China
| | - Yang Yang
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, People’s Republic of China
| | - Lei Jia
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, People’s Republic of China
| | - Yu Han
- Department of Dermatology, Civil Aviation General Hospital, Beijing, People’s Republic of China
| | - Wai Li
- Beijing Fangshan District Center for Disease Prevention and Control, Beijing, People’s Republic of China
| | - Yang Pan
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, People’s Republic of China
| | - Wenjie Tan
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Peng Yang
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, People’s Republic of China
| | - Quanyi Wang
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, People’s Republic of China
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De la Herrán-Arita AK, González-Galindo C, Inzunza-Leyva GK, Valdez-Flores MA, Norzagaray-Valenzuela CD, Camacho-Zamora A, Batiz-Beltrán JC, Urrea-Ramírez FJ, Romero-Utrilla A, Angulo-Rojo C, Guadrón-Llanos AM, Picos-Cárdenas VJ, Camberos-Barraza J, Rábago-Monzón ÁR, Osuna-Ramos JF. Clinical Predictors of Monkeypox Diagnosis: A Case-Control Study in a Nonendemic Region during the 2022 Outbreak. Microorganisms 2023; 11:2287. [PMID: 37764131 PMCID: PMC10535336 DOI: 10.3390/microorganisms11092287] [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: 07/24/2023] [Revised: 08/24/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
Monkeypox (Mpox) is an emerging zoonotic disease with the potential for severe complications. Early identification and diagnosis are essential to prompt treatment, control its spread, and reduce the risk of human-to-human transmission. This study aimed to develop a clinical diagnostic tool and describe the clinical and sociodemographic features of 19 PCR-confirmed Mpox cases during an outbreak in a nonendemic region of northwestern Mexico. The median age of patients was 35 years, and most were male. Mpox-positive patients commonly reported symptoms such as fever, lumbago, and asthenia, in addition to experiencing painful ulcers and a high frequency of HIV infection among people living with HIV (PLWH). Two diagnostic models using logistic regression were devised, with the best model exhibiting a prediction accuracy of 0.92 (95% CI: 0.8-1), a sensitivity of 0.86, and a specificity of 0.93. The high predictive values and accuracy of the top-performing model highlight its potential to significantly improve early Mpox diagnosis and treatment in clinical settings, aiding in the control of future outbreaks.
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Affiliation(s)
- Alberto Kousuke De la Herrán-Arita
- Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán Rosales 80019, Sinaloa, Mexico; (A.K.D.l.H.-A.); (M.A.V.-F.); (A.C.-Z.); (J.C.B.-B.); (F.J.U.-R.); (C.A.-R.); (A.M.G.-L.); (V.J.P.-C.); (Á.R.R.-M.)
| | | | - Gerardo Kenny Inzunza-Leyva
- Dirección de Prevención y Promoción de la Salud, Secretaría de Salud de Sinaloa, Culiacán Rosales 80020, Sinaloa, Mexico;
| | - Marco Antonio Valdez-Flores
- Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán Rosales 80019, Sinaloa, Mexico; (A.K.D.l.H.-A.); (M.A.V.-F.); (A.C.-Z.); (J.C.B.-B.); (F.J.U.-R.); (C.A.-R.); (A.M.G.-L.); (V.J.P.-C.); (Á.R.R.-M.)
| | | | - Alejandro Camacho-Zamora
- Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán Rosales 80019, Sinaloa, Mexico; (A.K.D.l.H.-A.); (M.A.V.-F.); (A.C.-Z.); (J.C.B.-B.); (F.J.U.-R.); (C.A.-R.); (A.M.G.-L.); (V.J.P.-C.); (Á.R.R.-M.)
| | - José Candelario Batiz-Beltrán
- Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán Rosales 80019, Sinaloa, Mexico; (A.K.D.l.H.-A.); (M.A.V.-F.); (A.C.-Z.); (J.C.B.-B.); (F.J.U.-R.); (C.A.-R.); (A.M.G.-L.); (V.J.P.-C.); (Á.R.R.-M.)
- Hospital Regional Dr. Manuel Cárdenas de la Vega, ISSSTE, Culiacán Rosales 80230, Sinaloa, Mexico
| | - Francisco Javier Urrea-Ramírez
- Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán Rosales 80019, Sinaloa, Mexico; (A.K.D.l.H.-A.); (M.A.V.-F.); (A.C.-Z.); (J.C.B.-B.); (F.J.U.-R.); (C.A.-R.); (A.M.G.-L.); (V.J.P.-C.); (Á.R.R.-M.)
- Hospital Regional Dr. Manuel Cárdenas de la Vega, ISSSTE, Culiacán Rosales 80230, Sinaloa, Mexico
| | - Alejandra Romero-Utrilla
- Departamento de Anatomía Patológica, Instituto Mexicano del Seguro Social, Culiacán Rosales 80230, Sinaloa, Mexico
| | - Carla Angulo-Rojo
- Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán Rosales 80019, Sinaloa, Mexico; (A.K.D.l.H.-A.); (M.A.V.-F.); (A.C.-Z.); (J.C.B.-B.); (F.J.U.-R.); (C.A.-R.); (A.M.G.-L.); (V.J.P.-C.); (Á.R.R.-M.)
- Maestría en Ciencias en Biomedicina Molecular, Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán Rosales 80019, Sinaloa, Mexico
| | - Alma Marlene Guadrón-Llanos
- Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán Rosales 80019, Sinaloa, Mexico; (A.K.D.l.H.-A.); (M.A.V.-F.); (A.C.-Z.); (J.C.B.-B.); (F.J.U.-R.); (C.A.-R.); (A.M.G.-L.); (V.J.P.-C.); (Á.R.R.-M.)
- Doctorado en Ciencias en Biomedicina Molecular, Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán Rosales 80019, Sinaloa, Mexico
| | - Verónica Judith Picos-Cárdenas
- Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán Rosales 80019, Sinaloa, Mexico; (A.K.D.l.H.-A.); (M.A.V.-F.); (A.C.-Z.); (J.C.B.-B.); (F.J.U.-R.); (C.A.-R.); (A.M.G.-L.); (V.J.P.-C.); (Á.R.R.-M.)
| | - Josué Camberos-Barraza
- Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán Rosales 80019, Sinaloa, Mexico; (A.K.D.l.H.-A.); (M.A.V.-F.); (A.C.-Z.); (J.C.B.-B.); (F.J.U.-R.); (C.A.-R.); (A.M.G.-L.); (V.J.P.-C.); (Á.R.R.-M.)
| | - Ángel Radamés Rábago-Monzón
- Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán Rosales 80019, Sinaloa, Mexico; (A.K.D.l.H.-A.); (M.A.V.-F.); (A.C.-Z.); (J.C.B.-B.); (F.J.U.-R.); (C.A.-R.); (A.M.G.-L.); (V.J.P.-C.); (Á.R.R.-M.)
| | - Juan Fidel Osuna-Ramos
- Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán Rosales 80019, Sinaloa, Mexico; (A.K.D.l.H.-A.); (M.A.V.-F.); (A.C.-Z.); (J.C.B.-B.); (F.J.U.-R.); (C.A.-R.); (A.M.G.-L.); (V.J.P.-C.); (Á.R.R.-M.)
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Zhu WF, Song SJ, Wei LW, Qiao JJ. Monkeypox presenting as a chancre-like rash: A case report. World J Clin Cases 2023; 11:6025-6030. [PMID: 37727494 PMCID: PMC10506028 DOI: 10.12998/wjcc.v11.i25.6025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/04/2023] [Accepted: 08/09/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Since May 2022, outbreaks of monkeypox have occurred in many countries around the world, and several cases have been reported in China. CASE SUMMARY A 38-year-old man presented with a small, painless, shallow ulcer on the coronary groove for 8 d. One day after the rash appeared, the patient developed inguinal lymphadenopathy with fever. The patient had a history of male-male sexual activity and denied a recent history of travel abroad. Monkeypox virus was detected by quantitative polymerase chain reaction from the rash site and throat swab. Based on the epidemiological history, clinical manifestations and nucleic acid test results, the patient was diagnosed with monkeypox. CONCLUSION Monkeypox is an emerging infectious disease in China. Monkeypox presenting as a chancre-like rash is easily misdiagnosed. Diagnosis can be made based on exposure history, clinical manifestations and nucleic acid test results.
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Affiliation(s)
- Wei-Fang Zhu
- Division of Dermatology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
| | - Shu-Juan Song
- Hangzhou Center of Disease Control and Prevention, Hangzhou Center of Disease Control and Prevention, Hangzhou 310000, Zhejiang Province, China
| | - Lin-Wei Wei
- Division of Dermatology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
| | - Jian-Jun Qiao
- Division of Dermatology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
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Martínez-Fernández DE, Fernández-Quezada D, Casillas-Muñoz FAG, Carrillo-Ballesteros FJ, Ortega-Prieto AM, Jimenez-Guardeño JM, Regla-Nava JA. Human Monkeypox: A Comprehensive Overview of Epidemiology, Pathogenesis, Diagnosis, Treatment, and Prevention Strategies. Pathogens 2023; 12:947. [PMID: 37513794 PMCID: PMC10384102 DOI: 10.3390/pathogens12070947] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/16/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
Monkeypox virus (MPXV) is an emerging zoonotic virus that belongs to the Orthopoxvirus genus and presents clinical symptoms similar to those of smallpox, such as fever and vesicular-pustular skin lesions. However, the differential diagnosis between smallpox and monkeypox is that smallpox does not cause lymphadenopathy but monkeypox generates swelling in the lymph nodes. Since the eradication of smallpox, MPXV has been identified as the most common Orthopoxvirus to cause human disease. Despite MPXV being endemic to certain regions of Africa, the current MPXV outbreak, which began in early 2022, has spread to numerous countries worldwide, raising global concern. As of the end of May 2023, over 87,545 cases and 141 deaths have been reported, with most cases identified in non-endemic countries, primarily due to human-to-human transmission. To better understand this emerging threat, this review presents an overview of key aspects of MPXV infection, including its animal reservoirs, modes of transmission, animal models, epidemiology, clinical and immunological features, diagnosis, treatments, vaccines, and prevention strategies. The material presented here provides a comprehensive understanding of MPXV as a disease, while emphasizing the significance and unique characteristics of the 2022 outbreak. This offers valuable information that can inform future research and aid in the development of effective interventions.
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Affiliation(s)
| | - David Fernández-Quezada
- Department of Neurosciences, University Center for Health Science (CUCS), University of Guadalajara, Guadalajara 44340, Mexico
| | | | | | - Ana Maria Ortega-Prieto
- Department of Microbiology, University of Málaga, 29010 Málaga, Spain
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29590 Málaga, Spain
| | - Jose M Jimenez-Guardeño
- Department of Microbiology, University of Málaga, 29010 Málaga, Spain
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, 29590 Málaga, Spain
| | - Jose Angel Regla-Nava
- Department of Microbiology and Pathology, University Center for Health Science (CUCS), University of Guadalajara, Guadalajara 44340, Mexico
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10
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Sorayaie Azar A, Naemi A, Babaei Rikan S, Bagherzadeh Mohasefi J, Pirnejad H, Wiil UK. Monkeypox detection using deep neural networks. BMC Infect Dis 2023; 23:438. [PMID: 37370031 DOI: 10.1186/s12879-023-08408-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 06/20/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND In May 2022, the World Health Organization (WHO) European Region announced an atypical Monkeypox epidemic in response to reports of numerous cases in some member countries unrelated to those where the illness is endemic. This issue has raised concerns about the widespread nature of this disease around the world. The experience with Coronavirus Disease 2019 (COVID-19) has increased awareness about pandemics among researchers and health authorities. METHODS Deep Neural Networks (DNNs) have shown promising performance in detecting COVID-19 and predicting its outcomes. As a result, researchers have begun applying similar methods to detect Monkeypox disease. In this study, we utilize a dataset comprising skin images of three diseases: Monkeypox, Chickenpox, Measles, and Normal cases. We develop seven DNN models to identify Monkeypox from these images. Two scenarios of including two classes and four classes are implemented. RESULTS The results show that our proposed DenseNet201-based architecture has the best performance, with Accuracy = 97.63%, F1-Score = 90.51%, and Area Under Curve (AUC) = 94.27% in two-class scenario; and Accuracy = 95.18%, F1-Score = 89.61%, AUC = 92.06% for four-class scenario. Comparing our study with previous studies with similar scenarios, shows that our proposed model demonstrates superior performance, particularly in terms of the F1-Score metric. For the sake of transparency and explainability, Local Interpretable Model-Agnostic Explanations (LIME) and Gradient-weighted Class Activation Mapping (Grad-Cam) were developed to interpret the results. These techniques aim to provide insights into the decision-making process, thereby increasing the trust of clinicians. CONCLUSION The DenseNet201 model outperforms the other models in terms of the confusion metrics, regardless of the scenario. One significant accomplishment of this study is the utilization of LIME and Grad-Cam to identify the affected areas and assess their significance in diagnosing diseases based on skin images. By incorporating these techniques, we enhance our understanding of the infected regions and their relevance in distinguishing Monkeypox from other similar diseases. Our proposed model can serve as a valuable auxiliary tool for diagnosing Monkeypox and distinguishing it from other related conditions.
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Affiliation(s)
| | - Amin Naemi
- Center for Health Informatics and Technology, The Maersk Mc-Kinney Moller Institute, University of Southern Denmark, Odense, Denmark
| | | | | | - Habibollah Pirnejad
- Patient Safety Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran
- Erasmus School of Health Policy & Management (ESHPM), Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Uffe Kock Wiil
- Center for Health Informatics and Technology, The Maersk Mc-Kinney Moller Institute, University of Southern Denmark, Odense, Denmark
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11
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Peruzzu D, Fecchi K, Venturi G, Gagliardi MC. Repurposing Amphotericin B and Its Liposomal Formulation for the Treatment of Human Mpox. Int J Mol Sci 2023; 24:ijms24108896. [PMID: 37240241 DOI: 10.3390/ijms24108896] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 05/12/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023] Open
Abstract
Mpox (monkeypox) is a zoonotic viral disease caused by the mpox virus (MPXV). Recently in 2022, a multi-country Mpox outbreak has determined great concern as the disease rapidly spreads. The majority of cases are being noticed in European regions and are unrelated to endemic travel or known contact with infected individuals. In this outbreak, close sexual contact appears to be important for MPXV transmission, and an increasing prevalence in people with multiple sexual partners and in men who have sex with men has been observed. Although Vaccinia virus (VACV)-based vaccines have been shown to induce a cross-reactive and protective immune response against MPXV, limited data support their efficacy against the 2022 Mpox outbreak. Furthermore, there are no specific antiviral drugs for Mpox. Host-cell lipid rafts are small, highly dynamic plasma-membrane microdomains enriched in cholesterol, glycosphingolipids and phospholipids that have emerged as crucial surface-entry platforms for several viruses. We previously demonstrated that the antifungal drug Amphotericin B (AmphB) inhibits fungal, bacterial and viral infection of host cells through its capacity to sequester host-cell cholesterol and disrupt lipid raft architecture. In this context, we discuss the hypothesis that AmphB could inhibit MPXV infection of host cells through disruption of lipid rafts and eventually through redistribution of receptors/co-receptors mediating virus entry, thus representing an alternative or additional therapeutic tool for human Mpox.
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Affiliation(s)
- Daniela Peruzzu
- Center for Gender-Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Katia Fecchi
- Center for Gender-Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Giulietta Venturi
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Maria Cristina Gagliardi
- Center for Gender-Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
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12
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Patel VM, Patel SV. Epidemiological Review on Monkeypox. Cureus 2023; 15:e34653. [PMID: 36895541 PMCID: PMC9991112 DOI: 10.7759/cureus.34653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2023] [Indexed: 02/07/2023] Open
Abstract
The significant increase in monkeypox cases that was reported at the beginning of 2022 was notable. The resurgence of viral zoonosis is especially concerning, given the current and recent COVID-19 epidemic. There are worries that a new pandemic may be beginning due to the virus that causes monkeypox spreading so quickly. This article aimed to provide an overview of the epidemiology, pathogenesis, and clinical symptoms of monkeypox. It has been known that monkeypox was primarily prevalent in Central and West Africa, but in recent years, cases of monkeypox infections have been reported around the world. The transmission of the infection to humans has been connected to exposure to a diseased animal or person's excretions and secretions. Various studies indicate that monkeypox clinically manifests as fever, fatigue, and a rash of smallpox-like lesions and can cause various complications, including pneumonia, encephalitis, and sepsis, which, when not properly managed, can lead to death. Those living in remote and forested areas, taking care of individuals infected with monkeypox, and trading and taking care of exotic animals are some of the risk factors for monkeypox. Men having sex with men are also at higher risk of contracting monkeypox. When dealing with individuals who have high-risk factors and come with new-onset progressive rashes, it is necessary for clinicians to highly suspect monkeypox. This review will serve as reference material and a supplement to the existing literature that will assist in the proper management and prevention of monkeypox.
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Affiliation(s)
| | - Shreya V Patel
- Internal Medicine, Brookwood Baptist Health, Birmingham, USA
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13
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Byareddy SN, Sharma K, Sachdev S, Reddy AS, Acharya A, Klaustermeier KM, Lorson CL, Singh K. Potential therapeutic targets for Mpox: the evidence to date. Expert Opin Ther Targets 2023; 27:419-431. [PMID: 37368464 PMCID: PMC10722886 DOI: 10.1080/14728222.2023.2230361] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 06/07/2023] [Accepted: 06/23/2023] [Indexed: 06/28/2023]
Abstract
INTRODUCTION The global Mpox (MPX) disease outbreak caused by the Mpox virus (MPXV) in 2022 alarmed the World Health Organization (WHO) and health regulation agencies of individual countries leading to the declaration of MPX as a Public Health Emergency. Owing to the genetic similarities between smallpox-causing poxvirus and MPXV, vaccine JYNNEOS, and anti-smallpox drugs Brincidofovir and Tecovirimat were granted emergency use authorization by the United States Food and Drug Administration. The WHO also included cidofovir, NIOCH-14, and other vaccines as treatment options. AREAS COVERED This article covers the historical development of EUA-granted antivirals, resistance to these antivirals, and the projected impact of signature mutations on the potency of antivirals against currently circulating MPXV. Since a high prevalence of MPXV infections in individuals coinfected with HIV and MPXV, the treatment results among these individuals have been included. EXPERT OPINION All EUA-granted drugs have been approved for smallpox treatment. These antivirals show good potency against Mpox. However, conserved resistance mutation positions in MPXV and related poxviruses, and the signature mutations in the 2022 MPXV can potentially compromise the efficacy of the EUA-granted treatments. Therefore, MPXV-specific medications are required not only for the current but also for possible future outbreaks.
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Affiliation(s)
- Siddappa N Byareddy
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | | | - Shrikesh Sachdev
- Bond Life Sciences Center, University of Missouri, Columbia, MO 65211, USA
| | - Athreya S. Reddy
- Bond Life Sciences Center, University of Missouri, Columbia, MO 65211, USA
| | - Arpan Acharya
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | | | - Christian L Lorson
- Bond Life Sciences Center, University of Missouri, Columbia, MO 65211, USA
- Department of Veterinary Pathobiology, University of Missouri, Columbia, MO 65211, USA
| | - Kamal Singh
- Department of Pharmaceutical Chemistry, DPSRU, New Delhi-110017
- Bond Life Sciences Center, University of Missouri, Columbia, MO 65211, USA
- Department of Veterinary Pathobiology, University of Missouri, Columbia, MO 65211, USA
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