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Mancon A, Raccagni AR, Gagliardi G, Moschese D, Rizzo A, Giacomelli A, Cutrera M, Salari F, Bracchitta F, Antinori S, Gori A, Rizzardini G, Castagna A, Gismondo MR, Nozza S, Mileto D. Evaluation of analytical performance of the STANDARD TM M10 MPX/OPX assay for the simultaneous DNA detection and clade attribution of Monkeypox virus. Emerg Microbes Infect 2024; 13:2337666. [PMID: 38572513 PMCID: PMC11018020 DOI: 10.1080/22221751.2024.2337666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 03/27/2024] [Indexed: 04/05/2024]
Abstract
Monkeypox virus (MPXV) infection confirmation needs reliable polymerase chain reaction (PCR) assays; in addition, viral clade attribution is a key factor in containment measures, considering a more severe syndrome in clade I and the possibility of simultaneous circulation. This study evaluates the performance of all-in-one STANDARD M10 MPX/OPX (SD BIOSENSOR, South Korea - M10). Frozen samples from 205 subjects were selected and stratified according to routine test results (RealStar® Orthopoxvirus PCR Kit 1.0, Altona DIAGNOTICS, Germany - RS; RS-1): in detail, 100 negative skin lesions (SL) and 200 positive samples at the variable stage of infection were analysed. Positive samples were retested with RS (RS-2). Positive and Negative Percent Agreements (PPA, NPA) were calculated. The median (IQR) Ct values of RS and M10 (OPXV target) assays were highly similar. The PPA of M10 compared to RS-1 was 89.5% considering system interpretation, and 96.0% when the operator classified results as positive if any target was detected; NPA was 100%. Comparing the RS-2 run and M10, an overall concordance of 95.3% between assays was found; however, considering operator interpretation, M10 returned more positive results than RS-2. The occurrence of False-Negative results was likely associated with the influence of thawing on low viral concentration; no False-Positive tests were observed. All samples collected at the time of Mpox diagnosis were positive and M10 correctly attributed the clade (West-Africa/II). The M10 MPX/OPX assay demonstrated high reliability in confirming MPXV infection and clade attribution.
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Affiliation(s)
- Alessandro Mancon
- Laboratory of Clincal Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, Milan, Italy
| | | | | | - Davide Moschese
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Alberto Rizzo
- Laboratory of Clincal Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Andrea Giacomelli
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | | | | | | | - Spinello Antinori
- University of Milan, Milan, Italy
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Andrea Gori
- University of Milan, Milan, Italy
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Giuliano Rizzardini
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Antonella Castagna
- Vita-Salute San Raffaele University, Milan, Italy
- Department of Infectious Diseases, San Raffaele Hospital, Milan, Italy
| | - Maria Rita Gismondo
- Laboratory of Clincal Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, Milan, Italy
- University of Milan, Milan, Italy
| | - Silvia Nozza
- Vita-Salute San Raffaele University, Milan, Italy
| | - Davide Mileto
- Laboratory of Clincal Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco, Milan, Italy
- CNR-SCITEC, Istituto di Scienze e Tecnologie Chimiche “Giulio Natta”, via C. Golgi 19, 20133Milan, Italy
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Paparini S, Whelan I, Mwendera C, Hayes R, Maatouk I, Lewis R, Prochazka Nunez M, Mozalevskis A, Wi T, Orkin C. Prevention of sexual transmission of mpox: a systematic review and qualitative evidence synthesis of approaches. Infect Dis (Lond) 2024:1-17. [PMID: 38958049 DOI: 10.1080/23744235.2024.2364801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 06/03/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND The ongoing multi-country mpox outbreak in previously unaffected countries is primarily affecting sexual networks of men who have sex with men. Evidence is needed on the effectiveness of recommended preventive interventions. To inform WHO guidelines, a systematic review and qualitative evidence synthesis were conducted on mpox preventive behavioural interventions to reduce: (i) sexual acquisition; (ii) onward sexual transmission from confirmed/probable cases; and (iii) utility of asymptomatic testing. METHODS Medline, EMBASE, PubMed, Cochrane and WHO trial databases, grey literature and conferences were searched for English-language primary research published since 1 January 2022. A reviewer team performed screening, data extraction and bias assessment. A qualitative thematic synthesis explored views and experiences of engagement in prevention in individuals at increased risk. RESULTS There were 16 studies: 1 on contact-tracing, 2 on sexual behaviour, and 13 on asymptomatic testing. Although MPXV was detected in varying proportions of samples (0.17%-6.5%), the testing studies provide insufficient evidence to fully evaluate this strategy. For the qualitative evidence synthesis, four studies evaluated the experiences of most affected communities. Preferences about preventive interventions were shaped by: mpox information; the diversity of sexual practices; accessibility and quality of mpox testing and care; and perceived cost to wellbeing. CONCLUSIONS Evidence on the effectiveness of interventions to prevent the sexual transmission of mpox remains scarce. Limited qualitative evidence on values and preferences provides insight into factors influencing intervention acceptability. Given global and local inequities in access to vaccines and treatment, further research is needed to establish the effectiveness of additional interventions.
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Affiliation(s)
- Sara Paparini
- SHARE Collaborative, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Isabelle Whelan
- SHARE Collaborative, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
- Department of Infection and Immunity, Barts Health NHS Trust, London, UK
| | - Chikondi Mwendera
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Rosalie Hayes
- SHARE Collaborative, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Ismael Maatouk
- Department of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland
| | - Rosamund Lewis
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Mateo Prochazka Nunez
- Department of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland
| | - Antons Mozalevskis
- Department of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland
| | - Teodora Wi
- Department of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland
| | - Chloe Orkin
- SHARE Collaborative, Blizard Institute, Queen Mary University of London, London, UK
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Boehm E, Summermatter K, Kaiser L. Orthopox viruses: is the threat growing? Clin Microbiol Infect 2024; 30:883-887. [PMID: 38387500 DOI: 10.1016/j.cmi.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/09/2024] [Accepted: 02/14/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Smallpox was a major cause of human mortality until its eradication, but the threat of orthopox viruses has not disappeared. Since the eradication of smallpox and the cessation of the related vaccination campaigns, the threat has been growing, as evidenced by the currently ongoing worldwide Mpox outbreak. In addition to threats of an evolving Mpox, we must also be aware of a myriad of other threats that remain. Many countries still lack biosecurity regulations reflecting the recent technological advances, and the threat of bioterrorism remains ever present. Reconstruction of smallpox is a distinct possibility, as are other scenarios whereby other orthopox viruses may be made more fit for transmission in humans. OBJECTIVES To outline and discuss potential biosafety and biosecurity threats posed by orthopox viruses. SOURCES Published scientific literature, news articles, and international agreements. CONTENT AND IMPLICATIONS It would be wise to take steps to mitigate these threats now. Vaccination campaigns should be considered in areas with frequent orthopox outbreaks, and more efforts must be made to put a final end to the Mpox outbreak. In many countries, national biosafety and biosecurity regulations may need to be revised and strengthened to better reflect the threats posed by new technologies, including controls on synthesis of smallpox sequences. Furthermore, more international cooperation and aid is needed. The present global Mpox outbreak could likely have been prevented had areas where Mpox is endemic not been neglected. Future outbreaks could be much worse.
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Affiliation(s)
- Erik Boehm
- Centre for Emerging Viral Diseases, Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland.
| | | | - Laurent Kaiser
- Centre for Emerging Viral Diseases, Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
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Obermeier PE, Plinke CF, Brinkmann A, Lachmann R, Melchert J, Corman VM, Nitsche A, Marcus U, Schmidt AJ, Jansen K, Buder SC. Reemergence of Clade IIb-Associated Mpox, Germany, July-December 2023. Emerg Infect Dis 2024; 30:1416-1419. [PMID: 38916584 PMCID: PMC11210634 DOI: 10.3201/eid3007.240092] [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] [Indexed: 06/26/2024] Open
Abstract
In July 2023, clade IIb-associated mpox reemerged in Germany at low levels, mainly affecting men who have sex with men. We report a representative case and phylogeny of available genome sequences. Our findings underscore the need for standardized surveillance and indication-based vaccination to limit transmission and help prevent endemicity.
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Pischel L, Martini BA, Yu N, Cacesse D, Tracy M, Kharbanda K, Ahmed N, Patel KM, Grimshaw AA, Malik AA, Goshua G, Omer SB. Vaccine effectiveness of 3rd generation mpox vaccines against mpox and disease severity: A systematic review and meta-analysis. Vaccine 2024:S0264-410X(24)00694-7. [PMID: 38906763 DOI: 10.1016/j.vaccine.2024.06.021] [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: 02/28/2024] [Revised: 06/05/2024] [Accepted: 06/06/2024] [Indexed: 06/23/2024]
Abstract
INTRODUCTION Before the global mpox outbreak which began in 2022, the real-world vaccine effectiveness (VE) of mpox vaccines was unknown. We quantified the VE in the global population of 3rd generation or later mpox vaccines (MVA-BN, LC16m8, OrthopoxVac) compared with unvaccinated or other vaccinated states for infection, hospitalization and death. VE was stratified by 1-dose and 2-doses and post-exposure prophylaxis (PEP). METHODS Studies were included if they measured vaccine efficacy or effectiveness in humans. Animal studies and immunogenicity studies were excluded. MEDLINE, Web of Science, Google Scholar, Embase, MedRxiv and grey literature were searched from January 1st, 1970, with the last search run on November 3, 2023 (Prospero, CRD42022345240). Risk of publication bias was assessed via funnel plots and Egger's test, and study quality via Newcastle-Ottawa scales. RESULTS A total of 11,892 records were identified via primary search, 3,223 via citation chasing. Thirty-three studies were identified of 3rd generation vaccines, 32 of which were MVA-BN. Two additional studies were re-analysis of existing data. Most of these studies were focused on gay, bisexual, or other men who have sex with men between the ages of 18-49 in May to October of 2022. VE of 1 dose of MVA-BN was 76% (95%CI 64-88%) from twelve studies. VE of 2 doses was 82% (95%CI 72-92%) from six studies. VE of MVA-BN PEP against mpox was 20% (95%CI -24-65%) from seven studies. All VE are calculated from random effects estimates. 18/33(55%) studies were rated as poor, 3/33(9%) as fair and 12/33(36%) as good. Studies included in the meta-analysis had higher quality: 11/16 (69%) were rated as good quality. CONCLUSION Both 1 and 2 doses of MVA-BN are highly effective at preventing mpox. Effectiveness estimates, specifically of PEP are limited by immortal time bias, predominant mode of mpox transmission, and real-world vaccine timing of administration.
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Affiliation(s)
- Lauren Pischel
- Yale School of Medicine, Section of Infectious Diseases, New Haven, CT, USA.
| | | | - Natalle Yu
- Yale School of Medicine, Department of Internal Medicine, New Haven, CT, USA
| | | | - Mahder Tracy
- Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern, Dallas, TX, USA
| | - Kolambi Kharbanda
- Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern, Dallas, TX, USA
| | - Noureen Ahmed
- Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern, Dallas, TX, USA
| | - Kavin M Patel
- Yale School of Medicine, Section of Infectious Diseases, New Haven, CT, USA
| | - Alyssa A Grimshaw
- Yale University, Harvey Cushing/John Hay Whitney Medical Library, New Haven, CT, USA
| | - Amyn A Malik
- Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern, Dallas, TX, USA
| | - George Goshua
- Yale School of Medicine, Section of Hematology, Department of Internal Medicine and Yale Cancer Center, New Haven, CT, USA; Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT, USA
| | - Saad B Omer
- Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern, Dallas, TX, USA
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Mbala-Kingebeni P, Rimoin AW, Kacita C, Liesenborghs L, Nachega JB, Kindrachuk J. The time is now (again) for mpox containment and elimination in Democratic Republic of the Congo. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003171. [PMID: 38848376 PMCID: PMC11161050 DOI: 10.1371/journal.pgph.0003171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2024]
Affiliation(s)
- Placide Mbala-Kingebeni
- Pathogen Genomics Laboratory, Epidemiology and Global Health Department, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
- Service de Microbiologie, Cliniques Universitaires, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Anne W. Rimoin
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, United States of America
- UCLA-DRC Health Research and Training Program, UCLA Fielding School of Public Health, Los Angeles, California, United States of America
| | - Cris Kacita
- Monkeypox and Viral Hemorrhagic Fever Control Program, Ministry of Public Health, Kinshasa, Democratic Republic of the Congo
| | - Laurens Liesenborghs
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Jean B. Nachega
- Departments of Epidemiology, Infectious Diseases and Microbiology and Center for Global Health, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, United States of America
- Departments of Epidemiology and International Health, Johns Hopkins Bloomberg School of Public Health, Center for Global Health, Johns Hopkins University Baltimore, Baltimore, Maryland, United States of America
- Department of Medicine, Division of Infectious Diseases, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, South Africa
| | - Jason Kindrachuk
- Department of Medical Microbiology & Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
- Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
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Berdahl CT, Krishnadasan A, Pathmarajah K, Moran GJ, Torres JR, Waxman M, Mower W, Garner OB, Duvergne LP, Rimoin AW, Gorbach PM, Talan DA. Mpox Surveillance Based on Rash Characteristics - 13 Emergency Departments, United States, June-December 2023. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2024; 73:507-513. [PMID: 38843078 PMCID: PMC11166258 DOI: 10.15585/mmwr.mm7322a1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
In 2022, a global mpox outbreak occurred, primarily affecting gay and bisexual men who have sex with men (GBMSM). To screen for mpox's reemergence and investigate potentially unsuspected cases among non-GBMSM, prospective surveillance of patients aged ≥3 months with an mpox-compatible rash (vesicular, pustular, ulcerated, or crusted) was conducted at 13 U.S. emergency departments (EDs) during June-December 2023. Demographic, historical, and illness characteristics were collected using questionnaires and electronic health records. Lesions were tested for monkeypox virus using polymerase chain reaction. Among 196 enrolled persons, the median age was 37.5 years (IQR = 21.0-53.5 years); 39 (19.9%) were aged <16 years, and 108 (55.1%) were male. Among all enrollees, 13 (6.6%) were GBMSM. Overall, approximately one half (46.4%) and one quarter (23.5%) of enrolled persons were non-Hispanic White and non-Hispanic Black or African American, respectively, and 38.8% reported Hispanic or Latino (Hispanic) ethnicity. Unstable housing was reported by 21 (10.7%) enrollees, and 24 (12.2%) lacked health insurance. The prevalence of mpox among ED patients evaluated for an mpox-compatible rash was 1.5% (95% CI = 0.3%-4.4%); all persons with a confirmed mpox diagnosis identified as GBMSM and reported being HIV-negative, not being vaccinated against mpox, and having engaged in sex with one or more partners met through smartphone dating applications. No cases were identified among women, children, or unhoused persons. Clinicians should remain vigilant for mpox and educate persons at risk for mpox about modifying behaviors that increase risk and the importance of receiving 2 appropriately spaced doses of JYNNEOS vaccine to prevent mpox.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - EMERGEncy ID NET Study Group
- Cedars-Sinai Medical Center, Los Angeles, California; David Geffen School of Medicine at UCLA, Los Angeles, California; Olive View-UCLA Medical Center, Los Angeles, California; Ronald Reagan UCLA Medical Center, Los Angeles, California; UCLA Fielding School of Public Health, Los Angeles, California
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8
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Caumes E. Travel and sex: addressing the spread of sexually transmitted infections. J Travel Med 2024; 31:taae066. [PMID: 38785329 DOI: 10.1093/jtm/taae066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Revised: 04/19/2024] [Indexed: 05/25/2024]
Abstract
Travellers are at risk of STIs. The relationship between travel and STIs is obvious, as evidenced by the histories of syphilis, HIV infection and more recently, Mpox. STIs continue to emerge. Antimicrobial resistance is a huge concern. Thus, the importance of safer sex and condom use should be re-emphasized.
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Affiliation(s)
- Eric Caumes
- Infectious and Tropical Diseases, Hopital de l'Hotel-Dieu, Paris 75014, France
- Sorbonne University, Paris 75005, France
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9
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Moss B. Understanding the biology of monkeypox virus to prevent future outbreaks. Nat Microbiol 2024; 9:1408-1416. [PMID: 38724757 DOI: 10.1038/s41564-024-01690-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 03/26/2024] [Indexed: 06/07/2024]
Abstract
Historically, monkeypox (mpox) was a zoonotic disease endemic in Africa. However, in 2022, a global outbreak occurred following a substantial increase in cases in Africa, coupled with spread by international travellers to other continents. Between January 2022 and October 2023, about 91,000 confirmed cases from 115 countries were reported, leading the World Health Organization to declare a public health emergency. The basic biology of monkeypox virus (MPXV) can be inferred from other poxviruses, such as vaccinia virus, and confirmed by genome sequencing. Here the biology of MPXV is reviewed, together with a discussion of adaptive changes during MPXV evolution and implications for transmission. Studying MPXV biology is important to inform specific host interactions, to aid in ongoing outbreaks and to predict those in the future.
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Affiliation(s)
- Bernard Moss
- Laboratory of Viral Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
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10
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McQuiston JH, Luce R, Kazadi DM, Bwangandu CN, Mbala-Kingebeni P, Anderson M, Prasher JM, Williams IT, Phan A, Shelus V, Bratcher A, Soke GN, Fonjungo PN, Kabamba J, McCollum AM, Perry R, Rao AK, Doty J, Christensen B, Fuller JA, Baird N, Chaitram J, Brown CK, Kirby AE, Fitter D, Folster JM, Dualeh M, Hartman R, Bart SM, Hughes CM, Nakazawa Y, Sims E, Christie A, Hutson CL. U.S. Preparedness and Response to Increasing Clade I Mpox Cases in the Democratic Republic of the Congo - United States, 2024. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2024; 73:435-440. [PMID: 38753567 PMCID: PMC11115432 DOI: 10.15585/mmwr.mm7319a3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
Clade I monkeypox virus (MPXV), which can cause severe illness in more people than clade II MPXVs, is endemic in the Democratic Republic of the Congo (DRC), but the country has experienced an increase in suspected cases during 2023-2024. In light of the 2022 global outbreak of clade II mpox, the increase in suspected clade I cases in DRC raises concerns that the virus could spread to other countries and underscores the importance of coordinated, urgent global action to support DRC's efforts to contain the virus. To date, no cases of clade I mpox have been detected outside of countries in Central Africa where the virus is endemic. CDC and other partners are working to support DRC's response. In addition, CDC is enhancing U.S. preparedness by raising awareness, strengthening surveillance, expanding diagnostic testing capacity for clade I MPXV, ensuring appropriate specimen handling and waste management, emphasizing the importance of appropriate medical treatment, and communicating guidance on the recommended contact tracing, containment, behavior modification, and vaccination strategies.
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Affiliation(s)
| | | | | | | | - Placide Mbala-Kingebeni
- Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC; Division of Global Health Protection, Global Health Center, CDC; National Public Health Institute, Kinshasa, Democratic Republic of the Congo; L’Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Office of the Director, Office of Readiness and Response, CDC; Division of Readiness and Response Science, Office of Readiness and Response, CDC; Office of Public Health Data, Surveillance, and Technology, CDC; Division of Global HIV and TB, Global Health Center, CDC; Influenza Division, National Center for Immunization and Respiratory Diseases, CDC; Global Immunization Division, Global Health Center, CDC; Office of the Director, Center for Laboratory Systems and Response, CDC; Division of Emergency Operations, Office of Readiness and Response, CDC; Division of Infectious Disease Readiness and Response, National Center for Emerging and Zoonotic Infectious Diseases, CDC; Division of Global Migration Health, National Center for Emerging and Zoonotic Infectious Diseases, CDC; Division of Core Laboratory Services and Response, National Center for Emerging and Zoonotic Infectious Diseases, CDC; Office of the Director, National Center for Emerging and Zoonotic Infectious Diseases, CDC; Office of the Director, Global Health Center, CDC
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - CDC 2024 Clade I Mpox Response Team
- Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, CDC; Division of Global Health Protection, Global Health Center, CDC; National Public Health Institute, Kinshasa, Democratic Republic of the Congo; L’Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo; Office of the Director, Office of Readiness and Response, CDC; Division of Readiness and Response Science, Office of Readiness and Response, CDC; Office of Public Health Data, Surveillance, and Technology, CDC; Division of Global HIV and TB, Global Health Center, CDC; Influenza Division, National Center for Immunization and Respiratory Diseases, CDC; Global Immunization Division, Global Health Center, CDC; Office of the Director, Center for Laboratory Systems and Response, CDC; Division of Emergency Operations, Office of Readiness and Response, CDC; Division of Infectious Disease Readiness and Response, National Center for Emerging and Zoonotic Infectious Diseases, CDC; Division of Global Migration Health, National Center for Emerging and Zoonotic Infectious Diseases, CDC; Division of Core Laboratory Services and Response, National Center for Emerging and Zoonotic Infectious Diseases, CDC; Office of the Director, National Center for Emerging and Zoonotic Infectious Diseases, CDC; Office of the Director, Global Health Center, CDC
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11
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Nakamura H, Yamamoto K. Mpox in people with HIV: A narrative review. HIV Med 2024. [PMID: 38745559 DOI: 10.1111/hiv.13661] [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: 01/10/2024] [Accepted: 05/02/2024] [Indexed: 05/16/2024]
Abstract
OBJECTIVE The 2022 global mpox outbreak disproportionately impacted people living with HIV. This review explores recent evidence on mpox in this group, focusing on clinical presentation, complications, treatment modalities and vaccine strategies. RECENT FINDINGS Recent studies have suggested that people with HIV diagnosed with mpox have a greater risk of proctitis and hospitalization compared with people without HIV. In addition, those with advanced immunosuppression face an elevated risk of severe mpox infection, which can lead to mortality. Comprehensive and prompt supportive care using antiretrovirals and mpox antivirals is crucial in this group. Although results from randomized clinical trials are still forthcoming, recent studies suggest that early initiation of tecovirimat can prevent disease progression in people with HIV. The non-replicative attenuated smallpox vaccine is well tolerated and effective in preventing monkeypox virus infections in people with HIV. Further studies are needed regarding long-term vaccine effectiveness for this population. CONCLUSION Evaluating the risk of severe mpox in people living with HIV requires assessing the level of immune suppression and viral control. Universal access to vaccination is imperative to prevent the resurgence of future outbreaks.
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Affiliation(s)
- Hideta Nakamura
- First Department of International Medicine, Division of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus Graduate School of Medicine, Nishihara-cho, Japan
| | - Kazuko Yamamoto
- First Department of International Medicine, Division of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus Graduate School of Medicine, Nishihara-cho, Japan
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12
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King WB, Goulart MA, Neilsen CD. A response to Gibbs et al., Category A waste processing and disposal is a critical weakness in the United States response plans for outbreaks of high consequence infectious diseases. Am J Infect Control 2024; 52:623-624. [PMID: 38649223 DOI: 10.1016/j.ajic.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 04/25/2024]
Affiliation(s)
- Walker B King
- Department of Infection Prevention and Control, University of Florida Health Jacksonville, Jacksonville, FL.
| | - Michael A Goulart
- Department of Infection Prevention and Control, University of Florida Health Jacksonville, Jacksonville, FL.
| | - Chad D Neilsen
- Department of Infection Prevention and Control, University of Florida Health Jacksonville, Jacksonville, FL.
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Port JR, Riopelle JC, Smith SG, Myers L, Kaiser FK, Lewis MC, Gallogly S, Okumura A, Bushmaker T, Schulz JE, Rosenke R, Prado-Smith J, Carmody A, Bane S, Smith BJ, Saturday G, Feldmann H, Rosenke K, Munster VJ. Infection with mpox virus via the genital mucosae increases shedding and transmission in the multimammate rat (Mastomys natalensis). Nat Microbiol 2024; 9:1231-1243. [PMID: 38649413 DOI: 10.1038/s41564-024-01666-1] [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: 05/04/2023] [Accepted: 03/06/2024] [Indexed: 04/25/2024]
Abstract
The 2022 mpox virus (MPXV) outbreak was sustained by human-to-human transmission; however, it is currently unclear which factors lead to sustained transmission of MPXV. Here we present Mastomys natalensis as a model for MPXV transmission after intraperitoneal, rectal, vaginal, aerosol and transdermal inoculation with an early 2022 human outbreak isolate (Clade IIb). Virus shedding and tissue replication were route dependent and occurred in the presence of self-resolving localized skin, lung, reproductive tract or rectal lesions. Mucosal inoculation via the rectal, vaginal and aerosol routes led to increased shedding, replication and a pro-inflammatory T cell profile compared with skin inoculation. Contact transmission was higher from rectally inoculated animals. This suggests that transmission might be sustained by increased susceptibility of the anal and genital mucosae for infection and subsequent virus release.
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Affiliation(s)
- Julia R Port
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Jade C Riopelle
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Samuel G Smith
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Lara Myers
- Research and Technologies Branch, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Franziska K Kaiser
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Matthew C Lewis
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Shane Gallogly
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Atsushi Okumura
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Trent Bushmaker
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Jonathan E Schulz
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Rebecca Rosenke
- Rocky Mountain Veterinary Branch, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Jessica Prado-Smith
- Rocky Mountain Veterinary Branch, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Aaron Carmody
- Research and Technologies Branch, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Sidy Bane
- International Center of Excellence in Research (ICER-Mali), University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Brian J Smith
- Rocky Mountain Veterinary Branch, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Greg Saturday
- Rocky Mountain Veterinary Branch, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Heinz Feldmann
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Kyle Rosenke
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA.
| | - Vincent J Munster
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA.
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14
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Pisano L, Magliulo M, Turco M, Farini J, Rapaccini AL, Lagi F, Bartoloni A, Pimpinelli N. The never-ending story of mpox epidemic: Tracing a new cluster in Florence, Italy. Travel Med Infect Dis 2024; 59:102704. [PMID: 38432283 DOI: 10.1016/j.tmaid.2024.102704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 02/29/2024] [Indexed: 03/05/2024]
Affiliation(s)
- Luigi Pisano
- Section of Dermatology, Health Sciences Department, University of Florence, Florence, Italy
| | - Manfredi Magliulo
- Section of Dermatology, Health Sciences Department, University of Florence, Florence, Italy
| | - Martina Turco
- Section of Dermatology, Health Sciences Department, University of Florence, Florence, Italy.
| | - Jacopo Farini
- Section of Dermatology, Health Sciences Department, University of Florence, Florence, Italy
| | - Anna Lisa Rapaccini
- Section of Dermatology, Health Sciences Department, University of Florence, Florence, Italy
| | - Filippo Lagi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Nicola Pimpinelli
- Section of Dermatology, Health Sciences Department, University of Florence, Florence, Italy
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15
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Desai AN, Koopmans M, Otter A, Grobusch MP, Jokelainen P, Atkinson B, Cunha F, Valdoleiros SR, Preda VG, Fusco FM, Rovers CP, Greub G, Di Caro A, Simonsen L, Ntoumi F, Petersen E. Implications of the 2023-2024 MPXV clade I outbreak in the Democratic Republic of Congo to global public health. Clin Microbiol Infect 2024:S1198-743X(24)00213-1. [PMID: 38697394 DOI: 10.1016/j.cmi.2024.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 04/14/2024] [Accepted: 04/15/2024] [Indexed: 05/05/2024]
Affiliation(s)
- Angel N Desai
- Division of Infectious Diseases, University of California Davis, Sacramento, CA, USA; ESCMID, Switzerland
| | - Marion Koopmans
- ESCMID, Switzerland; Erasmus MC, Department of Viroscience and Pandemic and Disaster Research Centre, Rotterdam, The Netherlands
| | - Ashley Otter
- ESCMID, Switzerland; Emerging Pathogen Serology Group, UK Health Security Agency, Porton Down, Wiltshire, UK
| | - Martin P Grobusch
- ESCMID, Switzerland; Centre of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, Amsterdam Infection and Immunity, Amsterdam Public Health, University of Amsterdam, AZ, Amsterdam, The Netherlands; Institut für Tropenmedizin, Eberhard Karls Universität Tübingen and German Center for Infection Research (DZIF), Tubingen, Germany
| | - Pikka Jokelainen
- ESCMID, Switzerland; Infectious Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark
| | - Barry Atkinson
- ESCMID, Switzerland; Research and Evaluation, UK Health Security Agency, Porton Down, Salisbury, SP4 0JG, UK
| | - Flavia Cunha
- ESCMID, Switzerland; Department of Infectious Diseases, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Sofia R Valdoleiros
- ESCMID, Switzerland; Department of Infectious Diseases, Centro Hospitalar Universitário de São João, Porto, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal
| | - Veronica G Preda
- ESCMID, Switzerland; Section of Virology, Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, London, UK
| | - Francesco Maria Fusco
- ESCMID, Switzerland; D. Cotugno Hospital, Azienda Ospedaliera Specialistica Dei Colli, Naples, Italy
| | - Chantal P Rovers
- ESCMID, Switzerland; Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, HB Nijmegen, The Netherlands
| | - Gilbert Greub
- ESCMID, Switzerland; Institute of Microbiology, University of Lausanne and University Hospital Center (CHUV), 1005 Lausanne, Switzerland; Service of Infectious Diseases, University Hospital Center (CHUV), Lausanne, Switzerland
| | - Antonino Di Caro
- ESCMID, Switzerland; Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy; Unicamillus, International Medical University of Rome, Rome, Italy
| | - Lone Simonsen
- PandemiX Center, Department of Science and Environment, Roskilde University, Denmark
| | - Francine Ntoumi
- Fondation Congolaise pour la Recherche Médicale, Brazzaville, People's Republic of Congo; Institute of Tropical Medicine, University of Tübinge, Germany
| | - Eskild Petersen
- ESCMID, Switzerland; PandemiX Center, Department of Science and Environment, Roskilde University, Denmark; Institute for Clinical Medicine, Faculty of Health Science, University of Aarhus, Denmark.
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16
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Sam-Agudu NA, Ogoina D. Ending the neglect of paediatric, maternal, and congenital mpox. Lancet Glob Health 2024; 12:e533-e534. [PMID: 38401555 DOI: 10.1016/s2214-109x(24)00054-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 01/29/2024] [Indexed: 02/26/2024]
Affiliation(s)
- Nadia Adjoa Sam-Agudu
- International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria; Department of Paediatrics and Child Health, University of Cape Coast School of Medical Sciences, Cape Coast, Ghana; Global Pediatrics Program and Division of Infectious Diseases, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA.
| | - Dimie Ogoina
- Infectious Diseases Unit, Department of Internal Medicine, Niger Delta University/Niger Delta University Teaching Hospital, Bayelsa, Nigeria
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17
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Shamier MC, Zaeck LM, Götz HM, Vieyra B, Verstrepen BE, Wijnans K, Welkers MR, Hoornenborg E, van Cleef BA, van Royen ME, Jonas KJ, Koopmans MP, de Vries RD, van de Vijver DA, GeurtsvanKessel CH. Scenarios of future mpox outbreaks among men who have sex with men: a modelling study based on cross-sectional seroprevalence data from the Netherlands, 2022. Euro Surveill 2024; 29:2300532. [PMID: 38666400 PMCID: PMC11063670 DOI: 10.2807/1560-7917.es.2024.29.17.2300532] [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: 09/01/2023] [Accepted: 01/29/2024] [Indexed: 04/30/2024] Open
Abstract
BackgroundFollowing the 2022-2023 mpox outbreak, crucial knowledge gaps exist regarding orthopoxvirus-specific immunity in risk groups and its impact on future outbreaks.AimWe combined cross-sectional seroprevalence studies in two cities in the Netherlands with mathematical modelling to evaluate scenarios of future mpox outbreaks among men who have sex with men (MSM).MethodsSerum samples were obtained from 1,065 MSM attending Centres for Sexual Health (CSH) in Rotterdam or Amsterdam following the peak of the Dutch mpox outbreak and the introduction of vaccination. For MSM visiting the Rotterdam CSH, sera were linked to epidemiological and vaccination data. An in-house developed ELISA was used to detect vaccinia virus (VACV)-specific IgG. These observations were combined with published data on serial interval and vaccine effectiveness to inform a stochastic transmission model that estimates the risk of future mpox outbreaks.ResultsThe seroprevalence of VACV-specific antibodies was 45.4% and 47.1% in Rotterdam and Amsterdam, respectively. Transmission modelling showed that the impact of risk group vaccination on the original outbreak was likely small. However, assuming different scenarios, the number of mpox cases in a future outbreak would be markedly reduced because of vaccination. Simultaneously, the current level of immunity alone may not prevent future outbreaks. Maintaining a short time-to-diagnosis is a key component of any strategy to prevent new outbreaks.ConclusionOur findings indicate a reduced likelihood of large future mpox outbreaks among MSM in the Netherlands under current conditions, but emphasise the importance of maintaining population immunity, diagnostic capacities and disease awareness.
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Affiliation(s)
- Marc C Shamier
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Luca M Zaeck
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Hannelore M Götz
- Department of Public Health, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, the Netherlands
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Bruno Vieyra
- Department of Public Health, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, the Netherlands
| | - Babs E Verstrepen
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Koen Wijnans
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Matthijs Ra Welkers
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands
- Amsterdam UMC location AMC, University of Amsterdam, Department of Medical Microbiology and Infection Prevention, Amsterdam, the Netherlands
| | - Elske Hoornenborg
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands
- Amsterdam UMC location AMC, University of Amsterdam, Department of Medical Microbiology and Infection Prevention, Amsterdam, the Netherlands
| | - Brigitte Agl van Cleef
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands
| | - Martin E van Royen
- Department of Pathology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Kai J Jonas
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Marion Pg Koopmans
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Rory D de Vries
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, the Netherlands
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18
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Damhorst GL, McLendon K, Morales E, Solis ZM, Fitts E, Bowers HB, Sabino C, Sullivan J, Greenleaf M, Roback JD, Colasanti JA, Sheth AN, Titanji BK, Martin GS, Bassit L, Lam WA, Rao A. Performance of the Xpert™ Mpox PCR assay with oropharyngeal, anorectal, and cutaneous lesion swab specimens. J Clin Virol 2024; 171:105659. [PMID: 38430669 PMCID: PMC11160946 DOI: 10.1016/j.jcv.2024.105659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/30/2024] [Accepted: 02/20/2024] [Indexed: 03/05/2024]
Abstract
Anorectal and oropharyngeal exposures are implicated in sexual transmission of mpox, but authorized assays in the United States are only validated with cutaneous lesion swabs. Diagnostic assays for anorectal and oropharyngeal swabs are needed to address potential future outbreaks. The Cepheid Xpert® Mpox is the first point-of-care assay to receive FDA emergency use authorization in the United States and would be a valuable tool for evaluating these sample types. Our exploratory study demonstrates 100 % positive agreement with our in-house PCR assay for natural positive anorectal and oropharyngeal specimens and 92 % sensitivity with low-positive spiked specimens. The Xpert® assay detected viral DNA in specimens not detected by our reference PCR assay from four participants with mpox DNA at other sites, suggesting it may be more sensitive at low viral loads. In conclusion, the validation of the Xpert® for oropharyngeal and anorectal sample types can be rapidly achieved if clinical need returns and prospective samples become available.
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Affiliation(s)
- Gregory L. Damhorst
- Division of Infectious Diseases, Department of Medicine, Emory University, Atlanta, GA, USA
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia, USA
- Ponce de Leon Center, Grady Health System, Atlanta, Georgia, USA
| | - Kaleb McLendon
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA
| | - Evelyn Morales
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA
| | - Zianya M. Solis
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA
| | - Eric Fitts
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA
| | - Heather B. Bowers
- Department of Pediatrics, Emory University and Children’s Healthcare of Atlanta, Atlanta, GA, USA
- Laboratory of Biochemical Pharmacology, Emory University, Atlanta, Georgia
| | - Courtney Sabino
- Department of Pediatrics, Emory University and Children’s Healthcare of Atlanta, Atlanta, GA, USA
- Laboratory of Biochemical Pharmacology, Emory University, Atlanta, Georgia
| | - Julie Sullivan
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia, USA
| | - Morgan Greenleaf
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia, USA
| | - John D. Roback
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA
| | - Jonathan A. Colasanti
- Division of Infectious Diseases, Department of Medicine, Emory University, Atlanta, GA, USA
- Ponce de Leon Center, Grady Health System, Atlanta, Georgia, USA
| | - Anandi N. Sheth
- Division of Infectious Diseases, Department of Medicine, Emory University, Atlanta, GA, USA
- Ponce de Leon Center, Grady Health System, Atlanta, Georgia, USA
| | - Boghuma K. Titanji
- Division of Infectious Diseases, Department of Medicine, Emory University, Atlanta, GA, USA
- Ponce de Leon Center, Grady Health System, Atlanta, Georgia, USA
| | - Greg S. Martin
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia, USA
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, Emory University, Atlanta, GA, USA
| | - Leda Bassit
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia, USA
- Department of Pediatrics, Emory University and Children’s Healthcare of Atlanta, Atlanta, GA, USA
- Laboratory of Biochemical Pharmacology, Emory University, Atlanta, Georgia
| | - Wilbur A. Lam
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia, USA
- Department of Pediatrics, Emory University and Children’s Healthcare of Atlanta, Atlanta, GA, USA
- Laboratory of Biochemical Pharmacology, Emory University, Atlanta, Georgia
- Aflac Cancer & Blood Disorders Center at Children’s Healthcare of Atlanta, Atlanta, Georgia, USA
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Anuradha Rao
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia, USA
- Department of Pediatrics, Emory University and Children’s Healthcare of Atlanta, Atlanta, GA, USA
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19
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Zuiani A, Dulberger CL, De Silva NS, Marquette M, Lu YJ, Palowitch GM, Dokic A, Sanchez-Velazquez R, Schlatterer K, Sarkar S, Kar S, Chawla B, Galeev A, Lindemann C, Rothenberg DA, Diao H, Walls AC, Addona TA, Mensa F, Vogel AB, Stuart LM, van der Most R, Srouji JR, Türeci Ö, Gaynor RB, Şahin U, Poran A. A multivalent mRNA monkeypox virus vaccine (BNT166) protects mice and macaques from orthopoxvirus disease. Cell 2024; 187:1363-1373.e12. [PMID: 38366591 DOI: 10.1016/j.cell.2024.01.017] [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: 10/04/2023] [Revised: 11/13/2023] [Accepted: 01/12/2024] [Indexed: 02/18/2024]
Abstract
In response to the 2022 outbreak of mpox driven by unprecedented human-to-human monkeypox virus (MPXV) transmission, we designed BNT166, aiming to create a highly immunogenic, safe, accessible, and scalable next-generation vaccine against MPXV and related orthopoxviruses. To address the multiple viral forms and increase the breadth of immune response, two candidate multivalent mRNA vaccines were evaluated pre-clinically: a quadrivalent vaccine (BNT166a; encoding the MPXV antigens A35, B6, M1, H3) and a trivalent vaccine (BNT166c; without H3). Both candidates induced robust T cell responses and IgG antibodies in mice, including neutralizing antibodies to both MPXV and vaccinia virus. In challenge studies, BNT166a and BNT166c provided complete protection from vaccinia, clade I, and clade IIb MPXV. Furthermore, immunization with BNT166a was 100% effective at preventing death and at suppressing lesions in a lethal clade I MPXV challenge in cynomolgus macaques. These findings support the clinical evaluation of BNT166, now underway (NCT05988203).
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Özlem Türeci
- BioNTech SE, Mainz, Germany; HI-TRON - Helmholtz Institute for Translational Oncology Mainz by DKFZ, Mainz, Germany
| | | | - Uğur Şahin
- BioNTech SE, Mainz, Germany; TRON gGmbH - Translational Oncology at the University Medical Center of the Johannes Gutenberg University, Mainz, Germany.
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20
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Masirika LM, Udahemuka JC, Schuele L, Ndishimye P, Otani S, Mbiribindi JB, Marekani JM, Mambo LM, Bubala NM, Boter M, Nieuwenhuijse DF, Lang T, Kalalizi EB, Musabyimana JP, Aarestrup FM, Koopmans M, Oude Munnink BB, Siangoli FB. Ongoing mpox outbreak in Kamituga, South Kivu province, associated with monkeypox virus of a novel Clade I sub-lineage, Democratic Republic of the Congo, 2024. Euro Surveill 2024; 29:2400106. [PMID: 38487886 PMCID: PMC10941309 DOI: 10.2807/1560-7917.es.2024.29.11.2400106] [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: 02/14/2024] [Accepted: 03/13/2024] [Indexed: 03/17/2024] Open
Abstract
Since the beginning of 2023, the number of people with suspected monkeypox virus (MPXV) infection have sharply increased in the Democratic Republic of the Congo (DRC). We report near-to-complete MPXV genome sequences derived from six cases from the South Kivu province. Phylogenetic analyses reveal that the MPXV affecting the cases belongs to a novel Clade I sub-lineage. The outbreak strain genome lacks the target sequence of the probe and primers of a commonly used Clade I-specific real-time PCR.
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Affiliation(s)
- Leandre Murhula Masirika
- Centre de Recherche en Sciences Naturelles de Lwiro, DS Bukavu, South Kivu, Bukavu, Democratic Republic of the Congo
- SaBio Instituto de Investigación en Recursos Cinegéticos IREC (Universidad de Castilla-La Mancha & CSIC), Ciudad Real, Spain
| | - Jean Claude Udahemuka
- Department of Veterinary Medicine, University of Rwanda, Nyagatare, Rwanda
- Stansile Research Organization, Kigali, Rwanda
| | - Leonard Schuele
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Pacifique Ndishimye
- Stansile Research Organization, Kigali, Rwanda
- Department of Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia, Canada
- Research and Innovation Centre, African Institute for Mathematical Sciences, Kigali, Rwanda
| | - Saria Otani
- Research Group for Genomic Epidemiology, National Food Institute, Technical University of Denmark, Kongens Lyngby, Denmark
| | | | - Jean M Marekani
- Unit of Animal Production and Health, Nature Conservation and Development, Department of Biology, Faculty of Science, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Léandre Mutimbwa Mambo
- Zone de Santé de Kamituga, Kamituga, South Kivu, Bukavu, Democratic Republic of the Congo
| | | | - Marjan Boter
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - David F Nieuwenhuijse
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Trudie Lang
- The Global Health Network, Oxford University, Oxford, United Kingdom
| | - Ernest Balyahamwabo Kalalizi
- SaBio Instituto de Investigación en Recursos Cinegéticos IREC (Universidad de Castilla-La Mancha & CSIC), Ciudad Real, Spain
| | - Jean Pierre Musabyimana
- Research, innovation and data science division, Rwanda Biomedical Center, Kigali, Rwanda
- Stansile Research Organization, Kigali, Rwanda
| | - Frank M Aarestrup
- Research Group for Genomic Epidemiology, National Food Institute, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Marion Koopmans
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Bas B Oude Munnink
- These authors contributed equally
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Freddy Belesi Siangoli
- These authors contributed equally
- Division Provinciale de la Santé, South Kivu, Bukavu, Democratic Republic of the Congo
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21
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Liesenborghs L, Coppens J, Van Dijck C, Brosius I, De Baetselier I, Vercauteren K, Van Esbroeck M. No Evidence for Clade I Monkeypox Virus Circulation, Belgium. Emerg Infect Dis 2024; 30:402. [PMID: 38190761 PMCID: PMC10826767 DOI: 10.3201/eid3002.231746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024] Open
Affiliation(s)
| | | | - Christophe Van Dijck
- Institute of Tropical Medicine, Antwerp, Belgium (L. Liesenborghs, J. Coppens, C. Van Dijck, I. Brosius, I. De Baetselier, K. Vercauteren, M. Van Esbroeck)
- Katholieke Universiteit Leuven, Leuven, Belgium (L. Liesenborghs, C. Van Dijck)
| | - Isabel Brosius
- Institute of Tropical Medicine, Antwerp, Belgium (L. Liesenborghs, J. Coppens, C. Van Dijck, I. Brosius, I. De Baetselier, K. Vercauteren, M. Van Esbroeck)
- Katholieke Universiteit Leuven, Leuven, Belgium (L. Liesenborghs, C. Van Dijck)
| | - Irith De Baetselier
- Institute of Tropical Medicine, Antwerp, Belgium (L. Liesenborghs, J. Coppens, C. Van Dijck, I. Brosius, I. De Baetselier, K. Vercauteren, M. Van Esbroeck)
- Katholieke Universiteit Leuven, Leuven, Belgium (L. Liesenborghs, C. Van Dijck)
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