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Chen JM, Chen RX, Gong HY, Zhao MM, Ji YF, Sun MH, Li GH, Tan SM, Zhang GH, Chen JW. Epidemiology-based analysis of the risks and elimination strategies of the monkeypox outbreak in 2022. Front Vet Sci 2022; 9:1064766. [PMID: 36532347 PMCID: PMC9748476 DOI: 10.3389/fvets.2022.1064766] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 11/14/2022] [Indexed: 08/30/2023] Open
Abstract
Human monkeypox, caused by monkeypox virus, has spread unprecedentedly to more than 100 countries since May 2022. Here we summarized the epidemiology of monkeypox through a literature review and elucidated the risks and elimination strategies of this outbreak mainly based on the summarized epidemiology. We demonstrated that monkeypox virus became more contagious and less virulent in 2022, which could result from the fact that the virus entered a special transmission network favoring close contacts (i.e., sexual behaviors of men who have sex with men outside Africa) and the possibility that the virus accumulated a few adaptive mutations. We gave the reasons to investigate whether cattle, goats, sheep, and pigs are susceptible to monkeypox virus and whether infection with monkeypox virus could be latent in some primates. We listed six potential scenarios for the future of the outbreak (e.g., the outbreak could lead to endemicity outside Africa with increased transmissibility or virulence). We also listed multiple factors aiding or impeding the elimination of the outbreak. We showed that the control measures strengthened worldwide after the World Health Organization declared the outbreak a public health emergency of international concern (PHEIC) could eliminate the outbreak in 2022. We clarified eight strategies, i.e., publicity and education, case isolation, vaccine stockpiling, risk-based vaccination or ring vaccination, importation quarantine, international collaboration, and laboratory management, for the elimination of the outbreak.
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Affiliation(s)
- Ji-Ming Chen
- School of Life Science and Engineering, Foshan University, Foshan, China
| | - Rui-Xu Chen
- School of Life Science and Engineering, Foshan University, Foshan, China
| | - Huan-Yu Gong
- School of Life Science and Engineering, Foshan University, Foshan, China
| | - Meng-Meng Zhao
- School of Life Science and Engineering, Foshan University, Foshan, China
| | - Yu-Fei Ji
- School of Life Science and Engineering, Foshan University, Foshan, China
| | - Ming-Hui Sun
- School of Life Science and Engineering, Foshan University, Foshan, China
| | - Guo-Hui Li
- School of Life Science and Engineering, Foshan University, Foshan, China
| | - Su-Mei Tan
- School of Life Science and Engineering, Foshan University, Foshan, China
| | - Gui-Hong Zhang
- Guangdong Provincial Key Laboratory of Zoonosis Prevention and Control, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China
| | - Ji-Wang Chen
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States
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Gushchin VA, Ogarkova DA, Dolzhikova IV, Zubkova OV, Grigoriev IV, Pochtovyi AA, Iliukhina AA, Ozharovskaia TA, Kuznetsova NA, Kustova DD, Shelkov AY, Zrelkin DI, Odintsova AS, Grousova DM, Kan VY, Davtyan SA, Siniavin AE, Belyaeva ED, Botikov AG, Bessonova AA, Vasilchenko LA, Vasina DV, Kleymenov DA, Slutskiy EA, Tkachuk AP, Burgasova OA, Loginova SY, Rozhdestvensky EV, Shcheblyakov DV, Tsibin AN, Komarov AG, Zlobin VI, Borisevich SV, Naroditsky BS, Logunov DY, Gintsburg AL. Estimation of anti-orthopoxvirus immunity in Moscow residents and potential risks of spreading Monkeypox virus. Front Immunol 2022; 13:1023164. [PMID: 36466896 PMCID: PMC9709467 DOI: 10.3389/fimmu.2022.1023164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/25/2022] [Indexed: 07/30/2023] Open
Abstract
WHO has declared the outbreak of monkeypox as a public health emergency of international concern. In less than three months, monkeypox was detected in more than 30 000 people and spread to more than 80 countries around the world. It is believed that the immunity formed to smallpox vaccine can protect from monkeypox infection with high efficiency. The widespread use of Vaccinia virus has not been carried out since the 1980s, which raises the question of the level of residual immunity among the population and the identification of groups requiring priority vaccination. We conducted a cross-sectional serological study of remaining immunity among Moscow residents. To do this, a collection of blood serum samples of age group over 30 years old was formed, an in-house ELISA test system was developed, and a virus neutralization protocol was set up. Serum samples were examined for the presence of IgG antibodies against Vaccinia virus (n=2908), as well as for the ability to neutralize plaque formation with a Vaccinia virus MNIIVP-10 strain (n=299). The results indicate the presence of neutralizing antibody titer of 1/20 or more in 33.3 to 53.2% of people older than 45 years. Among people 30-45 years old who probably have not been vaccinated, the proportion with virus neutralizing antibodies ranged from 3.2 to 6.7%. Despite the higher level of antibodies in age group older than 66 years, the proportion of positive samples in this group was slightly lower than in people aged 46-65 years. The results indicate the priority of vaccination in groups younger than 45, and possibly older than 66 years to ensure the protection of the population in case of spread of monkeypox among Moscow residents. The herd immunity level needed to stop the circulation of the virus should be at least 50.25 - 65.28%.
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Affiliation(s)
- Vladimir A. Gushchin
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
- Department of Virology, Biological Faculty, Lomonosov Moscow State University, Moscow, Russia
| | - Darya A. Ogarkova
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Inna V. Dolzhikova
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Olga V. Zubkova
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Igor V. Grigoriev
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Andrei A. Pochtovyi
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
- Department of Virology, Biological Faculty, Lomonosov Moscow State University, Moscow, Russia
| | - Anna A. Iliukhina
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Tatiana A. Ozharovskaia
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Nadezhda A. Kuznetsova
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Daria D. Kustova
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Artem Y. Shelkov
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Denis I. Zrelkin
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Alina S. Odintsova
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Daria M. Grousova
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Vladislav Y. Kan
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Sona A. Davtyan
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Andrei E. Siniavin
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Elizaveta D. Belyaeva
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Andrei G. Botikov
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Arina A. Bessonova
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Lyudmila A. Vasilchenko
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Daria V. Vasina
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Denis A. Kleymenov
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | | | - Artem P. Tkachuk
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Olga A. Burgasova
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
- Moscow Healthcare Department, Moscow, Russia
- Department of Infectious Diseases with the Courses of Epidemiology and Phthisiology, Peoples Friendship University of Russia (RUDN) University, Moscow, Russia
| | - Svetlana Y. Loginova
- Department of Especially Dangerous Viral Infections, 48-Central Research Institute of the Ministry of Defence of the Russian Federation, Moscow, Russia
| | - Evgeny V. Rozhdestvensky
- Department of Especially Dangerous Viral Infections, 48-Central Research Institute of the Ministry of Defence of the Russian Federation, Moscow, Russia
| | - Dmitry V. Shcheblyakov
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | | | | | - Vladimir I. Zlobin
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Sergei V. Borisevich
- Department of Especially Dangerous Viral Infections, 48-Central Research Institute of the Ministry of Defence of the Russian Federation, Moscow, Russia
| | - Boris S. Naroditsky
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Denis Y. Logunov
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Alexander L. Gintsburg
- Department of Science, Federal State Budget Institution “National Research Centre for Epidemiology and Microbiology Named After Honorary Academician N. F. Gamaleya” of the Ministry of Health of the Russian Federation, Moscow, Russia
- Department of Infectiology and Virology, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov, First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
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103
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Osborn LJ, Villarreal D, Wald-Dickler N, Bard JD. Monkeypox: Clinical Considerations, Epidemiology, and Laboratory Diagnostics. CLINICAL MICROBIOLOGY NEWSLETTER 2022; 44:199-208. [PMID: 36438980 PMCID: PMC9674185 DOI: 10.1016/j.clinmicnews.2022.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Monkeypox virus (MPXV) has garnered recent attention as outbreaks are continually reported outside historic regions of endemicity in Africa. Consequently, MPXV is becoming routinely included in the differential diagnosis of rash illnesses, requiring clinicians and laboratorians alike to quickly adapt to a new public health emergency. This review discusses the epidemiology, clinical presentation, and laboratory testing of MPXV in the context of recent outbreaks.
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Affiliation(s)
- Lucas J Osborn
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, California
| | - Diana Villarreal
- Department of Pediatrics, Maternal Child and Adolescent/Adult Center for Infectious Diseases and Virology, University of Southern California, Los Angeles, California
- Department of Medicine and Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Noah Wald-Dickler
- Department of Internal Medicine, Division of Infectious Diseases, University of Southern California, Los Angeles, California
- Department of Medicine and Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Jennifer Dien Bard
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, California
- Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, California
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104
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Antunes F, Virgolino A. Monkeypox Mysteries of the New Outbreak in Non-Endemic Areas. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14881. [PMID: 36429600 PMCID: PMC9690550 DOI: 10.3390/ijerph192214881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/09/2022] [Accepted: 11/09/2022] [Indexed: 06/16/2023]
Abstract
Monkeypox virus (MPXV) was declared by the World Health Organization (WHO) in mid-2022 to be a public health emergency of international concern, following its spread around the world after circulating in Western and Central Africa. This new outbreak is concentrated in men who have sex with men (MSM). Moreover, beyond the epidemiological change, compared with endemic countries, differences in clinical features and many other aspects have also been detected. These and other characteristics are unusual and still unclear. Based on the available data, the authors try to help to clarify some of the current major gaps in monkeypox knowledge to strengthen the outbreak response.
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Affiliation(s)
- Francisco Antunes
- Instituto de Saúde Ambiental, Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal
- Laboratório Associado TERRA, Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Ana Virgolino
- Instituto de Saúde Ambiental, Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal
- Laboratório Associado TERRA, Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal
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105
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Affiliation(s)
- Antoine Gessain
- From Institut Pasteur, Université de Paris Cité, Centre National de la Recherche Scientifique, UMR3569, Unité d'Épidémiologie et Physiopathologie des Virus Oncogènes, Département de Virologie (A.G.), and Assistance Publique-Hôpitaux de Paris, Department of Infectious and Tropical Diseases, Bichat-Claude Bernard University Hospital, INSERM, ANRS Maladies Infectieuses Émergentes (Y.Y.) - both in Paris; and Institut Pasteur de Bangui, Bangui, Central African Republic (E.N.)
| | - Emmanuel Nakoune
- From Institut Pasteur, Université de Paris Cité, Centre National de la Recherche Scientifique, UMR3569, Unité d'Épidémiologie et Physiopathologie des Virus Oncogènes, Département de Virologie (A.G.), and Assistance Publique-Hôpitaux de Paris, Department of Infectious and Tropical Diseases, Bichat-Claude Bernard University Hospital, INSERM, ANRS Maladies Infectieuses Émergentes (Y.Y.) - both in Paris; and Institut Pasteur de Bangui, Bangui, Central African Republic (E.N.)
| | - Yazdan Yazdanpanah
- From Institut Pasteur, Université de Paris Cité, Centre National de la Recherche Scientifique, UMR3569, Unité d'Épidémiologie et Physiopathologie des Virus Oncogènes, Département de Virologie (A.G.), and Assistance Publique-Hôpitaux de Paris, Department of Infectious and Tropical Diseases, Bichat-Claude Bernard University Hospital, INSERM, ANRS Maladies Infectieuses Émergentes (Y.Y.) - both in Paris; and Institut Pasteur de Bangui, Bangui, Central African Republic (E.N.)
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106
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Singh S, Kumar R, Singh SK. All That We Need to Know About the Current and Past Outbreaks of Monkeypox: A Narrative Review. Cureus 2022; 14:e31109. [DOI: 10.7759/cureus.31109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2022] [Indexed: 11/07/2022] Open
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107
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Dibia EO, Olaoye DQ. Strengthening monkeypox diagnostics and healthcare amidst Covid-19 realities: A call to action. Ann Med Surg (Lond) 2022; 84:104898. [PMID: 36408438 PMCID: PMC9659318 DOI: 10.1016/j.amsu.2022.104898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 11/07/2022] [Indexed: 11/15/2022] Open
Abstract
Monkeypox virus is a zoonotic DNA virus related to the virus that causes smallpox. It was first isolated and identified in 1958 but its first confirmed human case was in 1970 when the virus was isolated from a child in the Democratic Republic of Congo. Since then, several cases have been reported within the African continent and globally. Despite its spread, Monkey pox disease has continued to suffer neglect in terms of research and funding due to its reported inefficiency in transmitting from Man to man as its transmission was reportedly limited to its endemic regions in Africa. Poor health data management, inadequate capacities in terms of testing infrastructure and health care workers and weak surveillance systems are some of the challenges faced by African countries. Multisectoral collaboration in breaking the transmission cycle of monkeypox infection and other preventive measures must be improved upon. Community advocacies and education play integral roles in infection spread preparedness, as well as in strengthening the healthcare system. Monkeypox virus infection remains a challenging health threat in sub-Saharan Africa, and the world at large. Research, monitoring, supporting, and sharing information among countries affected by monkeypox should be improved. Research priorities towards monkeypox virus vaccine production should be prioritised. Sensitization toward the populations at risk must be invested into.
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Abstract
INTRODUCTION The reemergence of monkeypox virus in the twenty-first century, calls for an urgency in its control and preventive measures. There is a long-standing concern that the reemergence of monkeypox across countries could lead to another epidemic like the COVID-19 pandemic. Understanding the disease ecology, preventing its transmission could help curbing its spread. The established treatment protocols along with development of new antiviral agents and vaccines could play a pivotal role in controlling its transmission. AREAS COVERED In this review, we summarize the different modes of transmission of this disease, the associated symptoms, the standard protocol of treatment, the available vaccines and use of alternative treatments. We have collated recent research on novel entities that could potentially treat monkeypox infection. EXPERT OPINION The One Health approach fostered by the World Health Organization (WHO) for emergent and reemerging zoonotic diseases has to be implemented with a view to curb their transmission. The growing global population and increased inter-country travel has led to rapid spread of transmissible pathogens. Stigmatization, associated with lack of knowledge can be prevented by enhancing awareness campaigns. Vaccines need to be administered to high-risk individuals, and drug discovery efforts need to be intensified to combat such diseases.
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Affiliation(s)
- Sahaya Nadar
- Department of Pharmaceutical Chemistry & Quality Assurance, St. John Institute of Pharmacy and Research, Palghar 401404, India.,Department of Pharmaceutical Chemistry & Quality Assurance, SVKM's Dr. Bhanuben Nanavati College of Pharmacy, Mumbai 400056, India
| | - Tabassum Khan
- Department of Pharmaceutical Chemistry & Quality Assurance, SVKM's Dr. Bhanuben Nanavati College of Pharmacy, Mumbai 400056, India
| | - Abdelwahab Omri
- The Novel Drug & Vaccine Delivery Systems Facility, Department of Chemistry and Biochemistry, Laurentian University, Sudbury ON P3E 2C6, Northern Ontario, Canada
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109
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Schrarstzhaupt IN, Fontes-Dutra M, Diaz-Quijano FA. Early estimates of the incidence trend and the reproductive number of the monkeypox epidemic in Brazil. Travel Med Infect Dis 2022; 50:102484. [PMID: 36342036 PMCID: PMC9617678 DOI: 10.1016/j.tmaid.2022.102484] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/11/2022] [Accepted: 10/18/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND We aimed to calculate the weekly growth of the incidence and the effective reproductive number (Rt) of the 2022 Monkeypox epidemic during its introduction in Brazil. METHOD We described the case distribution in the country and calculated the incidence trend and the Rt in the four geographical states with the highest case reports. By using two regression approaches, count model and the Prais-Winsten, we calculated the relative incidence increase. Moreover, we estimated the Rt for the period between the 24th and the 50th days after the first official report, using a serial interval reported in another population and two alternative values (± 3 days). RESULTS Up to August 22, 3.896 Monkeypox cases were confirmed in Brazil. The weekly incidence increases were between 37.5% (95% CI: 20.7% - 56,6%) and 82.1% (95% CI: 59.5%-107.8%), and all estimates of Rt were significantly higher than 1 in the four states analyzed. CONCLUSIONS The Monkeypox outbreak in Brazil is a significant public health emergency that requires coordinated public health strategies such as testing, contact tracing, and vaccination.
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Affiliation(s)
| | - Mellanie Fontes-Dutra
- University of Vale do Rio dos Sinos (UNISINOS), School of Health, Rio Grande do Sul, RS, Brazil
| | - Fredi Alexander Diaz-Quijano
- University of São Paulo, School of Public Health, Department of Epidemiology - Laboratory of Causal Inference in Epidemiology (LINCE-USP), São Paulo, SP, Brazil
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El-Mesady A, Elsonbaty A, Adel W. On nonlinear dynamics of a fractional order monkeypox virus model. CHAOS, SOLITONS, AND FRACTALS 2022; 164:112716. [PMID: 36247712 PMCID: PMC9534146 DOI: 10.1016/j.chaos.2022.112716] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/26/2022] [Accepted: 09/17/2022] [Indexed: 05/21/2023]
Abstract
In this work, we examine a fractional-order model for simulating the spread of the monkeypox virus in the human host and rodent populations. The employment of the fractional form of the model gives a better insight into the dynamics and spread of the virus, which will help in providing some new control measures. The model is formulated into eight mutually exclusive compartments and the form of a nonlinear system of differential equations. The reproduction number for the present epidemic system is found. In addition, the equilibrium points of the model are investigated and the associated stability analysis is carried out. The influences of key parameters in the model and the ways to control the monkeypox epidemic have been thoroughly examined for the fractional model. To ensure that the model accurately simulates the nonlinear phenomenon, we adapt an efficient numerical technique to solve the presented model, and the acquired results reveal the dynamic behaviors of the model. It is observed that when memory influences are considered for the present model, through Caputo fractional-order derivatives, they affect the speed and time taken by solution trajectories towards steady-state equilibria.
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Affiliation(s)
- A El-Mesady
- Department of Physics and Engineering Mathematics, Faculty of Electronic Engineering, Menoufia University, Menouf 32952, Egypt
| | - Amr Elsonbaty
- Department of Mathematics, College of Science and Humanities in Al-Kharj, Prince Sattam bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
- Department of Mathematics and Engineering Physics, Faculty of Engineering, Mansoura University, Mansoura, Egypt
| | - Waleed Adel
- Department of Mathematics and Engineering Physics, Faculty of Engineering, Mansoura University, Mansoura, Egypt
- Université Française d'Egypte, Ismailia Desert Road, El-Shorouk, Cairo, Egypt
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111
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Kumar R, Singh S, Singh SK. A Systematic Review of 5110 Cases of Monkeypox: What Has Changed Between 1970 and 2022? Cureus 2022; 14:e30841. [DOI: 10.7759/cureus.30841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2022] [Indexed: 11/06/2022] Open
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112
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Papukashvili D, Rcheulishvili N, Liu C, Wang X, He Y, Wang PG. Strategy of developing nucleic acid-based universal monkeypox vaccine candidates. Front Immunol 2022; 13:1050309. [PMID: 36389680 PMCID: PMC9646902 DOI: 10.3389/fimmu.2022.1050309] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 10/12/2022] [Indexed: 08/08/2023] Open
Abstract
Until May 2022, zoonotic infectious disease monkeypox (MPX) caused by the monkeypox virus (MPXV) was one of the forgotten viruses considered to be geographically limited in African countries even though few cases outside of Africa were identified. Central and West African countries are known to be endemic for MPXV. However, since the number of human MPX cases has rapidly increased outside of Africa the global interest in this virus has markedly grown. The majority of infected people with MPXV have never been vaccinated against smallpox virus. Noteworthily, the MPXV spreads fast in men who have sex with men (MSM). Preventive measures against MPXV are essential to be taken, indeed, vaccination is the key. Due to the antigenic similarities, the smallpox vaccine is efficient against MPXV. Nevertheless, there is no specific MPXV vaccine until now. Nucleic acid vaccines deserve special attention since the emergency approval of two messenger RNA (mRNA)-based coronavirus disease 2019 (COVID-19) vaccines in 2020. This milestone in vaccinology has opened a new platform for developing more mRNA- or DNA-based vaccines. Certainly, this type of vaccine has a number of advantages including time- and cost-effectiveness over conventional vaccines. The platform of nucleic acid-based vaccines gives humankind a huge opportunity. Ultimately, there is a strong need for developing a universal vaccine against MPXV. This review will shed the light on the strategies for developing nucleic acid vaccines against MPXV in a timely manner. Consequently, developing nucleic acid-based vaccines may alleviate the global threat against MPXV.
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Affiliation(s)
| | | | | | | | - Yunjiao He
- Department of Pharmacology, School of Medicine, Southern University of Science and Technology, Shenzhen, China
| | - Peng George Wang
- Department of Pharmacology, School of Medicine, Southern University of Science and Technology, Shenzhen, China
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Mungmunpuntipantip R, Wiwanitkit V. Smallpox vaccination discontinuation and monkeypox incidence in an African endemic region: a reanalysis on the relationship between the withdrawal of smallpox vaccine and subsequent morbidity. AMERICAN JOURNAL OF CLINICAL AND EXPERIMENTAL IMMUNOLOGY 2022; 11:78-83. [PMID: 36420348 PMCID: PMC9678744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 09/06/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Monkey pox has expanded across Europe as a result of the widespread outbreak, creating a severe public health risk. Monkey pox is an uncommon pox infection that has reappeared due to zoonosis. Monkey pox has spread over Europe and North America, posing a serious public health risk. The regular smallpox vaccine has been shown to be effective against monkeypox. The suspension of smallpox immunization is currently being debated due to the possibility of a connection with the current monkeypox outbreak. In clinical immunology, the link between a desire for smallpox vaccination, low population immunity, and a higher incidence of monkeypox is an intriguing topic. METHODS This is a descriptive analysis done in the past. The writers investigate the situation in West Africa in this research. The available data on monkeypox incidence in an African endemic area was reassessed. RESULTS Based on a recent analysis of epidemiological data from an endemic area, there is no indication of a yearly ongoing increase in monkeypox incidence following the discontinuation of the smallpox vaccine, and incidence varies. CONCLUSION There is no evidence of an annual increase in monkeypox incidence following the withdrawal of smallpox immunization.
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Affiliation(s)
| | - Viroj Wiwanitkit
- Department of Joseph Ayobaalola UniversityIkeji-Arakeji, Nigeria
- DY Patil UniversityPune, India
- Faculty of Medicine, University of NisSerbia
- Hainan Medical UniversityHaikou, China
- Parasitic Disease Research Center, Suranaree University of TechnologyNakhon Ratchasima, Thailand
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114
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MohanaSundaram A, Shanmugarajan TS, Velayutham R. Strides toward a better understanding of the "Current efforts and challenges facing responses to Monkeypox in United Kingdom". Biomed J 2022; 46:100565. [PMID: 36228997 PMCID: PMC9550296 DOI: 10.1016/j.bj.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 10/08/2022] [Indexed: 11/21/2022] Open
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115
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Atkinson B, Burton C, Pottage T, Thompson K, Ngabo D, Crook A, Pitman J, Summers S, Lewandowski K, Furneaux J, Davies K, Brooks T, Bennett AM, Richards KS. Infection-competent monkeypox virus contamination identified in domestic settings following an imported case of monkeypox into the UK. Environ Microbiol 2022; 24:4561-4569. [PMID: 35837859 PMCID: PMC9796424 DOI: 10.1111/1462-2920.16129] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/06/2022] [Accepted: 07/06/2022] [Indexed: 01/01/2023]
Abstract
An imported case of monkeypox was diagnosed in December 2019 in a traveller returning from Nigeria to the UK. Subsequently, environmental sampling was performed at two adjoining single-room residences occupied by the patient and their sibling. Monkeypox virus DNA was identified in multiple locations throughout both properties, and monkeypox virus was isolated from several samples 3 days after the patient was last in these locations. Positive samples were identified following the use of both vacuum and surface sampling techniques; these methodologies allowed for environmental analysis of potentially contaminated porous and non-porous surfaces via real-time quantitative reverse transcriptase PCR analysis in addition to viral isolation to confirm the presence of infection-competent virus. This report confirms the potential for infection-competent monkeypox virus to be recovered in environmental settings associated with known positive cases and the necessity for rapid environmental assessment to reduce potential exposure to close contacts and the general public. The methods adopted in this investigation may be used for future confirmed cases of monkeypox in order to establish levels of contamination, confirm the presence of infection-competent material and to identify locations requiring additional cleaning.
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Affiliation(s)
- Barry Atkinson
- Research and EvaluationUK Health Security Agency, Porton DownSalisburyUK
| | - Christopher Burton
- High Containment MicrobiologyUK Health Security Agency, Porton DownSalisburyUK
| | - Thomas Pottage
- Research and EvaluationUK Health Security Agency, Porton DownSalisburyUK
| | - Katy‐Anne Thompson
- Research and EvaluationUK Health Security Agency, Porton DownSalisburyUK
| | - Didier Ngabo
- Research and EvaluationUK Health Security Agency, Porton DownSalisburyUK
| | - Ant Crook
- Research and EvaluationUK Health Security Agency, Porton DownSalisburyUK
| | - James Pitman
- High Containment MicrobiologyUK Health Security Agency, Porton DownSalisburyUK
| | - Sian Summers
- High Containment MicrobiologyUK Health Security Agency, Porton DownSalisburyUK
| | - Kuiama Lewandowski
- Research and EvaluationUK Health Security Agency, Porton DownSalisburyUK
| | - Jenna Furneaux
- Rare and Imported Pathogens LaboratoryUK Health Security Agency, Porton DownSalisburyUK
| | - Katherine Davies
- Research and EvaluationUK Health Security Agency, Porton DownSalisburyUK
| | - Timothy Brooks
- Rare and Imported Pathogens LaboratoryUK Health Security Agency, Porton DownSalisburyUK
- National Institute for Health ResearchHealth Protection Research Unit in Emerging and Zoonotic InfectionsLiverpoolUK
| | - Allan M. Bennett
- Research and EvaluationUK Health Security Agency, Porton DownSalisburyUK
| | - Kevin S. Richards
- High Containment MicrobiologyUK Health Security Agency, Porton DownSalisburyUK
- Oxford Brookes University, Headington CampusOxfordUK
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116
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Onukansi F, Lucero-Prisno III DE. Ensuring appropriate reporting and surveillance of monkeypox cases in Nigeria. POPULATION MEDICINE 2022. [DOI: 10.18332/popmed/154851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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117
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Monkeypox: From A Neglected Tropical Disease to a Public Health Threat. Infect Dis Rep 2022; 14:772-783. [PMID: 36286200 PMCID: PMC9602669 DOI: 10.3390/idr14050079] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/23/2022] [Accepted: 09/27/2022] [Indexed: 11/11/2022] Open
Abstract
Since the first case of human monkeypox was diagnosed in 1970, the disease remained endemic in several countries in West and Central Africa. In 1996, there was a sudden increase in cases in the Democratic Republic of Congo (DRC), and since 2017 an ongoing outbreak in Nigeria took place, probably related to the population growth, human invasion of MPXV animal habitat reservoirs, and the waning of the cross-protection offered from smallpox immunization, later ending in 1980. Since May 2022, an unprecedented outbreak of human monkeypox has rapidly spread around the world, outside endemic regions of Africa, through new modes of transmission, showing differences in clinical features compared with previous reports. The 2022 MPXV strain belongs to the clade of West Africa but diverges from the original strain, making the virus more transmissible. The authors review the main milestones in more than 50 years of history of human monkeypox, from a rare viral zoonotic infection to a public health emergency.
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118
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de la Calle-Prieto F, Estébanez Muñoz M, Ramírez G, Díaz-Menéndez M, Velasco M, Azkune Galparsoro H, Salavert Lletí M, Mata Forte T, Blanco JL, Mora-Rillo M, Arsuaga M, de Miguel Buckley R, Arribas JR, Membrillo FJ. [Treatment and prevention of monkeypox]. Enferm Infecc Microbiol Clin 2022; 41:S0213-005X(22)00167-7. [PMID: 36249471 PMCID: PMC9534155 DOI: 10.1016/j.eimc.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 08/08/2022] [Indexed: 11/20/2022]
Abstract
Monkeypox is a zoonosis that is spread mainly through direct contact with fluids and skin lesions of infected people with vesicles still active. Although the virus was isolated for the first time in 1958 and the first human case was identified in a child in 1970, in the Democratic Republic of the Congo, the disease has progressively increased its incidence in Africa reaching in May 2022 sustained transmission outside this continent. As it is a newly introduced virus in our health system, it is necessary to learn the epidemiological pattern in a different environment from that of traditionally endemic areas and to know the available antiviral treatments, as well as the prophylactic measures that could be considered, knowing that as a virus emerging in our regions, scientific evidence is still limited. There are antivirals that have been shown, in animal models, to effectively combat the disease with very good clinical tolerance. This disease has also forced us to review the characteristics of smallpox vaccines, because they have shown a protective effect against monkeypox. For this reason, it is important to have a document that compiles all the scientific information published in this regard.
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Affiliation(s)
- Fernando de la Calle-Prieto
- Unidad de Patología Importada y Salud Internacional, CSUR para Patología Tropical Importada Adultos y Pediatría, Unidad de Aislamiento de Alto Nivel, Hospital Universitario La Paz-Carlos III-Cantoblanco. IdiPAZ. CIBERINFEC. Madrid, España
| | - Miriam Estébanez Muñoz
- Unidad NRBQ-Infecciosas. Sección de Infecciosas, Unidad de Aislamiento de Alto Nivel, Hospital Central de la Defensa Gómez Ulla, Madrid, España
| | - Germán Ramírez
- Unidad NRBQ-Infecciosas. Sección de Infecciosas, Unidad de Aislamiento de Alto Nivel, Hospital Central de la Defensa Gómez Ulla, Madrid, España
| | - Marta Díaz-Menéndez
- Unidad de Patología Importada y Salud Internacional, CSUR para Patología Tropical Importada Adultos y Pediatría, Unidad de Aislamiento de Alto Nivel, Hospital Universitario La Paz-Carlos III-Cantoblanco. IdiPAZ. CIBERINFEC. Madrid, España
| | - María Velasco
- Enfermedades Infecciosas y Medicina Tropical, Hospital Universitario Fundación Alcorcón, Universidad Rey Juan Carlos, Madrid, España
| | - Harkaitz Azkune Galparsoro
- Servicio de Enfermedades Infecciosas. Unidad de Aislamiento de Alto Nivel, Hospital Universitario Donostia, Biodonostia. Universidad del Pais Vasco, Gipuzkoa, España
| | - Miguel Salavert Lletí
- Unidad de Enfermedades Infecciosas, Área Clínica Médica. Unidad de Aislamiento de Alto Nivel La Fe, Hospital Universitario y Politécnico La Fe de Valencia, Valencia, España
| | - Tatiana Mata Forte
- Unidad NRBQ-Infecciosas. Sección de Infecciosas, Unidad de Aislamiento de Alto Nivel, Hospital Central de la Defensa Gómez Ulla, Madrid, España
| | - José Luis Blanco
- Departamento de Enfermedades Infecciosas, Unidad de Aislamiento de Alto Nivel, Hospital Clinic-IDIBAPS, Universidad de Barcelona. CIBERINFEC, Barcelona, España
| | - Marta Mora-Rillo
- Unidad de Enfermedades Infecciosas y Microbiología Clínica. Unidad de Aislamiento de Alto Nivel, Hospital Universitario La Paz-Carlos III-Cantoblanco, IdiPAZ. CIBERINFEC, Madrid, España
| | - Marta Arsuaga
- Unidad de Patología Importada y Salud Internacional, CSUR para Patología Tropical Importada Adultos y Pediatría, Unidad de Aislamiento de Alto Nivel, Hospital Universitario La Paz-Carlos III-Cantoblanco. IdiPAZ. CIBERINFEC. Madrid, España
| | - Rosa de Miguel Buckley
- Unidad de Patología Importada y Salud Internacional, CSUR para Patología Tropical Importada Adultos y Pediatría, Unidad de Aislamiento de Alto Nivel, Hospital Universitario La Paz-Carlos III-Cantoblanco. IdiPAZ. CIBERINFEC. Madrid, España
| | - Jose Ramón Arribas
- Unidad de Enfermedades Infecciosas. Departamento de Medicina Interna, Hospital Universitario La Paz-Carlos III-Cantoblanco, Escuela de Medicina, Universidad Autónoma de Madrid. IdiPAZ. CIBERINFEC, Madrid, España
| | - Francisco Javier Membrillo
- Unidad NRBQ-Infecciosas. Sección de Infecciosas, Unidad de Aislamiento de Alto Nivel, Hospital Central de la Defensa Gómez Ulla, Madrid, España
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119
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Harvala H, Simmonds P. Evaluating the risk of transfusion and transplant-transmitted monkeypox infections. Transfus Med 2022; 32:460-466. [PMID: 36134432 PMCID: PMC10087182 DOI: 10.1111/tme.12918] [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: 06/10/2022] [Revised: 08/17/2022] [Accepted: 09/11/2022] [Indexed: 10/14/2022]
Abstract
The recent emergence of monkeypox virus (MPXV) in the UK and elsewhere is of urgent public health concern. Several aspects of MPXV epidemiology and pathogenesis, including its systemic spread and viraemia during acute infection, furthermore represent an important potential threat to the safety of blood transfusion and organ transplantation. Reported infections in the UK have been exponentially increasing over the last 2 months, with 1552 reported cases in the UK by 7th July 2022. This is likely to be considerable underestimate given current limitations in diagnostic capacity and clinical diagnoses hampered by its similar disease presentations to other causes of rash and genitourinary disease. While MPXV infections are currently most widespread in gay, bisexual or other men who have sex with men, wider spread of MPXV outside defined risk groups for infection may prevent identification of infection risk in donors. While typically mild disease outcomes have been reported in UK cases, case fatality rates ranging from 1% to over 10% are reported for different MPXV strains in its source area in sub-Saharan Africa. Recipients of blood components and organs transplant, especially those who are immunosuppressed, may reproduce the greater systemic spread and morbidity of those infected through percutaneous routes. There is a potential risk of MPXV transmission and severe disease outcomes in blood and transplant recipients. In addition to current risk assessments performed in the UK and exclusion of donors with recent MPXV exposure, determining viraemia frequencies in donors and directly evaluating transmission risk would be of considerable value in assessing whether MPXV nucleic acid screening should be implemented.
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Affiliation(s)
- Heli Harvala
- Microbiology Services, NHS Blood and Transplant, London, UK
| | - Peter Simmonds
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
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120
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Yao KH, DU QQ, Hu YH. [Diagnosis and treatment of human monkeypox]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2022; 24:960-966. [PMID: 36111711 PMCID: PMC9495245 DOI: 10.7499/j.issn.1008-8830.2207088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 07/26/2022] [Indexed: 06/15/2023]
Abstract
The guideline for the diagnosis and treatment of monkeypox (2022 edition) issued by National Health Commission of the People's Republic of China introduces the key knowledge of the diagnosis and treatment of human monkeypox (HMPX) and does not systematically introduce the sampling methods and requirements of specimens for HMPX etiology testing and the discrepancy in diagnostic criteria between China and overseas. However, the doctors who are not engaged in dermatology lack understanding of the sampling methods and requirements of specimens for laboratory diagnosis of HMPX, and there are few relevant references available. This article collects the information on the diagnosis and treatment of HMPX, so as to provide a reference for learning, understanding, and application of this guideline.
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Affiliation(s)
- Kai-Hu Yao
- National Center for Children's Health/Beijing Children's Hospital, Capital Medical University/Laboratory of Dermatology, Beijing Pediatric Research Institute/National Key Discipline of Pediatrics (Capital Medical University)/Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - Qian-Qian DU
- National Center for Children's Health/Beijing Children's Hospital, Capital Medical University/Laboratory of Dermatology, Beijing Pediatric Research Institute/National Key Discipline of Pediatrics (Capital Medical University)/Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
| | - Ya-Hong Hu
- National Center for Children's Health/Beijing Children's Hospital, Capital Medical University/Laboratory of Dermatology, Beijing Pediatric Research Institute/National Key Discipline of Pediatrics (Capital Medical University)/Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
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121
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Loconsole D, Sallustio A, Centrone F, Casulli D, Accogli M, Saracino A, Foti C, Grandolfo M, Buccoliero GB, Vitale V, De Nitto S, Conversano M, Desiante F, Del Sambro L, Simone D, Parisi A, Prato R, Martinelli D, Chironna M. Monkeypox Virus Infections in Southern Italy: Is There a Risk for Community Spread? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811719. [PMID: 36141993 PMCID: PMC9517482 DOI: 10.3390/ijerph191811719] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/06/2022] [Accepted: 09/15/2022] [Indexed: 06/07/2023]
Abstract
The ongoing outbreak of the Monkeypox virus (MPXV) is characterized by sustained human-to-human transmission, particularly among men who have sex with men (MSM). The aim of the study was to describe the characteristics of the MPXV infection identified in Southern Italy. Clinical samples for each suspected case identified from 1 June to 1 August 2022 were tested for MPXV, and whole-genome sequencing (WGS) was performed on two strains. Ten cases were identified: eight were young adult males, including six MSMs, and two were female. Nine subjects reported recent sexual exposure. One female subject without sexual exposure only reported attendance at a social gathering. Overall, 7 of 10 skin lesion samples had a high viral load of MPXV DNA, and 6/9 whole blood samples and 6/8 nasopharyngeal swab samples also tested positive. The analyzed sequences belonged to Clade 3, lineage B.1, and B.1.5, respectively. Despite this recent multinational outbreak of MPXV cases having revealed a high proportion of cases occurring among MSM, the identification of cases among heterosexual subjects and in a female subject without sexual risk factors should raise awareness among clinicians about the possible spread of MPXV in the general population.
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Affiliation(s)
- Daniela Loconsole
- Hygiene Section, Department of Interdisciplinary Medicine, University of Bari, 70124 Bari, Italy
| | - Anna Sallustio
- Hygiene Unit, Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, 70124 Bari, Italy
| | - Francesca Centrone
- Hygiene Section, Department of Interdisciplinary Medicine, University of Bari, 70124 Bari, Italy
| | - Daniele Casulli
- Hygiene Unit, Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, 70124 Bari, Italy
| | - Marisa Accogli
- Hygiene Section, Department of Interdisciplinary Medicine, University of Bari, 70124 Bari, Italy
| | - Annalisa Saracino
- Infectious Diseases Section, Department of Biomedical Sciences and Human Oncology, University of Bari, 70124 Bari, Italy
| | - Caterina Foti
- Section of Dermatology, Department of Biomedical Sciences and Human Oncology, University of Bari, 70124 Bari, Italy
| | - Mauro Grandolfo
- Section of Dermatology, Department of Biomedical Sciences and Human Oncology, University of Bari, 70124 Bari, Italy
| | | | - Viviana Vitale
- Department of Prevention, Local Health Authority of Bari, 70100 Bari, Italy
| | - Sara De Nitto
- Department of Prevention, Local Health Authority of Bari, 70100 Bari, Italy
| | - Michele Conversano
- Department of Prevention, Local Health Authority of Taranto, 74121 Taranto, Italy
| | - Francesco Desiante
- Department of Prevention, Local Health Authority of Taranto, 74121 Taranto, Italy
| | - Laura Del Sambro
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
| | - Domenico Simone
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
| | - Antonio Parisi
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy
| | - Rosa Prato
- Hygiene Section, Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
| | - Domenico Martinelli
- Hygiene Section, Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
| | - Maria Chironna
- Hygiene Section, Department of Interdisciplinary Medicine, University of Bari, 70124 Bari, Italy
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122
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Atypical and Unique Transmission of Monkeypox Virus during the 2022 Outbreak: An Overview of the Current State of Knowledge. Viruses 2022; 14:v14092012. [PMID: 36146818 PMCID: PMC9501469 DOI: 10.3390/v14092012] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/05/2022] [Accepted: 09/07/2022] [Indexed: 12/30/2022] Open
Abstract
An ongoing monkeypox outbreak in non-endemic countries has resulted in the declaration of a public health emergency of international concern by the World Health Organization (WHO). Though monkeypox has long been endemic in regions of sub-Saharan Africa, relatively little is known about its ecology, epidemiology, and transmission. Here, we consider the relevant research on both monkeypox and smallpox, a close relative, to make inferences about the current outbreak. Undetected circulation combined with atypical transmission and case presentation, including mild and asymptomatic disease, have facilitated the spread of monkeypox in non-endemic regions. A broader availability of diagnostics, enhanced surveillance, and targeted education, combined with a better understanding of the routes of transmission, are critical to identify at-risk populations and design science-based countermeasures to control the current outbreak.
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123
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Namdar AB, Keikha M. The global reemergence of human Monkeypox; is mass vaccination essential? VACUNAS 2022; 23:245-246. [PMID: 36320219 PMCID: PMC9597904 DOI: 10.1016/j.vacun.2022.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 06/21/2022] [Accepted: 06/22/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Ali Beheshti Namdar
- Gastroenterology and Hepatology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoud Keikha
- Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Microbiology and Virology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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124
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Farahat RA, Sah R, El-Sakka AA, Benmelouka AY, Kundu M, Labieb F, Shaheen RS, Abdelaal A, Abdelazeem B, Bonilla-Aldana DK, Franco-Paredes C, Henao-Martinez AF, Garout MA, León-Figueroa DA, Pachar M, Suárez JA, Ramirez JD, Paniz-Mondolfi A, Rabaan AA, Al-Tawfiq JA, Nishiura H, Ortiz-Martínez Y, Garcia-Robledo JE, Cimerman S, Barbosa AN, Pagliano P, Zambrano-Sanchez G, Cardona-Ospina JA, Bížová B, Rodriguez-Morales AJ. Human monkeypox disease (MPX). LE INFEZIONI IN MEDICINA 2022; 30:372-391. [PMID: 36148174 PMCID: PMC9448318 DOI: 10.53854/liim-3003-6] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 07/24/2022] [Indexed: 05/24/2023]
Abstract
Monkeypox is a rare viral infection, endemic in many central and western African countries. The last international outbreak of monkeypox reported outside Africa occurred back in 2003. However, monkeypox has reemerged at a global scale with numerous confirmed cases across the globe in 2022. The rapid spread of cases through different countries has raised serious concerns among public health officials worldwide prompting accelerated investigations aimed to identify the origins and cause of the rapid expansion of cases. The current situation is reminiscent of the very early stages of the still ongoing COVID-19 pandemic. Overlapping features between these, two seemingly alike viral entities include the possibility for airborne transmission and the currently unexplained and rapid spread across borders. Early recognition of cases and timely intervention of potential transmission chains are necessary to contain further outbreaks. Measures should include rapid and accurate diagnosis of cases meeting case definitions, active surveillance efforts, and appropriate containment of confirmed cases. Governments and health policymakers must apply lessons learned from previous outbreaks and start taking active steps toward limiting the recent global spread of monkeypox. Herein, we discuss the status of the current monkeypox outbreaks worldwide, the epidemiological and public health situation at a global scale and what can be done to keep at bay its further expansion and future global implications.
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Affiliation(s)
| | - Ranjit Sah
- Department of Microbiology, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Amro A. El-Sakka
- Faculty of Medicine, Suez Canal University, Ismailia 41511, Egypt
| | | | - Mrinmoy Kundu
- Institute of Medical Sciences and SUM Hospital, Siksha ‘O’ Anusandhan, Bhubaneswar 751003, India
| | - Fatma Labieb
- Faculty of Medicine, Beni-Suef Univesity, Beni-Suef 62511, Egypt
| | | | - Abdelaziz Abdelaal
- Harvard Medical School, Boston, MA 02115, USA
- Boston University, MA 02215, USA
- Tanta University Hospitals, 31516 Egypt
| | - Basel Abdelazeem
- Department of Internal Medicine, McLaren Health Care, Flint, Michigan 48532, USA
- Department of Internal Medicine, Michigan State University, East Lansing, Michigan 48823, USA
| | - D. Katterine Bonilla-Aldana
- Grupo de Investigación Biomedicina, Faculty of Medicine, Institución Universitaria Visión de las Américas, Pereira, Risaralda, Colombia
- Latin American Network on MOnkeypox VIrus research (LAMOVI), Pereira, Risaralda, Colombia
| | | | | | - Mohammed A. Garout
- Community Medicine and Pilgrims Health Department, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Darwin A. León-Figueroa
- Grupo de Investigación Biomedicina, Faculty of Medicine, Institución Universitaria Visión de las Américas, Pereira, Risaralda, Colombia
- Facultad de Medicina Humana, Universidad de San Martín de Porres, Chiclayo, Peru
- Emerge, Unidad de Investigación en Enfermedades Emergentes y Cambio Climático, Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Monica Pachar
- Medicine Department-Infectious Diseases Service, Hospital Santo Tomas, Panama City, Panama
| | - José Antonio Suárez
- Investigador SNI Senacyt Panamá, Clinical Research Deparment, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panama
| | - Juan David Ramirez
- Department of Pathology, Molecular, and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Centro de Investigaciones en Microbiología y Biotecnología-UR (CIMBIUR), Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Alberto Paniz-Mondolfi
- Department of Pathology, Molecular, and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ali A. Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, 31311, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh, 11533, Saudi Arabia
- Department of Public Health and Nutrition, The University of Haripur, Haripur, 22610, Pakistan
| | - Jaffar A. Al-Tawfiq
- Specialty Internal Medicine and Quality Department, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
- Infectious Diseases Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Infectious Diseases Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Hiroshi Nishiura
- Kyoto University School of Public Health, Yoshidakonoecho, Sakyoku, Kyoto City 6068501, Japan
| | - Yeimer Ortiz-Martínez
- Grupo de Investigación Biomedicina, Faculty of Medicine, Institución Universitaria Visión de las Américas, Pereira, Risaralda, Colombia
- Department of Internal Medicine, Universidad Industrial de Santander, Bucaramanga, Santander, Colombia
| | | | - Sergio Cimerman
- Instituto de Infectologia Emílio Ribas, São Paulo, SP, Brazil Brazilian Society for Infectious Diseases, São Paulo, SP, Brazil
| | - Alexandre Naime Barbosa
- Infectious Diseases Department, Botucatu Medical School, UNESP Brazilian Society for Infectious Diseases, São Paulo, SP, Brazil
| | - Pasquale Pagliano
- Department of Infectious Diseases, University of Salerno, Salerno, Italy
| | | | - Jaime A. Cardona-Ospina
- Institución Universitaria Visión de las Américas, Pereira, Risaralda, Colombia
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas, 660003, Pereira, Risaralda, Colombia
| | - Beatrice Bížová
- Department of Dermatovenerology, Second Faculty of Medicine, Charles University, University Hospital Bulovka, Prague, Czech Republic
| | - Alfonso J. Rodriguez-Morales
- Grupo de Investigación Biomedicina, Faculty of Medicine, Institución Universitaria Visión de las Américas, Pereira, Risaralda, Colombia
- Latin American Network on MOnkeypox VIrus research (LAMOVI), Pereira, Risaralda, Colombia
- Institución Universitaria Visión de las Américas, Pereira, Risaralda, Colombia
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas, 660003, Pereira, Risaralda, Colombia
- Master of Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, 4861, Peru
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125
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Haider N, Guitian J, Simons D, Asogun D, Ansumana R, Honeyborne I, Velavan TP, Ntoumi F, Valdoleiros SR, Petersen E, Kock R, Zumla A. Increased outbreaks of monkeypox highlight gaps in actual disease burden in Sub-Saharan Africa and in animal reservoirs. Int J Infect Dis 2022; 122:107-111. [PMID: 35640830 PMCID: PMC9534138 DOI: 10.1016/j.ijid.2022.05.058] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 05/25/2022] [Accepted: 05/25/2022] [Indexed: 01/25/2023] Open
Abstract
We explain research gaps on Monkeypox (MPX) virus epidemiology in endemic countries and present hypotheses for the recent increase of MPX cases in West Africa as a possible explanation for the current epidemic in Europe, America, and Australia. The detection of >400 MPX cases in less than a month in May 2022, across many countries underscores the epidemic potential of MPX in humans and demonstrates several important research gaps. First, the true burden of MPX in West and Central Africa is poorly understood, although it is critical for prevention and control of future outbreaks. Second, the diversity and extent of the animal reservoir remain unknown. We hypothesize that the synanthropic rodent population has increased in recent years in Africa leading to more human-rodent interactions and thus increased transmission of MPXV. We further hypothesise that nearly 45 years after the end of routine smallpox vaccination, the larger and more interconnected immune-naïve population has crossed a threshold resulting in more sustainable human-to-human transmission of MPXV. The current epidemic in the Western World is possibly a consequence of increased local transmission of MPXV in Africa. A new estimation of the basic and effective reproduction rate (R0 and Re) in different populations is required. National, regional, and international collaborations are needed to address research gaps related to MPX outbreaks.
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Affiliation(s)
- Najmul Haider
- The Royal Veterinary College, University of London, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, United Kingdom.
| | - Javier Guitian
- The Royal Veterinary College, University of London, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, United Kingdom.
| | - David Simons
- The Royal Veterinary College, University of London, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, United Kingdom.
| | - Danny Asogun
- Irrua Specialized Teaching Hospital, Irrua, Nigeria.
| | - Rashid Ansumana
- School of Community Health Science, Njala University, Bo Campus, Sierra Leone.
| | - Isobella Honeyborne
- Division of Infection and Immunity, Centre for Clinical Microbiology, University College London, United Kingdom.
| | - Thirumalaisamy P Velavan
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany; Vietnamese-German Center for Medical Research (VG-CARE), Hanoi, Vietnam.
| | - Francine Ntoumi
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany; Congolese Foundation for Medical Research, Brazzaville, Republic of Congo.
| | - Sofia R Valdoleiros
- Infectious Diseases Department, Centro Hospitalar Universitário de São João, Porto, Portugal; European Society for Clinical Microbiology and Infectious Diseases, Basel, Switzerland.
| | - Eskild Petersen
- European Society for Clinical Microbiology and Infectious Diseases, Basel, Switzerland; Institute for Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - Richard Kock
- The Royal Veterinary College, University of London, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, United Kingdom.
| | - Alimuddin Zumla
- Division of Infection and Immunity, Centre for Clinical Microbiology, University College London, United Kingdom; NIHR-BRC, University College London Hospitals, London, United Kingdom.
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126
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Comparison of Transcriptomic Signatures between Monkeypox-Infected Monkey and Human Cell Lines. J Immunol Res 2022; 2022:3883822. [PMID: 36093436 PMCID: PMC9458371 DOI: 10.1155/2022/3883822] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 07/21/2022] [Indexed: 12/11/2022] Open
Abstract
Monkeypox virus (MPV) is a smallpox-like virus belonging to the genus Orthopoxvirus of the family Poxviridae. Unlike smallpox with no animal reservoir identified and patients suffering from milder symptoms with less mortality, several animals were confirmed to serve as natural hosts of MPV. The reemergence of a recently reported monkeypox epidemic outbreak in nonendemic countries has raised concerns about a global outburst. Since the underlying mechanism of animal-to-human transmission remains largely unknown, comprehensive analyses to discover principal differences in gene signatures during disease progression have become ever more critical. In this study, two MPV-infected in vitro models, including human immortal epithelial cancer (HeLa) cells and rhesus monkey (Macaca mulatta) kidney epithelial (MK2) cells, were chosen as the two subjects to identify alterations in gene expression profiles, together with co-regulated genes and pathways that are affected during monkeypox disease progression. Using Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and MetaCore analyses, we discovered that elevated expression of genes associated with interleukins (ILs), G protein-coupled receptors (GPCRs), heat shock proteins (HSPs), Toll-like receptors (TLRs), and metabolic-related pathways play major roles in disease progression of both monkeypox-infected monkey MK2 and human HeLa cell lines. Interestingly, our analytical results also revealed that a cluster of differentiation 40 (CD40), plasmin, and histamine served as major regulators in the monkeypox-infected monkey MK2 cell line model, while interferons (IFNs), macrophages, and neutrophil-related signaling pathways dominated the monkeypox-infected human HeLa cell line model. Among immune pathways of interest, apart from traditional monkeypox-regulated signaling pathways such as nuclear factor- (NF-κB), mitogen-activated protein kinases (MAPKs), and tumor necrosis factors (TNFs), we also identified highly significantly expressed genes in both monkey and human models that played pivotal roles during the progression of monkeypox infection, including CXCL1, TNFAIP3, BIRC3, IL6, CCL2, ZC3H12A, IL11, CSF2, LIF, PTX3, IER3, EGR1, ADORA2A, and DUOX1, together with several epigenetic regulators, such as histone cluster family gene members, HIST1H3D, HIST1H2BJ, etc. These findings might contribute to specific underlying mechanisms related to the pathophysiology and provide suggestions regarding modes of transmission, post-infectious sequelae, and vaccine development for monkeypox in the future.
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127
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MacIntyre CR, Grulich AE. Is Australia ready for monkeypox? Med J Aust 2022; 217:193-194. [DOI: 10.5694/mja2.51647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 06/16/2022] [Accepted: 06/21/2022] [Indexed: 11/17/2022]
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128
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Di Gennaro F, Veronese N, Marotta C, Shin JI, Koyanagi A, Silenzi A, Antunes M, Saracino A, Bavaro DF, Soysal P, Segala FV, Butler L, Milano E, Barbagallo M, Barnett Y, Parris C, Nicastri E, Pizzol D, Smith L. Human Monkeypox: A Comprehensive Narrative Review and Analysis of the Public Health Implications. Microorganisms 2022; 10:1633. [PMID: 36014051 PMCID: PMC9416167 DOI: 10.3390/microorganisms10081633] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/05/2022] [Accepted: 08/09/2022] [Indexed: 01/13/2023] Open
Abstract
Recently, numerous cases of monkeypox were reported from several non-endemic countries in Europe, North America, and Oceania, suggesting an unusual and alarming public health issue, particularly considering that the disease is not directly related to human or animal travels. Attention is currently being drawn to this phenomenon since more than 70% of the global population is no longer vaccinated against smallpox. Indeed, the smallpox vaccination also confers some indirect degree of protection against other poxviruses, including monkeypox. We performed a narrative review to describe the existing literature with regard to monkeypox using the MEDLINE, EMBASE, and Scopus databases. This review aims to provide updated evidence of findings on the epidemiology, clinical features, diagnosis, management, and prevention of monkeypox, also considering the concurrent zoonotic pandemic caused by the COVID-19 coronavirus, SARS-CoV-2.
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Affiliation(s)
- Francesco Di Gennaro
- Clinic of Infectious Diseases, University of Bari, University Hospital Policlinico, 70121 Bari, Italy
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy
| | - Claudia Marotta
- General Directorate of Health Prevention, Ministry of Health, 00144 Rome, Italy
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, 08010 Barcelona, Spain
- ICREA, Passeig Lluis Companys 23, 08010 Barcelona, Spain
| | - Andrea Silenzi
- General Directorate of Health Prevention, Ministry of Health, 00144 Rome, Italy
| | - Mario Antunes
- Department of Surgery, Catholic University of Mozambique, Beira 13016, Mozambique
| | - Annalisa Saracino
- Clinic of Infectious Diseases, University of Bari, University Hospital Policlinico, 70121 Bari, Italy
| | - Davide Fiore Bavaro
- Clinic of Infectious Diseases, University of Bari, University Hospital Policlinico, 70121 Bari, Italy
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul 34093, Turkey
| | | | - Laurie Butler
- Faculty of Science and Engineering, Anglia Ruskin University, Cambridge CB1 1PT, UK
| | - Eugenio Milano
- Clinic of Infectious Diseases, University of Bari, University Hospital Policlinico, 70121 Bari, Italy
| | - Mario Barbagallo
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy
| | - Yvonne Barnett
- Faculty of Science and Engineering, Anglia Ruskin University, Cambridge CB1 1PT, UK
| | - Christopher Parris
- Faculty of Science and Engineering, Anglia Ruskin University, Cambridge CB1 1PT, UK
| | - Emanuele Nicastri
- National Institute for Infectious Diseases, Lazzaro Spallanzani, IRCCS, Via Portuense, 292, 00149 Rome, Italy
| | - Damiano Pizzol
- Italian Agency for Development Cooperation, 00135 Khartoum, Sudan
| | - Lee Smith
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge CB1 1PT, UK
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129
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Haddad N. The presumed receptivity and susceptibility to monkeypox of European animal species. Infect Dis Now 2022; 52:294-298. [PMID: 35753629 PMCID: PMC9767312 DOI: 10.1016/j.idnow.2022.06.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 06/22/2022] [Indexed: 12/24/2022]
Abstract
The Monkeypox virus belongs to the Orthopoxvius genus, as does the specifically human smallpox virus. It is zoonotic and had never previously been considered as capable of human-to-human transmission over more than nine viral generation cycles. While relevant animal reservoirs have yet to be identified, non-human primates (NHP) are only accidental hosts. The potentially high number of current human shedders during the clinical phase (3 weeks maximum) raises the question of a risk in our countries of animals being contaminated by infected humans (reverse zoonosis). Cats as well as cows are susceptible to the Cowpox virus, another zoonotic Orthopoxvirus, which they transmit to humans. Dogs are much less susceptible to this virus and seem only receptive to Vaccinia virus (also belonging to the Orthopoxvirus genus). On the other hand, one study has demonstrated the pronounced susceptibility of the adult albino rabbit and of young animals of several rodent species to Monkeypox virus (MPXV). Given the susceptibility to MPXV of prairie dogs, which are American Sciuridae, the potential for infection of European squirrels cannot be ruled out.
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Affiliation(s)
- Nadia Haddad
- Anses, INRAe, Ecole Nationale Vétérinaire d'Alfort, UMR BIPAR, Laboratoire de Santé Animale, Maisons-Alfort 94700, France.
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130
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Karbalaei M, Keikha M. Human monkeypox coinfections; lessons from available cases - Correspondence. Int J Surg 2022; 104:106734. [PMID: 35760344 PMCID: PMC9628635 DOI: 10.1016/j.ijsu.2022.106734] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 06/22/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Mohsen Karbalaei
- Department of Microbiology and Virology, School of Medicine, Jiroft University of Medical Sciences, Jiroft, Iran
| | - Masoud Keikha
- Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Microbiology and Virology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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131
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Gong Q, Wang C, Chuai X, Chiu S. Monkeypox virus: a re-emergent threat to humans. Virol Sin 2022; 37:477-482. [PMID: 35820590 PMCID: PMC9437600 DOI: 10.1016/j.virs.2022.07.006] [Citation(s) in RCA: 134] [Impact Index Per Article: 44.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 07/05/2022] [Indexed: 12/17/2022] Open
Abstract
Human monkeypox (MPX) is a rare zoonotic infection characterized by smallpox-like signs and symptoms. It is caused by monkeypox virus (MPXV), a double stranded DNA virus belonging to the genus Orthopoxvirus. MPX was first identified in 1970 and mostly prevailed in the rural rainforests of Central and West Africa in the past. Outside Africa, MPX was reported in the United Kingdom, the USA, Israel, and Singapore. In 2022, the resurgence of MPX in Europe and elsewhere posed a potential threat to humans. MPXV was transmitted by the animals-human or human-human pathway, and the symptoms of MPXV infection are similar to that of smallpox, but in a milder form and with lower mortality (1%-10%). Although the smallpox vaccination has been shown to provide 85% protection against MPXV infection, and two anti-smallpox virus drugs have been approved to treat MPXV, there are still no specific vaccines and drugs against MPXV infection. Therefore it is urgent to take active measures including the adoption of novel anti-MPXV strategies to control the spread of MPXV and prevent MPX epidemic. In this review, we summarize the biological features, epidemiology, pathogenicity, laboratory diagnosis, and prevention and treatment strategies on MPXV. This review provides the basic knowledge for prevention and control of future outbreaks of this emerging infection.
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Affiliation(s)
- Qizan Gong
- Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026, China
| | - Changle Wang
- Department of Pathogenic Biology, Hebei Medical University, Shijiazhuang, Hebei, 050017, China
| | - Xia Chuai
- Department of Pathogenic Biology, Hebei Medical University, Shijiazhuang, Hebei, 050017, China.
| | - Sandra Chiu
- Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026, China.
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132
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Rouhani J, Keikha M. The past, present, and future of a silent multi-country human monkeypox outbreak 2022 – Correspondence. Int J Surg 2022; 104:106817. [PMID: 35944802 PMCID: PMC9356592 DOI: 10.1016/j.ijsu.2022.106817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 08/02/2022] [Indexed: 10/29/2022]
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133
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Matias WR, Koshy JM, Nagami EH, Kovac V, Moeng LR, Shenoy ES, Hooper DC, Madoff LC, Barshak MB, Johnson JA, Rowley CF, Julg B, Hohmann EL, Lazarus JE. Tecovirimat for the treatment of human monkeypox: an initial series from Massachusetts, United States. Open Forum Infect Dis 2022; 9:ofac377. [PMID: 35949403 PMCID: PMC9356679 DOI: 10.1093/ofid/ofac377] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 07/26/2022] [Indexed: 11/18/2022] Open
Abstract
A large, ongoing multicountry outbreak of human monkeypox has the potential to cause considerable morbidity and mortality. Therapeutics for the treatment of smallpox, a related Orthopoxvirus, may be used and affect the natural history of monkeypox. We present 3 patients from our hospitals treated with tecovirimat, a pan-Orthopoxvirus inhibitor currently available under an expanded access investigational new drug protocol for monkeypox.
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Affiliation(s)
- Wilfredo R Matias
- Massachusetts General Hospital, Boston , Massachusetts , USA
- Brigham and Women’s Hospital, Boston , Massachusetts , USA
- Harvard Medical School , Boston, Massachusetts , USA
- Mass General Center for Global Health , Boston, Massachusetts , USA
| | - Jacob M Koshy
- Harvard Medical School , Boston, Massachusetts , USA
- Beth Israel Deaconess Medical Center, Boston , Massachusetts , USA
| | - Ellen H Nagami
- Massachusetts General Hospital, Boston , Massachusetts , USA
- Brigham and Women’s Hospital, Boston , Massachusetts , USA
- Harvard Medical School , Boston, Massachusetts , USA
| | - Victor Kovac
- Massachusetts General Hospital, Boston , Massachusetts , USA
- Brigham and Women’s Hospital, Boston , Massachusetts , USA
- Harvard Medical School , Boston, Massachusetts , USA
| | - Letumile R Moeng
- Harvard Medical School , Boston, Massachusetts , USA
- Beth Israel Deaconess Medical Center, Boston , Massachusetts , USA
| | - Erica S Shenoy
- Massachusetts General Hospital, Boston , Massachusetts , USA
- Harvard Medical School , Boston, Massachusetts , USA
| | - David C Hooper
- Massachusetts General Hospital, Boston , Massachusetts , USA
- Harvard Medical School , Boston, Massachusetts , USA
| | - Lawrence C Madoff
- Massachusetts Department of Public Health, Boston, and University of Massachusetts Chan Medical School , Worcester, Massachusetts , USA
| | - Miriam B Barshak
- Massachusetts General Hospital, Boston , Massachusetts , USA
- Harvard Medical School , Boston, Massachusetts , USA
| | - Jennifer A Johnson
- Brigham and Women’s Hospital, Boston , Massachusetts , USA
- Harvard Medical School , Boston, Massachusetts , USA
| | - Christopher F Rowley
- Harvard Medical School , Boston, Massachusetts , USA
- Beth Israel Deaconess Medical Center, Boston , Massachusetts , USA
| | - Boris Julg
- Massachusetts General Hospital, Boston , Massachusetts , USA
- Harvard Medical School , Boston, Massachusetts , USA
- Ragon Institute of MGH, MIT and Harvard , Cambridge, Massachusetts , USA
| | - Elizabeth L Hohmann
- Massachusetts General Hospital, Boston , Massachusetts , USA
- Harvard Medical School , Boston, Massachusetts , USA
| | - Jacob E Lazarus
- Massachusetts General Hospital, Boston , Massachusetts , USA
- Harvard Medical School , Boston, Massachusetts , USA
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134
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Yao KH. [Learning from the past: the history of human monkeypox and the atypical multi-country outbreak in 2022]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2022; 24:717-727. [PMID: 35894184 PMCID: PMC9336622 DOI: 10.7499/j.issn.1008-8830.2206019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 06/14/2022] [Indexed: 01/25/2023]
Abstract
In 2022, the outbreak of human monkeypox (HMPX) occurred in many non-endemic countries. World Health Organization (WHO) assesses that this outbreak is "atypical". The history of monkeypox and HMPX must be reviewed to clearly recognize the "typical" outbreaks to fully understand this comment. Therefore, this paper reviews the epidemiological history of monkeypox, especially HMPX, and discusses and analyzes the atypical manifestations and the possible causes of the present outbreak based on the recent views of WHO, other organizations/institutions, and experts. The text describes the thought-provoking history of the interaction between the monkeypox virus and the human being in the past 64 years, and provides various information and views on the outbreak of HMPX, which is helpful to understand risk assessment and the potential impact of this outbreak on clinical and public health in future.
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Affiliation(s)
- Kai-Hu Yao
- National Center for Children's Health/Beijing Children's Hospital, Capital Medical University/Laboratory of Dermatology, Beijing Pediatric Research Institute/National Key Discipline of Pediatrics (Capital Medical University)/Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China
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135
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Riccò M, Ferraro P, Camisa V, Satta E, Zaniboni A, Ranzieri S, Baldassarre A, Zaffina S, Marchesi F. When a Neglected Tropical Disease Goes Global: Knowledge, Attitudes and Practices of Italian Physicians towards Monkeypox, Preliminary Results. Trop Med Infect Dis 2022; 7:135. [PMID: 35878146 PMCID: PMC9316880 DOI: 10.3390/tropicalmed7070135] [Citation(s) in RCA: 96] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/09/2022] [Accepted: 07/12/2022] [Indexed: 02/04/2023] Open
Abstract
Monkeypox (MPX) has been regarded as a neglected tropic disease of Western and Central Africa since the early 70s. However, during May 2022, an unprecedent outbreak of MPX has involved most of European Countries, as well as North and South America. While the actual extent of this outbreak is being assessed by health authorities, we performed a pilot study on specific knowledge, attitudes, and practices (KAP) in a sample of Italian medical professionals (24-30 May 2022; 10,293 potential recipients), focusing on Occupational Physicians (OP), Public Health Professionals (PH), and General Practitioners (GP), i.e., medical professionals more likely involved in the early management of incident cases. More specifically, we inquired into their attitude on the use of variola vaccine in order to prevent MPX infection. From a total of 566 questionnaire (response rate of 5.5%), 163 participants were included in the final analyses. Knowledge status was quite unsatisfying, with substantial knowledge gaps on all aspect of MPX. In turn, analysis of risk perception suggested a substantial overlooking of MPX as a pathogen, particularly when compared to SARS-CoV-2, TB, HIV, and HBV. Overall, 58.6% of respondents were somehow favorable to implement variola vaccination in order to prevent MPX, and the main effectors of this attitude were identified in having been previously vaccinated against seasonal influenza (adjusted Odds Ratio [aOR] 6.443, 95% Confidence Interval [95%CI] 1.798-23.093), and being favorable to receive variola vaccine (aOR 21.416; 95%CI 7.290-62.914). In summary, the significant extent of knowledge gaps and the erratic risk perception, associated collectively stress the importance of appropriate information campaigns among first-line medical professionals.
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Affiliation(s)
- Matteo Riccò
- Servizio di Prevenzione e Sicurezza Negli Ambienti di Lavoro (SPSAL), AUSL-IRCCS di Reggio Emilia, Via Amendola n.2, I-42122 Reggio Emilia, Italy
| | - Pietro Ferraro
- Occupational Medicine Unit, Direzione Sanità, Italian Railways’ Infrastructure Division, RFI SpA, I-00161 Rome, Italy;
| | - Vincenzo Camisa
- Health Directorate, Occupational Medicine Unit, Bambino Gesù Children’s Hospital IRCCS, I-00146 Rome, Italy; (V.C.); (S.Z.)
| | - Elia Satta
- Department of Medicine and Surgery, University of Parma, Via Gramsci, 14, I-43126 Parma, Italy; (E.S.); (A.Z.); (S.R.); (F.M.)
| | - Alessandro Zaniboni
- Department of Medicine and Surgery, University of Parma, Via Gramsci, 14, I-43126 Parma, Italy; (E.S.); (A.Z.); (S.R.); (F.M.)
| | - Silvia Ranzieri
- Department of Medicine and Surgery, University of Parma, Via Gramsci, 14, I-43126 Parma, Italy; (E.S.); (A.Z.); (S.R.); (F.M.)
| | - Antonio Baldassarre
- Occupational Medicine Unit, Careggi University Hospital, I-50134 Florence, Italy;
| | - Salvatore Zaffina
- Health Directorate, Occupational Medicine Unit, Bambino Gesù Children’s Hospital IRCCS, I-00146 Rome, Italy; (V.C.); (S.Z.)
| | - Federico Marchesi
- Department of Medicine and Surgery, University of Parma, Via Gramsci, 14, I-43126 Parma, Italy; (E.S.); (A.Z.); (S.R.); (F.M.)
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136
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Peiró-Mestres A, Fuertes I, Camprubí-Ferrer D, Marcos MÁ, Vilella A, Navarro M, Rodriguez-Elena L, Riera J, Català A, Martínez MJ, Blanco JL. Frequent detection of monkeypox virus DNA in saliva, semen, and other clinical samples from 12 patients, Barcelona, Spain, May to June 2022. Euro Surveill 2022; 27. [PMID: 35837964 DOI: 10.2807/1560-7917.es.2022.27.28.2200503/cite/plaintext] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023] Open
Abstract
A monkeypox (MPX) outbreak has expanded worldwide since May 2022. We tested 147 clinical samples collected at different time points from 12 patients by real-time PCR. MPX DNA was detected in saliva from all cases, sometimes with high viral loads. Other samples were frequently positive: rectal swab (11/12 cases), nasopharyngeal swab (10/12 cases), semen (7/9 cases), urine (9/12 cases) and faeces (8/12 cases). These results improve knowledge on virus shedding and the possible role of bodily fluids in disease transmission.
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Affiliation(s)
- Aida Peiró-Mestres
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Irene Fuertes
- Dermatology Department, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Daniel Camprubí-Ferrer
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - María Ángeles Marcos
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
- Microbiology Department, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Anna Vilella
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
- Preventive Medicine and Epidemiology Department, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Mireia Navarro
- Microbiology Department, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | | | - Josep Riera
- Dermatology Department, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Alba Català
- Dermatology Department, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Miguel J Martínez
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
- Microbiology Department, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Jose L Blanco
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Universitat de Barcelona, Barcelona, Spain
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137
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Peiró-Mestres A, Fuertes I, Camprubí-Ferrer D, Marcos MÁ, Vilella A, Navarro M, Rodriguez-Elena L, Riera J, Català A, Martínez MJ, Blanco JL. Frequent detection of monkeypox virus DNA in saliva, semen, and other clinical samples from 12 patients, Barcelona, Spain, May to June 2022. Euro Surveill 2022; 27:2200503. [PMID: 35837964 PMCID: PMC9284919 DOI: 10.2807/1560-7917.es.2022.27.28.2200503] [Citation(s) in RCA: 202] [Impact Index Per Article: 67.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 07/14/2022] [Indexed: 12/29/2022] Open
Abstract
A monkeypox (MPX) outbreak has expanded worldwide since May 2022. We tested 147 clinical samples collected at different time points from 12 patients by real-time PCR. MPX DNA was detected in saliva from all cases, sometimes with high viral loads. Other samples were frequently positive: rectal swab (11/12 cases), nasopharyngeal swab (10/12 cases), semen (7/9 cases), urine (9/12 cases) and faeces (8/12 cases). These results improve knowledge on virus shedding and the possible role of bodily fluids in disease transmission.
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Affiliation(s)
- Aida Peiró-Mestres
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Irene Fuertes
- Dermatology Department, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Daniel Camprubí-Ferrer
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - María Ángeles Marcos
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
- Microbiology Department, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Anna Vilella
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
- Preventive Medicine and Epidemiology Department, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Mireia Navarro
- Microbiology Department, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | | | - Josep Riera
- Dermatology Department, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Alba Català
- Dermatology Department, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Miguel J Martínez
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
- Microbiology Department, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Jose L Blanco
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Infectious Diseases Department, Hospital Clínic-IDIBAPS, Universitat de Barcelona, Barcelona, Spain
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138
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Hraib M, Jouni S, Albitar MM, Alaidi S, Alshehabi Z. The outbreak of monkeypox 2022: An overview. Ann Med Surg (Lond) 2022; 79:104069. [PMID: 35860140 PMCID: PMC9289401 DOI: 10.1016/j.amsu.2022.104069] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 06/22/2022] [Indexed: 12/17/2022] Open
Abstract
On May 6, 2022 an outbreak of monkeypox (MPX) was confirmed in the United Kingdom, originating from a British resident who had travelled to Nigeria. As of May 21, 2022, 92 cases have been confirmed worldwide, from 13 countries where monkeypox virus (MPXV) is not endemic. Reported cases thus far have mainly but not exclusively been identified among gay and bisexual men aged 20–50. MPXV is a viral zoonosis transmitted to humans via contacting or eating an infected animal, and direct connect with natural host's blood and body fluids. In addition to contacting with a patient's respiratory droplets, lesions, body fluids and polluted personal objects. Symptoms including shivers, headaches, fainting, backaches, and myodynia do not have any specific characteristics making it difficult to establish a proper diagnosis. Nevertheless, lymphatic hyperplasia, one of the most common symptoms of monkeypox, can be useful for diagnosing the disease. Clinical symptoms help establish the suspicion of monkeypox. However, in the absence of confirmed diagnostic tests it is very difficult to verify the disease and determine its cause based on clinical symptoms alone. There are numerous methods for detecting MPX, involving genetic, phenotypic, immunological methods, and electron microscopy. These tests require modern equipment and expert hands, which may not be available in developing countries where this disease is prevalent. Currently, there is no definite treatment for MPX. CDC recommends administering the smallpox vaccine within 4 days of exposure which may prevent the disease from happening, and within 2 weeks to reduce symptoms severity. To promptly identify patients and prevent further spreading, physicians should be aware of the travel or contact history of the patient with compatible symptoms. On May 6, 2022 an outbreak of monkeypox (MPX) was confirmed in the United Kingdom, originating from a British resident who had travelled to Nigeria. As of May 21, 2022, 92 cases have been confirmed worldwide, from 13 countries where monkeypox virus (MPXV) is not endemic. MPXV is a viral zoonosis transmitted to humans via contacting or eating an infected animal, and direct connect with natural host's blood and body fluids. In addition to contacting with a patient's respiratory droplets, lesions, body fluids and polluted personal objects. Symptoms do not have any specific characteristics. Nevertheless, lymphatic hyperplasia, one of the most common symptoms of monkeypox, can be useful for diagnosing the disease.
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Affiliation(s)
- Munawar Hraib
- Faculty of Medicine, Tishreen University, Latakia, Syria
| | - Sarah Jouni
- Faculty of Medicine, Tishreen University, Latakia, Syria
| | | | - Sara Alaidi
- Faculty of Medicine, Tishreen University, Latakia, Syria
| | - Zuheir Alshehabi
- Department of Pathology, Tishreen University Hospital, Latakia, Syria
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139
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Affiliation(s)
- Thirumalaisamy P Velavan
- Institute of Tropical Medicine, Universitätsklinikum Tübingen, Tübingen, Germany
- Vietnamese German Center for Medical Research (VG-CARE), Hanoi, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Christian G Meyer
- Institute of Tropical Medicine, Universitätsklinikum Tübingen, Tübingen, Germany
- Vietnamese German Center for Medical Research (VG-CARE), Hanoi, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
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140
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Shchelkunov SN, Yakubitskiy SN, Sergeev AA, Starostina EV, Titova KA, Pyankov SA, Shchelkunova GA, Borgoyakova MB, Zadorozhny AM, Orlova LA, Kisakov DN, Karpenko LI. Enhancing the Immunogenicity of Vaccinia Virus. Viruses 2022; 14:v14071453. [PMID: 35891430 PMCID: PMC9317313 DOI: 10.3390/v14071453] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 06/27/2022] [Accepted: 06/29/2022] [Indexed: 11/24/2022] Open
Abstract
The conventional live smallpox vaccine based on the vaccinia virus (VACV) cannot be widely used today because it is highly reactogenic. Therefore, there is a demand for designing VACV variants possessing enhanced immunogenicity, making it possible to reduce the vaccine dose and, therefore, significantly eliminate the pathogenic effect of the VACV on the body. In this study, we analyzed the development of the humoral and T cell-mediated immune responses elicited by immunizing mice with low-dose VACV variants carrying the mutant A34R gene (which increases production of extracellular virions) or the deleted A35R gene (whose protein product inhibits antigen presentation by the major histocompatibility complex class II). The VACV LIVP strain, which is used as a smallpox vaccine in Russia, and its recombinant variants LIVP-A34R*, LIVP-dA35R, and LIVP-A34R*-dA35R, were compared upon intradermal immunization of BALB/c mice at a dose of 104 pfu/animal. The strongest T cell-mediated immunity was detected in mice infected with the LIVP-A34R*-dA35R virus. The parental LIVP strain induced a significantly lower antibody level compared to the strains carrying the modified A34R and A35R genes. Simultaneous modification of the A34R gene and deletion of the A35R gene in VACV LIVP synergistically enhanced the immunogenic properties of the LIVP-A34R*-dA35R virus.
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141
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Lübbert C, Pietsch C. Orthopoxviren. Dtsch Med Wochenschr 2022. [DOI: 10.1055/a-1848-9445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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142
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Li Z, Er S. Scientists’ interest in monkeypox may help countries worldwide. JOURNAL OF BIOSAFETY AND BIOSECURITY 2022; 4:86-87. [DOI: 10.1016/j.jobb.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 06/16/2022] [Indexed: 10/17/2022] Open
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143
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Simões P, Bhagani S. A viewpoint: The 2022 monkeypox outbreak. J Virus Erad 2022; 8:100078. [PMID: 35784677 PMCID: PMC9241087 DOI: 10.1016/j.jve.2022.100078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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144
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Luo Q, Han J. Preparedness for a monkeypox outbreak. INFECTIOUS MEDICINE 2022; 1:124-134. [PMID: 38013719 PMCID: PMC9295333 DOI: 10.1016/j.imj.2022.07.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/01/2022] [Accepted: 07/04/2022] [Indexed: 10/31/2022]
Abstract
In light of the ongoing COVID-19 pandemic, the unexpected outbreak and worldwide spread of monkeypox has gained global attention. As of June 22, 2022, there were 3340 confirmed cases of monkeypox globally, which is the largest and most widespread monkeypox epidemic outside Africa. Monkeypox virus (MPXV) is transmitted from human-to-human through direct contact with infectious skin or mucosal skin lesions, respiratory droplets, or indirect contact with contaminated objects or materials, as well as mother-to-child vertical transmission. It is also possibly sexually transmitted through semen/vaginal fluid, and the possibility of community transmission cannot be ruled out. Monkeypox is a viral zoonotic disease caused by MPXV, which is an enveloped, linear, double-stranded DNA virus belonging to the Orthopoxvirus genus, of the Chordopoxvirinae subfamily, within the Poxviridae family. Monkeypox is usually a self-limiting infection, with symptoms lasting 2-4 weeks, and has a fatality rate that has historically fluctuated from 0% to 11%. Symptoms of monkeypox include intense headaches, fever, lesions, and lymphadenopathy. Although there is no specific treatment or vaccine for MPXV infection, antiviral drugs and vaccines for smallpox have been approved for use in several countries in response to the monkeypox outbreak. Before the virus can be allowed to establish efficient person-to-person transmission, rapid action must be taken to contain the local spread and, by extension, the multi-country outbreak of monkeypox.
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Affiliation(s)
- Qin Luo
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Rd, Beijing 102206, China
| | - Jun Han
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Rd, Beijing 102206, China
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145
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Rao AK, Schulte J, Chen TH, Hughes CM, Davidson W, Neff JM, Markarian M, Delea KC, Wada S, Liddell A, Alexander S, Sunshine B, Huang P, Honza HT, Rey A, Monroe B, Doty J, Christensen B, Delaney L, Massey J, Waltenburg M, Schrodt CA, Kuhar D, Satheshkumar PS, Kondas A, Li Y, Wilkins K, Sage KM, Yu Y, Yu P, Feldpausch A, McQuiston J, Damon IK, McCollum AM. Monkeypox in a Traveler Returning from Nigeria - Dallas, Texas, July 2021. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2022; 71:509-516. [PMID: 35389974 PMCID: PMC8989376 DOI: 10.15585/mmwr.mm7114a1] [Citation(s) in RCA: 170] [Impact Index Per Article: 56.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Monkeypox is a rare, sometimes life-threatening zoonotic infection that occurs in west and central Africa. It is caused by Monkeypox virus, an orthopoxvirus similar to Variola virus (the causative agent of smallpox) and Vaccinia virus (the live virus component of orthopoxvirus vaccines) and can spread to humans. After 39 years without detection of human disease in Nigeria, an outbreak involving 118 confirmed cases was identified during 2017-2018 (1); sporadic cases continue to occur. During September 2018-May 2021, six unrelated persons traveling from Nigeria received diagnoses of monkeypox in non-African countries: four in the United Kingdom and one each in Israel and Singapore. In July 2021, a man who traveled from Lagos, Nigeria, to Dallas, Texas, became the seventh traveler to a non-African country with diagnosed monkeypox. Among 194 monitored contacts, 144 (74%) were flight contacts. The patient received tecovirimat, an antiviral for treatment of orthopoxvirus infections, and his home required large-scale decontamination. Whole genome sequencing showed that the virus was consistent with a strain of Monkeypox virus known to circulate in Nigeria, but the specific source of the patient's infection was not identified. No epidemiologically linked cases were reported in Nigeria; no contact received postexposure prophylaxis (PEP) with the orthopoxvirus vaccine ACAM2000.
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146
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Bunge EM, Hoet B, Chen L, Lienert F, Weidenthaler H, Baer LR, Steffen R. The changing epidemiology of human monkeypox-A potential threat? A systematic review. PLoS Negl Trop Dis 2022; 16:e0010141. [PMID: 35148313 PMCID: PMC8870502 DOI: 10.1371/journal.pntd.0010141] [Citation(s) in RCA: 1006] [Impact Index Per Article: 335.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 02/24/2022] [Accepted: 01/04/2022] [Indexed: 12/17/2022] Open
Abstract
Monkeypox, a zoonotic disease caused by an orthopoxvirus, results in a smallpox-like disease in humans. Since monkeypox in humans was initially diagnosed in 1970 in the Democratic Republic of the Congo (DRC), it has spread to other regions of Africa (primarily West and Central), and cases outside Africa have emerged in recent years. We conducted a systematic review of peer-reviewed and grey literature on how monkeypox epidemiology has evolved, with particular emphasis on the number of confirmed, probable, and/or possible cases, age at presentation, mortality, and geographical spread. The review is registered with PROSPERO (CRD42020208269). We identified 48 peer-reviewed articles and 18 grey literature sources for data extraction. The number of human monkeypox cases has been on the rise since the 1970s, with the most dramatic increases occurring in the DRC. The median age at presentation has increased from 4 (1970s) to 21 years (2010-2019). There was an overall case fatality rate of 8.7%, with a significant difference between clades-Central African 10.6% (95% CI: 8.4%- 13.3%) vs. West African 3.6% (95% CI: 1.7%- 6.8%). Since 2003, import- and travel-related spread outside of Africa has occasionally resulted in outbreaks. Interactions/activities with infected animals or individuals are risk behaviors associated with acquiring monkeypox. Our review shows an escalation of monkeypox cases, especially in the highly endemic DRC, a spread to other countries, and a growing median age from young children to young adults. These findings may be related to the cessation of smallpox vaccination, which provided some cross-protection against monkeypox, leading to increased human-to-human transmission. The appearance of outbreaks beyond Africa highlights the global relevance of the disease. Increased surveillance and detection of monkeypox cases are essential tools for understanding the continuously changing epidemiology of this resurging disease.
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Affiliation(s)
- Eveline M. Bunge
- Pallas Health Research and Consultancy, Rotterdam, The Netherlands
| | | | - Liddy Chen
- Bavarian Nordic, Inc., Morrisville, North Carolina, United States of America
| | | | | | - Lorraine R. Baer
- Baer PharMed Consulting, Ltd., Skokie, Illinois, United States of America
| | - Robert Steffen
- Epidemiology, Biostatistics and Prevention Institute, WHO Collaborating Center on Travelers’ Health, University of Zurich, Zurich, Switzerland
- Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health, Houston, Texas, United States of America
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147
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Masood W, Khan HA, Cheema HA, Shahid A, Bilal W, Kamal MA, Essar MY, Ahmad S, Marzo RR. The Past, Present, and Future of Monkeypox: A Rapid Review Regarding Prevalence and Prevention. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2022; 59:469580221139366. [PMID: 36484333 PMCID: PMC9742718 DOI: 10.1177/00469580221139366] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 10/30/2022] [Accepted: 10/31/2022] [Indexed: 12/13/2022]
Abstract
While monkeypox virus (MPXV) remained endemic in central and western African countries, a sudden unusual spike of global cases among non-endemic countries is an enigma for scientists. With 257 cases reported as of 26th May 2021, a multi-country outbreak of monkeypox has been declared in countries including the UK, EU/EEA states, and North America. Even though the likelihood of transmissibility of MPXV is limited compared to COVID-19, yet a coordinated multidisciplinary effort is required to prevent any further global expansion. Few appropriate responsive approaches to contain the infection could be; limiting the contact with potential animal reservoirs, isolation of confirmed cases, using PPEs to prevent human-human transmission, awareness activities, and administration of pre and post prophylactic vaccination. In this review, we have discussed the previous and current outbreaks of MPXV along with the abrupt actions that are needed to address the situation.
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Affiliation(s)
| | | | | | - Abia Shahid
- King Edward Medical University, Lahore, Pakistan
| | - Wajeeha Bilal
- Dow University of Health Sciences, Karachi, Pakistan
| | | | | | - Shoaib Ahmad
- District Head Quarter Teaching Hospital, Faisalabad, Pakistan
| | - Roy Rillera Marzo
- Department of Community Medicine, International Medical School, Management and Science University, Malaysia
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
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148
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Jayswal S, Kakadiya J. A narrative review of pox: smallpox vs monkeypox. THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2022; 34:90. [PMCID: PMC9746567 DOI: 10.1186/s43162-022-00174-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 11/15/2022] [Indexed: 12/15/2022] Open
Abstract
The famed variola (smallpox) virus and the monkeypox virus (MPXV) are closely related, and MPXV causes a milder form of febrile rash disease in people. Human monkeypox was mostly an uncommon zoonotic illness that was restricted to West and Central African wooded areas in the twentieth century. The global population’s smallpox vaccine-induced immunity, however, has started to decrease as the number of cases and the geographic breadth have both increased significantly in this century. Several countries have seen human monkeypox outbreaks since May 2022. A possible shift in the monkeypox transmission pattern that might represent a bigger worldwide danger is raised by the atypical nature of these outbreaks, which are characterized by their high-case numbers and absence of ties to endemic countries. Here, we explore a wide range of MPXV biology topics.
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Affiliation(s)
- Samiksha Jayswal
- grid.510466.00000 0004 5998 4868Department of Pharmacology, Parul Institute of Pharmacy and Research, Parul University, Vadodara, 391760 Gujarat India
| | - Jagdish Kakadiya
- grid.510466.00000 0004 5998 4868Department of Pharmacology, Parul Institute of Pharmacy and Research, Parul University, Vadodara, 391760 Gujarat India
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149
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Transmission dynamics of Monkeypox virus: a mathematical modelling approach. ACTA ACUST UNITED AC 2021; 8:3423-3434. [PMID: 34667829 PMCID: PMC8516625 DOI: 10.1007/s40808-021-01313-2] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 09/30/2021] [Indexed: 12/17/2022]
Abstract
Monkeypox (MPX), similar to both smallpox and cowpox, is caused by the monkeypox virus (MPXV). It occurs mostly in remote Central and West African communities, close to tropical rain forests. It is caused by the monkeypox virus in the Poxviridae family, which belongs to the genus Orthopoxvirus. We develop and analyse a deterministic mathematical model for the monkeypox virus. Both local and global asymptotic stability conditions for disease-free and endemic equilibria are determined. It is shown that the model undergo backward bifurcation, where the locally stable disease-free equilibrium co-exists with an endemic equilibrium. Furthermore, we determine conditions under which the disease-free equilibrium of the model is globally asymptotically stable. Finally, numerical simulations to demonstrate our findings and brief discussions are provided. The findings indicate that isolation of infected individuals in the human population helps to reduce disease transmission.
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150
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Hobson G, Adamson J, Adler H, Firth R, Gould S, Houlihan C, Johnson C, Porter D, Rampling T, Ratcliffe L, Russell K, Shankar AG, Wingfield T. Family cluster of three cases of monkeypox imported from Nigeria to the United Kingdom, May 2021. Euro Surveill 2021; 26:2100745. [PMID: 34387184 PMCID: PMC8365177 DOI: 10.2807/1560-7917.es.2021.26.32.2100745] [Citation(s) in RCA: 128] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 08/12/2021] [Indexed: 11/20/2022] Open
Abstract
Most reported cases of human monkeypox occur in Central and West Africa, where the causing virus is endemic. We describe the identification and public health response to an imported case of West African monkeypox from Nigeria to the United Kingdom (UK) in May 2021. Secondary transmission from the index case occurred within the family to another adult and a toddler. Concurrent COVID-19-related control measures upon arrival and at the hospital, facilitated detection and limited the number of potential contacts.
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Affiliation(s)
- Gemma Hobson
- Health Protection, Public Health Wales, Cardiff, United Kingdom
| | - James Adamson
- Health Protection, Public Health Wales, Cardiff, United Kingdom
| | - Hugh Adler
- Tropical and Infectious Disease Unit, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
- Departments of International Public Health and Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Richard Firth
- Health Protection, Public Health Wales, Cardiff, United Kingdom
| | - Susan Gould
- Tropical and Infectious Disease Unit, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
- Departments of International Public Health and Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Catherine Houlihan
- Rare and Imported Pathogens Laboratory, Public Health England, Porton, Salisbury, United Kingdom
- Department of Virology, University College Hospital London, London, United Kingdom
| | | | - David Porter
- Department of Paediatric Infectious Diseases, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
| | - Tommy Rampling
- Rare and Imported Pathogens Laboratory, Public Health England, Porton, Salisbury, United Kingdom
- Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Libuse Ratcliffe
- Tropical and Infectious Disease Unit, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
| | - Katherine Russell
- Emerging Infections and Zoonoses Section, National Infection Service, Public Health England, Colindale, London, United Kingdom
| | | | - Tom Wingfield
- Tropical and Infectious Disease Unit, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
- Departments of International Public Health and Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- World Health Organization Collaborating Centre on Tuberculosis and Social Medicine, Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
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