Emergence of monkeypox: a worldwide public health crisis

Next-gen novel nanocage-based multivalent vaccine candidate to tackle the rising menace of Mpox

The recent emergence and global spread of the human Monkeypox virus (MPXV), including its transmission to non-endemic regions, have raised significant global health concerns. In this proof-of-concept study, we developed a recombinant protein-based MPXV vaccine candidate, employing an innovative and versatile multivalent, self-assembled nanocage protein scaffold. Two immunogenic antigens derived from the contemporary circulating MPXV strain have been incorporated into a self-assembled non-structural protein-10 (NSP-10) scaffold, expressed, and purified using an Escherichia coli expression system without a purification tag. The vaccine candidate elicited strong antibody responses in mice and conferred protection against the lethal Vaccinia virus in an intranasal and skin pock in vivo study. Additionally, an intranasal challenge with the MPXV strain clade IIb in immunized mice demonstrated promising outcomes, including a significant reduction in viral titres and eliciting a robust neutralizing antibody response. This study demonstrates a feasible, scalable, and cost-effective approach for the development of the MPXV vaccine.

Copper-Silver Nanoparticle/Lipase Nanobiohybrids for Enhanced Activity Against Viral Pathogens

The development of sustainable, low-toxicity materials that are effective against a wide range of microorganisms is crucial in addressing emerging infectious diseases. The recent spread of monkeypox virus (MPXV), respiratory pathogens such as rhinoviruses or seasonal coronaviruses, and animal pathogens such as porcine reproductive and respiratory syndrome virus (PRRSV) highlights the urgent need for innovative solutions in both human and animal health. In this study, we designed a bimetallic nanobiohybrid material, NanoCuAg, composed of a lipase and in situ-synthesized copper and silver nanoparticles, with a low silver-to-copper ratio, through a simple and sustainable synthetic process. The nanobiomaterial, featuring a supramolecular flower structure containing ∼4 nm average diameter nanoparticles, contains 32% copper and 3% silver, mainly in the Cu-(II) and Ag-(I) oxidation states. Despite its low silver content, the nanobiomaterial showed a strong catalytic efficacy in different model reactions. Then, its virucidal activity was evaluated under different conditions. At 200 ppm, in combination with hydrogen peroxide, it inactivated 99% of human rhinovirus B14 and 99.99% of human coronavirus 229E. At 1000 ppm, it achieved 90% efficacy against MPXV and a 4.8 log10 (≈99.999%) reduction in PRRSV. These results demonstrate the potential of NanoCuAg as a highly effective virucidal material, capable of inactivating both enveloped and nonenveloped viruses at low concentrations, making it a promising candidate for broad-spectrum virucidal applications.

The relationship between maternal emotional self-disclosure and children's anxiety in the post-COVID-19 era

BACKGROUND

Following pandemics, anxiety often remains prevalent within families, particularly among mothers, even after the acute phase. Mothers typically engage in increased emotional self-disclosure and interactions with family members, which can promote improved mental health and strengthen family dynamics through the shared expression and management of psychological concerns. This study aimed to determine the relationship between maternal emotional self-disclosure and children's anxiety in the post-COVID-19 era.

METHODS

In this cross-sectional correlation study, 305 mothers of elementary school children in Borujerd, Lorestan, Iran, in 2022 were included using a multi-stage sampling method. Data collection tools comprised demographic questionnaires, the Emotional Self-Disclosure Scale, and the Spence Children's Anxiety Scale-Parent Report, all of which were completed by mothers as self-reports. Independent t-tests, one-way analysis of variance, Pearson's correlation test, and multivariate regression were employed to analyze the data.

RESULTS

There was a negative and significant correlation between mothers' emotional self-disclosure and children's anxiety (r = -0.890, P < 0.001) which remained significant after controlling for confounding variables (B = -0.667, P < 0.001). There was a statistically significant difference in mothers' mean emotional self-disclosure scores based on their place of residence, education, occupation, and their spouse's age, education, and occupation, as well as the child's sex, educational level, and age (P < 0.001). However, the results were insignificant concerning the mother's age (P > 0.05).

CONCLUSIONS

There was an inverse and relatively strong relationship between maternal emotional self-disclosure and child anxiety. This indicates that an increase in maternal emotional self-disclosure was associated with a reduction in child anxiety. Therefore, in similar crises, managing and promoting emotional self-disclosure among mothers may help in reducing children's anxiety, particularly in mothers who are well-educated, employed, reside in urban areas; have younger, well-educated, and employed spouses; and have female children with younger age and lower educational levels.

Emergence and evolution of monkeypox virus: Epidemiology, pathology, clinical symptoms, preventative and treatment measures

As the COVID-19 pandemic situation was on an end, a new monkeypox menace has been discovered in several places of the world. The most comforting thing is that the fatality rate of monkeypox is unlike Covid-19. But the recent global outbreaks and the rise in the number of cases has drawn attention of world towards it. The number of cases in multiple countries have already surpassed 25,000, according to the WHO report released on July 25, 2022. The zoonotic disease monkey-pox virus causes a feverish sickness in humans, with characteristic skin rashes and is similar to smallpox in structure, clinical presentation, and response to antiviral medicine. This review offers important insights on the evolution of the monkeypox virus and its different modes of transmission. It also discusses epidemiology, clinical findings, management, challenges, and current strategies for the disease, as well as the implications of the current epidemic on public health. Comprehensive research on the pathophysiology and management of monkeypox is still lacking. In order to solve this problem, we reviewed the pathology and virology of monkeypox infection and provided an overview of the most recent developments in anti-monkeypox medications.

Recurrent Mpox: divergent virulent clades and the urgent need for strategic measures including novel vaccine development to sustain global health security

In August 2024, the Africa CDC and WHO declared Mpox a Public Health Emergency of Continental Security and a Public Health Emergency of International Concern, respectively, following a devastating global outbreak driven by newly emerged virulent clades I (Ia, IIb) and II (IIa, IIb) of the Mpox virus. These new clades are genetically and phylogenetically distinct from previously known strains, with the re-emerging variants originating from the Democratic Republic of the Congo (DRC) and rapidly spreading to neighbouring regions and across the globe. The ongoing epidemic is characterized by alarming morbidity and mortality, and the newly identified clades are linked to significant changes in the epidemiology of the disease, resulting in worse clinical outcomes. Sexual transmission has emerged as a key factor in sustaining the spread of the virus, particularly among sexually active young adults, facilitating the virus's spread beyond Africa. To combat the growing threat, there is an urgent need for the development of a polyvalent vaccine that incorporates the diverse circulating clades as part of other mitigation measures.. Widespread vaccination with such a vaccine could help achieve herd immunity and complement other infection prevention and control strategies to effectively mitigate the impact of this global health crisis.

Development of a multiplex droplet digital PCR method for detection and differentiation of mpox virus clades

BACKGROUND

The current outbreak of mpox has been declared a public health emergency of international concern by the World Health Organization. However, distinguishing symptoms of mpox virus (MPXV) infection from other orthopoxviruses is atypical, necessitating laboratory confirmatory tests to aid in clinical diagnosis. Therefore, rapid and accurate detection and differentiation of various clades of MPXV are imperative.

OBJECTIVE

A multiplex droplet digital PCR (ddPCR) method was developed to detect and differentiate various clades of MPXV with subsequent evaluation of its sensitivity and accessibility through the analysis of 17 clinical samples.

METHODS

Primers and probes for multiple ddPCR were designed by comparing multiple complete genomes of orthopoxviruses. Primer and probe concentrations, reaction conditions were tentatively optimized on the Biorad QX200 platform. Seventeen clinical samples of MPXV were detected and verified by Sanger sequencing.

RESULTS

The established ddPCR method could detect and differentiate MPXV, and the results were consistent with those of Sanger sequencing.

CONCLUSION

Multiplex ddPCR could be used to detect and distinguish different clades of MPXV rapidly and accurately.

Monkeypox: a re-emergent virus with global health implications - a comprehensive review

Monkeypox virus (MPXV) is an enclosed, double-stranded DNA virus from the Orthopoxvirus genus, which also contains variola, vaccinia, and cowpox. MPXV, which was once confined to West and Central Africa, has recently had a rebound, spreading beyond its original range since 2017. The virus is distinguished by its unique morphology, which includes an oval or brick-shaped structure and a complex lipid and protein makeup. The current multi-country outbreak designated a public health emergency in 2022, has highlighted MPXV's shifting epidemiology and ability to spread rapidly over the globe. 'No one is safe until everyone is safe' is a slogan we often heard during the COVID-19 pandemic, which is now also required for the growing global and regional mpox outbreaks. The epidemic is divided into two clades: Clade I and Clade II, which have distinct pathogenic characteristics. Diagnostic approaches have developed with advances in molecular techniques, yet problems persist in resource-constrained situations. This overview summarizes the virus's history, epidemiology, morphology, and clinical characteristics, offering insights into its recent comeback and current global response efforts.

Monkeypox (Mpox): Diagnosis and Emerging Challenges

Monkeypox (Mpox) has once again been designated a Public Health Emergency of International Concern (PHEIC) as of August, 2024. The severity of the disease is underscored by its significant mortality rate, and unfortunately, there are no targeted therapeutics currently available for this viral infection. Management relies on preventive measures and the use of existing smallpox vaccines due to their genetic similarity to the Mpox virus. Diagnosing a disease is a critical aspect of managing any health condition, and for a highly contagious viral infection like Mpox, it is essential to employ a specific and sensitive diagnostic approach. The lack of adequate diagnostic facilities in laboratories poses a significant challenge, hindering accurate diagnoses and the identification of underlying etiologies, particularly in low-resource settings. Current serology-based diagnostic tests lack specificity for the Mpox virus, leading to cross-reactivity with other orthopoxviruses. With the emergence of new viral variants, molecular and genomic diagnostic methods are far more reliable for accurately confirming Mpox infections. This review focuses on current diagnostic methods approved worldwide and the future challenges that need to be addressed to effectively control and mitigate the spread of Mpox.

Mpox and Lessons Learned in the Light of the Recent Outbreak: A Narrative Review

According to the WHO, more than 90,000 cases of mpox have been reported since the 2022 worldwide outbreak, which resulted in 167 deaths, while a new outbreak in Africa since 2023 has resulted in over 18,000 cases and 617 deaths. Mpox is a zoonosis caused by the monkeypox virus, a double-stranded DNA virus belonging to the Orthopoxvirus genus, which causes smallpox-like illness. Until 2022, cases were predominately located in West and Central Africa, with only sporadic cases and outbreaks reported in other parts of the world. During the 2022 outbreak, the primary mode of transmission was sexual contact among men who have sex with men. The changing epidemiology of mpox resulted in new disease phenotypes and populations at risk, disproportionally affecting people who live with HIV. Commonly presenting as a mild, self-limiting illness, mpox can cause severe and protracted disease in people with HIV with a CD4 count < 200 cell/mm3. The global emergence of mpox that followed and intersected with COVID-19 mobilized the scientific community and healthcare stakeholders to provide accurate diagnostics, preventive vaccines and treatment to those most affected. Despite existing gaps, this rapid response helped to contain the outbreak, but challenges remain as new variants emerge. Preparedness and readiness to respond to the next outbreak is crucial in order to minimize the impact to the most vulnerable.

Exploring Monkeypox: prospects for therapeutics through computational-aided drug discovery

Monkeypox virus (MPXV) has emerged as a significant public health concern due to its potential for human transmission and its severe clinical manifestations. This review synthesizes findings from peer-reviewed articles spanning the last two decades, shedding light on diverse aspects of MPXV research. The exploration commences with an analysis of transmission dynamics, including zoonotic and human-to-human transmission, and potential reservoir hosts. Detailed insights into viral replication mechanisms illuminate its influence on disease progression and pathogenicity. Understanding the genomic and virion structure of MPXV is pivotal for targeted interventions. Genomic characteristics contributing to virulence are examined, alongside recent advancements in virion structure elucidation through cutting-edge imaging techniques. Emphasizing combat strategies, the review lists potential protein targets within the MPXV lifecycle for computer-aided drug design (CADD). The role of protein-ligand interactions and molecular docking simulations in identifying potential drug candidates is highlighted. Despite the absence of approved MPXV medications, the review outlines updates on ongoing small molecules and vaccine development efforts, spanning traditional and innovative platforms. The evolving landscape of computational drug research for MPXV is explored, encompassing advanced algorithms, machine learning, and high-performance computing. In conclusion, this review offers a holistic perspective on MPXV research by integrating insights spanning transmission dynamics to drug design. Equipping researchers with multifaceted understanding underscore the importance of innovative methodologies and interdisciplinary collaborations in addressing MPXV's challenges as research advances.

Mpox outbreak: Time series analysis with multifractal and deep learning network

This article presents an overview of an mpox epidemiological situation in the most affected regions-Africa, Americas, and Europe-tailoring fractal interpolation for pre-processing the mpox cases. This keen analysis has highlighted the irregular and fractal patterns in the trend of mpox transmission. During the current scenario of public health emergency of international concern due to an mpox outbreak, an additional significance of this article is the interpretation of mpox spread in light of multifractality. The self-similar measure, namely, the multifractal measure, is utilized to explore the heterogeneity in the mpox cases. Moreover, a bidirectional long-short term memory neural network has been employed to forecast the future mpox spread to alert the outbreak as it seems to be a silent symptom for global epidemic.

Insights into the emergence and evolution of monkeypox virus: Historical perspectives, epidemiology, genetic diversity, transmission, and preventative measures

In 2022, just before the COVID-19 pandemic ended, many countries noticed a viral monkeypox outbreak. Monkeypox virus, a zoonotic pathogen, causes a febrile illness in humans and resembles smallpox. Prevention strategies encompass vaccination, strict infection control measures, and avoiding contact with infected persons. As monkeypox and related poxviruses continue to pose challenges, ongoing surveillance, early diagnosis, prompt isolation, and effective control measures are crucial for limiting transmission and mitigating the impact of outbreaks on public health. This review provides valuable insights into the evolution of the monkeypox virus and its various modes of transmission, including postmortem transmission, and offers an overall perspective on the guidelines issued by the Government of India to prevent and effectively control the spread of this disease.

Monkeypox Virus (MPXV) Infection: A Review

Monkeypox is a viral disease; its outbreak was recently declared a global emergency by the World Health Organization. For the first time, a monkeypox virus (MPXV)-infected patient was found in India. Various researchers back-to-back tried to find the solution to this health emergency just after COVID-19. In this review, we discuss the current outbreak status of India, its transmission, virulence factors, symptoms, treatment, and the preventive guidelines generated by the Indian Health Ministry. We found that monkeypox virus (MPXV) disease is different from smallpox, and the age group between 30-40 years old is more prone to MPXV disease. We also found that, besides homosexuals, gays, bisexuals, and non-vegetarians, it also affects normal straight men and women who have no history of travel. Close contact should be avoided from rats, monkeys and sick people who are affected by monkeypox. To date, there are no monkeypox drugs, but Tecovirimat is more effective than other drugs that are used for other viral diseases like smallpox. Therefore, we need to develop an effective antiviral agent against the virulence factor of MXPV.

Differences in pathogenicity among the mpox virus clades: impact on drug discovery and vaccine development

Since May 2022, mpox virus (MPXV) has attracted considerable attention due to a multi-country outbreak. Marked differences in epidemiology, transmission, and pathology between the 2022 global mpox outbreak (clade IIb) and classical mpox disease, endemic in Africa (clades I and IIa) have been highlighted. MPXV genome analysis has identified the genomic changes characterizing clade IIb and the drivers of MPXV rapid evolution. Although mpox cases have largely declined, MPXV cryptic transmission and microevolution continues, which may lead to an MPXV of unpredictable pathogenicity. Vaccines and antivirals developed against variola virus, the agent that caused the extinguished plague smallpox, have been used to contain the 2022 mpox outbreak. In this review article, recent findings on MPXV origin and evolution and relevant models able to recapitulate differences in MPXV pathogenicity, which are important for drug and vaccine development, are discussed.

Emerging evidence on Monkeypox: resurgence, global burden, molecular insights, genomics and possible management

An outbreak of monkeypox (encoded enveloped double stranded DNA), resurgence and expansion has emerged in early 2022, posing a new threat to global health. Even though, many reports are available on monkeypox, still a comprehensive updated review is needed. Present updated review is focused to fill the research gaps pertaining to the monkeypox, and an extensive search was conducted in a number of databases, including Google Scholar, Scopus, Web of Science, and Science Direct. Although the disease usually progresses self-limiting, some patients require admission for kidney injury, pharyngitis, myocarditis, and soft tissue super infections. There is no well-known treatment available yet; still there has been a push for the use of antiviral therapy and tecovirimat as a promising option when dealing with co-morbidities. In this study, we mapped and discussed the updates and scientific developments surrounding monkeypox, including its potential molecular mechanisms, genomics, transmission, risk factors, diagnosis, prevention, vaccines, treatment, possible plant-based treatment along with their proposed mechanisms. Each day, a growing number of monkeypox cases are reported, and more cases are expected in the near future. As of now, monkeypox does not have a well-established and proven treatment, and several investigations are underway to find the best possible treatment from natural or synthetic drug sources. Multiple molecular mechanisms on pathophysiological cascades of monkeypox virus infection are discussed here along with updates on genomics, and possible preventive and therapeutic strategies.