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Haque MA, Halder AS, Hossain MJ, Islam MR. Prediction of potential public health risk of the recent multicountry monkeypox outbreak: An update after the end declaration of global public health emergency. Health Sci Rep 2024; 7:e2136. [PMID: 38817885 PMCID: PMC11136639 DOI: 10.1002/hsr2.2136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 05/05/2024] [Accepted: 05/07/2024] [Indexed: 06/01/2024] Open
Abstract
Background and Aims A double-stranded DNA virus called monkeypox virus (MPV) belonging to the Poxviridae family and Orthopoxvirus genus causes monkeypox (mpox) infection. This virus used to infect only Central, East, and West Africa. However, it has spread to an extent outside Africa recently. The range of MPV outbreaks was so high that on July 23, 2022, the World Health Organization (WHO) declared it a Public Health Emergency of International Concern (PHEIC). About a year later, the WHO notified the end of a global public health emergency for mpox on May 11, 2023. Here, we aimed to assess the current pathogenicity and potential risk of MPV causing public health emergencies. Methods We searched information from published articles available in PubMed, Scopus, and ScienceDirect. We used monkeypox, mpox, monkeypox outbreak, and monkeypox virus as keywords during the literature search. Results Many new variants of MPV have emerged throughout the world that created PHEIC for mpox. Considering the low lethality and transmission rate, mpox is no longer a global public health threat. In addition, the availability of therapeutic and preventive measures helped the healthcare authorities fight the mpox infection in an efficient manner. In this review, we have portrayed the history and evolution of mpox from past to present and an idea of its future outcomes. Also, we have discussed the symptoms related to mpox and approved antiviral treatment strategies to fight off the infection in this piece. This review also emphasized the preventive guidelines set by the WHO for patients, caregivers, and healthcare providers to control the outbreak of mpox infection. Conclusion We believe this article would give an idea about the potential public health threats of the recent multi-country monkeypox outbreak to the healthcare authorities for taking measures accordingly.
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Bailey AE, Chai SJ, Snyder RE, Bui DP, Lewis LS, Saadeh K, Bertumen JB, Epson E, Siegel JD. Healthcare personnel with laboratory-confirmed mpox in California during the 2022 outbreak. Infect Control Hosp Epidemiol 2024:1-3. [PMID: 38533591 DOI: 10.1017/ice.2024.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
The California Department of Public Health (CDPH) reviewed 109 cases of healthcare personnel (HCP) with laboratory-confirmed mpox to understand transmission risk in healthcare settings. Overall, 90% of HCP with mpox had nonoccupational exposure risk factors. One occupationally acquired case was associated with sharps injury while unroofing a patient's lesion for diagnostic testing.
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Affiliation(s)
- Allison E Bailey
- California Department of Public Health, Richmond and Sacramento, California
| | - Shua J Chai
- California Department of Public Health, Richmond and Sacramento, California
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Robert E Snyder
- California Department of Public Health, Richmond and Sacramento, California
| | - David P Bui
- California Department of Public Health, Richmond and Sacramento, California
- Portland Oregon Veterans Affairs Medical Center, Oregon
| | - Linda S Lewis
- California Department of Public Health, Richmond and Sacramento, California
| | - Kayla Saadeh
- California Department of Public Health, Richmond and Sacramento, California
| | - J Bradford Bertumen
- California Department of Public Health, Richmond and Sacramento, California
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Erin Epson
- California Department of Public Health, Richmond and Sacramento, California
| | - Jane D Siegel
- California Department of Public Health, Richmond and Sacramento, California
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Zelencik S, VanDine A, Campos-Bovee M, Goitia K, Cela V, Walblay K, Galanto D, Pacilli M, Kim DY, Black SR. Health Care Personnel Exposure Risk Assessment and Management During a Mpox Outbreak in Chicago, Illinois, 17 May to 8 July 2022. J Infect Dis 2024; 229:S207-S212. [PMID: 38019754 DOI: 10.1093/infdis/jiad531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/17/2023] [Accepted: 11/27/2023] [Indexed: 12/01/2023] Open
Abstract
This report summarizes risk assessment interviews and follow-up with health care personnel (HCP) after exposure to patients with mpox disease during 17 May to 8 July 2022. HCP-case interactions were assessed using a standard questionnaire to categorize the risk associated with patient encounters. We assessed 150 interactions among 142 HCP and 30 cases. Four (2.7%) interactions were defined as high risk, 5 (3.3%) intermediate, 107 (71.3%) low, and 31 (20.7%) no risk. High and intermediate exposures were offered postexposure prophylaxis; 4 accepted. No documented mpox transmission after exposure was identified. These findings suggest transmission risk in health care settings during routine patient care is low.
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Affiliation(s)
- Shane Zelencik
- Chicago Department of Public Health, Chicago, Illinois, USA
| | - Alison VanDine
- Chicago Department of Public Health, Chicago, Illinois, USA
| | | | | | - Valbona Cela
- Chicago Department of Public Health, Chicago, Illinois, USA
| | - Kelly Walblay
- Chicago Department of Public Health, Chicago, Illinois, USA
| | - Daniel Galanto
- Chicago Department of Public Health, Chicago, Illinois, USA
| | | | - Do Young Kim
- Chicago Department of Public Health, Chicago, Illinois, USA
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Ahmed SK, Dabou EA, Ibrahim FM, Mohammed MG, Chandran D, Basit J, Chakraborty S, Emran TB, Islam R, Dhama K. Challenges and Counteracting Strategies Including Optimum Health Service Practices for Frontline Nurses During the Mpox Outbreak and Futuristic Vision. SAGE Open Nurs 2024; 10:23779608241256209. [PMID: 38784647 PMCID: PMC11113054 DOI: 10.1177/23779608241256209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 03/28/2024] [Accepted: 05/04/2024] [Indexed: 05/25/2024] Open
Abstract
Introduction Monkeypox (mpox) is an evolving infectious disease caused by the monkeypox virus (MPXV). On July 23, 2022, the WHO declared the recent mpox outbreaks a public health emergency of international concern (PHEIC), which terminated on May 11, 2023. As of July 11, 2023, 88,288 confirmed cases and 149 deaths have been reported from 112 countries and territories. Currently, mpox is not a PHEIC, as the outbreak and its impacts are nearly over. Nurses played significant roles during the mpox 2022 outbreak as frontline workers. Purpose In light of the impending mpox global outbreak in 2022, this brief report provides an update on the enormous difficulties faced by frontline nurses while playing a crucial role in handling the mpox outbreak and some potential solutions to these difficulties. The methodological framework employed in this narrative brief report involves conducting a comprehensive analysis and synthesis of relevant literature and hypothetical scenarios. The aim is to put forth practical strategies that can effectively tackle the difficulties encountered by frontline nurses in the context of the mpox outbreak. Additionally, the report seeks to envision a healthcare system that is more resilient in the face of future challenges. Conclusion It is important to understand the challenges the nurses face from their perspective. As frontline health care workers, the various health issues of nurses and their concerns must be taken care of appropriately by adopting optimum health service practices, adequate safety measures, recommended precautionary measures, and boosting them mentally while handling mpox patients. Counseling and the arrangement of workshops are required. Appropriate care should be taken to address the various health issues concerning nurses by adopting health service practices at optimum levels. Side by side, recommended safety and precautionary measures should be followed.
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Affiliation(s)
- Sirwan Khalid Ahmed
- College of Nursing, University of Raparin, Rania, Sulaymaniyah, Kurdistan Region, Iraq
- Ministry of Health, General Directorate of Health-Raparin, Rania, Sulaymaniyah, Kurdistan Region, Iraq
| | - Eman A. Dabou
- RAK College of Nursing, RAK Medical and Health Sciences University, Ras Al Khiamah, UAE
| | - Fatma M. Ibrahim
- RAK College of Nursing, RAK Medical and Health Sciences University, Ras Al Khiamah, UAE
| | - Mona G. Mohammed
- RAK College of Nursing, RAK Medical and Health Sciences University, Ras Al Khiamah, UAE
| | - Deepak Chandran
- (Department of Animal Husbandry, Government of Kerala, Palakkad, Kerala, India
| | - Jawad Basit
- Department of Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan
| | - Sandip Chakraborty
- State Disease Investigation Laboratory, ARDD, Abhoynagar, Agartala, West Tripura, India
| | - Talha Bin Emran
- Department of Pharmacy, BGC Trust University Bangladesh, Chittagong, Bangladesh
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka, Bangladesh
| | - Rabiul Islam
- School of Pharmacy, BRAC University, Dhaka, Bangladesh
| | - Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute (IVRI), Bareilly, Uttar Pradesh, India
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Wetsch WA, Heger E, Drinhaus H, Böttiger BW, Overbeek R, Lehmann C, Fätkenheuer G, Jung N, Fischer J, Kneifel J, Zweigner J, Klein F, Wieland U. Lack of monkeypox virus (MPXV) transmission despite occupational exposure of a large number of health care workers. J Med Virol 2024; 96:e29353. [PMID: 38178611 DOI: 10.1002/jmv.29353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/27/2023] [Accepted: 12/17/2023] [Indexed: 01/06/2024]
Affiliation(s)
- Wolfgang A Wetsch
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Eva Heger
- Institute of Virology, University Hospital Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Hendrik Drinhaus
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Bernd W Böttiger
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Remco Overbeek
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Clara Lehmann
- Department I of Internal Medicine, University Hospital Cologne, Faculty of Medicine, University of Cologne, German Center for Infection Research Partner Side Köln-Bonn, University of Cologne, Cologne, Germany
| | - Gerd Fätkenheuer
- Department I of Internal Medicine, University Hospital Cologne, Faculty of Medicine, University of Cologne, German Center for Infection Research Partner Side Köln-Bonn, University of Cologne, Cologne, Germany
| | - Norma Jung
- Department I of Internal Medicine, University Hospital Cologne, Faculty of Medicine, University of Cologne, German Center for Infection Research Partner Side Köln-Bonn, University of Cologne, Cologne, Germany
| | - Julia Fischer
- Department I of Internal Medicine, University Hospital Cologne, Faculty of Medicine, University of Cologne, German Center for Infection Research Partner Side Köln-Bonn, University of Cologne, Cologne, Germany
| | - Jens Kneifel
- Department of Hospital Hygiene and Infection Control, University Hospital Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Janine Zweigner
- Department of Hospital Hygiene and Infection Control, University Hospital Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Florian Klein
- Institute of Virology, University Hospital Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Ulrike Wieland
- Institute of Virology, University Hospital Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany
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Antinori S, Casalini G, Giacomelli A, Rodriguez-Morales AJ. Update on Mpox: a brief narrative review. LE INFEZIONI IN MEDICINA 2023; 31:269-276. [PMID: 37701385 PMCID: PMC10495048 DOI: 10.53854/liim-3103-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 07/30/2023] [Indexed: 09/14/2023]
Abstract
Mpox (formerly Monkeypox), a neglected tropical disease once confined to Central and West Africa, emerged as a global epidemic outbreak in May, 2022 with 87,529 cases reported as of May, 23, 2023. It predominantly affected men (96.2%) who have sex with men (84-100%), although other transmission routes have been reported, including occupational exposure and vertical transmission. Concomitant HIV infection has been recorded in 21-46.9% and pre-exposure prophylaxis against HIV infection has been reported in 11-57% of published cases. The current outbreak clinical presentation differs from endemic cases with prodromal symptoms that could be absent: the number of lesions is generally low, with skin lesions predominantly localised in the ano-genital areas and frequent lesions present in different stages of progression (i.e., asynchronous). Asymptomatic Mpox infection can occur in 1.8-6.5% of at-risk subjects. People living with HIV with severe immunodeficiency (less than 100 CD4+ lymphocytes per microliter) are at risk of more severe clinical manifestations and death. According to a systematic review and meta-analysis, the hospitalisation rate is around 6% and the observed case-fatality rate is less than 0.1%. Tecovirimat is the drug of choice for treating severe cases although there is no evidence of efficacy from randomised controlled trials. Immunization with a live non-replicating vaccine (JYNNEOS) effectively reduces the disease's incidence.
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Affiliation(s)
- Spinello Antinori
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Italy
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milano, Italy
| | - Giacomo Casalini
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Italy
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milano, Italy
| | - Andrea Giacomelli
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milano, Italy
| | - Alfonso J Rodriguez-Morales
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon
- Master of Clinical Epidemiology and Biostatistics, Universidad Cientifica del Sur, Lima 15024, Peru
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Raccagni AR, Gianotti N, Moro M, Mileto D, Gordo Perez V, Castagna A, Nozza S. Mpox Virus: Control of In-Hospital Occupational Transmission Experience from a Tertiary Level Hospital in Milan, Italy. Life (Basel) 2023; 13:1705. [PMID: 37629562 PMCID: PMC10455684 DOI: 10.3390/life13081705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/06/2023] [Accepted: 08/06/2023] [Indexed: 08/27/2023] Open
Abstract
Mpox has caused a global outbreak since May 2022, particularly affecting people belonging to key populations, but cases among healthcare providers have been reported. The aim of this work is to present the experience of the Infectious Diseases Unit of San Raffaele Scientific Institute, Milan, Italy with respect to infection control and prevention of mpox occupational transmission. Between May-November 2022, 140 individuals were diagnosed with mpox and six required hospitalization. Overall, 12 medical doctors and 22 nurses provided care to people with mpox. A hospital policy aimed at controlling viral transmission was implemented in May 2022. Protective equipment was used for all healthcare providers. One accidental puncture occurred with a scalpel contaminated with blood from a mpox viremic individual (mpox plasma cycle threshold = 36); no mpox related symptoms were observed and mpox testing ruled out transmission. Six months following exposure, neutralizing antibodies were not detectable, ruling out contagion. Overall, we observed no mpox transmission among healthcare workers, despite the number of visits and procedures performed, including bodily-fluids sampling, and even following puncture with contaminated blood. Hospital preparedness for the management of new infectious disease outbreaks, with rapid implementation of policies aimed at controlling infection, is paramount to avoid occupational transmission.
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Affiliation(s)
- Angelo Roberto Raccagni
- Infectious Diseases Unit, Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.C.); (S.N.)
| | - Nicola Gianotti
- Infectious Diseases Unit, San Raffaele Scientific Institute, 20132 Milan, Italy; (N.G.); (V.G.P.)
| | - Matteo Moro
- Infection Control, Chief Medical Office, San Raffaele Scientific Institute, 20132 Milan, Italy;
| | - Davide Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, L. Sacco University Hospital, 20122 Milan, Italy;
| | - Victoria Gordo Perez
- Infectious Diseases Unit, San Raffaele Scientific Institute, 20132 Milan, Italy; (N.G.); (V.G.P.)
| | - Antonella Castagna
- Infectious Diseases Unit, Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.C.); (S.N.)
- Infectious Diseases Unit, San Raffaele Scientific Institute, 20132 Milan, Italy; (N.G.); (V.G.P.)
| | - Silvia Nozza
- Infectious Diseases Unit, Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.C.); (S.N.)
- Infectious Diseases Unit, San Raffaele Scientific Institute, 20132 Milan, Italy; (N.G.); (V.G.P.)
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Zachary KC, Philpotts LL, Shenoy ES. Mpox exposure and transmission in healthcare settings during the 2022 global outbreak. Curr Opin Infect Dis 2023; 36:257-262. [PMID: 37431555 DOI: 10.1097/qco.0000000000000933] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
PURPOSE OF REVIEW The risk of nosocomial transmission of mpox during the 2022 global outbreak is not well described. We evaluated reports of exposures to healthcare personnel (HCP) and patients in healthcare settings and risk of transmission. RECENT FINDINGS Reported nosocomial transmission of mpox has been rare and associated primarily with sharps injuries and breaches in transmission-based precautions. SUMMARY Currently recommended infection control practices, including the use of standard and transmission-based precautions in the care of patients with known or suspected mpox are highly effective. Diagnostic sampling should not involve the use of needles or other sharp instruments.
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Affiliation(s)
- Kimon C Zachary
- Regional Emerging Special Pathogens Treatment Center
- Infection Control Unit
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital
- Harvard Medical School
| | - Lisa L Philpotts
- Treadwell Library, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Erica S Shenoy
- Regional Emerging Special Pathogens Treatment Center
- Infection Control Unit
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital
- Harvard Medical School
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