1
|
Sun Y, Nie W, Tian D, Ye Q. Human monkeypox virus: Epidemiologic review and research progress in diagnosis and treatment. J Clin Virol 2024; 171:105662. [PMID: 38432097 DOI: 10.1016/j.jcv.2024.105662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/22/2024] [Accepted: 02/25/2024] [Indexed: 03/05/2024]
Abstract
Monkeypox virus (MPXV) is responsible for causing a zoonotic disease called monkeypox (mpox), which sporadically infects humans in West and Central Africa. It first infected humans in 1970 and, along with the variola virus, belongs to the genus Orthopoxvirus in the poxvirus family. Since the World Health Organization declared the MPXV outbreak a "Public Health Emergency of International Concern" on July 23, 2022, the number of infected patients has increased dramatically. To control this epidemic and address this previously neglected disease, MPXV needs to be better understood and reevaluated. In this review, we cover recent research on MPXV, including its genomic and pathogenic characteristics, transmission, mutations and mechanisms, clinical characteristics, epidemiology, laboratory diagnosis, and treatment measures, as well as prevention of MPXV infection in light of the 2022 and 2023 global outbreaks. The 2022 MPXV outbreak has been primarily associated with close intimate contact, including sexual activity, with most cases diagnosed among men who have sex with men. The incubation period of MPXV infection usually lasts from 6 to 13 days, and symptoms include fever, muscle pains, headache, swollen lymph nodes, and a characteristic painful rash, including several stages, such as macules, papules, blisters, pustules, scabs, and scab shedding involving the genitals and anus. Polymerase chain reaction (PCR) is usually used to detect MPXV in skin lesion material. Treatment includes supportive care, antivirals, and intravenous vaccinia immune globulin. Smallpox vaccines have been designed with four givens emergency approval for use against MPXV infection.
Collapse
Affiliation(s)
- Yanhong Sun
- Department of Clinical Laboratory, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China
| | - Wenjian Nie
- Department of Clinical Laboratory, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China
| | - Dandan Tian
- Department of Clinical Laboratory, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China
| | - Qing Ye
- Department of Clinical Laboratory, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China.
| |
Collapse
|
2
|
Mmerem JI, Umenzekwe CC, Johnson SM, Onukak AE, Chika-Igwenyi NM, Chukwu SK, Onyeaghala CA, Ozougwu JJ, Alasia D, Ehiakhamen O, Nwankwo HM, Ezejiofor OI, Unigwe US, Iroezindu MO. Mpox and Chickenpox Coinfection: Case Series From Southern Nigeria. J Infect Dis 2024; 229:S260-S264. [PMID: 38058122 DOI: 10.1093/infdis/jiad556] [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: 11/25/2023] [Accepted: 12/04/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND We describe clinicoepidemiologic characteristics of mpox-chickenpox coinfection in Nigeria. METHODS A retrospective cohort analysis was performed of confirmed mpox cases in Nigeria from January 2022 to March 2023. Mpox and chickenpox were confirmed by real-time polymerase chain reaction (RT-PCR). RESULTS Of 94 (60.0%) suspected cases, 56 had confirmed mpox, of whom 16 (28.6%) had chickenpox coinfection. The median age of confirmed mpox cases was 29 years (interquartile range, 20-37 years), 24 were men (60.7%), 6 (10.7%) were bisexual, and 5 (8.9%) died. Mpox-chickenpox-coinfected patients had more complications than mpox-monoinfected cases (56.3% vs 22.5%, P = .015). CONCLUSIONS The high frequency of mpox-chickenpox coinfection argues for accelerated access to mpox and chickenpox vaccines in Africa.
Collapse
Affiliation(s)
- Juliet I Mmerem
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
| | - Chukwudi C Umenzekwe
- Department of Internal Medicine, Nnamdi Azikwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
| | - Simon M Johnson
- Department of Internal Medicine, Federal University Teaching Hospital, Owerri, Imo State, Nigeria
| | - Asukwo E Onukak
- Department of Internal Medicine, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria
| | - Nneka M Chika-Igwenyi
- Department of Internal Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - Sunday K Chukwu
- Department of Internal Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - Chizaram A Onyeaghala
- Department of Internal Medicine, University of Port-Harcourt Teaching Hospital, Port-Harcourt, Rivers State, Nigeria
| | - Jideofor J Ozougwu
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
- Department of Internal Medicine, Federal University Teaching Hospital, Owerri, Imo State, Nigeria
| | - Datonye Alasia
- Department of Internal Medicine, University of Port-Harcourt Teaching Hospital, Port-Harcourt, Rivers State, Nigeria
| | - Odianosen Ehiakhamen
- National Mpox Emergency Operating Centre, National Centre for Disease Control, Abuja, Nigeria
| | - Henry M Nwankwo
- Department of Internal Medicine, Nnamdi Azikwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
| | - Ogochukwu I Ezejiofor
- Department of Internal Medicine, Nnamdi Azikwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
| | - Uche S Unigwe
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
- Department of Internal Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - Michael O Iroezindu
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
| |
Collapse
|
3
|
Nakoune E, Yagata FEM, Nimbona A, Belizaire MRD, Boum Y. Mpox: interdependence and inequity. THE LANCET. INFECTIOUS DISEASES 2023; 23:1335-1336. [PMID: 37625432 DOI: 10.1016/s1473-3099(23)00487-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 07/21/2023] [Indexed: 08/27/2023]
Affiliation(s)
| | | | - Aimee Nimbona
- African Leadership Academy, Bangui, Central African Republic
| | | | - Yap Boum
- Institut Pasteur de Bangui, Bangui, Central African Republic; Faculté de Médecine et Sciences Biomédicales, Université de Yaoundé I, Cameroun.
| |
Collapse
|
4
|
Ogoina D, Damon I, Nakoune E. Clinical review of human mpox. Clin Microbiol Infect 2023; 29:1493-1501. [PMID: 37704017 DOI: 10.1016/j.cmi.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 09/03/2023] [Accepted: 09/05/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND Historically, human mpox was predominantly a zoonotic disease occurring more frequently in rural children in Africa and characterized by a largely self-limiting febrile centrifugal monomorphic rash illness. However, the 2022 mpox global outbreak has shown that the disease is changing in many ways, including sustained human-to-human transmission via sexual contact, novel clinical presentations, and adverse associations between mpox and advanced HIV. OBJECTIVES The aim of this paper is to review the traditional and emerging clinical aspects of human mpox and provide updated information on the clinical course and outcome of the disease. SOURCES We searched electronic databases including PubMed and Google Scholar and identified relevant published literature on mpox. CONTENT The clinical presentation of human mpox is influenced by the route of infectious exposure, the strain and dose of the infecting virus, and the host immune system. Exposure to the virus can result in sub-clinical or clinical diseases of variable severity. Infections caused by clade I viral strains are more severe than class IIa and IIb strains, which are associated with a milder febrile rash illness, and with anogenital skin lesions in clade IIb infections. Most cases of mpox recover entirely within 2-4 weeks after onset of illness and a few develop skin-related sequelae. Overall, people with advanced HIV infection, children <5 years of age, and pregnant women may present with more severe disease and higher case fatalities. IMPLICATIONS The continued endemicity of the classical mpox in Africa, the emergence of a new clinical form of the disease during the 2022 global outbreak, and the adverse associations between advanced HIV and mpox have implications for the surveillance, clinical diagnosis, and management of human mpox.
Collapse
Affiliation(s)
- Dimie Ogoina
- Department of Internal Medicine, Infectious Diseases Unit, Niger Delta University/Niger Delta University Teaching Hospital, Bayelsa, Nigeria.
| | - Inger Damon
- Department of Medicine, Emory University, Atlanta, GA, USA
| | - Emmanuel Nakoune
- Department of Viral Haemorrhagic Fevers, Institut Pasteur de Bangui, Bangui, Central African Republic
| |
Collapse
|