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Zhou J, Ye T, Yang Y, Li E, Zhang K, Wang Y, Chen S, Hu J, Zhang K, Liu F, Gong R, Chuai X, Wang Z, Chiu S. Circular RNA vaccines against monkeypox virus provide potent protection against vaccinia virus infection in mice. Mol Ther 2024; 32:1779-1789. [PMID: 38659224 DOI: 10.1016/j.ymthe.2024.04.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/27/2024] [Accepted: 04/18/2024] [Indexed: 04/26/2024] Open
Abstract
Since the outbreak of monkeypox (mpox) in 2022, widespread concern has been placed on imposing an urgent demand for specific vaccines that offer safer and more effective protection. Using an efficient and scalable circular RNA (circRNA) platform, we constructed four circRNA vaccines that could induce robust neutralizing antibodies as well as T cell responses by expressing different surface proteins of mpox virus (MPXV), resulting in potent protection against vaccinia virus (VACV) in mice. Strikingly, the combination of the four circular RNA vaccines demonstrated the best protection against VACV challenge among all the tested vaccines. Our study provides a favorable approach for developing MPXV-specific vaccines by using a circular mRNA platform and opens up novel avenues for future vaccine research.
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Affiliation(s)
- Jinge Zhou
- State Key Laboratory of Virology, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan 430207, Hubei, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Tianxi Ye
- State Key Laboratory of Virology, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan 430207, Hubei, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yun Yang
- Research and Development Department, Shanghai CirCode Biomedicine Co. Ltd, Shanghai 200131, China
| | - Entao Li
- Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230027, Anhui, China; Key Laboratory of Anhui Province for Emerging and Reemerging Infectious Diseases, Hefei 230027, Anhui, China
| | - Kaiyue Zhang
- State Key Laboratory of Virology, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan 430207, Hubei, China
| | - Yuping Wang
- State Key Laboratory of Virology, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan 430207, Hubei, China
| | - Shaohong Chen
- State Key Laboratory of Virology, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan 430207, Hubei, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Jiang Hu
- Research and Development Department, Shanghai CirCode Biomedicine Co. Ltd, Shanghai 200131, China
| | - Kai Zhang
- Research and Development Department, Shanghai CirCode Biomedicine Co. Ltd, Shanghai 200131, China
| | - Fang Liu
- Research and Development Department, Shanghai CirCode Biomedicine Co. Ltd, Shanghai 200131, China
| | - Rui Gong
- University of Chinese Academy of Sciences, Beijing 100049, China; CAS Key Laboratory of Special Pathogens and Biosafety, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan 430207, Hubei, China; Hubei Jiangxia Laboratory, Wuhan 430200, Hubei, China.
| | - Xia Chuai
- State Key Laboratory of Virology, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan 430207, Hubei, China.
| | - Zefeng Wang
- Research and Development Department, Shanghai CirCode Biomedicine Co. Ltd, Shanghai 200131, China; School of Life Science, Southern University of Science and Technology, Shenzhen 518055, China.
| | - Sandra Chiu
- Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230027, Anhui, China; Key Laboratory of Anhui Province for Emerging and Reemerging Infectious Diseases, Hefei 230027, Anhui, China.
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Berry MT, Khan SR, Schlub TE, Notaras A, Kunasekaran M, Grulich AE, MacIntyre CR, Davenport MP, Khoury DS. Predicting vaccine effectiveness for mpox. Nat Commun 2024; 15:3856. [PMID: 38719852 PMCID: PMC11078999 DOI: 10.1038/s41467-024-48180-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 04/22/2024] [Indexed: 05/12/2024] Open
Abstract
The Modified Vaccinia Ankara vaccine developed by Bavarian Nordic (MVA-BN) was widely deployed to prevent mpox during the 2022 global outbreak. This vaccine was initially approved for mpox based on its reported immunogenicity (from phase I/II trials) and effectiveness in animal models, rather than evidence of clinical efficacy. However, no validated correlate of protection after vaccination has been identified. Here we performed a systematic search and meta-analysis of the available data to test whether vaccinia-binding ELISA endpoint titer is predictive of vaccine effectiveness against mpox. We observe a significant correlation between vaccine effectiveness and vaccinia-binding antibody titers, consistent with the existing assumption that antibody levels may be a correlate of protection. Combining this data with analysis of antibody kinetics after vaccination, we predict the durability of protection after vaccination and the impact of dose spacing. We find that delaying the second dose of MVA-BN vaccination will provide more durable protection and may be optimal in an outbreak with limited vaccine stock. Although further work is required to validate this correlate, this study provides a quantitative evidence-based approach for using antibody measurements to predict the effectiveness of mpox vaccination.
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Affiliation(s)
- Matthew T Berry
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Shanchita R Khan
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Timothy E Schlub
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Adriana Notaras
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | | | - Andrew E Grulich
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - C Raina MacIntyre
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
- College of Public Service and Community Solutions, and College of Health Solutions, Arizona State University, Tempe, AZ, USA
| | - Miles P Davenport
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
| | - David S Khoury
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
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Reques L, Mercuriali L, Silué Y, Chazelle E, Spaccaferri G, Velter A, Mailles A, Frange P, Tarantola A. Mpox in children and adolescents and contact follow-up in school settings in greater Paris, France, May 2022 to July 2023. Euro Surveill 2024; 29:2300555. [PMID: 38785093 PMCID: PMC11128737 DOI: 10.2807/1560-7917.es.2024.29.21.2300555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/23/2024] [Indexed: 05/25/2024] Open
Abstract
BackgroundDuring the 2022 mpox outbreak in Europe, primarily affecting men who have sex with men, a limited number of cases among children and adolescents were identified. Paediatric cases from outbreaks in endemic countries have been associated with a higher likelihood of severe illness. Detailed clinical case descriptions and interventions in school settings before 2022 are limited.AimTo describe clinical characteristics of mpox cases among children (< 15 years) and adolescents (15-17 years) in the greater Paris area in France, and infection control measures in schools.MethodsWe describe all notified laboratory-confirmed and non-laboratory-confirmed cases among children and adolescents identified from May 2022 to July 2023, including demographic and clinical characterisation and infection control measures in school settings, i.e. contact tracing, contact vaccination, secondary attack rate and post-exposure vaccination uptake.ResultsNineteen cases were notified (13 children, 6 adolescents). Four adolescent cases reported sexual contact before symptom onset. Ten child cases were secondary cases of adult patients; three cases were cryptic, with vesicles on hands, arms and/or legs and one case additionally presented with genitoanal lesions. Five cases attended school during their infectious period, with 160 at-risk contacts identified, and one secondary case. Five at-risk contacts were vaccinated following exposure.ConclusionCases among children and adolescents are infrequent but require a careful approach to identify the source of infection and ensure infection control measures. We advocate a 'contact warning' strategy vs 'contact tracing' in order to prevent alarm and stigma. Low post-exposure vaccination rates are expected.
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Affiliation(s)
- Laura Reques
- Health Surveillance and Safety Department, Regional Health Agency in the Île-de-France Region (Agence Régionale de Santé d'Île-de-France), Saint-Denis, France
| | - Lilas Mercuriali
- Health Surveillance and Safety Department, Regional Health Agency in the Île-de-France Region (Agence Régionale de Santé d'Île-de-France), Saint-Denis, France
| | | | - Emilie Chazelle
- Santé publique France, the national public health agency, Saint-Maurice, France
| | | | - Annie Velter
- Santé publique France, the national public health agency, Saint-Maurice, France
| | - Alexandra Mailles
- Santé publique France, the national public health agency, Saint-Maurice, France
| | - Pierre Frange
- Infection Control Unit, Laboratory of Clinical Microbiology, Necker - Enfants malades Hospital, AP-HP, Université Paris Cité, Paris, France
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Port JR, Riopelle JC, Smith SG, Myers L, Kaiser FK, Lewis MC, Gallogly S, Okumura A, Bushmaker T, Schulz JE, Rosenke R, Prado-Smith J, Carmody A, Bane S, Smith BJ, Saturday G, Feldmann H, Rosenke K, Munster VJ. Infection with mpox virus via the genital mucosae increases shedding and transmission in the multimammate rat (Mastomys natalensis). Nat Microbiol 2024; 9:1231-1243. [PMID: 38649413 DOI: 10.1038/s41564-024-01666-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 03/06/2024] [Indexed: 04/25/2024]
Abstract
The 2022 mpox virus (MPXV) outbreak was sustained by human-to-human transmission; however, it is currently unclear which factors lead to sustained transmission of MPXV. Here we present Mastomys natalensis as a model for MPXV transmission after intraperitoneal, rectal, vaginal, aerosol and transdermal inoculation with an early 2022 human outbreak isolate (Clade IIb). Virus shedding and tissue replication were route dependent and occurred in the presence of self-resolving localized skin, lung, reproductive tract or rectal lesions. Mucosal inoculation via the rectal, vaginal and aerosol routes led to increased shedding, replication and a pro-inflammatory T cell profile compared with skin inoculation. Contact transmission was higher from rectally inoculated animals. This suggests that transmission might be sustained by increased susceptibility of the anal and genital mucosae for infection and subsequent virus release.
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Affiliation(s)
- Julia R Port
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Jade C Riopelle
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Samuel G Smith
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Lara Myers
- Research and Technologies Branch, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Franziska K Kaiser
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Matthew C Lewis
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Shane Gallogly
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Atsushi Okumura
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Trent Bushmaker
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Jonathan E Schulz
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Rebecca Rosenke
- Rocky Mountain Veterinary Branch, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Jessica Prado-Smith
- Rocky Mountain Veterinary Branch, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Aaron Carmody
- Research and Technologies Branch, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Sidy Bane
- International Center of Excellence in Research (ICER-Mali), University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Brian J Smith
- Rocky Mountain Veterinary Branch, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Greg Saturday
- Rocky Mountain Veterinary Branch, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Heinz Feldmann
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Kyle Rosenke
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA.
| | - Vincent J Munster
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA.
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Piparva KG, Fichadiya N, Joshi T, Malek S. Monkeypox: From Emerging Trends to Therapeutic Concerns. Cureus 2024; 16:e58866. [PMID: 38800170 PMCID: PMC11116278 DOI: 10.7759/cureus.58866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2024] [Indexed: 05/29/2024] Open
Abstract
Monkeypox is a zoonotic viral disease. Monkeypox was first reported in humans about 54 years ago. Prior to the global outbreak, monkeypox was endemic to the rainforests of central and western African countries. In the last three years, increasing numbers of human monkeypox have been reported from various countries. Responding to the severity, monkeypox was declared a Public Health Emergency of International Concern by the World Health Organization. In the absence of approved drugs or clinical studies, repurposed drugs and therapeutic medical countermeasures effective against other orthopoxviruses have been utilized to treat severe human monkeypox cases. Currently, clinical trials are underway exploring the potential therapeutic effectiveness of tecovirimate in human monkeypox cases. Monoclonal antibodies, IFN-β, resveratrol, and 15 triple-targeting FDA-approved drugs represent potential new drug targets for human monkeypox, necessitating further research.
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Affiliation(s)
- Kiran G Piparva
- Department of Pharmacology, All India Institute of Medical Sciences (AIIMS) Rajkot, Rajkot, IND
| | - Nilesh Fichadiya
- Department of Preventive and Social Medicine, Pandit Deendayal Upadhyay (PDU) Government Medical College, Rajkot, IND
| | - Tejal Joshi
- Department of Microbiology, Pandit Deendayal Upadhyay (PDU) Government Medical College, Rajkot, IND
| | - Shahenaz Malek
- Department of Pharmacology, Government Medical College, Surat, IND
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6
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Brien SC, LeBreton M, Doty JB, Mauldin MR, Morgan CN, Pieracci EG, Ritter JM, Matheny A, Tafon BG, Tamoufe U, Missoup AD, Nwobegahay J, Takuo JM, Nkom F, Mouiche MMM, Feussom JMK, Wilkins K, Wade A, McCollum AM. Clinical Manifestations of an Outbreak of Monkeypox Virus in Captive Chimpanzees in Cameroon, 2016. J Infect Dis 2024; 229:S275-S284. [PMID: 38164967 DOI: 10.1093/infdis/jiad601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 12/16/2023] [Accepted: 12/19/2023] [Indexed: 01/03/2024] Open
Abstract
Monkeypox virus (MPXV) is a reemerging virus of global concern. An outbreak of clade I MPXV affected 20 captive chimpanzees in Cameroon in 2016. We describe the epidemiology, virology, phylogenetics, and clinical progression of this outbreak. Clinical signs included exanthema, facial swelling, perilaryngeal swelling, and eschar. Mpox can be lethal in captive chimpanzees, with death likely resulting from respiratory complications. We advise avoiding anesthesia in animals with respiratory signs to reduce the likelihood of death. This outbreak presented a risk to animal care staff. There is a need for increased awareness and a One Health approach to preparation for outbreaks in wildlife rescue centers in primate range states where MPXV occurs. Control measures should include quarantining affected animals, limiting human contacts, surveillance of humans and animals, use of personal protective equipment, and regular decontamination of enclosures.
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Affiliation(s)
- Stephanie C Brien
- Royal (Dick) School of Veterinary Studies and the Roslin Institute, Easter Bush Campus, The University of Edinburgh, Roslin, United Kingdom
- Ape Action Africa, Mefou Park, Cameroon
| | | | - Jeffrey B Doty
- Division of High Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Matthew R Mauldin
- Division of High Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Clint N Morgan
- Division of High Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Emily G Pieracci
- Division of High Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jana M Ritter
- Division of High Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Audrey Matheny
- Division of High Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Alain D Missoup
- Zoology Unit, Laboratory of Biology and Physiology of Animal Organisms, Faculty of Science, University of Douala, Cameroon
| | | | | | | | - Moctar M M Mouiche
- Mosaic, Yaoundé, Cameroon
- School of Veterinary Medicine and Sciences, University of Ngaounderé, Cameroon
| | - Jean Marc K Feussom
- Cameroon Epidemiological Network for Animal Diseases, Directorate of Veterinary Services, Ministry of Livestock, Fisheries and Animal Industries, Yaoundé, Cameroon
| | - Kimberly Wilkins
- Division of High Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Abel Wade
- National Veterinary Laboratory, Garoua, Cameroon
| | - Andrea M McCollum
- Division of High Consequence Pathogens and Pathology, US Centers for Disease Control and Prevention, Atlanta, GA, USA
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Ward T, Overton CE, Paton RS, Christie R, Cumming F, Fyles M. Understanding the infection severity and epidemiological characteristics of mpox in the UK. Nat Commun 2024; 15:2199. [PMID: 38467622 PMCID: PMC10928097 DOI: 10.1038/s41467-024-45110-8] [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: 05/30/2023] [Accepted: 01/15/2024] [Indexed: 03/13/2024] Open
Abstract
In May 2022, individuals infected with the monkeypox virus were detected in the UK without clear travel links to endemic areas. Understanding the clinical characteristics and infection severity of mpox is necessary for effective public health policy. The study period of this paper, from the 1st June 2022 to 30th September 2022, included 3,375 individuals that tested positive for the monkeypox virus. The posterior mean times from infection to hospital admission and length of hospital stay were 14.89 days (95% Credible Intervals (CrI): 13.60, 16.32) and 7.07 days (95% CrI: 6.07, 8.23), respectively. We estimated the modelled Infection Hospitalisation Risk to be 4.13% (95% CrI: 3.04, 5.02), compared to the overall sample Case Hospitalisation Risk (CHR) of 5.10% (95% CrI: 4.38, 5.86). The overall sample CHR was estimated to be 17.86% (95% CrI: 6.06, 33.11) for females and 4.99% (95% CrI: 4.27, 5.75) for males. A notable difference was observed between the CHRs that were estimated for each sex, which may be indicative of increased infection severity in females or a considerably lower infection ascertainment rate. It was estimated that 74.65% (95% CrI: 55.78, 86.85) of infections with the monkeypox virus in the UK were captured over the outbreak.
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Affiliation(s)
- Thomas Ward
- UK Health Security Agency, Data Analytics & Surveillance, London, UK.
| | - Christopher E Overton
- UK Health Security Agency, Data Analytics & Surveillance, London, UK
- Department of Mathematical Sciences, University of Liverpool, Liverpool, UK
| | - Robert S Paton
- UK Health Security Agency, Data Analytics & Surveillance, London, UK
| | - Rachel Christie
- UK Health Security Agency, Data Analytics & Surveillance, London, UK
| | - Fergus Cumming
- UK Health Security Agency, Data Analytics & Surveillance, London, UK
| | - Martyn Fyles
- UK Health Security Agency, Data Analytics & Surveillance, London, UK
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Kuehn R, Fox T, Guyatt G, Lutje V, Gould S. Infection prevention and control measures to reduce the transmission of mpox: A systematic review. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002731. [PMID: 38236835 PMCID: PMC10796032 DOI: 10.1371/journal.pgph.0002731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 11/28/2023] [Indexed: 01/22/2024]
Abstract
OBJECTIVES To make inferences regarding the effectiveness of respiratory interventions and case isolation measures in reducing or preventing the transmission of mpox based on synthesis of available literature. METHODS The WHO Clinical Management and Infection Prevention and Control 2022 guideline and droplet precautions in healthcare facilities and home isolation infection prevention control measures for patients with mpox. We conducted a systematic review that included a broad search of five electronic databases. In a two-stage process, we initially sought only randomized controlled trials and observational comparative studies; when the search failed to yield eligible studies, the subsequent search included all study designs including clinical and environmental sampling studies. RESULTS No studies were identified that directly addressed airborne and droplet precautions and home isolation infection prevention control measures. To inform the review questions the review team synthesized route of transmission data in mpox. There were 2366/4309 (54.9%) cases in which investigators identified mpox infection occurring following transmission through direct physical sexual contact. There were no reported mpox cases in which investigators identified inhalation as a single route of transmission. There were 2/4309 cases in which investigators identified fomite as a single route of transmission. Clinical and environmental sampling studies isolated mpox virus in a minority of saliva, oropharangeal swabs, mpox skin lesions, and hospital room air. CONCLUSIONS Current findings provide compelling evidence that transmission of mpox occurs through direct physical contact. Because investigators have not reported any cases of transmission via inhalation alone, the impact of airborne and droplet infection prevention control measures in reducing transmission will be minimal. Avoiding physical contact with others, covering mpox lesions and wearing a medical mask is likely to reduce onward mpox transmission; there may be minimal reduction in transmission from additionally physically isolating patients with mild disease at home.
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Affiliation(s)
- Rebecca Kuehn
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Tilly Fox
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Gordon Guyatt
- Department of Health Research Methods Evidence and Impact, McMaster University, Hamilton, Canada
| | - Vittoria Lutje
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Susan Gould
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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9
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Grabmeier-Pfistershammer K, Skorepa C, Breuer M, Masood M, Chromy D, Strassl R. No evidence of asymptomatic monkeypox infection in a highly sexually active MSM population in Austria. HIV Med 2024; 25:150-153. [PMID: 37652894 DOI: 10.1111/hiv.13535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 08/06/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND The 2022 outbreak of monkeypox virus (MPXV) revealed new transmission routes. Incidence declined sharply in September 2022, and it remains unclear whether MPXV is circulating in asymptomatic individuals because of increased immunity. OBJECTIVES Our study aimed to assesss the number of asymtomatic MPXV carriers in individuals at high risk for STI. METHODS We analysed anal samples from asymptomatic highly sexually active men who have sex with men for the presence of MPXV. RESULTS We detected a high number of concomitant sexually transmitted infections but did not find a single sample with MPXV. CONCLUSIONS Our results indicate that the general recommendation to implement screening for MPXV is not currently justified.
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Affiliation(s)
| | - Christopher Skorepa
- Division of Clinical Virology, Department of Laboratory Medicine, Medical University Vienna, Vienna, Austria
| | - Monika Breuer
- Division of Clinical Virology, Department of Laboratory Medicine, Medical University Vienna, Vienna, Austria
| | - Maheen Masood
- Division of Clinical Virology, Department of Laboratory Medicine, Medical University Vienna, Vienna, Austria
| | - David Chromy
- Department of Dermatology, Medical University Vienna, Vienna, Austria
| | - Robert Strassl
- Division of Clinical Virology, Department of Laboratory Medicine, Medical University Vienna, Vienna, Austria
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10
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Kalaba MH, El-Sherbiny GM, Sharaf MH, Farghal EE. Biological Characteristics and Pathogenesis of Monkeypox Virus: An Overview. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1451:91-109. [PMID: 38801573 DOI: 10.1007/978-3-031-57165-7_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Although the smallpox virus has been eradicated worldwide, the World Health Organization (WHO) has issued a warning about the virus's potential to propagate globally. The WHO labeled monkeypox a world public health emergency in July 2022, requiring urgent prevention and treatment. The monkeypox virus is a part of the Poxviridae family, Orthopoxvirus genus, and is accountable for smallpox, which has killed over a million people in the past. Natural hosts of the virus include squirrels, Gambian rodents, chimpanzees, and other monkeys. The monkeypox virus has transmitted to humans through primary vectors (various animal species) and secondary vectors, including direct touch with lesions, breathing particles from body fluids, and infected bedding. The viral particles are ovoid or brick-shaped, 200-250 nm in diameter, contain a single double-stranded DNA molecule, and reproduce only in the cytoplasm of infected cells. Monkeypox causes fever, cold, muscle pains, headache, fatigue, and backache. The phylogenetic investigation distinguished between two genetic clades of monkeypox: the more pathogenic Congo Basin clade and the West Africa clade. In recent years, the geographical spread of the human monkeypox virus has accelerated despite a paucity of information regarding the disease's emergence, ecology, and epidemiology. Using lesion samples and polymerase chain reaction (PCR), the monkeypox virus was diagnosed. In the USA, the improved Ankara vaccine can now be used to protect people who are at a higher risk of getting monkeypox. Antivirals that we have now work well against smallpox and may stop the spread of monkeypox, but there is no particular therapy for monkeypox.
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Affiliation(s)
- Mohamed H Kalaba
- Botany and Microbiology Department, Faculty of Science, Al-Azhar University, Cairo, 11884, Egypt
| | - Gamal M El-Sherbiny
- Botany and Microbiology Department, Faculty of Science, Al-Azhar University, Cairo, 11884, Egypt.
| | - Mohammed H Sharaf
- Botany and Microbiology Department, Faculty of Science, Al-Azhar University, Cairo, 11884, Egypt
| | - Eman E Farghal
- Clinical and Chemical Pathology, Faculty of Medicine, Tanta University, Tanta, Egypt
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11
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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.
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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
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12
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Van Dijck C, Hoff NA, Mbala-Kingebeni P, Low N, Cevik M, Rimoin AW, Kindrachuk J, Liesenborghs L. Emergence of mpox in the post-smallpox era-a narrative review on mpox epidemiology. Clin Microbiol Infect 2023; 29:1487-1492. [PMID: 37574113 DOI: 10.1016/j.cmi.2023.08.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 07/09/2023] [Accepted: 08/08/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND The 2022 mpox outbreak drew global attention to this neglected pathogen. While most of the world was taken by surprise, some countries have seen this pathogen emerge and become endemic several decades prior to this epidemic. OBJECTIVES This narrative review provides an overview of mpox epidemiology since its discovery through the 2022 global outbreak. SOURCES We searched PubMed for relevant literature about mpox epidemiology and transmission through 28 February 2023. CONTENT The emergence of human mpox is intertwined with the eradication of smallpox and the cessation of the global smallpox vaccination campaign. The first human clade I and II monkeypox virus (MPXV) infections were reported as zoonoses in Central and West Africa, respectively, around 1970 with sporadic infections reported throughout the rest of the decade. Over the next five decades, Clade I MPXV was more common and caused outbreaks of increasing size and frequency, mainly in the Democratic Republic of the Congo. Clade II MPXV was rarely observed, until its re-emergence and ongoing transmission in Nigeria, since 2017. Both clades showed a shift from zoonotic to human-to-human transmission, with potential transmission through sexual contact being observed in Nigeria. In 2022, clade II MPXV caused a large human outbreak which to date has caused over 86,000 cases in 110 countries, with strong evidence of transmission during sexual contact. By February 2023, the global epidemic has waned in most countries, but endemic regions continue to suffer from mpox. IMPLICATIONS The changing epidemiology of mpox demonstrates how neglected zoonosis turned into a global health threat within a few decades. Thus, mpox pathophysiology and transmission dynamics need to be further investigated, and preventive and therapeutic interventions need to be evaluated. Outbreak response systems need to be strengthened and sustained in endemic regions to reduce the global threat of mpox.
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Affiliation(s)
- Christophe Van Dijck
- Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Nicole A Hoff
- Department of Epidemiology, University of California, Los Angeles, CA, USA
| | - Placide Mbala-Kingebeni
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of Congo; Université de Kinshasa, Democratic Republic of Congo
| | - Nicola Low
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Muge Cevik
- Division of Infection and Global Health, University of St Andrews, St Andrews, Scotland
| | - Anne W Rimoin
- Department of Epidemiology, University of California, Los Angeles, CA, USA
| | - Jason Kindrachuk
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada
| | - Laurens Liesenborghs
- Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium.
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13
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Ghazy RM, Elrewany E, Gebreal A, ElMakhzangy R, Fadl N, Elbanna EH, Tolba MM, Hammad EM, Youssef N, Abosheaishaa H, Hamouda EEM, Mehana ZEE, Al Zomia AS, A Alnami RA, Salma EAS, Alqahtani AS, Alshehri AF, Hussein M. Systematic Review on the Efficacy, Effectiveness, Safety, and Immunogenicity of Monkeypox Vaccine. Vaccines (Basel) 2023; 11:1708. [PMID: 38006040 PMCID: PMC10674429 DOI: 10.3390/vaccines11111708] [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: 09/22/2023] [Revised: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND The variation in the reported vaccine safety and effectiveness could contribute to the high rates of vaccine hesitancy among the general population and healthcare workers in areas where monkeypox (mpox) is circulating. In this review, our objective was to evaluate the safety, immunogenicity, effectiveness, and efficacy of the mpox vaccines. METHODS An extensive search for articles across multiple databases was performed, including searching six databases (PubMed Central, PubMed Medline, Scopus, Web of Science, Cochrane, ProQuest), two pre-print databases (European PMC Preprint and MedRxiv), and Google Scholar. RESULTS A total of 4290 citations were retrieved from the included databases. Following the removal of duplicates and the initial screening of records, a total of 36 studies were included into the analysis. Additionally, we identified five more studies through manual searches, resulting in a total of 41 eligible articles for qualitative synthesis. The study findings revealed that mpox vaccines demonstrate the ability to generate adequate antibodies; however, their effectiveness may decrease over time, exhibiting varying safety profiles. Most of the included studies consistently reported substantial levels of effectiveness and efficacy against mpox. Interestingly, the number of vaccine doses administered was found to influence the degree of immunogenicity, subsequently impacting the overall effectiveness and efficacy of the vaccines. Furthermore, we found that smallpox vaccines exhibited a form of cross-protection against mpox. CONCLUSIONS Vaccines can be used to prevent mpox and effectively control its spread.
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Affiliation(s)
- Ramy Mohamed Ghazy
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria 21561, Egypt; (R.M.G.); (E.E.)
| | - Ehab Elrewany
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria 21561, Egypt; (R.M.G.); (E.E.)
| | - Assem Gebreal
- Alexandria Faculty of Medicine, Alexandria University, Alexandria 21561, Egypt; (A.G.); (E.M.H.); (Z.E.E.M.)
| | - Rony ElMakhzangy
- Family Health Department, High Institute of Public Health, Alexandria University, Alexandria 21561, Egypt; (R.E.); (N.F.)
| | - Noha Fadl
- Family Health Department, High Institute of Public Health, Alexandria University, Alexandria 21561, Egypt; (R.E.); (N.F.)
| | - Eman Hassan Elbanna
- Health Administration and Behavioral Sciences Department, High Institute of Public Health, Alexandria University, Alexandria 21561, Egypt;
| | - Mahmoud M. Tolba
- Pharmaceutical Division, Ministry of Health and Population, Faiyum City 63723, Egypt;
| | - Elsayed Mohamed Hammad
- Alexandria Faculty of Medicine, Alexandria University, Alexandria 21561, Egypt; (A.G.); (E.M.H.); (Z.E.E.M.)
| | - Naglaa Youssef
- Medical-Surgical Nursing, Faculty of Nursing, Cairo University, Cairo 11562, Egypt;
| | | | | | - Zeyad Elsayed Eldeeb Mehana
- Alexandria Faculty of Medicine, Alexandria University, Alexandria 21561, Egypt; (A.G.); (E.M.H.); (Z.E.E.M.)
| | - Ahmed Saad Al Zomia
- College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (A.S.A.Z.); (R.A.A.A.); (E.A.S.S.); (A.S.A.); (A.F.A.)
| | - Raad Ahmed A Alnami
- College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (A.S.A.Z.); (R.A.A.A.); (E.A.S.S.); (A.S.A.); (A.F.A.)
| | - Emad Ali Saeed Salma
- College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (A.S.A.Z.); (R.A.A.A.); (E.A.S.S.); (A.S.A.); (A.F.A.)
| | - Abdulaziz Saleh Alqahtani
- College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (A.S.A.Z.); (R.A.A.A.); (E.A.S.S.); (A.S.A.); (A.F.A.)
| | - Abdulaziz Fayez Alshehri
- College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (A.S.A.Z.); (R.A.A.A.); (E.A.S.S.); (A.S.A.); (A.F.A.)
| | - Mai Hussein
- Clinical Research Administration, Alexandria Directorate of Health Affairs, Alexandria 21561, Egypt
- Egyptian Ministry of Health and Population, Cairo 11562, Egypt
- Master of Medical Science in Clinical Investigation, Harvard Medical School, Boston, MA 02115, USA
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14
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Dudani P, Sharma A, Tammineni MS, Gupta S. Monkeypox (Mpox): Evolution of Transmission and Comprehensive Review. Indian J Dermatol 2023; 68:647-656. [PMID: 38371541 PMCID: PMC10869021 DOI: 10.4103/ijd.ijd_335_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024] Open
Abstract
The human monkeypox (mpox) virus is an orthopox virus that can be transmitted to humans. Though the disease has been endemic in Africa, the recent mpox outbreak since May 2022. We attempted to examine differences between the endemic form of mpox and the current outbreak. Review of electronic medical database with relevant keywords. The current outbreak of mpox has disproportionately impacted the gay, bisexual and other men who have sex with men (MSM) community. This is also the first time that widespread semen testing has turned up evidence of mpox viral deoxyribonucleic acid (DNA). Cases in the present outbreak are more likely to affect adults, involve the genitalia, and have no prodrome. Close diagnostic differentials include varicella and hand-foot-mouth disease. The disease is usually self-limiting; though secondary infections, anorectal pain, pharyngitis, ocular lesions and rarely, renal injury and myocarditis may occur. This review focuses primarily on the novel clinical characteristics and emerging sexual transmission route of the mpox virus, which, although unconfirmed, appears extremely likely as the route of spread. Dermatologists have an important role in this health emergency, as early diagnosis can cause a significant reduction in disease transmission.
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Affiliation(s)
- Pankhuri Dudani
- From the Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Ananya Sharma
- From the Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Morini S. Tammineni
- Department of Dermatology and Cutaneous Surgery, University of Miami, Florida, United States
| | - Somesh Gupta
- From the Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, Delhi, India
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15
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Hoxha A, Kerr SM, Laurenson-Schafer H, Sklenovská N, Mirembe BB, Nezu IH, Ndumbi P, Fitzner J, Almiron M, Vila M, Pebody R, Vaughan AM, Haussig JM, de Sousa LA, Lukoya OC, Sanni OF, Nabeth P, Naiene JD, Kato M, Matsui T, Kuppalli K, Mala PO, Lewis RF, de Waroux OLP, Pavlin BI. Mpox in Children and Adolescents during Multicountry Outbreak, 2022-2023. Emerg Infect Dis 2023; 29:2125-2129. [PMID: 37647121 PMCID: PMC10521596 DOI: 10.3201/eid2910.230516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
Abstract
The 2022-2023 mpox outbreak predominantly affected adult men; 1.3% of reported cases were in children and adolescents <18 years of age. Analysis of global surveillance data showed 1 hospital intensive care unit admission and 0 deaths in that age group. Transmission routes and clinical manifestations varied across age subgroups.
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Affiliation(s)
| | | | - Henry Laurenson-Schafer
- Health Emergencies Programme, World Health Organization (WHO), Geneva, Switzerland (A. Hoxha, H. Laurenson-Schafer, N. Sklenovska, B.B. Mirembe, I.H. Nezu, P. Ndumbi, J. Fitzner, K. Kuppalli, P.O. Mala, R.F. Lewis, O. le Polain de Waroux, B.I. Pavlin)
- CPC Analytics, Berlin, Germany (S.M. Kerr)
- WHO Regional Office for the Americas, Washington, DC, USA (M. Almiron, M. Vila)
- WHO Regional Office for Europe, Copenhagen, Denmark (R. Pebody, A.M. Vaughan)
- European Centre for Disease Prevention and Control, Solna, Sweden (J.M. Haussig, L. Alves de Sousa)
- WHO Regional Office for Africa, Brazzaville, Republic of the Congo (O.C. Lukoya, O.F. Sanni)
- WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt (P. Nabeth, J.D. Naiene)
- WHO Regional Office for South-East Asia, Delhi, India (M. Kato)
- WHO Regional Office for the Western Pacific, Manila, Philippines (T. Matsui)
| | - Nikola Sklenovská
- Health Emergencies Programme, World Health Organization (WHO), Geneva, Switzerland (A. Hoxha, H. Laurenson-Schafer, N. Sklenovska, B.B. Mirembe, I.H. Nezu, P. Ndumbi, J. Fitzner, K. Kuppalli, P.O. Mala, R.F. Lewis, O. le Polain de Waroux, B.I. Pavlin)
- CPC Analytics, Berlin, Germany (S.M. Kerr)
- WHO Regional Office for the Americas, Washington, DC, USA (M. Almiron, M. Vila)
- WHO Regional Office for Europe, Copenhagen, Denmark (R. Pebody, A.M. Vaughan)
- European Centre for Disease Prevention and Control, Solna, Sweden (J.M. Haussig, L. Alves de Sousa)
- WHO Regional Office for Africa, Brazzaville, Republic of the Congo (O.C. Lukoya, O.F. Sanni)
- WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt (P. Nabeth, J.D. Naiene)
- WHO Regional Office for South-East Asia, Delhi, India (M. Kato)
- WHO Regional Office for the Western Pacific, Manila, Philippines (T. Matsui)
| | - Bernadette Basuta Mirembe
- Health Emergencies Programme, World Health Organization (WHO), Geneva, Switzerland (A. Hoxha, H. Laurenson-Schafer, N. Sklenovska, B.B. Mirembe, I.H. Nezu, P. Ndumbi, J. Fitzner, K. Kuppalli, P.O. Mala, R.F. Lewis, O. le Polain de Waroux, B.I. Pavlin)
- CPC Analytics, Berlin, Germany (S.M. Kerr)
- WHO Regional Office for the Americas, Washington, DC, USA (M. Almiron, M. Vila)
- WHO Regional Office for Europe, Copenhagen, Denmark (R. Pebody, A.M. Vaughan)
- European Centre for Disease Prevention and Control, Solna, Sweden (J.M. Haussig, L. Alves de Sousa)
- WHO Regional Office for Africa, Brazzaville, Republic of the Congo (O.C. Lukoya, O.F. Sanni)
- WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt (P. Nabeth, J.D. Naiene)
- WHO Regional Office for South-East Asia, Delhi, India (M. Kato)
- WHO Regional Office for the Western Pacific, Manila, Philippines (T. Matsui)
| | - Ingrid Hammermeister Nezu
- Health Emergencies Programme, World Health Organization (WHO), Geneva, Switzerland (A. Hoxha, H. Laurenson-Schafer, N. Sklenovska, B.B. Mirembe, I.H. Nezu, P. Ndumbi, J. Fitzner, K. Kuppalli, P.O. Mala, R.F. Lewis, O. le Polain de Waroux, B.I. Pavlin)
- CPC Analytics, Berlin, Germany (S.M. Kerr)
- WHO Regional Office for the Americas, Washington, DC, USA (M. Almiron, M. Vila)
- WHO Regional Office for Europe, Copenhagen, Denmark (R. Pebody, A.M. Vaughan)
- European Centre for Disease Prevention and Control, Solna, Sweden (J.M. Haussig, L. Alves de Sousa)
- WHO Regional Office for Africa, Brazzaville, Republic of the Congo (O.C. Lukoya, O.F. Sanni)
- WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt (P. Nabeth, J.D. Naiene)
- WHO Regional Office for South-East Asia, Delhi, India (M. Kato)
- WHO Regional Office for the Western Pacific, Manila, Philippines (T. Matsui)
| | - Patricia Ndumbi
- Health Emergencies Programme, World Health Organization (WHO), Geneva, Switzerland (A. Hoxha, H. Laurenson-Schafer, N. Sklenovska, B.B. Mirembe, I.H. Nezu, P. Ndumbi, J. Fitzner, K. Kuppalli, P.O. Mala, R.F. Lewis, O. le Polain de Waroux, B.I. Pavlin)
- CPC Analytics, Berlin, Germany (S.M. Kerr)
- WHO Regional Office for the Americas, Washington, DC, USA (M. Almiron, M. Vila)
- WHO Regional Office for Europe, Copenhagen, Denmark (R. Pebody, A.M. Vaughan)
- European Centre for Disease Prevention and Control, Solna, Sweden (J.M. Haussig, L. Alves de Sousa)
- WHO Regional Office for Africa, Brazzaville, Republic of the Congo (O.C. Lukoya, O.F. Sanni)
- WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt (P. Nabeth, J.D. Naiene)
- WHO Regional Office for South-East Asia, Delhi, India (M. Kato)
- WHO Regional Office for the Western Pacific, Manila, Philippines (T. Matsui)
| | - Julia Fitzner
- Health Emergencies Programme, World Health Organization (WHO), Geneva, Switzerland (A. Hoxha, H. Laurenson-Schafer, N. Sklenovska, B.B. Mirembe, I.H. Nezu, P. Ndumbi, J. Fitzner, K. Kuppalli, P.O. Mala, R.F. Lewis, O. le Polain de Waroux, B.I. Pavlin)
- CPC Analytics, Berlin, Germany (S.M. Kerr)
- WHO Regional Office for the Americas, Washington, DC, USA (M. Almiron, M. Vila)
- WHO Regional Office for Europe, Copenhagen, Denmark (R. Pebody, A.M. Vaughan)
- European Centre for Disease Prevention and Control, Solna, Sweden (J.M. Haussig, L. Alves de Sousa)
- WHO Regional Office for Africa, Brazzaville, Republic of the Congo (O.C. Lukoya, O.F. Sanni)
- WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt (P. Nabeth, J.D. Naiene)
- WHO Regional Office for South-East Asia, Delhi, India (M. Kato)
- WHO Regional Office for the Western Pacific, Manila, Philippines (T. Matsui)
| | - Maria Almiron
- Health Emergencies Programme, World Health Organization (WHO), Geneva, Switzerland (A. Hoxha, H. Laurenson-Schafer, N. Sklenovska, B.B. Mirembe, I.H. Nezu, P. Ndumbi, J. Fitzner, K. Kuppalli, P.O. Mala, R.F. Lewis, O. le Polain de Waroux, B.I. Pavlin)
- CPC Analytics, Berlin, Germany (S.M. Kerr)
- WHO Regional Office for the Americas, Washington, DC, USA (M. Almiron, M. Vila)
- WHO Regional Office for Europe, Copenhagen, Denmark (R. Pebody, A.M. Vaughan)
- European Centre for Disease Prevention and Control, Solna, Sweden (J.M. Haussig, L. Alves de Sousa)
- WHO Regional Office for Africa, Brazzaville, Republic of the Congo (O.C. Lukoya, O.F. Sanni)
- WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt (P. Nabeth, J.D. Naiene)
- WHO Regional Office for South-East Asia, Delhi, India (M. Kato)
- WHO Regional Office for the Western Pacific, Manila, Philippines (T. Matsui)
| | - Marcelo Vila
- Health Emergencies Programme, World Health Organization (WHO), Geneva, Switzerland (A. Hoxha, H. Laurenson-Schafer, N. Sklenovska, B.B. Mirembe, I.H. Nezu, P. Ndumbi, J. Fitzner, K. Kuppalli, P.O. Mala, R.F. Lewis, O. le Polain de Waroux, B.I. Pavlin)
- CPC Analytics, Berlin, Germany (S.M. Kerr)
- WHO Regional Office for the Americas, Washington, DC, USA (M. Almiron, M. Vila)
- WHO Regional Office for Europe, Copenhagen, Denmark (R. Pebody, A.M. Vaughan)
- European Centre for Disease Prevention and Control, Solna, Sweden (J.M. Haussig, L. Alves de Sousa)
- WHO Regional Office for Africa, Brazzaville, Republic of the Congo (O.C. Lukoya, O.F. Sanni)
- WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt (P. Nabeth, J.D. Naiene)
- WHO Regional Office for South-East Asia, Delhi, India (M. Kato)
- WHO Regional Office for the Western Pacific, Manila, Philippines (T. Matsui)
| | - Richard Pebody
- Health Emergencies Programme, World Health Organization (WHO), Geneva, Switzerland (A. Hoxha, H. Laurenson-Schafer, N. Sklenovska, B.B. Mirembe, I.H. Nezu, P. Ndumbi, J. Fitzner, K. Kuppalli, P.O. Mala, R.F. Lewis, O. le Polain de Waroux, B.I. Pavlin)
- CPC Analytics, Berlin, Germany (S.M. Kerr)
- WHO Regional Office for the Americas, Washington, DC, USA (M. Almiron, M. Vila)
- WHO Regional Office for Europe, Copenhagen, Denmark (R. Pebody, A.M. Vaughan)
- European Centre for Disease Prevention and Control, Solna, Sweden (J.M. Haussig, L. Alves de Sousa)
- WHO Regional Office for Africa, Brazzaville, Republic of the Congo (O.C. Lukoya, O.F. Sanni)
- WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt (P. Nabeth, J.D. Naiene)
- WHO Regional Office for South-East Asia, Delhi, India (M. Kato)
- WHO Regional Office for the Western Pacific, Manila, Philippines (T. Matsui)
| | - Aisling M. Vaughan
- Health Emergencies Programme, World Health Organization (WHO), Geneva, Switzerland (A. Hoxha, H. Laurenson-Schafer, N. Sklenovska, B.B. Mirembe, I.H. Nezu, P. Ndumbi, J. Fitzner, K. Kuppalli, P.O. Mala, R.F. Lewis, O. le Polain de Waroux, B.I. Pavlin)
- CPC Analytics, Berlin, Germany (S.M. Kerr)
- WHO Regional Office for the Americas, Washington, DC, USA (M. Almiron, M. Vila)
- WHO Regional Office for Europe, Copenhagen, Denmark (R. Pebody, A.M. Vaughan)
- European Centre for Disease Prevention and Control, Solna, Sweden (J.M. Haussig, L. Alves de Sousa)
- WHO Regional Office for Africa, Brazzaville, Republic of the Congo (O.C. Lukoya, O.F. Sanni)
- WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt (P. Nabeth, J.D. Naiene)
- WHO Regional Office for South-East Asia, Delhi, India (M. Kato)
- WHO Regional Office for the Western Pacific, Manila, Philippines (T. Matsui)
| | - Joana M. Haussig
- Health Emergencies Programme, World Health Organization (WHO), Geneva, Switzerland (A. Hoxha, H. Laurenson-Schafer, N. Sklenovska, B.B. Mirembe, I.H. Nezu, P. Ndumbi, J. Fitzner, K. Kuppalli, P.O. Mala, R.F. Lewis, O. le Polain de Waroux, B.I. Pavlin)
- CPC Analytics, Berlin, Germany (S.M. Kerr)
- WHO Regional Office for the Americas, Washington, DC, USA (M. Almiron, M. Vila)
- WHO Regional Office for Europe, Copenhagen, Denmark (R. Pebody, A.M. Vaughan)
- European Centre for Disease Prevention and Control, Solna, Sweden (J.M. Haussig, L. Alves de Sousa)
- WHO Regional Office for Africa, Brazzaville, Republic of the Congo (O.C. Lukoya, O.F. Sanni)
- WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt (P. Nabeth, J.D. Naiene)
- WHO Regional Office for South-East Asia, Delhi, India (M. Kato)
- WHO Regional Office for the Western Pacific, Manila, Philippines (T. Matsui)
| | - Luis Alves de Sousa
- Health Emergencies Programme, World Health Organization (WHO), Geneva, Switzerland (A. Hoxha, H. Laurenson-Schafer, N. Sklenovska, B.B. Mirembe, I.H. Nezu, P. Ndumbi, J. Fitzner, K. Kuppalli, P.O. Mala, R.F. Lewis, O. le Polain de Waroux, B.I. Pavlin)
- CPC Analytics, Berlin, Germany (S.M. Kerr)
- WHO Regional Office for the Americas, Washington, DC, USA (M. Almiron, M. Vila)
- WHO Regional Office for Europe, Copenhagen, Denmark (R. Pebody, A.M. Vaughan)
- European Centre for Disease Prevention and Control, Solna, Sweden (J.M. Haussig, L. Alves de Sousa)
- WHO Regional Office for Africa, Brazzaville, Republic of the Congo (O.C. Lukoya, O.F. Sanni)
- WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt (P. Nabeth, J.D. Naiene)
- WHO Regional Office for South-East Asia, Delhi, India (M. Kato)
- WHO Regional Office for the Western Pacific, Manila, Philippines (T. Matsui)
| | - Okot Charles Lukoya
- Health Emergencies Programme, World Health Organization (WHO), Geneva, Switzerland (A. Hoxha, H. Laurenson-Schafer, N. Sklenovska, B.B. Mirembe, I.H. Nezu, P. Ndumbi, J. Fitzner, K. Kuppalli, P.O. Mala, R.F. Lewis, O. le Polain de Waroux, B.I. Pavlin)
- CPC Analytics, Berlin, Germany (S.M. Kerr)
- WHO Regional Office for the Americas, Washington, DC, USA (M. Almiron, M. Vila)
- WHO Regional Office for Europe, Copenhagen, Denmark (R. Pebody, A.M. Vaughan)
- European Centre for Disease Prevention and Control, Solna, Sweden (J.M. Haussig, L. Alves de Sousa)
- WHO Regional Office for Africa, Brazzaville, Republic of the Congo (O.C. Lukoya, O.F. Sanni)
- WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt (P. Nabeth, J.D. Naiene)
- WHO Regional Office for South-East Asia, Delhi, India (M. Kato)
- WHO Regional Office for the Western Pacific, Manila, Philippines (T. Matsui)
| | - Olaniyi Felix Sanni
- Health Emergencies Programme, World Health Organization (WHO), Geneva, Switzerland (A. Hoxha, H. Laurenson-Schafer, N. Sklenovska, B.B. Mirembe, I.H. Nezu, P. Ndumbi, J. Fitzner, K. Kuppalli, P.O. Mala, R.F. Lewis, O. le Polain de Waroux, B.I. Pavlin)
- CPC Analytics, Berlin, Germany (S.M. Kerr)
- WHO Regional Office for the Americas, Washington, DC, USA (M. Almiron, M. Vila)
- WHO Regional Office for Europe, Copenhagen, Denmark (R. Pebody, A.M. Vaughan)
- European Centre for Disease Prevention and Control, Solna, Sweden (J.M. Haussig, L. Alves de Sousa)
- WHO Regional Office for Africa, Brazzaville, Republic of the Congo (O.C. Lukoya, O.F. Sanni)
- WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt (P. Nabeth, J.D. Naiene)
- WHO Regional Office for South-East Asia, Delhi, India (M. Kato)
- WHO Regional Office for the Western Pacific, Manila, Philippines (T. Matsui)
| | - Pierre Nabeth
- Health Emergencies Programme, World Health Organization (WHO), Geneva, Switzerland (A. Hoxha, H. Laurenson-Schafer, N. Sklenovska, B.B. Mirembe, I.H. Nezu, P. Ndumbi, J. Fitzner, K. Kuppalli, P.O. Mala, R.F. Lewis, O. le Polain de Waroux, B.I. Pavlin)
- CPC Analytics, Berlin, Germany (S.M. Kerr)
- WHO Regional Office for the Americas, Washington, DC, USA (M. Almiron, M. Vila)
- WHO Regional Office for Europe, Copenhagen, Denmark (R. Pebody, A.M. Vaughan)
- European Centre for Disease Prevention and Control, Solna, Sweden (J.M. Haussig, L. Alves de Sousa)
- WHO Regional Office for Africa, Brazzaville, Republic of the Congo (O.C. Lukoya, O.F. Sanni)
- WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt (P. Nabeth, J.D. Naiene)
- WHO Regional Office for South-East Asia, Delhi, India (M. Kato)
- WHO Regional Office for the Western Pacific, Manila, Philippines (T. Matsui)
| | - Jeremias Domingos Naiene
- Health Emergencies Programme, World Health Organization (WHO), Geneva, Switzerland (A. Hoxha, H. Laurenson-Schafer, N. Sklenovska, B.B. Mirembe, I.H. Nezu, P. Ndumbi, J. Fitzner, K. Kuppalli, P.O. Mala, R.F. Lewis, O. le Polain de Waroux, B.I. Pavlin)
- CPC Analytics, Berlin, Germany (S.M. Kerr)
- WHO Regional Office for the Americas, Washington, DC, USA (M. Almiron, M. Vila)
- WHO Regional Office for Europe, Copenhagen, Denmark (R. Pebody, A.M. Vaughan)
- European Centre for Disease Prevention and Control, Solna, Sweden (J.M. Haussig, L. Alves de Sousa)
- WHO Regional Office for Africa, Brazzaville, Republic of the Congo (O.C. Lukoya, O.F. Sanni)
- WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt (P. Nabeth, J.D. Naiene)
- WHO Regional Office for South-East Asia, Delhi, India (M. Kato)
- WHO Regional Office for the Western Pacific, Manila, Philippines (T. Matsui)
| | - Masaya Kato
- Health Emergencies Programme, World Health Organization (WHO), Geneva, Switzerland (A. Hoxha, H. Laurenson-Schafer, N. Sklenovska, B.B. Mirembe, I.H. Nezu, P. Ndumbi, J. Fitzner, K. Kuppalli, P.O. Mala, R.F. Lewis, O. le Polain de Waroux, B.I. Pavlin)
- CPC Analytics, Berlin, Germany (S.M. Kerr)
- WHO Regional Office for the Americas, Washington, DC, USA (M. Almiron, M. Vila)
- WHO Regional Office for Europe, Copenhagen, Denmark (R. Pebody, A.M. Vaughan)
- European Centre for Disease Prevention and Control, Solna, Sweden (J.M. Haussig, L. Alves de Sousa)
- WHO Regional Office for Africa, Brazzaville, Republic of the Congo (O.C. Lukoya, O.F. Sanni)
- WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt (P. Nabeth, J.D. Naiene)
- WHO Regional Office for South-East Asia, Delhi, India (M. Kato)
- WHO Regional Office for the Western Pacific, Manila, Philippines (T. Matsui)
| | - Tamano Matsui
- Health Emergencies Programme, World Health Organization (WHO), Geneva, Switzerland (A. Hoxha, H. Laurenson-Schafer, N. Sklenovska, B.B. Mirembe, I.H. Nezu, P. Ndumbi, J. Fitzner, K. Kuppalli, P.O. Mala, R.F. Lewis, O. le Polain de Waroux, B.I. Pavlin)
- CPC Analytics, Berlin, Germany (S.M. Kerr)
- WHO Regional Office for the Americas, Washington, DC, USA (M. Almiron, M. Vila)
- WHO Regional Office for Europe, Copenhagen, Denmark (R. Pebody, A.M. Vaughan)
- European Centre for Disease Prevention and Control, Solna, Sweden (J.M. Haussig, L. Alves de Sousa)
- WHO Regional Office for Africa, Brazzaville, Republic of the Congo (O.C. Lukoya, O.F. Sanni)
- WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt (P. Nabeth, J.D. Naiene)
- WHO Regional Office for South-East Asia, Delhi, India (M. Kato)
- WHO Regional Office for the Western Pacific, Manila, Philippines (T. Matsui)
| | - Krutika Kuppalli
- Health Emergencies Programme, World Health Organization (WHO), Geneva, Switzerland (A. Hoxha, H. Laurenson-Schafer, N. Sklenovska, B.B. Mirembe, I.H. Nezu, P. Ndumbi, J. Fitzner, K. Kuppalli, P.O. Mala, R.F. Lewis, O. le Polain de Waroux, B.I. Pavlin)
- CPC Analytics, Berlin, Germany (S.M. Kerr)
- WHO Regional Office for the Americas, Washington, DC, USA (M. Almiron, M. Vila)
- WHO Regional Office for Europe, Copenhagen, Denmark (R. Pebody, A.M. Vaughan)
- European Centre for Disease Prevention and Control, Solna, Sweden (J.M. Haussig, L. Alves de Sousa)
- WHO Regional Office for Africa, Brazzaville, Republic of the Congo (O.C. Lukoya, O.F. Sanni)
- WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt (P. Nabeth, J.D. Naiene)
- WHO Regional Office for South-East Asia, Delhi, India (M. Kato)
- WHO Regional Office for the Western Pacific, Manila, Philippines (T. Matsui)
| | - Peter Omondi Mala
- Health Emergencies Programme, World Health Organization (WHO), Geneva, Switzerland (A. Hoxha, H. Laurenson-Schafer, N. Sklenovska, B.B. Mirembe, I.H. Nezu, P. Ndumbi, J. Fitzner, K. Kuppalli, P.O. Mala, R.F. Lewis, O. le Polain de Waroux, B.I. Pavlin)
- CPC Analytics, Berlin, Germany (S.M. Kerr)
- WHO Regional Office for the Americas, Washington, DC, USA (M. Almiron, M. Vila)
- WHO Regional Office for Europe, Copenhagen, Denmark (R. Pebody, A.M. Vaughan)
- European Centre for Disease Prevention and Control, Solna, Sweden (J.M. Haussig, L. Alves de Sousa)
- WHO Regional Office for Africa, Brazzaville, Republic of the Congo (O.C. Lukoya, O.F. Sanni)
- WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt (P. Nabeth, J.D. Naiene)
- WHO Regional Office for South-East Asia, Delhi, India (M. Kato)
- WHO Regional Office for the Western Pacific, Manila, Philippines (T. Matsui)
| | - Rosamund F. Lewis
- Health Emergencies Programme, World Health Organization (WHO), Geneva, Switzerland (A. Hoxha, H. Laurenson-Schafer, N. Sklenovska, B.B. Mirembe, I.H. Nezu, P. Ndumbi, J. Fitzner, K. Kuppalli, P.O. Mala, R.F. Lewis, O. le Polain de Waroux, B.I. Pavlin)
- CPC Analytics, Berlin, Germany (S.M. Kerr)
- WHO Regional Office for the Americas, Washington, DC, USA (M. Almiron, M. Vila)
- WHO Regional Office for Europe, Copenhagen, Denmark (R. Pebody, A.M. Vaughan)
- European Centre for Disease Prevention and Control, Solna, Sweden (J.M. Haussig, L. Alves de Sousa)
- WHO Regional Office for Africa, Brazzaville, Republic of the Congo (O.C. Lukoya, O.F. Sanni)
- WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt (P. Nabeth, J.D. Naiene)
- WHO Regional Office for South-East Asia, Delhi, India (M. Kato)
- WHO Regional Office for the Western Pacific, Manila, Philippines (T. Matsui)
| | - Olivier le Polain de Waroux
- Health Emergencies Programme, World Health Organization (WHO), Geneva, Switzerland (A. Hoxha, H. Laurenson-Schafer, N. Sklenovska, B.B. Mirembe, I.H. Nezu, P. Ndumbi, J. Fitzner, K. Kuppalli, P.O. Mala, R.F. Lewis, O. le Polain de Waroux, B.I. Pavlin)
- CPC Analytics, Berlin, Germany (S.M. Kerr)
- WHO Regional Office for the Americas, Washington, DC, USA (M. Almiron, M. Vila)
- WHO Regional Office for Europe, Copenhagen, Denmark (R. Pebody, A.M. Vaughan)
- European Centre for Disease Prevention and Control, Solna, Sweden (J.M. Haussig, L. Alves de Sousa)
- WHO Regional Office for Africa, Brazzaville, Republic of the Congo (O.C. Lukoya, O.F. Sanni)
- WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt (P. Nabeth, J.D. Naiene)
- WHO Regional Office for South-East Asia, Delhi, India (M. Kato)
- WHO Regional Office for the Western Pacific, Manila, Philippines (T. Matsui)
| | - Boris I. Pavlin
- Health Emergencies Programme, World Health Organization (WHO), Geneva, Switzerland (A. Hoxha, H. Laurenson-Schafer, N. Sklenovska, B.B. Mirembe, I.H. Nezu, P. Ndumbi, J. Fitzner, K. Kuppalli, P.O. Mala, R.F. Lewis, O. le Polain de Waroux, B.I. Pavlin)
- CPC Analytics, Berlin, Germany (S.M. Kerr)
- WHO Regional Office for the Americas, Washington, DC, USA (M. Almiron, M. Vila)
- WHO Regional Office for Europe, Copenhagen, Denmark (R. Pebody, A.M. Vaughan)
- European Centre for Disease Prevention and Control, Solna, Sweden (J.M. Haussig, L. Alves de Sousa)
- WHO Regional Office for Africa, Brazzaville, Republic of the Congo (O.C. Lukoya, O.F. Sanni)
- WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt (P. Nabeth, J.D. Naiene)
- WHO Regional Office for South-East Asia, Delhi, India (M. Kato)
- WHO Regional Office for the Western Pacific, Manila, Philippines (T. Matsui)
| | - WHO Mpox surveillance and Analytics Team
- Health Emergencies Programme, World Health Organization (WHO), Geneva, Switzerland (A. Hoxha, H. Laurenson-Schafer, N. Sklenovska, B.B. Mirembe, I.H. Nezu, P. Ndumbi, J. Fitzner, K. Kuppalli, P.O. Mala, R.F. Lewis, O. le Polain de Waroux, B.I. Pavlin)
- CPC Analytics, Berlin, Germany (S.M. Kerr)
- WHO Regional Office for the Americas, Washington, DC, USA (M. Almiron, M. Vila)
- WHO Regional Office for Europe, Copenhagen, Denmark (R. Pebody, A.M. Vaughan)
- European Centre for Disease Prevention and Control, Solna, Sweden (J.M. Haussig, L. Alves de Sousa)
- WHO Regional Office for Africa, Brazzaville, Republic of the Congo (O.C. Lukoya, O.F. Sanni)
- WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt (P. Nabeth, J.D. Naiene)
- WHO Regional Office for South-East Asia, Delhi, India (M. Kato)
- WHO Regional Office for the Western Pacific, Manila, Philippines (T. Matsui)
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16
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Li E, Guo X, Hong D, Gong Q, Xie W, Li T, Wang J, Chuai X, Chiu S. Duration of humoral immunity from smallpox vaccination and its cross-reaction with Mpox virus. Signal Transduct Target Ther 2023; 8:350. [PMID: 37709783 PMCID: PMC10502045 DOI: 10.1038/s41392-023-01574-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 06/11/2023] [Accepted: 07/26/2023] [Indexed: 09/16/2023] Open
Abstract
The ongoing pandemic caused by mpox virus (MPXV) has become an international public health emergency that poses a significant threat to global health. The vaccinia virus Tiantan strain (VTT) was used to vaccinate against smallpox in China 42 years ago. It is urgent to assess the level of immunity to smallpox in individuals vaccinated 43 or more years ago and evaluate their immunological susceptibility to MPXV. Here, we recruited 294 volunteers and detected the level of residual humoral immunity, including the vaccinia-specific IgG level and neutralizing antibody titer, and the cross-antibodies of MPXV A29L, B6R, A35R, and M1R. Our results showed that the humoral immunity from the smallpox vaccine in the population still remains, and VTT-specific NAb levels wane with age. The majority of the population pre-1981 who should be immunized with VTT still maintains certain levels of MPXV-specific antibodies, in particular, targeting A35R and B6R antigens. Furthermore, we separately analyzed the correlations between the OD450 values of VTT-specific IgG and A35R-specific IgG, B6R-specific IgG, and A29L-specific IgG with plasma samples diluted 1:40, showing a linear correlation (p < 0.0001). Our findings suggest that most Chinese populations still maintain VTT-specific IgG antibodies for 42 or more years after smallpox vaccination and could provide some level of protection against MPXV.
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Affiliation(s)
- Entao Li
- Department of Laboratory Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
- Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Xiaoping Guo
- Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Dongxiang Hong
- Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Qizan Gong
- Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Wenyu Xie
- Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Tingting Li
- Department of Clinical Laboratory, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Jian Wang
- Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.
| | - Xia Chuai
- State Key Laboratory of Virology, Wuhan Institute of Virology, Center for Biosafety Mega Science, Chinese Academy of Sciences, Wuhan, Hubei, China.
| | - Sandra Chiu
- Department of Laboratory Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.
- Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.
- Core Unit of National Clinical Research Center for Laboratory Medicine, Hefei, Anhui, China.
- Key Laboratory of Anhui Province for Emerging and Reemerging Infectious Diseases, Hefei, Anhui, China.
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17
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Suvvari TK, Sandeep M, Kumar J, Satapathy P, Chenchula S, Gandhi AP, Shamim MA, Schlagenhauf P, Rodríguez-Morales AJ, Sah R, Pradhan KB, Rustagi S, Hermis AH, Padhi BK. A meta-analysis and mapping of global mpox infection among children and adolescents. Rev Med Virol 2023; 33:e2472. [PMID: 37529964 DOI: 10.1002/rmv.2472] [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: 04/13/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 08/03/2023]
Abstract
Monkeypox (mpox) is a significant health concern affecting children and adolescents globally. This systematic review and meta-analysis aims to synthesise the available evidence on the proportion of children and adolescents affected by the mpox virus. A comprehensive search was conducted in seven electronic databases (PubMed, Scopus, Web of Science, EMBASE, ProQuest, EBSCOHost, and Cochrane) to identify the original reports on mpox cases in children and adolescents till 15 January 2023. Descriptive reports on probable or laboratory-confirmed mpox in children and adolescents (0-17 years old) were considered eligible. Studies not providing separate data for the above age group and case-control studies were excluded. The primary outcome was pooled proportion of mpox cases among children and adolescents. Proportion meta-analysis and heterogeneity between studies were determined using a restricted maximum likelihood estimator, and a random-effects model was fitted to the data. Sensitivity analysis and subgroup analysis were also conducted. A drapery plot was also provided as a complementary figure to the forest plot. The protocol was prospectively registered with PROSPERO (CRD42023392475). A total of 440 studies were identified, of which 37 were included in the review and 25 in the meta-analysis (62,701 participants with 3306 children and adolescents). The pooled proportion of children and adolescents was 0.46 (95% CI: 0.30-0.63, I2 :100%). The proportion of children and adolescents was significantly lower (p < 0.001) in the ongoing pandemic 0.04 (95% CI: 0.00-0.32) than before 2022 0.62 (95% CI: 0.49-0.74). The meta-regression showed that the higher the study's sample size, the lower the proportion of children among the mpox cases. Both overall and subgroup heterogeneity were high. Adolescents and children below 5 years are commonly affected by the ongoing pandemic. In conclusion, the high proportion of children affected by the mpox virus highlights the need for increased research and targeted interventions to prevent and control the spread of the virus in this population.
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Affiliation(s)
- Tarun Kumar Suvvari
- Rangaraya Medical College, Kakinada, Andhra Pradesh, India
- Squad Medicine and Research (SMR), Visakhapatnam, Andhra Pradesh, India
| | - Mokanpally Sandeep
- School of Medical Sciences, University of Hyderabad, Hyderabad, Telangana, India
| | - Jogender Kumar
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Santenna Chenchula
- Department of Pharmacology, All India Institute of Medical Sciences, Bhopal, India
| | - Aravind P Gandhi
- Department of Community Medicine, ESIC Medical College & Hospital, Hyderabad, India
| | | | - Patricia Schlagenhauf
- WHO Collaborating Centre for Travellers' Health, Institute for Epidemiology, Biostatistics and Prevention, University of Zürich Centre for Travel Medicine, MilMedBiol Competence Centre, University of Zürich, Zürich, Switzerland
| | - Alfonso J Rodríguez-Morales
- Master of Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon
| | - Ranjit Sah
- Tribhuvan University Teaching Hospital, Kathmandu, Nepal
- Dr. D.Y Patil Medical College, Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | | | - Sarvesh Rustagi
- School of Applied and Life Sciences, Uttaranchal University, Dehradun, Uttarakhand, India
| | | | - Bijaya K Padhi
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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18
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Yano R, Terada-Hirashima J, Uemura Y, Tomita N, Shimizu Y, Iwasaki H, Okumura N, Suzuki T, Saito S, Ujiie M, Sugiura W, Ohmagari N. Efficacy and Safety of the Smallpox Vaccine for Postexposure Prophylaxis in Monkeypox: Protocol for an Open-Labeled, Single-Armed Study. JMIR Res Protoc 2023; 12:e46955. [PMID: 37624623 PMCID: PMC10492167 DOI: 10.2196/46955] [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: 03/03/2023] [Revised: 07/07/2023] [Accepted: 07/19/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND In May 2022, a case of monkeypox (currently known as "mpox") with no history of overseas travel was reported in the United Kingdom, followed by reports of infections reported in Europe, the United States, and other countries worldwide. Due to the significant overlap in immune responses among viruses of the genus Orthopoxvirus (including smallpox virus, mpox virus, and vaccinia virus), it is believed that cross-immunity can be achieved by administering the smallpox virus vaccine. In Japan, a smallpox vaccine (LC16m8 strain vaccine) has been approved; however, there was no regulatory approval for the mpox vaccine during the design of this study. Although it is believed that individuals exposed to the mpox virus may receive smallpox vaccination as mpox prophylaxis, the existing evidence is not clear. OBJECTIVE The primary objective was to evaluate the efficacy of the LC16m8 strain vaccine, approved for smallpox in Japan, for postexposure prophylaxis against mpox when administered to close contacts of individuals with mpox. The secondary objective was to investigate the safety of the vaccine for postexposure prophylaxis against mpox. METHODS The study aimed to enroll 100 vaccinated participants who had been identified as close contacts of individuals with mpox. Consent was obtained, and the participants are inoculated with the vaccine. Daily recordings of symptoms (body temperature, headache, rash, and side effects) were made until day 21 and then again on day 28. Furthermore, additional evaluations of adverse events were performed by the investigators on days 7, 14, 21, and 28. Considering that the maximum incubation period for mpox is 21 days, the primary end point is the presence or absence of the disease 21 days after close contact. The primary analysis focused on cases within 4 days of intense contact as it has been reported that vaccination within this timeframe can reduce the incidence of the disease. RESULTS The first trial participant was enrolled on July 28, 2022, and the research period concluded in March 2023. The study results will be published in a peer-reviewed scientific journal. CONCLUSIONS This study allowed us to investigate the efficacy and safety of the LC16m8 strain vaccine in postexposure prophylaxis against mpox. TRIAL REGISTRATION Japan Registry of Clinical Trials jRCTs031220137; https://jrct.niph.go.jp/en-latest-detail/jRCTs031220137. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/46955.
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Affiliation(s)
- Rina Yano
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Junko Terada-Hirashima
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yukari Uemura
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Noriko Tomita
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yosuke Shimizu
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Haruka Iwasaki
- Disease Control and Prevention Center, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Nobumasa Okumura
- Disease Control and Prevention Center, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Tetsuya Suzuki
- Disease Control and Prevention Center, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Sho Saito
- Disease Control and Prevention Center, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Mugen Ujiie
- Disease Control and Prevention Center, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Wataru Sugiura
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
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19
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Precious ND, Agboola P, Oluwatimilehin O, Olakunle OK, Olaniyi P, Adiatu AI, Olusogo AP, Obiwulu DJ, Adeola OA, Ebubechukwu ES, Oluwakayode AM, Akano OS, Kolawole QO. Re-emergence of monkeypox virus outbreak in Nigeria: epidemic preparedness and response (Review-Commentary). Ann Med Surg (Lond) 2023; 85:3990-3996. [PMID: 37554898 PMCID: PMC10406091 DOI: 10.1097/ms9.0000000000001069] [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: 02/23/2023] [Accepted: 07/02/2023] [Indexed: 08/10/2023] Open
Abstract
The re-emergence of the monkeypox virus has come with many burdens on nations. This is partly after the effects of the coronavirus disease 2019 virus is subsiding. The burden of the monkeypox virus is seen even more in developing and third-world countries. Beyond the monkeypox virus re-emergence, there have also been several other viruses within the world and in Nigeria. This study assessed Nigeria's preparedness and response to the re-emergence of the monkeypox virus. The Nigerian Government showed its preparedness in the fight against the monkeypox virus by bringing together both Human and Animal Health Sectors. It ensured interventions and programs were created. Among these is Surveillance Outbreak, Response, Management, and Analysis System, a Surveillance and monitoring intervention to manage any outbreak. A second intervention is the Emergency Operation Center. It is recommended that vaccines should be made available, personnel should be adequately trained, and improved diagnostics equipment be made available. Nigeria has had cases of the monkeypox virus, and we wanted to see how far it has come in its preparedness and how it will respond if the need arises. This study reviewed existing literature on Nigeria's battle against the monkeypox virus in times past, the actions taken, and the programs developed.
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20
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Zahmatyar M, Fazlollahi A, Motamedi A, Zolfi M, Seyedi F, Nejadghaderi SA, Sullman MJM, Mohammadinasab R, Kolahi AA, Arshi S, Safiri S. Human monkeypox: history, presentations, transmission, epidemiology, diagnosis, treatment, and prevention. Front Med (Lausanne) 2023; 10:1157670. [PMID: 37547598 PMCID: PMC10397518 DOI: 10.3389/fmed.2023.1157670] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 07/03/2023] [Indexed: 08/08/2023] Open
Abstract
Human monkeypox is a zoonotic infection that is similar to the diseases caused by other poxviruses. It is endemic among wild rodents in the rainforests of Central and Western Africa, and can be transmitted via direct skin contact or mucosal exposure to infected animals. The initial symptoms include fever, headache, myalgia, fatigue, and lymphadenopathy, the last of which is the main symptom that distinguishes it from smallpox. In order to prevent and manage the disease, those who are infected must be rapidly diagnosed and isolated. Several vaccines have already been developed (e.g., JYNNEOS, ACAM2000 and ACAM3000) and antiviral drugs (e.g., cidofovir and tecovirimat) can also be used to treat the disease. In the present study, we reviewed the history, morphology, clinical presentations, transmission routes, diagnosis, prevention, and potential treatment strategies for monkeypox, in order to enable health authorities and physicians to better deal with this emerging crisis.
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Affiliation(s)
- Mahdi Zahmatyar
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Asra Fazlollahi
- Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- Tuberculosis and Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Motamedi
- Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maedeh Zolfi
- Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Seyedi
- Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyed Aria Nejadghaderi
- Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Mark J. M. Sullman
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
- Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
| | - Reza Mohammadinasab
- Department of History of Medicine, School of Traditional Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali-Asghar Kolahi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahnam Arshi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeid Safiri
- Clinical Research Development Unit of Tabriz Valiasr Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
- Social Determinants of Health Research Center, Department of Community Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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21
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Hubert M, Guivel-Benhassine F, Bruel T, Porrot F, Planas D, Vanhomwegen J, Wiedemann A, Burrel S, Marot S, Palich R, Monsel G, Diombera H, Gallien S, Lopez-Zaragoza JL, Vindrios W, Taieb F, Fernandes-Pellerin S, Delhaye M, Laude H, Arowas L, Ungeheuer MN, Hocqueloux L, Pourcher V, Prazuck T, Marcelin AG, Lelièvre JD, Batéjat C, Lévy Y, Manuguerra JC, Schwartz O. Complement-dependent mpox-virus-neutralizing antibodies in infected and vaccinated individuals. Cell Host Microbe 2023; 31:937-948.e4. [PMID: 37196656 PMCID: PMC10188274 DOI: 10.1016/j.chom.2023.05.001] [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: 03/21/2023] [Revised: 04/22/2023] [Accepted: 05/01/2023] [Indexed: 05/19/2023]
Abstract
Mpox virus (MPXV) caused a multi-country outbreak in non-endemic areas in 2022. Following historic success of smallpox vaccination with vaccinia virus (VACV)-based vaccines, the third generation modified vaccinia Ankara (MVA)-based vaccine was used as prophylaxis for MPXV, but its effectiveness remains poorly characterized. Here, we applied two assays to quantify neutralizing antibodies (NAbs) in sera from control, MPXV-infected, or MVA-vaccinated individuals. Various levels of MVA NAbs were detected after infection, historic smallpox, or recent MVA vaccination. MPXV was minimally sensitive to neutralization. However, addition of complement enhanced detection of responsive individuals and NAb levels. Anti-MVA and -MPXV NAbs were observed in 94% and 82% of infected individuals, respectively, and 92% and 56% of MVA vaccinees, respectively. NAb titers were higher in individuals born before 1980, highlighting the impact of historic smallpox vaccination on humoral immunity. Altogether, our results indicate that MPXV neutralization is complement dependent and uncover mechanisms underlying vaccine effectiveness.
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Affiliation(s)
- Mathieu Hubert
- Institut Pasteur, Université Paris Cité, Virus and Immunity Unit, CNRS UMR3569, 75015 Paris, France.
| | | | - Timothée Bruel
- Institut Pasteur, Université Paris Cité, Virus and Immunity Unit, CNRS UMR3569, 75015 Paris, France; Vaccine Research Institute, 94000 Créteil, France
| | - Françoise Porrot
- Institut Pasteur, Université Paris Cité, Virus and Immunity Unit, CNRS UMR3569, 75015 Paris, France
| | - Delphine Planas
- Institut Pasteur, Université Paris Cité, Virus and Immunity Unit, CNRS UMR3569, 75015 Paris, France; Vaccine Research Institute, 94000 Créteil, France
| | - Jessica Vanhomwegen
- Institut Pasteur, Université Paris Cité, Unité Environnement et Risques Infectieux, Cellule d'Intervention Biologique d'Urgence (CIBU), 75015 Paris, France
| | - Aurélie Wiedemann
- Vaccine Research Institute, Université Paris Est Créteil, Faculté de Médecine, INSERM U955, Team 16, 94000 Créteil, France
| | - Sonia Burrel
- Université de Bordeaux, CNRS UMR 5234, Fundamental Microbiology and Pathogenicity, Hôpital Universitaire de Bordeaux, Service de Virologie, 33000 Bordeaux, France
| | - Stéphane Marot
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, Laboratoire de Virologie, 75013 Paris, France
| | - Romain Palich
- Sorbonne Université, INSERM 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013 Paris, France
| | - Gentiane Monsel
- Sorbonne Université, INSERM 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013 Paris, France
| | - Harouna Diombera
- Vaccine Research Institute, Université Paris Est Créteil, Faculté de Médecine, INSERM U955, Team 16, 94000 Créteil, France
| | - Sébastien Gallien
- Assistance Publique-Hôpitaux de Paris, Groupe Henri-Mondor Albert-Chenevier, Service Immunologie Clinique, 94000 Créteil, France
| | - Jose Luis Lopez-Zaragoza
- Assistance Publique-Hôpitaux de Paris, Groupe Henri-Mondor Albert-Chenevier, Service Immunologie Clinique, 94000 Créteil, France
| | - William Vindrios
- Assistance Publique-Hôpitaux de Paris, Groupe Henri-Mondor Albert-Chenevier, Service Immunologie Clinique, 94000 Créteil, France
| | - Fabien Taieb
- Medical Center of Institut Pasteur, 75015 Paris, France
| | | | | | - Hélène Laude
- ICAReB-Clin platform, Institut Pasteur, 75015 Paris, France
| | | | | | | | - Valérie Pourcher
- Sorbonne Université, INSERM 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013 Paris, France
| | - Thierry Prazuck
- CHR Orléans, Service de Maladies Infectieuses, 45100 Orléans, France
| | - Anne-Geneviève Marcelin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, Laboratoire de Virologie, 75013 Paris, France
| | - Jean-Daniel Lelièvre
- Vaccine Research Institute, Université Paris Est Créteil, Faculté de Médecine, INSERM U955, Team 16, 94000 Créteil, France; Assistance Publique-Hôpitaux de Paris, Groupe Henri-Mondor Albert-Chenevier, Service Immunologie Clinique, 94000 Créteil, France
| | - Christophe Batéjat
- Institut Pasteur, Université Paris Cité, Unité Environnement et Risques Infectieux, Cellule d'Intervention Biologique d'Urgence (CIBU), 75015 Paris, France
| | - Yves Lévy
- Vaccine Research Institute, Université Paris Est Créteil, Faculté de Médecine, INSERM U955, Team 16, 94000 Créteil, France; Assistance Publique-Hôpitaux de Paris, Groupe Henri-Mondor Albert-Chenevier, Service Immunologie Clinique, 94000 Créteil, France
| | - Jean-Claude Manuguerra
- Institut Pasteur, Université Paris Cité, Unité Environnement et Risques Infectieux, Cellule d'Intervention Biologique d'Urgence (CIBU), 75015 Paris, France
| | - Olivier Schwartz
- Institut Pasteur, Université Paris Cité, Virus and Immunity Unit, CNRS UMR3569, 75015 Paris, France; Vaccine Research Institute, 94000 Créteil, France.
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22
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Alizadeh I, Shafaati M, Zandi M. Is it possible that arthropods could be an accidental reservoir for the outbreak of mpox virus in 2022? New Microbes New Infect 2023; 53:101138. [PMID: 37152613 PMCID: PMC10148720 DOI: 10.1016/j.nmni.2023.101138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/29/2023] [Accepted: 04/20/2023] [Indexed: 05/09/2023] Open
Affiliation(s)
- Ismaeil Alizadeh
- Department of Vector Biology and Control, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Shafaati
- Department of Microbiology, Faculty Science, Jahrom Branch, Islamic Azad University, Jahrom, Iran
- Occupational Sleep Research, Baharloo Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Milad Zandi
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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23
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Banuet-Martinez M, Yang Y, Jafari B, Kaur A, Butt ZA, Chen HH, Yanushkevich S, Moyles IR, Heffernan JM, Korosec CS. Monkeypox: a review of epidemiological modelling studies and how modelling has led to mechanistic insight. Epidemiol Infect 2023; 151:e121. [PMID: 37218612 PMCID: PMC10468816 DOI: 10.1017/s0950268823000791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/04/2023] [Accepted: 05/11/2023] [Indexed: 05/24/2023] Open
Abstract
Human monkeypox (mpox) virus is a viral zoonosis that belongs to the Orthopoxvirus genus of the Poxviridae family, which presents with similar symptoms as those seen in human smallpox patients. Mpox is an increasing concern globally, with over 80,000 cases in non-endemic countries as of December 2022. In this review, we provide a brief history and ecology of mpox, its basic virology, and the key differences in mpox viral fitness traits before and after 2022. We summarize and critique current knowledge from epidemiological mathematical models, within-host models, and between-host transmission models using the One Health approach, where we distinguish between models that focus on immunity from vaccination, geography, climatic variables, as well as animal models. We report various epidemiological parameters, such as the reproduction number, R0, in a condensed format to facilitate comparison between studies. We focus on how mathematical modelling studies have led to novel mechanistic insight into mpox transmission and pathogenesis. As mpox is predicted to lead to further infection peaks in many historically non-endemic countries, mathematical modelling studies of mpox can provide rapid actionable insights into viral dynamics to guide public health measures and mitigation strategies.
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Affiliation(s)
- Marina Banuet-Martinez
- Climate Change and Global Health Research Group, School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Yang Yang
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Behnaz Jafari
- Mathematics and Statistics Department, Faculty of Science, University of Calgary, Calgary, AB, Canada
- Department of Biomedical Engineering, Schulich School of Engineering, University of Calgary, Calgary, AB, Canada
| | - Avneet Kaur
- Irving K. Barber School of Arts and Sciences, Department of Computer Science, Mathematics, Physics and Statistics, University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Zahid A. Butt
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Helen H. Chen
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Svetlana Yanushkevich
- Department of Biomedical Engineering, Schulich School of Engineering, University of Calgary, Calgary, AB, Canada
| | - Iain R. Moyles
- Modelling Infection and Immunity Lab, Mathematics and Statistics, York University, Toronto, ON, Canada
- Centre for Disease Modelling, Mathematics and Statistics, York University, Toronto, ON, Canada
| | - Jane M. Heffernan
- Modelling Infection and Immunity Lab, Mathematics and Statistics, York University, Toronto, ON, Canada
- Centre for Disease Modelling, Mathematics and Statistics, York University, Toronto, ON, Canada
| | - Chapin S. Korosec
- Modelling Infection and Immunity Lab, Mathematics and Statistics, York University, Toronto, ON, Canada
- Centre for Disease Modelling, Mathematics and Statistics, York University, Toronto, ON, Canada
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24
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Feng Y, Zhang Y, Liu S, Guo M, Huang H, Guo C, Wang W, Zhang W, Tang H, Wan Y. Unexpectedly higher levels of anti-orthopoxvirus neutralizing antibodies are observed among gay men than general adult population. BMC Med 2023; 21:183. [PMID: 37189197 DOI: 10.1186/s12916-023-02872-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 04/19/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND The confirmed cases in the current outbreak of Monkeypox are predominantly identified in the networks of men who have sex with men (MSM). The preexisting antibodies may profoundly impact the transmission of monkeypox virus (MPXV), however the current-day prevalence of antibodies against MPXV among gay men is not well characterized. METHODS A cohort of gay men (n = 326) and a cohort of the general adult population (n = 295) were enrolled in this study. Binding antibodies responses against MPXV/vaccinia and neutralizing antibody responses against vaccinia virus (Tiantan strain) were measured. The antibody responses of these two cohorts were then compared, as well as the responses of individuals born before and in/after 1981 (when the smallpox vaccination ceased in China). Finally, the correlation between the anti-MPXV antibody responses and the anti-vaccinia antibody responses, and the associations between preexisting anti-orthopoxvirus antibody responses and the diagnosed sexually transmitted infections (STIs) in the MSM cohort were analyzed separately. RESULTS Our data showed that binding antibodies against MPXV H3, A29, A35, E8, B6, M1 proteins and vaccinia whole-virus lysate could be detected in individuals born both before and in/after 1981, of which the prevalence of anti-vaccinia binding antibodies was significantly higher among individuals born before 1981 in the general population cohort. Moreover, we unexpectedly found that the positive rates of binding antibody responses against MPXV H3, A29, A35, E8 and M1 proteins were significantly lower among individuals of the MSM cohort born in/after 1981, but the positive rates of anti-MPXV B6 and anti-vaccinia neutralizing antibody responses were significantly higher among these individuals compared to those of age-matched participants in the general population cohort. Additionally, we demonstrated that the positive and negative rates of anti-MPXV antibody responses were associated with the anti-vaccinia antibody responses among individuals born before 1981 in the general population cohort, but no significant association was observed among individuals born in/after 1981 in both cohorts. The positive rates of both the binding and the neutralizing antibody responses were comparable between individuals with and without diagnosed STIs in the MSM cohort. CONCLUSIONS Anti-MPXV and anti-vaccinia antibodies could be readily detected in an MSM cohort and a general population cohort. And a higher level of anti-vaccinia neutralizing antibody responses was observed among individuals who did not get vaccinated against smallpox in the MSM cohort compared to age-matched individuals in the general population cohort.
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Affiliation(s)
- Yanmeng Feng
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430065, China
| | - Yifan Zhang
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China
- Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University, Key Laboratory of Laboratory Medicine of Henan Province, Zhengzhou, 450052, China
| | - Shengya Liu
- Shenzhen International Travel Health Care Center (Shenzhen Customs District Port Outpatient Clinics), Shenzhen Customs District, Shenzhen, 518033, China
| | - Meng Guo
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430065, China
| | - Haojie Huang
- Wuhan Pioneer Social Work Service Center, Wuhan, 430071, China
| | - Cuiyuan Guo
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China
- Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University, Key Laboratory of Laboratory Medicine of Henan Province, Zhengzhou, 450052, China
| | - Wanhai Wang
- Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University, Key Laboratory of Laboratory Medicine of Henan Province, Zhengzhou, 450052, China
| | - Wenhong Zhang
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China.
- Shanghai Huashen Institute of Microbes and Infections, 6 Lane 1220 Huashan Rd., Shanghai, 200052, NO, China.
| | - Heng Tang
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430065, China.
| | - Yanmin Wan
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China.
- Shanghai Huashen Institute of Microbes and Infections, 6 Lane 1220 Huashan Rd., Shanghai, 200052, NO, China.
- Department of Radiology, Shanghai Public Health Clinical Center, Shanghai, 201508, China.
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25
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Sun W. Monkeypox, smallpox, FDA, and accelerated approval of vaccines - A regulatory perspective. Vaccine 2023:S0264-410X(23)00526-1. [PMID: 37198023 DOI: 10.1016/j.vaccine.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 04/17/2023] [Accepted: 05/01/2023] [Indexed: 05/19/2023]
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26
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Maru V, Ghaffar UB, Rawat A, Yunus M, Langaliya AK, Vyas S, Mehta D, Ojha A. Clinical and Epidemiological Interventions for Monkeypox Management in Children: A Systematic Review. Cureus 2023; 15:e38521. [PMID: 37288174 PMCID: PMC10241661 DOI: 10.7759/cureus.38521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 05/03/2023] [Indexed: 06/09/2023] Open
Abstract
This review aims to compile the available literature on monkeypox, identify risk factors for developing the disease, and recommend effective preventative methods to reduce the number of reported cases and fatalities in children and pregnant women. In seeking out pertinent studies on monkeypox virus in children and pregnant women, we searched the literature using the databases Cochrane Library, Google Scholar, PubMed, EMBASE, Web of Science, and Scopus up to 1st February 2023. This study analyzed data from case studies of monkeypox in children and pregnant women. Clinical data and test findings of monkeypox patients less than 18 years old and pregnant women were analyzed. The Newcastle-Ottawa Scale was used to do the quality evaluation. Our record examination spanned the years 1985 to 2023 and found 17 children and five pregnant female patients treated with monkeypox in various hospitals/community centers. Zaire, Gabon, Chicago, Sierra Leone, Central African Republic, Northern DR Congo, Liberia, Cameroon, the Democratic Republic of the Congo, the United Kingdom, the Netherlands, and Florida all contributed to the 14 studies analyzed. There were no studies identified for meta-analysis of selected case studies of hospitalized children and pregnant women who were diagnosed with monkeypox. The incidence, prevalence, clinical characteristics, diagnosis, management, prevention, vaccinations, infant care, and care for expectant mothers are all discussed in this systematic review of monkeypox in children. Our research findings may provide a foundation for further focused research and the development of related recommendations or guidelines.
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Affiliation(s)
- Viral Maru
- Pediatric Dentistry, Government Dental College and Hospital, Mumbai, IND
| | | | - Anurag Rawat
- Interventional Cardiology, Himalayan Institute of Medical Sciences, Dehradun, IND
| | - Mohammed Yunus
- Pathology, Imam Abdulrahman Bin Faisal University, Dammam, SAU
| | - Akshayraj K Langaliya
- Conservative Dentistry and Endodontics, AMC Dental College and Hospital, Ahmedabad, IND
| | - Shubhangi Vyas
- Dentistry, AMC Dental College and Hospital, Ahmedabad, IND
| | - Dhaval Mehta
- Oral Medicine and Radiology, Narsinhbhai Patel Dental College and Hospital, Sankalchand Patel University, Visnagar, IND
| | - Akshaya Ojha
- Pediatric Dentistry, Private Practice, Jammu, IND
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27
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Saied AA. Mpox virus Clade IIb detection in the air. J Med Virol 2023; 95:e28775. [PMID: 37212310 DOI: 10.1002/jmv.28775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/17/2023] [Accepted: 04/22/2023] [Indexed: 05/23/2023]
Abstract
Mpox is a viral zoonotic disease endemic in Central and West Africa that is caused by the Mpox virus, which belongs to the Orthopoxvirus genus and Poxviridae family. The clinical manifestations of mpox infection are milder than those of smallpox, and the incubation time of mpox varies from 5 to 21 days. Since May 2022, the mpox outbreak (formerly known as monkeypox) has suddenly and unexpectedly spread in non-endemic countries, suggesting that there may have been some undetected transmissions. Based on molecular analysis, there are two major genetic clades that represent the mpox virus: Clade I (formerly the Congo Basin clade OR the Central African clade) and Clade II (formerly the West African clade). It is believed that people who are asymptomatic or paucisymptomatic may spread the mpox virus. Infectious viruses cannot be distinguished by PCR testing; therefore, virus culture should be carried out. Recent evidence regarding the detection of the mpox virus (Clade IIb) in air samples collected from the patient's environment during the 2022 mpox outbreak was reviewed. Further studies are needed to evaluate the extent to which the presence of mpox virus DNA in the air could affect immunocompromised patients in healthcare facilities, and further epidemiological studies are crucial, especially in Africa.
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Affiliation(s)
- AbdulRahman A Saied
- National Food Safety Authority (NFSA), Aswan Branch, Aswan, Egypt
- Ministry of Tourism and Antiquities, Aswan Office, Aswan, Egypt
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28
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Chauhan RP, Fogel R, Limson J. Overview of Diagnostic Methods, Disease Prevalence and Transmission of Mpox (Formerly Monkeypox) in Humans and Animal Reservoirs. Microorganisms 2023; 11:1186. [PMID: 37317160 DOI: 10.3390/microorganisms11051186] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 04/26/2023] [Accepted: 04/28/2023] [Indexed: 06/16/2023] Open
Abstract
Mpox-formerly monkeypox-is a re-emerging zoonotic virus disease, with large numbers of human cases reported during multi-country outbreaks in 2022. The close similarities in clinical symptoms that Mpox shares with many orthopoxvirus (OPXV) diseases make its diagnosis challenging, requiring laboratory testing for confirmation. This review focuses on the diagnostic methods used for Mpox detection in naturally infected humans and animal reservoirs, disease prevalence and transmission, clinical symptoms and signs, and currently known host ranges. Using specific search terms, up to 2 September 2022, we identified 104 relevant original research articles and case reports from NCBI-PubMed and Google Scholar databases for inclusion in the study. Our analyses observed that molecular identification techniques are overwhelmingly being used in current diagnoses, especially real-time PCR (3982/7059 cases; n = 41 studies) and conventional PCR (430/1830 cases; n = 30 studies) approaches being most-frequently-used to diagnose Mpox cases in humans. Additionally, detection of Mpox genomes, using qPCR and/or conventional PCR coupled to genome sequencing methods, offered both reliable detection and epidemiological analyses of evolving Mpox strains; identified the emergence and transmission of a novel clade 'hMPXV-1A' lineage B.1 during 2022 outbreaks globally. While a few current serologic assays, such as ELISA, reported on the detection of OPXV- and Mpox-specific IgG (891/2801 cases; n = 17 studies) and IgM antibodies (241/2688 cases; n = 11 studies), hemagglutination inhibition (HI) detected Mpox antibodies in human samples (88/430 cases; n = 6 studies), most other serologic and immunographic assays used were OPXV-specific. Interestingly, virus isolation (228/1259 cases; n = 24 studies), electron microscopy (216/1226 cases; n = 18 studies), and immunohistochemistry (28/40; n = 7 studies) remain useful methods of Mpox detection in humans in select instances using clinical and tissue samples. In animals, OPXV- and Mpox-DNA and antibodies were detected in various species of nonhuman primates, rodents, shrews, opossums, a dog, and a pig. With evolving transmission dynamics of Mpox, information on reliable and rapid detection methods and clinical symptoms of disease is critical for disease management.
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Affiliation(s)
- Ravendra P Chauhan
- Biotechnology Innovation Centre, Rhodes University, Makhanda 6139, Eastern Cape, South Africa
| | - Ronen Fogel
- Biotechnology Innovation Centre, Rhodes University, Makhanda 6139, Eastern Cape, South Africa
| | - Janice Limson
- Biotechnology Innovation Centre, Rhodes University, Makhanda 6139, Eastern Cape, South Africa
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29
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Pinto P, Costa MA, Gonçalves MFM, Rodrigues AG, Lisboa C. Mpox Person-to-Person Transmission-Where Have We Got So Far? A Systematic Review. Viruses 2023; 15:v15051074. [PMID: 37243160 DOI: 10.3390/v15051074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/20/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023] Open
Abstract
The recent multi-country outbreak of Mpox (Monkeypox disease) constituted a public health emergency. Although animal-to-human transmission is known to be the primary way of transmission, an increasing number of cases transmitted by person-to-person contact have been reported. During the recent Mpox outbreak sexual or intimate contact has been considered the most important way of transmission. However, other routes of transmission must not be ignored. The knowledge of how the Monkeypox Virus (MPXV) spreads is crucial to implement adequate measures to contain the spread of the disease. Therefore, this systematic review aimed to collect scientific data published concerning other implicated sources of infection beyond sexual interaction, such as the involvement of respiratory particles, contact with contaminated surfaces and skin-to-skin contact. The current study was performed using the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Publications analyzing contacts of Mpox index cases and their outcome after contact were included. A total of 7319 person-to-person contacts were surveyed and 273 of them became positive cases. Positive secondary transmission of MPXV was verified after contact with people cohabiting in the same household, with family members, with healthcare workers, or within healthcare facilities, and sexual contact or contact with contaminated surfaces. Using the same cup, sharing the same dishes, and sleeping in the same room or bed were also positively associated with transmission. Five studies showed no evidence of transmission despite contact with surfaces, skin-to-skin contact, or through airway particles within healthcare facilities where containment measures were taken. These records support the case for person-to-person transmission and suggest that other types of contact beyond sexual contact pose a significant risk of acquiring the infection. Further investigation is crucial to elucidate MPXV transmission dynamics, and to implement adequate measures to contain the spread of the infection.
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Affiliation(s)
- Pedro Pinto
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
| | - Miguel Alves Costa
- Department of Dermatology and Venereology, Centro Hospitalar Vila Nova de Gaia/Espinho, 4434-502 Porto, Portugal
| | - Micael F M Gonçalves
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
| | - Acácio Gonçalves Rodrigues
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Centre for Health Technology and Services Research/Rede de Investigação em Saúde (CINTESIS@RISE), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
| | - Carmen Lisboa
- Division of Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Centre for Health Technology and Services Research/Rede de Investigação em Saúde (CINTESIS@RISE), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Department of Dermatology and Venereology, University Hospital Centre of São João, 4200-319 Porto, Portugal
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30
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Stilpeanu RI, Stercu AM, Stancu AL, Tanca A, Bucur O. Monkeypox: a global health emergency. Front Microbiol 2023; 14:1094794. [PMID: 37180247 PMCID: PMC10169603 DOI: 10.3389/fmicb.2023.1094794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 03/20/2023] [Indexed: 05/16/2023] Open
Abstract
Over the past 2 years, the world has faced the impactful Coronavirus Disease-2019 (COVID-19) pandemic, with a visible shift in economy, medicine, and beyond. As of recent times, the emergence of the monkeypox (mpox) virus infections and the growing number of infected cases have raised panic and fear among people, not only due to its resemblance to the now eradicated smallpox virus, but also because another potential pandemic could have catastrophic consequences, globally. However, studies of the smallpox virus performed in the past and wisdom gained from the COVID-19 pandemic are the two most helpful tools for humanity that can prevent major outbreaks of the mpox virus, thus warding off another pandemic. Because smallpox and mpox are part of the same virus genus, the Orthopoxvirus genus, the structure and pathogenesis, as well as the transmission of both these two viruses are highly similar. Because of these similarities, antivirals and vaccines approved and licensed in the past for the smallpox virus are effective and could successfully treat and prevent an mpox virus infection. This review discusses the main components that outline this current global health issue raised by the mpox virus, by presenting it as a whole, and integrating aspects such as its structure, pathogenesis, clinical aspects, prevention, and treatment options, and how this ongoing phenomenon is being globally approached.
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Affiliation(s)
- Ruxandra Ilinca Stilpeanu
- Victor Babes National Institute of Pathology, Bucharest, Romania
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Ana Maria Stercu
- Victor Babes National Institute of Pathology, Bucharest, Romania
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Andreea Lucia Stancu
- Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
| | - Antoanela Tanca
- Victor Babes National Institute of Pathology, Bucharest, Romania
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Octavian Bucur
- Victor Babes National Institute of Pathology, Bucharest, Romania
- Viron Molecular Medicine Institute, Boston, MA, United States
- Genomics Research and Development Institute, Bucharest, Romania
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Ahmed SK, Mohamed MG, Dabou EA, Abuijlan I, Chandran D, El-Shall NA, Chopra H, Dhama K. Monkeypox (mpox) in immunosuppressed patients. F1000Res 2023; 12:127. [PMID: 37089133 PMCID: PMC10113800 DOI: 10.12688/f1000research.130272.2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/24/2023] [Indexed: 04/05/2023] Open
Abstract
The World Health Organization (WHO) proclaimed a public health emergency in July 2022 due to the emergence of Mpox (formerly monkeypox) while the globe was still dealing with the COVID-19 epidemic. The characteristics of mpox in immunocompetent individuals are well-characterized, despite difficulties in diagnostics, immunization, and access to treatment that persist in low-income countries. Patients with weakened immune systems are more likely to spread an illness and die from it than healthy people because they cannot mount a protective immune response against it, such as a neutralizing IgG and poxvirus-specific Th1 response. A health warning on severe mpox in people who are immunocompromised due to Human Immunodeficiency virus (HIV) and other illnesses was released by the U.S. Centers for Disease Control and Prevention (CDC) on September 29, 2022. The advice does not specifically include primary immunodeficiency, but it does define other immunocompromising disorders as “having autoimmune disease with immunodeficiency as a clinical component”. Both those with healthy immune systems and those with weakened immune systems, such as those who are immunosuppressed, older people, children, etc., have encountered serious health issues, but the latter group is more likely to do so. According to the advisory, “of the people with severe mpox manifestations for whom CDC has been consulted, the majority have had HIV with CD4 counts 200 cells/ml, indicating substantial immunosuppression”. However, new cases are still expected to be discovered, especially in low-income countries with limited access to diagnosis, treatment, and prevention, and where a large percentage of the mpox-infected population also has advanced HIV infection. Thus, further research is always needed to determine the best way to treat mpox in immunocompromised people. In this context, we discussed /reviewed the mpox clinical presentation, available treatment options and current preventive guidelines in immunocompromised patients.
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Affiliation(s)
- Sirwan Khalid Ahmed
- Department of Pediatrics, Rania Pediatric & Maternity Teaching Hospital, Rania, Sulaymaniyah, Kurdistan Region, 46012, Iraq
| | - Mona Gamal Mohamed
- RAK College of Nursing, RAK Medical and Health Sciences University, Ras Al Khiamah, United Arab Emirates
| | - Eman Abdelaziz Dabou
- RAK College of Nursing, RAK Medical and Health Sciences University, Ras Al Khiamah, United Arab Emirates
| | - Israa Abuijlan
- RAK College of Nursing, RAK Medical and Health Sciences University, Ras Al Khiamah, United Arab Emirates
| | - Deepak Chandran
- Department of Veterinary Sciences and Animal Husbandry, Amrita School of Agricultural Sciences, Amrita Vishwa Vidyapeetham University, Coimbatore, Tamil Nadu, 642109, India
| | - Nahed A. El-Shall
- Department of Poultry and Fish Diseases, Faculty of Veterinary Medicine, Alexandria University, Edfina, El-Beheira, 22758, Egypt
| | - Hitesh Chopra
- Chitkara College of Pharmacy, Chitkara University, Punjab, 140401, India
| | - Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Bareilly, Uttar Pradesh, 243122, India
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32
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Taube JC, Rest EC, Lloyd-Smith JO, Bansal S. The global landscape of smallpox vaccination history and implications for current and future orthopoxvirus susceptibility: a modelling study. THE LANCET. INFECTIOUS DISEASES 2023; 23:454-462. [PMID: 36455590 PMCID: PMC10040439 DOI: 10.1016/s1473-3099(22)00664-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/26/2022] [Accepted: 09/28/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND More than four decades after the eradication of smallpox, the ongoing 2022 monkeypox outbreak and increasing transmission events of other orthopoxviruses necessitate a greater understanding of the global distribution of susceptibility to orthopoxviruses. We aimed to characterise the current global landscape of smallpox vaccination history and orthopoxvirus susceptibility. METHODS We characterised the global landscape of smallpox vaccination at a subnational scale by integrating data on current demography with historical smallpox vaccination programme features (coverage and cessation dates) from eradication documents and published literature. We analysed this landscape to identify the factors that were most associated with geographical heterogeneity in current vaccination coverage. We considered how smallpox vaccination history might translate into age-specific susceptibility profiles for orthopoxviruses under different vaccination effectiveness scenarios. FINDINGS We found substantial global spatial heterogeneity in the landscape of smallpox vaccination, with vaccination coverage estimated to range from 7% to 60% within admin-1 regions (ie, regions one administrative level below country) globally, with negligible uncertainty (99·6% of regions have an SD less than 5%). We identified that geographical variation in vaccination coverage was driven mostly by differences in subnational demography. Additionally, we found that susceptibility for orthopoxviruses was highly age specific based on age at cessation and age-specific coverage; however, the age profile was consistent across vaccine effectiveness values. INTERPRETATION The legacy of smallpox eradication can be observed in the current landscape of smallpox vaccine protection. The strength and longevity of smallpox vaccination campaigns globally, combined with current demographic heterogeneity, have shaped the epidemiological landscape today, revealing substantial geographical variation in orthopoxvirus susceptibility. This study alerts public health decision makers to non-endemic regions that might be at greatest risk in the case of widespread and sustained transmission in the 2022 monkeypox outbreak and highlights the importance of demography and fine-scale spatial dynamics in predicting future public health risks from orthopoxviruses. FUNDING US National Institutes of Health and US National Science Foundation.
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Affiliation(s)
- Juliana C Taube
- Department of Biology, Georgetown University, Washington, DC, USA
| | - Eva C Rest
- Department of Biology, Georgetown University, Washington, DC, USA
| | - James O Lloyd-Smith
- Department of Ecology and Evolutionary Biology, University of California Los Angeles, Los Angeles, CA, USA
| | - Shweta Bansal
- Department of Biology, Georgetown University, Washington, DC, USA.
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Núñez-Cortés R, Calatayud J, López-Gil JF, Koyanagi A, Casaña J, López-Bueno R. Risk profile and mode of transmission of Mpox: A rapid review and individual patient data meta-analysis of case studies. Rev Med Virol 2023; 33:e2410. [PMID: 36447360 DOI: 10.1002/rmv.2410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 12/05/2022]
Abstract
Since May 2022, an outbreak of Mpox in non-endemic countries has become a potential public health threat. The objective of this rapid review was to examine the risk profile and modes of transmission of Mpox. PubMed, Web of Science, and Scopus were searched from inception through July 30 to collect case reports/series on patients with Mpox infection. For meta-analysis, data on the total number of participants and deaths by binary categories of exposure (age, sex, country, other co-infections or existing conditions, and mode of contagion) were used. A total of 62 studies (4659 cases) were included. Most cases came from Africa (84.3%), followed by Europe (13.9%). In 63.6% of the cases, the mode of contagion was human contact, while 22.8% of the cases were by animal contact, and 13.5% were unknown or not reported. The mortality rate was 6.5% throughout these studies. The risk of mortality was higher in the younger age group (risk difference: 0.19; 95% CI: 0.02-0.36), in cases with other co-infections or current chronic conditions (risk difference: 0.03; 95% CI: 0.01-0.05) and in the category of low- and middle-income countries (risk difference: 0.06; 95% CI: 0.05-0.08). There were no significant differences with respect to sex or mode of contagion. These results help to understand the major infection pathways and mortality risk profiles of Mpox and underscores the importance of preventing outbreaks in specific settings, especially in settings densely populated by children, such as day care centres and schools.
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Affiliation(s)
- Rodrigo Núñez-Cortés
- Department of Physiotherapy, Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), University of Valencia, Valencia, Spain
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Joaquín Calatayud
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | | | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, ICREA, Barcelona, Spain
| | - José Casaña
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Rubén López-Bueno
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain
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Cabanillas B, Murdaca G, Guemari A, Torres MJ, Azkur AK, Aksoy E, Vitte J, de Las Vecillas L, Giovannini M, Fernández-Santamaria R, Castagnoli R, Orsi A, Amato R, Giberti I, Català A, Ambrozej D, Schaub B, Tramper-Stranders GA, Novak N, Nadeau KC, Agache I, Akdis M, Akdis CA. A compilation answering 50 questions on monkeypox virus and the current monkeypox outbreak. Allergy 2023; 78:639-662. [PMID: 36587287 DOI: 10.1111/all.15633] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/29/2022] [Accepted: 12/14/2022] [Indexed: 01/02/2023]
Abstract
The current monkeypox disease (MPX) outbreak constitutes a new threat and challenge for our society. With more than 55,000 confirmed cases in 103 countries, World Health Organization declared the ongoing MPX outbreak a Public Health Emergency of International Concern (PHEIC) on July 23, 2022. The current MPX outbreak is the largest, most widespread, and most serious since the diagnosis of the first case of MPX in 1970 in the Democratic Republic of the Congo (DRC), a country where MPX is an endemic disease. Throughout history, there have only been sporadic and self-limiting outbreaks of MPX outside Africa, with a total of 58 cases described from 2003 to 2021. This figure contrasts with the current outbreak of 2022, in which more than 55,000 cases have been confirmed in just 4 months. MPX is, in most cases, self-limiting; however, severe clinical manifestations and complications have been reported. Complications are usually related to the extent of virus exposure and patient health status, generally affecting children, pregnant women, and immunocompromised patients. The expansive nature of the current outbreak leaves many questions that the scientific community should investigate and answer in order to understand this phenomenon better and prevent new threats in the future. In this review, 50 questions regarding monkeypox virus (MPXV) and the current MPX outbreak were answered in order to provide the most updated scientific information and to explore the potential causes and consequences of this new health threat.
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Affiliation(s)
- Beatriz Cabanillas
- Department of Allergy, Instituto de Investigacion Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Giuseppe Murdaca
- Departments of Internal Medicine, University of Genova, Genova, Italy
| | - Amir Guemari
- Aix-Marseille Univ, IRD, MEPHI, IHU Méditerranée Infection, Marseille, France
| | - Maria Jose Torres
- Allergy Unit, Hospital Regional Universitario de Málaga-ARADyAL, Málaga, Spain
| | - Ahmet Kursat Azkur
- Department of Virology, Faculty of Veterinary Medicine, Kirikkale University, Kirikkale, Turkey
| | - Emel Aksoy
- Department of Virology, Faculty of Veterinary Medicine, Kirikkale University, Kirikkale, Turkey
| | - Joana Vitte
- Aix-Marseille Univ, IRD, MEPHI, IHU Méditerranée Infection, Marseille, France.,Montpellier University, IDESP INSERM UMR UA 11, Montpellier, France
| | | | - Mattia Giovannini
- Allergy Unit, Department of Pediatrics, Meyer Children's Hospital, Florence, Italy.,Department of Health Sciences, University of Florence, Florence, Italy
| | | | - Riccardo Castagnoli
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.,Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Andrea Orsi
- Department of Health Sciences, University of Genova, Genova, Italy
| | - Rosa Amato
- Department of Health Sciences, University of Genova, Genova, Italy
| | - Irene Giberti
- Department of Health Sciences, University of Genova, Genova, Italy
| | - Alba Català
- Dermatology Department, Sexually Transmitted Diseases Clinic, Hospital Clinic, Barcelona, Spain
| | - Dominika Ambrozej
- Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Warsaw, Poland.,Doctoral School, Medical University of Warsaw, Warsaw, Poland
| | - Bianca Schaub
- Pediatric Allergology, Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU, Munich, Germany.,Member of German Center for Lung Research - DZL, LMU, Munich, Germany
| | | | - Natalija Novak
- Department of Dermatology and Allergy, University Hospital Bonn, Bonn, Germany
| | - Kari C Nadeau
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, California, USA
| | - Ioana Agache
- Transylvania University, Brasov, Romania.,Theramed Medical Center, Brasov, Romania
| | - Mubeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland.,Christine Kühne Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
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Javelle E, Ficko C, Savini H, Mura M, Ferraris O, Tournier JN, de Laval F. Monkeypox clinical disease: Literature review and a tool proposal for the monitoring of cases and contacts. Travel Med Infect Dis 2023; 52:102559. [PMID: 36809829 PMCID: PMC9946014 DOI: 10.1016/j.tmaid.2023.102559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 10/26/2022] [Accepted: 02/17/2023] [Indexed: 02/24/2023]
Abstract
The human monkeypox disease has mainly been described in Western and Central Africa. Since May 2022, the monkeypox virus has been spreading worldwide in a new epidemiological pattern, where cases result from person-to-person transmission, and develop clinically milder or less typical illness than during previous outbreaks in endemic areas. The newly-emerging monkeypox disease needs to be described over the long term, to improve cases definitions, to implement prompt control measures against epidemics, and to provide supportive care. Hence, we first conducted a review of historical and recent outbreaks to define the full clinical spectrum of the monkeypox disease and its course known so far. Then, we built a self-administrated questionnaire collecting daily symptoms of the monkeypox infection to follow cases and their contacts, even remotely. This tool will assist in the management of cases, the surveillance of contacts, and the conduct of clinical studies.
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Affiliation(s)
- Emilie Javelle
- Institut de Recherche Biomédicale des Armées IRBA, Microbiology and Infectious Diseases Department, Marseille, France; Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; Laveran Military Teaching Hospital, Marseille, France.
| | - Cécile Ficko
- Bégin Military Teaching Hospital, Saint-Mandé, France; Ecole Du Val-de-Grâce, Paris, France
| | - Hélène Savini
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; Laveran Military Teaching Hospital, Marseille, France
| | - Marie Mura
- Institut de Recherche Biomédicale des Armées IRBA, Microbiology and Infectious Diseases Department, Brétigny-sur-Orge, France; Institut Pasteur, Innovation Lab: Vaccines, Paris, France
| | - Olivier Ferraris
- Institut de Recherche Biomédicale des Armées IRBA, Microbiology and Infectious Diseases Department, Brétigny-sur-Orge, France; CNR-LE National Reference Center-expert Laboratory Orthopoxvirus, IRBA, Brétigny-sur-Orge, France
| | - Jean Nicolas Tournier
- Ecole Du Val-de-Grâce, Paris, France; Institut de Recherche Biomédicale des Armées IRBA, Microbiology and Infectious Diseases Department, Brétigny-sur-Orge, France; Institut Pasteur, Innovation Lab: Vaccines, Paris, France
| | - Franck de Laval
- Service de Santé des Armées SSA, French Armed Forces Center for Epidemiology and Public Health CESPA, Marseille, France; Aix Marseille University, INSERM, IRD, Sciences Economiques Sociales de La Santé & Traitement de L'Information Médicale SESSTIM, Marseille, France
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36
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Lim EY, Whitehorn J, Rivett L. Monkeypox: a review of the 2022 outbreak. Br Med Bull 2023; 145:17-29. [PMID: 36751952 DOI: 10.1093/bmb/ldad002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/11/2023] [Indexed: 02/09/2023]
Abstract
INTRODUCTION In May 2022, the World Health Organisation declared a multi-country monkeypox outbreak in non-endemic countries following cases reported from 12 member states that were not endemic for monkeypox virus. SOURCES OF DATA Pubmed search. AREAS OF AGREEMENT The virology, epidemiology, transmission, incubation and aspects of infection control are described. Clinical features of previous and current outbreaks are described, with growing observations that the current outbreak presents with clinical features distinct from previous outbreaks. AREAS OF CONTROVERSY There are variations in clinical presentations seen in the current outbreak that have not been seen in prior outbreaks. More research is needed to investigate the reasons for these differences. GROWING POINTS The higher numbers of HIV-positive patients in the current outbreak has allowed better description of the disease in patients co-infected with HIV and monkeypox. The absence of more severe symptoms in HIV-positive patients in the current outbreak could possibly be due to the fact that most of these patients had well-controlled HIV, although further characterization of this cohort of patients would be useful. AREAS FOR DEVELOPING RESEARCH Current treatment and vaccination options have been extrapolated from studies of other Orthopox viruses. There remains a need for more data on the safety and efficacy of these options in the context of monkeypox infections.
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Affiliation(s)
- Eleanor Y Lim
- Department of Infectious Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
| | - James Whitehorn
- Department of Infectious Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK.,Clinical Microbiology and Public Health Laboratory, Public Health England, Cambridge CB21 5XA, UK
| | - Lucy Rivett
- Department of Infectious Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK.,Clinical Microbiology and Public Health Laboratory, Public Health England, Cambridge CB21 5XA, UK
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Ahmed SK, Mohamed MG, Dabou EA, Abuijlan I, Chandran D, El-Shall NA, Chopra H, Dhama K. Monkeypox (mpox) in immunosuppressed patients. F1000Res 2023; 12:127. [PMID: 37089133 PMCID: PMC10113800 DOI: 10.12688/f1000research.130272.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/27/2023] [Indexed: 02/05/2023] Open
Abstract
The World Health Assembly declared that smallpox had been completely eradicated from the human population in 1980. Monkeypox, a zoonosis native to damp forested regions in West and Central Africa, is the illness that is most comparable to smallpox clinically and immunologically. Both illnesses could be prevented by the smallpox vaccine. Although the monkeypox virus is a less effective human disease than the smallpox virus, it could now spread among human populations if smallpox had not been eradicated and population-wide immunity had not been developed. A health warning on severe monkeypox in people who are immunocompromised due to Human Immunodeficiency virus (HIV) and other illnesses was released by the U.S. Centers for Disease Control and Prevention (CDC) on September 29, 2022. The advise does not specifically include primary immunodeficiency, but it does define other immunocompromising disorders as “having autoimmune disease with immunodeficiency as a clinical component”. The documented severe signs of monkeypox include widespread rashes with secondary fungal or bacterial skin infections or tissue death (necrosis), intestine obstruction, and difficulties with the heart, lungs, urinary system, and nervous system. Both those with healthy immune systems and those with weakened immune systems, such as those who are immunosuppressed, older people, children, etc., have encountered serious health issues, but the latter group is more likely to do so. According to the advisory, “of the people with severe monkeypox manifestations for whom CDC has been consulted, the majority have had HIV with CD4 counts 200 cells/ml, indicating substantial immunosuppression”. The current article goes into great detail about monkeypox disease occurring in immunocompromised patients and preventive guidelines.
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Affiliation(s)
- Sirwan Khalid Ahmed
- Department of Pediatrics, Rania Pediatric & Maternity Teaching Hospital, Rania, Sulaymaniyah, Kurdistan Region, 46012, Iraq
| | - Mona Gamal Mohamed
- RAK College of Nursing, RAK Medical and Health Sciences University, Ras Al Khiamah, United Arab Emirates
| | - Eman Abdelaziz Dabou
- RAK College of Nursing, RAK Medical and Health Sciences University, Ras Al Khiamah, United Arab Emirates
| | - Israa Abuijlan
- RAK College of Nursing, RAK Medical and Health Sciences University, Ras Al Khiamah, United Arab Emirates
| | - Deepak Chandran
- Department of Veterinary Sciences and Animal Husbandry, Amrita School of Agricultural Sciences, Amrita Vishwa Vidyapeetham University, Coimbatore, Tamil Nadu, 642109, India
| | - Nahed A. El-Shall
- Department of Poultry and Fish Diseases, Faculty of Veterinary Medicine, Alexandria University, Edfina, El-Beheira, 22758, Egypt
| | - Hitesh Chopra
- Chitkara College of Pharmacy, Chitkara University, Punjab, 140401, India
| | - Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Bareilly, Uttar Pradesh, 243122, India
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Pan D, Nazareth J, Sze S, Martin CA, Decker J, Fletcher E, Déirdre Hollingsworth T, Barer MR, Pareek M, Tang JW. Transmission of monkeypox/mpox virus: A narrative review of environmental, viral, host, and population factors in relation to the 2022 international outbreak. J Med Virol 2023; 95:e28534. [PMID: 36708091 PMCID: PMC10107822 DOI: 10.1002/jmv.28534] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/05/2022] [Accepted: 01/24/2023] [Indexed: 01/29/2023]
Abstract
Monkeypox virus (MPXV) has spread globally. Emerging studies have now provided evidence regarding MPXV transmission, that can inform rational evidence-based policies and reduce misinformation on this topic. We aimed to review the evidence on transmission of the virus. Real-world studies have isolated viable viruses from high-touch surfaces for as long as 15 days. Strong evidence suggests that the current circulating monkeypox (mpox) has evolved from previous outbreaks outside of Africa, but it is yet unknown whether these mutations may lead to an inherently increased infectivity of the virus. Strong evidence also suggests that the main route of current MPXV transmission is sexual; through either close contact or directly, with detection of culturable virus in saliva, nasopharynx, and sperm for prolonged periods and the presence of rashes mainly in genital areas. The milder clinical presentations and the potential presence of presymptomatic transmission in the current circulating variant compared to previous clades, as well as the dominance of spread amongst men who have sex with men (MSMs) suggests that mpox has a developed distinct clinical phenotype that has increased its transmissibility. Increased public awareness of MPXV transmission modalities may lead to earlier detection of the spillover of new cases into other groups.
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Affiliation(s)
- Daniel Pan
- Department of Respiratory SciencesUniversity of LeicesterLeicesterUK
- Department of Infectious Diseases and HIV MedicineUniversity Hospitals of Leicester NHS TrustLeicesterUK
- Li Ka Shing Centre for Health Information and Discovery, Big Data InstituteUniversity of OxfordOxfordUK
- NIHR Leicester Biomedical Research CentreLiecesterUK
| | - Joshua Nazareth
- Department of Respiratory SciencesUniversity of LeicesterLeicesterUK
- Department of Infectious Diseases and HIV MedicineUniversity Hospitals of Leicester NHS TrustLeicesterUK
- NIHR Leicester Biomedical Research CentreLiecesterUK
| | - Shirley Sze
- Department of Cardiovascular SciencesUniversity of LeicesterLeicesterUK
| | - Christopher A. Martin
- Department of Respiratory SciencesUniversity of LeicesterLeicesterUK
- Department of Infectious Diseases and HIV MedicineUniversity Hospitals of Leicester NHS TrustLeicesterUK
- NIHR Leicester Biomedical Research CentreLiecesterUK
| | - Jonathan Decker
- Department of Respiratory SciencesUniversity of LeicesterLeicesterUK
| | - Eve Fletcher
- Department of Respiratory SciencesUniversity of LeicesterLeicesterUK
| | - T. Déirdre Hollingsworth
- Li Ka Shing Centre for Health Information and Discovery, Big Data InstituteUniversity of OxfordOxfordUK
| | - Michael R. Barer
- Department of Respiratory SciencesUniversity of LeicesterLeicesterUK
- Department of Clinical MicrobiologyUniversity Hospitals of Leicester NHS TrustLeicesterUK
| | - Manish Pareek
- Department of Respiratory SciencesUniversity of LeicesterLeicesterUK
- Department of Infectious Diseases and HIV MedicineUniversity Hospitals of Leicester NHS TrustLeicesterUK
- NIHR Leicester Biomedical Research CentreLiecesterUK
| | - Julian W. Tang
- Department of Respiratory SciencesUniversity of LeicesterLeicesterUK
- Department of VirologyUniversity Hospitals of Leicester NHS TrustLeicesterUK
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Beeson AM, Haston J, McCormick DW, Reynolds M, Chatham-Stephens K, McCollum AM, Godfred-Cato S. Mpox in Children and Adolescents: Epidemiology, Clinical Features, Diagnosis, and Management. Pediatrics 2023; 151:e2022060179. [PMID: 36471498 PMCID: PMC9995221 DOI: 10.1542/peds.2022-060179] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
Although mpox is rare among children in the United States, pediatric cases are being reported during the 2022 multinational mpox outbreak. Vaccines and antiviral medications developed for other orthopoxviruses have recently become widely used to prevent and treat mpox in both children and adults in the United States. Although scientific literature regarding mpox in children and adolescents is scant, prior case reports can provide valuable information about the clinical features and potential complications of untreated clade II mpox in these age groups. In this review, we summarize the epidemiology and clinical features of mpox in children and adolescents and provide recommendations for clinicians regarding its diagnosis, management, and prevention. Robust, dedicated surveillance of pediatric exposures and cases in the current outbreak, including the use of vaccines and therapeutics, are needed to guide clinical management and public health strategies.
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Affiliation(s)
- Amy M Beeson
- Centers for Disease Control and Prevention, Atlanta, Georgia
- Epidemic Intelligence Service, Atlanta, Georgia
| | - Julia Haston
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Mary Reynolds
- Centers for Disease Control and Prevention, Atlanta, Georgia
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Williams A, Chaturvedi R, Aaronson J, Weinberg R, White R. The impact of monkeypox in pregnant patients on obstetric anesthesiology. Int J Obstet Anesth 2023; 53:103622. [PMID: 36634446 PMCID: PMC9795806 DOI: 10.1016/j.ijoa.2022.103622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 12/07/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022]
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Kamal A, Suppah M, Saadoun R, Yassin M. A Comprehensive Review of the Current Monkeypox Outbreak. Cureus 2023; 15:e34807. [PMID: 36915842 PMCID: PMC10008051 DOI: 10.7759/cureus.34807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2023] [Indexed: 02/11/2023] Open
Abstract
Monkeypox is a zoonotic disease caused by an orthopoxvirus named monkeypox virus. The virus was identified in 1958, while the first human monkeypox case was discovered in 1970. Monkeypox caused a wide outbreak that was considered a global health emergency in July 2022. Monkeypox is transmitted through direct or indirect contact with the lesions and respiratory droplets. Animals can also transmit the disease if contacted without protection or if their products are consumed without proper processing. The disease presents as a prodromal period followed by the appearance of a rash filled with exudate. The rash appears initially on the face and then spreads to involve the genital area and the anus. Typically, the disease is mild and resolves spontaneously, but antiviral therapy with tecovirimat might be required. Monkeypox can be controlled by avoiding contact with the cases and vaccinating those at high risk for acquiring the infection and those at high risk for developing severe illness (immune deficient individuals, pregnant women, and children). Our review aims to comprehensively review the current literature regarding Monkeypox, including modes of transmission, pathogenesis, clinical presentation, diagnosis, treatment, preventive measures, and epidemiology.
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Affiliation(s)
- Abdallah Kamal
- Oncology, University of Pittsburgh Medical Center, Pittsburgh, USA
| | | | - Rakan Saadoun
- Otolaryngology, Ruprecht Karls University Heidelberg, Mannheim, DEU
| | - Mohamed Yassin
- Infectious Diseases, University of Pittsburgh Medical Center, Pittsburgh, USA
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Grothe JH, Cornely OA, Salmanton-García J. Monkeypox in children and adult women in Europe: Results from a flash VACCELERATE pilot survey. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2023; 41:309-311. [PMID: 36710162 PMCID: PMC9882968 DOI: 10.1016/j.eimce.2022.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 08/16/2022] [Indexed: 01/29/2023]
Affiliation(s)
- Jan Hendrik Grothe
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany,University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | - Oliver A. Cornely
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany,University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany,German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany,University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany
| | - Jon Salmanton-García
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany,University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany,Corresponding author
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43
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Skin Manifestation of Human Monkeypox. J Clin Med 2023; 12:jcm12030914. [PMID: 36769562 PMCID: PMC9918194 DOI: 10.3390/jcm12030914] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 01/03/2023] [Accepted: 01/10/2023] [Indexed: 01/26/2023] Open
Abstract
Monkeypox is a zoonotic infectious disease caused by the monkeypox virus (MPXV) infection, which is mainly manifested as characteristic rashes. It spreads mainly through direct skin-to-skin contact. In some cases, respiratory transmission occurs through contact with respiratory droplets when in close contact with an infected person for a long time. The monkeypox outbreak in 2022 frequently occurred in the MSM (men who have sex with men) population, raising concerns about whether monkeypox could be transmitted through sexual behavior. This article mainly reviews the research progress of skin manifestations of monkeypox, including typical and atypical rashes of monkeypox, and different skin manifestations in some special groups, such as children, pregnant women and individuals co-infected with HIV (human immunodeficiency virus) and MPXV. At present, dermatologists are not very familiar with the diagnosis and treatment of monkeypox, it is therefore necessary to review the skin manifestations of monkeypox, which can help clinicians diagnose the sporadic cases and monitor the occurrence of monkeypox early, particularly in people at higher risk of infection. Early clinical diagnosis and treatment can largely avoid serious complications and death from monkeypox.
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Du M, Sun H, Zhang S, Yuan J, Yan W, Liu Q, Qin C, Liu M, Liu J. Global Epidemiological Features of Human Monkeypox Cases and Their Associations With Social-Economic Level and International Travel Arrivals: A Systematic Review and Ecological Study. Int J Public Health 2023; 68:1605426. [PMID: 36743344 PMCID: PMC9894882 DOI: 10.3389/ijph.2023.1605426] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 01/12/2023] [Indexed: 01/22/2023] Open
Abstract
Objectives: We aimed to evaluate global epidemiological features of human monkeypox (mpox) cases and their associations with social-economic level and international travel arrivals. Methods: We estimated the pooled value by random-effects models. Then, we conducted an ecological study to evaluate the relationship of confirmed cases with social-economic indices and international travel arrivals using correlation analyses. Results: The average age (2022: 35.52, 95% CI [28.09, 42.94] vs. before 2022: 18.38, 95% CI [14.74, 22.02]) and comorbidity rate (2022: 15.7%, 95% CI [8.9%, 22.4%] vs. before 2022: 14.9%, 95% CI [8.5%, 21.3%]) of mpox cases in the 2022 human mpox outbreak were significantly higher than those of cases before 2022. During the 2022 mpox outbreak, the proportion of men who have sex with men (MSM) was high (79.8%, 95% CI [65.5%, 94.2%]). The number of confirmed mpox cases in 2022 significantly correlated with high social-economic levels and international travel arrivals (all p < 0.05). Conclusion: Our findings highlighted the importance of early surveillance and timely detection in high-risk populations, including older people, MSM, and travelers, which is crucial to curb the wide transmission of mpox.
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Affiliation(s)
- Min Du
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Huimin Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Shimo Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jie Yuan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Wenxing Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Qiao Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Chenyuan Qin
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Min Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China,Global Center for Infectious Disease and Policy Research, Global Health and Infectious Diseases Group, Peking University, Beijing, China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China,Global Center for Infectious Disease and Policy Research, Global Health and Infectious Diseases Group, Peking University, Beijing, China,Institute for Global Health and Development, Peking University, Beijing, China,*Correspondence: Jue Liu,
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45
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Mitjà O, Ogoina D, Titanji BK, Galvan C, Muyembe JJ, Marks M, Orkin CM. Monkeypox. Lancet 2023; 401:60-74. [PMID: 36403582 PMCID: PMC9671644 DOI: 10.1016/s0140-6736(22)02075-x] [Citation(s) in RCA: 142] [Impact Index Per Article: 142.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/12/2022] [Accepted: 10/19/2022] [Indexed: 11/19/2022]
Abstract
Monkeypox is a zoonotic illness caused by the monkeypox virus, an Orthopoxvirus in the same genus as the variola, vaccinia, and cowpox viruses. Since the detection of the first human case in the Democratic Republic of the Congo in 1970, the disease has caused sporadic infections and outbreaks, mainly restricted to some countries in west and central Africa. In July, 2022, WHO declared monkeypox a Public Health Emergency of International Concern, on account of the unprecedented global spread of the disease outside previously endemic countries in Africa and the need for global solidarity to address this previously neglected disease. The 2022 outbreak has been primarily associated with close intimate contact (including sexual activity) and most cases have been diagnosed among men who have sex with men, who often present with novel epidemiological and clinical characteristics. In the 2022 outbreak, the incubation period ranges from 7 days to 10 days and most patients present with a systemic illness that includes fever and myalgia and a characteristic rash, with papules that evolve to vesicles, pustules, and crusts in the genital, anal, or oral regions and often involve the mucosa. Complications that require medical treatment (eg, antiviral therapy, antibacterials, and pain control) occur in up to 40% of patients and include rectal pain, odynophagia, penile oedema, and skin and anorectal abscesses. Most patients have a self-limited illness; between 1% and 13% require hospital admission (for treatment or isolation), and the case-fatality rate is less than 0·1%. A diagnosis can be made through the presence of Orthopoxvirus DNA in PCRs from lesion swabs or body fluids. Patients with severe manifestations and people at risk of severe disease (eg, immunosuppressed people) could benefit from antiviral treatment (eg, tecovirimat). The current strategy for post-exposure prophylaxis or pre-exposure prophylaxis for people at high risk is vaccination with the non-replicating modified vaccinia Ankara. Antiviral treatment and vaccines are not yet available in endemic countries in Africa.
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Affiliation(s)
- Oriol Mitjà
- Skin Neglected Tropical Diseases and Sexually Transmitted Infections section, Hospital Universitari Germans Trías i Pujol, Badalona, Spain; Fight Infectious Diseases Foundation, Badalona, Spain; School of Medicine and Health Sciences, University of Papua New Guinea, Port Moresby, Papua New Guinea.
| | - Dimie Ogoina
- Department of Internal Medicine, Infectious Diseases Unit, Niger Delta University and Niger Delta University Teaching Hospital, Bayelsa, Nigeria
| | - Boghuma K Titanji
- Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA; Medecins du Cameroun (Medcamer), Yaoundé, Cameroon
| | | | - Jean-Jacques Muyembe
- Institut National de Recherche Biomedicale, Kinshasa, Democratic Republic of the Congo
| | - Michael Marks
- London School of Hygiene & Tropical Medicine, London, UK; Hospital for Tropical Diseases, University College London Hospital, London, UK; Division of Infection and Immunology, University College London, London, UK
| | - Chloe M Orkin
- Centre for Immunobiology, Blizard Institute, Queen Mary University, London, UK
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46
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Harrison LB, Bergeron G, Cadieux G, Charest H, Fafard J, Levade I, Blais AC, Huchet E, Trottier B, Vlad D, Szabo J, Thomas R, Poulin S, Greenaway C, Zaharatos GJ, Oughton M, Chakravarti A, Pilarski R, Bui-Nguyen A, Benomar K, Libman MD, Vinh DC, Duggan AT, Graham M, Klein MB, Barkati S. Monkeypox in Montréal: Epidemiology, Phylogenomics, and Public Health Response to a Large North American Outbreak. Ann Intern Med 2023; 176:67-76. [PMID: 36508736 DOI: 10.7326/m22-2699] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Monkeypox, a viral zoonotic disease, is causing a global outbreak outside of endemic areas. OBJECTIVE To characterize the outbreak of monkeypox in Montréal, the first large outbreak in North America. DESIGN Epidemiologic and laboratory surveillance data and a phylogenomic analysis were used to describe and place the outbreak in a global context. SETTING Montréal, Canada. PATIENTS Probable or confirmed cases of monkeypox. MEASUREMENTS Epidemiologic, clinical, and demographic data were aggregated. Whole-genome sequencing and phylogenetic analysis were performed for a set of outbreak sequences. The public health response and its evolution are described. RESULTS Up to 18 October 2022, a total of 402 cases of monkeypox were reported mostly among men who have sex with men (MSM), most of which were suspected to be acquired through sexual contact. All monkeypox genomes nested within the B.1 lineage. Montréal Public Health worked closely with the affected communities to control the outbreak, becoming the first jurisdiction to offer 1 dose of the Modified Vaccinia Ankara-Bavarian Nordic vaccine as preexposure prophylaxis (PrEP) to those at risk in early June 2022. Two peaks of cases were seen in early June and July (43 and 44 cases per week, respectively) followed by a decline toward near resolution of the outbreak in October. Reasons for the biphasic peak are not fully elucidated but may represent the tempo of vaccination and/or several factors related to transmission dynamics and case ascertainment. LIMITATIONS Clinical data are self-reported. Limited divergence among sequences limited genomic epidemiologic conclusions. CONCLUSION A large outbreak of monkeypox occurred in Montréal, primarily among MSM. Successful control of the outbreak rested on early and sustained engagement with the affected communities and rapid offer of PrEP vaccination to at-risk persons. PRIMARY FUNDING SOURCE None.
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Affiliation(s)
- Luke B Harrison
- Department of Medicine, Division of Infectious Diseases, McGill University Health Centre, Montréal, Québec, Canada (L.B.H.)
| | - Geneviève Bergeron
- Direction régionale de santé publique de Montréal, Montréal, Québec, Canada (G.B.)
| | - Geneviève Cadieux
- Direction régionale de santé publique de Montréal and Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada (G.C.)
| | - Hugues Charest
- Laboratoire de santé publique du Québec, INSPQ, Sainte-Anne-de-Bellevue, and Département de microbiologie, infectiologie et immunologie, Université de Montréal, Montréal, Québec, Canada (H.C., J.F.)
| | - Judith Fafard
- Laboratoire de santé publique du Québec, INSPQ, Sainte-Anne-de-Bellevue, and Département de microbiologie, infectiologie et immunologie, Université de Montréal, Montréal, Québec, Canada (H.C., J.F.)
| | - Inès Levade
- Laboratoire de Santé publique du Québec, INSPQ, Sainte-Anne-de-Bellevue, Québec, Canada (I.L.)
| | | | | | - Benoît Trottier
- Clinique Médicale du Quartier Latin, Montréal, Québec, Canada (B.T., D.V.)
| | - Dragos Vlad
- Clinique Médicale du Quartier Latin, Montréal, Québec, Canada (B.T., D.V.)
| | - Jason Szabo
- Clinique Médicale l'Actuel, Montréal, Québec, Canada (J.S., R.T.)
| | - Réjean Thomas
- Clinique Médicale l'Actuel, Montréal, Québec, Canada (J.S., R.T.)
| | | | - Christina Greenaway
- Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Department of Medicine, Division of Infectious Diseases, Jewish General Hospital, and J.D. MacLean Centre for Tropical Diseases at McGill University, Montréal, Québec, Canada (C.G.)
| | - Gerasimos J Zaharatos
- Department of Medicine, Division of Infectious Diseases, Jewish General Hospital, Montréal, Québec, Canada (G.J.Z., M.O.)
| | - Matthew Oughton
- Department of Medicine, Division of Infectious Diseases, Jewish General Hospital, Montréal, Québec, Canada (G.J.Z., M.O.)
| | - Arpita Chakravarti
- Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada (A.C.)
| | - Robert Pilarski
- Clinique Médicale La Licorne, Montréal, Québec, Canada (R.P.)
| | | | | | - Michael D Libman
- Department of Medicine, Division of Infectious Diseases, McGill University Health Centre, J.D. MacLean Centre for Tropical Diseases at McGill University, and Research Institute of the McGill University Health Centre, Montréal, Québec, Canada (M.D.L., S.B.)
| | - Donald C Vinh
- Department of Medicine, Division of Infectious Diseases, McGill University Health Centre, and Research Institute of the McGill University Health Centre, Montréal, Québec, Canada (D.C.V.)
| | - Ana T Duggan
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada (A.T.D.)
| | - Morag Graham
- National Microbiology Laboratory, Public Health Agency of Canada, and Department of Medical Microbiology & Infectious Diseases, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada (M.G.)
| | - Marina B Klein
- Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, and Research Institute of the McGill University Health Centre, Montréal, Québec, Canada (M.B.K.)
| | - Sapha Barkati
- Department of Medicine, Division of Infectious Diseases, McGill University Health Centre, J.D. MacLean Centre for Tropical Diseases at McGill University, and Research Institute of the McGill University Health Centre, Montréal, Québec, Canada (M.D.L., S.B.)
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47
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Ko Y, Mendoza VM, Mendoza R, Seo Y, Lee J, Jung E. Estimation of monkeypox spread in a nonendemic country considering contact tracing and self-reporting: A stochastic modeling study. J Med Virol 2023; 95:e28232. [PMID: 36254095 DOI: 10.1002/jmv.28232] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 01/11/2023]
Abstract
In May 2022, monkeypox started to spread in nonendemic countries. To investigate contact tracing and self-reporting of the primary case in the local community, a stochastic model is developed. An algorithm based on Gillespie's stochastic chemical kinetics is used to quantify the number of infections, contacts, and duration from the arrival of the primary case to the detection of the index case (or until there are no more local infections). Different scenarios were set considering the delay in contact tracing and behavior of infectors. We found that the self-reporting behavior of a primary case is the most significant factor affecting outbreak size and duration. Scenarios with a self-reporting primary case have an 86% reduction in infections (average: 5-7, in a population of 10 000) and contacts (average: 27-72) compared with scenarios with a non-self-reporting primary case (average number of infections and contacts: 27-72 and 197-537, respectively). Doubling the number of close contacts per day is less impactful compared with the self-reporting behavior of the primary case as it could only increase the number of infections by 45%. Our study emphasizes the importance of the prompt detection of the primary case.
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Affiliation(s)
- Youngsuk Ko
- Department of Mathematics, Konkuk University, Seoul, South Korea
| | - Victoria May Mendoza
- Department of Mathematics, Konkuk University, Seoul, South Korea.,Institute of Mathematics, University of the Philippines Diliman, Quezon City, Philippines
| | - Renier Mendoza
- Department of Mathematics, Konkuk University, Seoul, South Korea.,Institute of Mathematics, University of the Philippines Diliman, Quezon City, Philippines
| | - Yubin Seo
- Department of Internal Medicine, Division of Infectious Disease, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Jacob Lee
- Department of Internal Medicine, Division of Infectious Disease, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Eunok Jung
- Department of Mathematics, Konkuk University, Seoul, South Korea
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48
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Abstract
In this issue of Cell Host & Microbe, Grifoni et al. provide reassuring evidence that the majority of epitopes induced by vaccinia virus vaccines are conserved in monkeypox virus and can elicit memory T cell responses, while also providing an extensive list of potential T cell epitopes.
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Affiliation(s)
- Dannielle Wellington
- Chinese Academy of Medical Science Oxford Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Tao Dong
- Chinese Academy of Medical Science Oxford Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK; MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK.
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49
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Desingu PA, Rubeni TP, Sundaresan NR. Evolution of monkeypox virus from 2017 to 2022: In the light of point mutations. Front Microbiol 2022; 13:1037598. [PMID: 36590408 PMCID: PMC9795006 DOI: 10.3389/fmicb.2022.1037598] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 11/24/2022] [Indexed: 12/23/2022] Open
Abstract
Monkeypox virus (MPXV) causing multi-country outbreak-2022 is related to viruses caused outbreak-2017-2018 in West Africa. Still not fully understood which proteins of the MPXV discovered in Nigeria in 2017 have mutated through different lineages to the extent that it could cause a multi-country outbreak in 2022; similarly, codon usage bias, host adaptation indices, and the role of selection or mutation pressure in the mutated genes are also not fully studied. Here we report that according to the available sequence data this monkeypox virus acquires point mutations in multiple proteins in each period, and these point mutations accumulate and become a virus that can root outbreak-2022. Viruses exported from Nigeria to Singapore, Israel, and the United Kingdom in 2018-2019 were developed as evolutionary ancestors to B.1 viruses (MPXVs causing multi-country outbreak-2022) through MPXV/United States/2021/MD virus. Although these exported viruses have different amino acid mutations in different proteins, amino acid mutations in 10 proteins are common among them. The MPXV-United Kingdom-P2 virus evolved with only mutations in these 10 proteins and further evolved into MPXV/United States/2021/MD with amino acid mutations in 26 (including amino acid mutations in 10 proteins of the MPXV-United States-P2) proteins. It is noteworthy that specific amino acid mutations in these 22/26 (presence in MPXV/United States/2021/MD) proteins are present in B.1 viruses. Further, analysis of Relative Synonymous Codon Usage (RSCU), Synonymous Codon Usage Fraction (SCUF), and Effective Number of Codons (ENc) revealed codon usage bias in genes that exhibited nucleotide mutations in lineage B.1. Also, host adaptation indices analyzes such as Codon Adaptation Index (CAI), Expected-CAI (eCAI), Relative Codon Deoptimization Index (RCDI) and Expected value for the RCDI (eRCDI) analyzes reveal that the genes that demonstrated nucleotide mutations in lineage B.1 are favorable for human adaptation. Similarly, ENc-GC3s plot, Neutrality plot, and Parity Rule 2 (PR2)-bias plot analyzes suggest a major role of selection pressure than mutation pressure in the evolution of genes displaying nucleotide mutations in lineage B.1. Overall, from 2017 to 2022, MPXV's mutation and spread suggests that this virus continues to evolve through point mutation in the genes according to the available sequence data.
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50
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Grifoni A, Zhang Y, Tarke A, Sidney J, Rubiro P, Reina-Campos M, Filaci G, Dan JM, Scheuermann RH, Sette A. Defining antigen targets to dissect vaccinia virus and monkeypox virus-specific T cell responses in humans. Cell Host Microbe 2022; 30:1662-1670.e4. [PMID: 36463861 PMCID: PMC9718645 DOI: 10.1016/j.chom.2022.11.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 10/17/2022] [Accepted: 11/07/2022] [Indexed: 12/04/2022]
Abstract
The monkeypox virus (MPXV) outbreak confirmed in May 2022 in non-endemic countries is raising concern about the pandemic potential of novel orthopoxviruses. Little is known regarding MPXV immunity in the context of MPXV infection or vaccination with vaccinia-based vaccines (VACV). As with vaccinia, T cells are likely to provide an important contribution to overall immunity to MPXV. Here, we leveraged the epitope information available in the Immune Epitope Database (IEDB) on VACV to predict potential MPXV targets recognized by CD4+ and CD8+ T cell responses. We found a high degree of conservation between VACV epitopes and MPXV and defined T cell immunodominant targets. These analyses enabled the design of peptide pools able to experimentally detect VACV-specific T cell responses and MPXV cross-reactive T cells in a cohort of vaccinated individuals. Our findings will facilitate the monitoring of cellular immunity following MPXV infection and vaccination.
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Affiliation(s)
- Alba Grifoni
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA 92037, USA
| | - Yun Zhang
- Department of Informatics, J. Craig Venter Institute, La Jolla, CA 92037, USA
| | - Alison Tarke
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA 92037, USA,Center of Excellence for Biomedical Research, Department of Experimental Medicine, University of Genoa, Genoa 16132, Italy
| | - John Sidney
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA 92037, USA
| | - Paul Rubiro
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA 92037, USA
| | - Maria Reina-Campos
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA 92037, USA
| | - Gilberto Filaci
- Center of Excellence for Biomedical Research, Department of Internal Medicine, University of Genoa, Genoa 16132, Italy,Biotherapy Unit, IRCCS Ospedale Policlinico San Martino, Genoa 16132, Italy
| | - Jennifer M. Dan
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA 92037, USA,Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, CA 92037, USA
| | - Richard H. Scheuermann
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA 92037, USA,Department of Informatics, J. Craig Venter Institute, La Jolla, CA 92037, USA,Department of Pathology, University of California, San Diego, La Jolla, CA 92093, USA,Global Virus Network, Baltimore, MD 21201, USA
| | - Alessandro Sette
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology (LJI), La Jolla, CA 92037, USA,Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, CA 92037, USA,Corresponding author
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