Impact of traveling on transmission trends of human monkeypox disease: worldwide data based observational analysis

Advancing the understanding and management of Mpox: insights into epidemiology, disease pathways, prevention, and therapeutic strategies

Mpox, previously known as monkeypox, is a zoonotic viral disease caused by the Mpox virus (MPXV), a member of the Orthopoxvirus genus. This disease is of significant concern due to its zoonotic transmission, which can be challenging to control, its ability to spread easily from person to person, the potential for severe symptoms or even fatality, and its history of frequent global outbreaks. Despite the growing threat, there is still limited research on the pathophysiology of the disease and available disease-modifying treatments. To address this gap, the latest developments in Mpox epidemiology, viral variant detection, and advanced diagnostic tools for accurate MPXV detection have been reviewed. Ongoing preventive measures, including vaccination strategies, have also been examined. Additionally, the genomic and proteomic characteristics of MPXV have been explored, and network and pathway enrichment analyses have been performed to identify potential therapeutic targets. The findings presented in this manuscript suggest the potential for novel disease-modifying treatments. Moreover, emerging technologies, such as artificial intelligence and "big data," are playing a crucial role in advancing disease management and enhancing prevention strategies. This review emphasizes the evolving understanding of Mpox and MPXV variants and underscores the importance of continued research and public health initiatives to combat the disease and prevent future global outbreaks.

Mpox cases finding: Evaluation of a Primary Care detection program in the Northern Metropolitan area from Barcelona (Spain)

MAIN AIM

In July 2022, an extensive outbreak of Mpox (monkeypox) was considered by WHO as a Public Health Emergency. The objective of this study is to describe the obtained results from a Mpox case detection program in a semi-urban healthcare area where approximately 420 Primary Care physicians work.

DESIGN

An observational prospective study performed between June 01, 2022 and December 31, 2023.

SETTING

The Northern Metropolitan area of Barcelona, with 1400.000hab (Catalonia, Spain).

METHODS

An unified Mpox management procedure was agreed, including a prior online training of Primary Care professionals, to individually assess all Mpox suspected cases from a clinical and epidemiological perspective.

PARTICIPANTS

All patients who met clinical and/or epidemiological criteria of Mpox.

DATA COLLECTION

Age, gender, risk classification (suspected/probable), cluster-linked (yes/no), high-risk sexual contact (yes/no), general symptoms, genital lesion and final diagnostic.

RESULTS

A total of 68 suspected Mpox cases were included, from which 16 (26.6%) were Mpox confirmed by PCR. Up to 13 (81.2%) were male and, among them, 12 (75%) men who have sex with men (MSM). The series, however, included two minors and three women. Among MSM, 3 (18.7%) were HIV positive and 3 had no regular access to the Public Healthcare system. Among discarded patients, any infectious disease was diagnosed in 55% of cases.

CONCLUSIONS

In spite of the short series, this Primary Care community-based study identified a sub-population group showing a different profile of Mpox cases compared to other published series (lower HIV prevalence, higher representativeness of heterosexual transmission and hard to reach population).

Complete Genome Sequence Analysis of the First Imported Mpox Virus Clade Ib Variant in China

Mpox, a zoonotic disease caused by the mpox virus (MPXV), has seen a significant shift in its epidemiological status since 2022, evolving from an initial local outbreak to a global epidemic. This recent outbreak of MPXV mainly emerged in several European and American countries and subsequently spread to over 100 countries and regions worldwide. The rapid evolution of MPXV, coupled with increased international interactions, has led to a gradual rise in mpox cases in certain regions of Asia, mostly involving MPXV clade II and its branch strains. In contrast, the more pathogenic and clinically severe MPXV clade Ib has been relatively rare, with no reports in China to date. Here, we analyzed the whole gene sequence of imported MPXV clade Ib variant from the first infection case detected in China. Through whole genome sequencing, we successfully obtained a full-length MPXV genome of 195,405 base pairs (bp). Phylogenetic analysis revealed that the genetic sequence of the MPXV in this case was predominantly clustered with MPXV clade Ib sequences previously reported from multiple African and European countries. Compared with the MPXV clade Ib reference strain DQ011155.1, there are 127 nucleotide alterations and 57 amino acid mutations in the MPXV genome of this case. Given that the MPXV clade Ib has started to appear in China, we must pay more attention to the prevention of and control measures for the spread of mpox.

Rising epidemiological trends in prevalence and mortality of mpox: Global insights and analysis

OBJECTIVES

To explore the global epidemiological trends in the prevalence and mortality due to mpox in various regions worldwide.

METHODS

In this cross-sectional study the data about mpox outbreak were recorded by the "World Health Organization, Centers for Disease Control and Prevention, and GSAID" from August 2023 to August 2024, analyzing the epidemiological trends from different countries worldwide.

RESULTS

The total number of mpox cases has reached 99,518 (95,196 cases from 115 countries that have not historically reported mpox; and 4,322 cases from 07 states that have traditionally reported mpox), from a total of 122 countries. The top 10 countries with the greatest number of mpox cases include the United States (33,435) followed by Brazil (11212), Spain (8084), France (4272), Colombia (4249), Mexico (4124), United Kingdom (3952), Peru (3875), Germany (3857), and Democratic Republic of Congo (3104). America has the highest number of cases (63,145) accounting for 63% of total cases globally, followed by Europe (27,194). Democratic Republic of Congo faces the highest increase in cases within a single year, with the infectious rate in the region up by 160%, alongside a higher risk of mortality.

CONCLUSION

Mpox cases have rapidly spread worldwide, reaching 99,518 cases across 122 countries, and being declared a "Public Health Emergency of International Concern" by the WHO. Healthcare authorities must take timely measures to control this outbreak since the world cannot afford the global burden of it being another potential pandemic.

Knowledge, Attitude and Associated Factors of Monkeypox Infection Among Healthcare Workers in Injibara General Hospital, Northwest Ethiopia

Background

Fighting health threats, especially the rise of new infectious diseases, is one of the main responsibilities of healthcare workers. However, their knowledge and attitudes toward monkeypox have not yet been assessed. Therefore, this study aimed to assess the knowledge, attitude, and factors associated with monkeypox infection among healthcare workers at Injibara General Hospital, Northwest Ethiopia.

Methods

Institution-based cross-sectional study was conducted from December 1-30, 2022. Data were collected using a structured self-administered questionnaire. A simple random sampling technique was used to select study participants. Descriptive statistics and multivariable logistic regression analyses were computed. The degree of association was interpreted using an odds ratio with a 95% confidence interval and a p-value < 0.05.

Results

Among the 200 healthcare workers who participated, 38.5% (95% CI: 32.5%-45%) and 62% (95% CI: 55-68.5%) had good knowledge and positive attitudes regarding monkeypox respectively. Having a master's degree or above (AOR = 11.25: 95% CI: 2.03-62.33), being vaccinated against COVID-19 (AOR = 2.60: 95% CI: 1.37-4.94), and having access to information about monkeypox (AOR = 3.37: 95% CI: 1.33-8.50) were the factors associated with good knowledge. Furthermore, a positive attitude was significantly associated with being 30 years of age or older (AOR = 2.95: 95% CI: 1.55-5.60) and having access to information about monkeypox (AOR = 4.14: 95% CI: 2.06, 8.30).

Conclusion

Both good knowledge and positive attitudes were relatively low among healthcare workers. Factors such as age, education level, COVID-19 vaccination status, and access to information about monkeypox were significantly associated with the knowledge and attitude of healthcare workers. To enhance the knowledge and attitude of healthcare workers, hospitals should consider offering educational upgrades, hosting educational events like seminars, conferences, webinars, and campaigns, and ensuring comprehensive coverage of the topic in medical curricula.

Mpox (formerly monkeypox): pathogenesis, prevention, and treatment

In 2022, a global outbreak of Mpox (formerly monkeypox) occurred in various countries across Europe and America and rapidly spread to more than 100 countries and regions. The World Health Organization declared the outbreak to be a public health emergency of international concern due to the rapid spread of the Mpox virus. Consequently, nations intensified their efforts to explore treatment strategies aimed at combating the infection and its dissemination. Nevertheless, the available therapeutic options for Mpox virus infection remain limited. So far, only a few numbers of antiviral compounds have been approved by regulatory authorities. Given the high mutability of the Mpox virus, certain mutant strains have shown resistance to existing pharmaceutical interventions. This highlights the urgent need to develop novel antiviral drugs that can combat both drug resistance and the potential threat of bioterrorism. Currently, there is a lack of comprehensive literature on the pathophysiology and treatment of Mpox. To address this issue, we conducted a review covering the physiological and pathological processes of Mpox infection, summarizing the latest progress of anti-Mpox drugs. Our analysis encompasses approved drugs currently employed in clinical settings, as well as newly identified small-molecule compounds and antibody drugs displaying potential antiviral efficacy against Mpox. Furthermore, we have gained valuable insights from the process of Mpox drug development, including strategies for repurposing drugs, the discovery of drug targets driven by artificial intelligence, and preclinical drug development. The purpose of this review is to provide readers with a comprehensive overview of the current knowledge on Mpox.