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Rani I, Joshi H, Sharma U, Kaur J, Sood S, Ramniwas S, Chauhan A, Abdulabbas HS, Tuli HS. Potential use of cidofovir, brincidofovir, and tecovirimat drugs in fighting monkeypox infection: recent trends and advancements. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2024; 397:2055-2065. [PMID: 37837475 DOI: 10.1007/s00210-023-02769-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 10/03/2023] [Indexed: 10/16/2023]
Abstract
Recent years have witnessed the rise of more recent pandemic outbreaks including COVID-19 and monkeypox. A multinational monkeypox outbreak creates a complex situation that necessitates countermeasures to the existing quo. The first incidence of monkeypox was documented in the 1970s, and further outbreaks led to a public health emergency of international concern. Yet as of right now, neither vaccines nor medicines are certain to treat monkeypox. Even the inability of conducting human clinical trials has prevented thousands of patients from receiving effective disease management. The current state of the disease's understanding, the treatment options available, financial resources, and lastly international policies to control an epidemic state are the major obstacles to controlling epidemics. The current review focuses on the epidemiology of monkeypox, scientific ideas, and available treatments, including potential monkeypox therapeutic methods. As a result, a thorough understanding of monkeypox literature will facilitate in the development of new therapeutic medications for the prevention and treatment of monkeypox.
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Affiliation(s)
- Isha Rani
- Department of Biochemistry, Maharishi Markandeshwar College of Medical Sciences and Research (MMCMSR), Sadopur, Ambala, 134007, India
| | - Hemant Joshi
- School of Biotechnology, Jawaharlal Nehru University, New Delhi, 110067, India
| | - Ujjawal Sharma
- Department of Human Genetics and Molecular Medicine, School of Health Sciences, Central University of Punjab, Bathinda, Punjab, 151401, India
| | - Jagjit Kaur
- Graduate School of Biomedical Engineering, Faculty of Engineering, The University of New South Wales, Sydney, 2052, Australia
| | - Shivani Sood
- GIOSTAR-USA, Global Institute of Stem Cell Therapy and Research, Mohali, 140308, India
| | - Seema Ramniwas
- University Centre for Research and Development, University Institute of Pharmaceutical Sciences, Chandigarh University, Gharuan, Mohali, 140413, India
| | - Abhishek Chauhan
- Amity Institute of Environmental Toxicology, Safety and Management, Amity University, Noida, 201303, India
| | - Hadi Sajid Abdulabbas
- Department of Biology, College of Science, University of Babylon, Babylon, 51002, Iraq
| | - Hardeep Singh Tuli
- Department of Bio-Sciences and Technology, Maharishi Markandeshwar Engineering College, Maharishi Markandeshwar (Deemed to Be University), Mullana, Ambala, 133207, India.
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Manirambona E, Khan SH, Siddiq A, Albakri K, Salamah HM, Hassan NAIF, Musa SS, Dhama K. Intriguing insight into unanswered questions about Mpox: exploring health policy implications and considerations. Health Res Policy Syst 2024; 22:37. [PMID: 38520018 PMCID: PMC10960492 DOI: 10.1186/s12961-024-01123-9] [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: 09/08/2023] [Accepted: 02/17/2024] [Indexed: 03/25/2024] Open
Abstract
The 2022 multi-country Monkeypox (Mpox) outbreak has added concerns to scientific research. However, unanswered questions about the disease remain. These unanswered questions lie in different aspects, such as transmission, the affected community, clinical presentations, infection and prevention control and treatment and vaccination. It is imperative to address these issues to stop the spread and transmission of disease. We documented unanswered questions with Mpox and offered suggestions that could help put health policy into practice. One of those questions is why gay, bisexual or other men who have sex with men (gbMSM) are the most affected community, underscoring the importance of prioritizing this community regarding treatment, vaccination and post-exposure prophylaxis. In addition, destigmatizing gbMSM and implementing community-based gbMSM consultation and action alongside ethical surveillance can facilitate other preventive measures such as ring vaccination to curb disease transmission and track vaccine efficacy. Relevant to that, vaccine and drug side effects have implied the questionability of their use and stimulated the importance of health policy development regarding expanded access and off-label use, expressing the need for safe drug and vaccine development manufacturing. The possibility of reverse zoonotic has also been raised, thus indicating the requirement to screen not only humans, but also their related animals to understand the real magnitude of reverse zoonosis and its potential risks. Implementing infection prevention and control measures to stop the virus circulation at the human-animal interface that includes One Health approach is essential.
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Affiliation(s)
- Emery Manirambona
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
| | | | | | - Khaled Albakri
- Faculty of Medicine, The Hashemite University, Zarqa, Jordan
| | | | | | | | - Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute (IVRI), Izatnagar, Bareilly, Uttar Pradesh, 243122, India
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Alakunle E, Kolawole D, Diaz-Cánova D, Alele F, Adegboye O, Moens U, Okeke MI. A comprehensive review of monkeypox virus and mpox characteristics. Front Cell Infect Microbiol 2024; 14:1360586. [PMID: 38510963 PMCID: PMC10952103 DOI: 10.3389/fcimb.2024.1360586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 02/20/2024] [Indexed: 03/22/2024] Open
Abstract
Monkeypox virus (MPXV) is the etiological agent of monkeypox (mpox), a zoonotic disease. MPXV is endemic in the forested regions of West and Central Africa, but the virus has recently spread globally, causing outbreaks in multiple non-endemic countries. In this paper, we review the characteristics of the virus, including its ecology, genomics, infection biology, and evolution. We estimate by phylogenomic molecular clock that the B.1 lineage responsible for the 2022 mpox outbreaks has been in circulation since 2016. We interrogate the host-virus interactions that modulate the virus infection biology, signal transduction, pathogenesis, and host immune responses. We highlight the changing pathophysiology and epidemiology of MPXV and summarize recent advances in the prevention and treatment of mpox. In addition, this review identifies knowledge gaps with respect to the virus and the disease, suggests future research directions to address the knowledge gaps, and proposes a One Health approach as an effective strategy to prevent current and future epidemics of mpox.
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Affiliation(s)
- Emmanuel Alakunle
- Department of Natural and Environmental Sciences, American University of Nigeria, Yola, Nigeria
| | - Daniel Kolawole
- Department of Natural and Environmental Sciences, American University of Nigeria, Yola, Nigeria
| | - Diana Diaz-Cánova
- Department of Medical Biology, UIT – The Arctic University of Norway, Tromsø, Norway
| | - Faith Alele
- School of Health, University of the Sunshine Coast, Sippy Downs, QLD, Australia
| | - Oyelola Adegboye
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Ugo Moens
- Department of Medical Biology, UIT – The Arctic University of Norway, Tromsø, Norway
| | - Malachy Ifeanyi Okeke
- Department of Natural and Environmental Sciences, American University of Nigeria, Yola, Nigeria
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Maqbool KU, Akhtar MT, Ayub S, Simran FNU, Malik J, Malik M, Zubair R, Mehmoodi A. Role of vaccination in patients with human monkeypox virus and its cardiovascular manifestations. Ann Med Surg (Lond) 2024; 86:1506-1516. [PMID: 38463133 PMCID: PMC10923390 DOI: 10.1097/ms9.0000000000001674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 12/20/2023] [Indexed: 03/12/2024] Open
Abstract
Human monkeypox, caused by the monkeypox virus (MPXV), is an emerging infectious disease with the potential for human-to-human transmission and diverse clinical presentations. While generally considered milder than smallpox, it can lead to severe cardiovascular complications. The virus primarily spreads through contact with infected animals or through human-to-human transmission. Cardiovascular involvement in human monkeypox is rare but has been associated with myocarditis, pericarditis, arrhythmias, and even fulminant myocardial infarction. Vaccination plays a crucial role in preventing and controlling monkeypox, but the eradication of smallpox has left global populations vulnerable. This review explores the cardiovascular manifestations of human monkeypox, the role of vaccination in disease prevention, and the importance of continued research and development of effective vaccines to protect against this emerging infectious threat. The global impact of monkeypox outbreaks, particularly on vulnerable populations, further highlights the importance of understanding and addressing this disease.
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Affiliation(s)
| | | | - Shayan Ayub
- Department of Cardiovascular Medicine, Cardiovascular Analytics Group
| | - FNU Simran
- Department of Cardiovascular Medicine, Cardiovascular Analytics Group
| | - Jahanzeb Malik
- Department of Cardiovascular Medicine, Cardiovascular Analytics Group
| | - Maria Malik
- Department of Cardiovascular Medicine, Cardiovascular Analytics Group
| | - Rafia Zubair
- Department of Cardiovascular Medicine, Cardiovascular Analytics Group
| | - Amin Mehmoodi
- Department of Medicine, Ibn e Seena Hospital, Kabul, Afghanistan
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León-Figueroa DA, Barboza JJ, Valladares-Garrido MJ, Sah R, Rodriguez-Morales AJ. Prevalence of intentions to receive monkeypox vaccine. A systematic review and meta-analysis. BMC Public Health 2024; 24:35. [PMID: 38166776 PMCID: PMC10763398 DOI: 10.1186/s12889-023-17473-y] [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: 09/26/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Immunization, as a preventive strategy against infectious diseases, has consolidated its position as a fundamental pillar in the field of public health. Therefore, the present study aimed to determine the prevalence of the intention to receive the monkeypox (Mpox) vaccine. METHODS A systematic review and meta-analysis of the available evidence was performed using five databases (PubMed, Scopus, Web of Science, Embase, and ScienceDirect) with a search strategy until July 24, 2023. Data analysis was performed in R software version 4.2.3. The quality of the included cross-sectional studies was assessed using the "JBI-MAStARI". In addition, a subgroup analysis by population and continent was developed. RESULTS Twenty-nine cross-sectional articles with a total sample of 52 658 participants were included. The pooled prevalence of intention to vaccinate against Mpox was 61% (95% CI: 53-69%; 52,658 participants; 29 studies; I2 = 100%). In the subgroup analysis, the intention to be vaccinated against Mpox according to continents was 64% (95% CI: 53-74%; 13,883 participants; 17 studies; I2 = 99%) in Asian countries, 43% (95% CI: 39-47%; 1538 participants; 3 studies; I2 = 53%) in African countries, 62% (95% CI: 45-78%; 35,811 participants; 6 studies; I2 = 99%) in European countries, and 63% (95% CI: 32-89%; 1426 participants; 3 studies; I2 = 99%) in American countries. In the subgroup analysis on the intention to be vaccinated against Mpox, according to study subjects, it was 54% (95% CI: 45-62%; 10,296 participants; 11 studies; I2 = 99%) in the general population, 57% (95% CI: 33-79%; 3333 participants; 10 studies; I2 = 99%) in health care workers, and 76% (95% CI: 70-82%; 39,029 participants; 8 studies; I2 = 98%) in the lesbian, gay, bisexual, transgender, and intersex (LGBTI) community. In addition, as a secondary outcome, a prevalence of refusal of Mpox vaccination was found to be 22% (95% CI: 16-30%; 45,577 participants; 21 studies; I2 = 99%). CONCLUSION The study highlights the importance of recognizing regional and subgroup disparities in Mpox vaccine willingness and refusal. It emphasizes the importance of employing strategies to achieve widespread vaccination coverage and safeguard public health worldwide. TERMS USED Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI), Prospective International Registry of Systematic Reviews (PROSPERO), and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).
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Affiliation(s)
| | - Joshuan J Barboza
- Unidad de Revisiones Sistemáticas y Meta-análisis, Universidad San Ignacio de Loyola, Lima, 15046, Peru
| | - Mario J Valladares-Garrido
- Universidad Continental, Lima, 15046, Peru.
- Oficina de Epidemiología, Hospital Regional Lambayeque, Chiclayo, 14012, Peru.
| | - Ranjit Sah
- Department of Microbiology, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, 44600, Nepal
- Department of Microbiology, Hospital and Research Centre, Dr. D. Y. Patil Medical College, Dr. D. Y. Patil Vidyapeeth, Pune, 411018, Maharashtra, India
- Department of Public Health Dentistry, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, 411018, Maharashtra, India
| | - Alfonso J Rodriguez-Morales
- Master of Clinical Epidemiology and Biostatistics, Universidad Cientifica del Sur, Lima, 15067, Peru
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, 1102, Lebanon
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Shah BM, Modi P. Breaking Barriers: Current Advances and Future Directions in Mpox Therapy. Curr Drug Targets 2024; 25:62-76. [PMID: 38151842 DOI: 10.2174/0113894501281263231218070841] [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: 09/08/2023] [Revised: 11/21/2023] [Accepted: 11/28/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Mpox, a newly discovered zoonotic infection, can be transmitted from animal to human and between humans. Serological and genomic studies are used to identify the virus. OBJECTIVE Currently, there are no proven effective treatments for Mpox. Also, the safety and efficacy of intravenous vaccinia immune globulin, oral Tecovirimat (an inhibitor of intracellular viral release), and oral Brincidofovir (a DNA polymerase inhibitor) against the Mpox virus are uncertain, highlighting the need for more effective and safe treatments. As a result, drug repurposing has emerged as a promising strategy to identify previously licensed drugs that can be repurposed to treat Mpox. RESULTS Various approaches have been employed to identify previously approved drugs that can target specific Mpox virus proteins, including thymidylate kinase, D9 decapping enzyme, E8 protein, Topoisomerase1, p37, envelope proteins (D13, A26, and H3), F13 protein, virus's main cysteine proteases, and DNA polymerase. CONCLUSION In this summary, we provide an overview of potential drugs that could be used to treat Mpox and discuss the underlying biological processes of their actions.
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Affiliation(s)
- Bhumi M Shah
- Department of Pharmaceutical Chemistry, L.J. Institute of Pharmacy, L.J. University, Ahmedabad, Gujarat 382210, India
| | - Palmi Modi
- Department of Pharmaceutical Chemistry, L.J. Institute of Pharmacy, L.J. University, Ahmedabad, Gujarat 382210, India
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Ramprasadh SV, Rajakumar S, Srinivasan S, Susha D, Sharma S, Chourasiya R. Computer-Aided Multi-Epitope Based Vaccine Design Against Monkeypox Virus Surface Protein A30L: An Immunoinformatics Approach. Protein J 2023; 42:645-663. [PMID: 37615828 DOI: 10.1007/s10930-023-10150-4] [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] [Accepted: 08/05/2023] [Indexed: 08/25/2023]
Abstract
Monkeypox, a viral zoonotic disease resembling smallpox, has emerged as a significant national epidemic primarily in Africa. Nevertheless, the recent global dissemination of this pathogen has engendered apprehension regarding its capacity to metamorphose into a sweeping pandemic. To effectively combat this menace, a multi-epitope vaccine has been meticulously engineered with the specific aim of targeting the cell envelope protein of Monkeypox virus (MPXV), thereby stimulating a potent immunological response while mitigating untoward effects. This new vaccine uses T-cell and B-cell epitopes from a highly antigenic, non-allergenic, non-toxic, conserved, and non-homologous A30L protein to provide protection against the virus. In order to ascertain the vaccine design with the utmost efficacy, protein-protein docking methodologies were employed to anticipate the intricate interactions with Toll-like receptors (TLR) 2, 3, 4, 6, and 8. This meticulous approach led the researchers to discern an optimal vaccine architecture, bolstered by affirmative prognostications derived from both molecular dynamics (MD) simulations and immune simulations. The current research findings indicate that the peptides ATHAAFEYSK, FFIVVATAAV, and MNSLSIFFV exhibited antigenic properties and were determined to be non-allergenic and non-toxic. Through the utilization of codon optimization and in-silico cloning techniques, our investigation revealed that the prospective vaccine exhibited a remarkable expression level within Escherichia coli. Moreover, upon conducting immune simulations, we observed the induction of a robust immune response characterized by elevated levels of both B-cell and T-cell mediated immunity. Moreover, as the initial prediction with in-silico techniques has yielded promising results these epitope-based vaccines can be recommended to in vitro and in silico studies to validate their immunogenic properties.
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Affiliation(s)
- S V Ramprasadh
- Department of Bioinformatics, BioNome, Bangalore, 560043, India
| | | | - S Srinivasan
- Department of Bioinformatics, BioNome, Bangalore, 560043, India
| | - D Susha
- Department of Bioinformatics, BioNome, Bangalore, 560043, India
| | - Sameer Sharma
- Department of Bioinformatics, BioNome, Bangalore, 560043, India.
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Lucena-Neto FD, Falcão LFM, Vieira-Junior AS, Moraes ECS, David JPF, Silva CC, Sousa JR, Duarte MIS, Vasconcelos PFC, Quaresma JAS. Monkeypox Virus Immune Evasion and Eye Manifestation: Beyond Eyelid Implications. Viruses 2023; 15:2301. [PMID: 38140542 PMCID: PMC10747317 DOI: 10.3390/v15122301] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 12/24/2023] Open
Abstract
Monkeypox virus (MPXV), belonging to the Poxviridae family and Orthopoxvirus genus, is closely related to the smallpox virus. Initial prodromal symptoms typically include headache, fever, and lymphadenopathy. This review aims to detail various ocular manifestations and immune evasion associated with the monkeypox viral infection and its complications, making it appropriate as a narrative review. Common external ocular manifestations of MPXV typically involve a generalized pustular rash, keratitis, discharges, and dried secretions related to conjunctival pustules, photophobia, and lacrimation. Orthopoxviruses can evade host immune responses by secreting proteins that antagonize the functions of host IFNγ, CC and CXC chemokines, IL-1β, and the complement system. One of the most important transcription factors downstream of pattern recognition receptors binding is IRF3, which controls the expression of the crucial antiviral molecules IFNα and IFNβ. We strongly recommend that ophthalmologists include MPXV as part of their differential diagnosis when they encounter similar cases presenting with ophthalmic manifestations such as conjunctivitis, blepharitis, or corneal lesions. Furthermore, because non-vaccinated individuals are more likely to exhibit these symptoms, it is recommended that healthcare administrators prioritize smallpox vaccination for at-risk groups, including very young children, pregnant women, older adults, and immunocompromised individuals, especially those in close contact with MPXV cases.
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Affiliation(s)
- Francisco D. Lucena-Neto
- Department of Infectious Disease, School of Medicine, State University of Pará, Belém 66087-670, PA, Brazil; (F.D.L.-N.); (L.F.M.F.); (A.S.V.-J.); (C.C.S.); (J.R.S.); (P.F.C.V.)
| | - Luiz F. M. Falcão
- Department of Infectious Disease, School of Medicine, State University of Pará, Belém 66087-670, PA, Brazil; (F.D.L.-N.); (L.F.M.F.); (A.S.V.-J.); (C.C.S.); (J.R.S.); (P.F.C.V.)
| | - Adolfo S. Vieira-Junior
- Department of Infectious Disease, School of Medicine, State University of Pará, Belém 66087-670, PA, Brazil; (F.D.L.-N.); (L.F.M.F.); (A.S.V.-J.); (C.C.S.); (J.R.S.); (P.F.C.V.)
| | - Evelly C. S. Moraes
- Department of Infectious Disease, School of Medicine, Federal University of Pará, Belém 66075-110, PA, Brazil; (E.C.S.M.); (J.P.F.D.)
| | - Joacy P. F. David
- Department of Infectious Disease, School of Medicine, Federal University of Pará, Belém 66075-110, PA, Brazil; (E.C.S.M.); (J.P.F.D.)
| | - Camilla C. Silva
- Department of Infectious Disease, School of Medicine, State University of Pará, Belém 66087-670, PA, Brazil; (F.D.L.-N.); (L.F.M.F.); (A.S.V.-J.); (C.C.S.); (J.R.S.); (P.F.C.V.)
| | - Jorge R. Sousa
- Department of Infectious Disease, School of Medicine, State University of Pará, Belém 66087-670, PA, Brazil; (F.D.L.-N.); (L.F.M.F.); (A.S.V.-J.); (C.C.S.); (J.R.S.); (P.F.C.V.)
| | - Maria I. S. Duarte
- Department of Infectious Disease, School of Medicine, São Paulo University, São Paulo 01246-904, SP, Brazil;
| | - Pedro F. C. Vasconcelos
- Department of Infectious Disease, School of Medicine, State University of Pará, Belém 66087-670, PA, Brazil; (F.D.L.-N.); (L.F.M.F.); (A.S.V.-J.); (C.C.S.); (J.R.S.); (P.F.C.V.)
| | - Juarez A. S. Quaresma
- Department of Infectious Disease, School of Medicine, State University of Pará, Belém 66087-670, PA, Brazil; (F.D.L.-N.); (L.F.M.F.); (A.S.V.-J.); (C.C.S.); (J.R.S.); (P.F.C.V.)
- Department of Infectious Disease, School of Medicine, Federal University of Pará, Belém 66075-110, PA, Brazil; (E.C.S.M.); (J.P.F.D.)
- Department of Infectious Disease, School of Medicine, São Paulo University, São Paulo 01246-904, SP, Brazil;
- Virology Section, Evandro Chagas Institute, Ananindeua 67030-000, PA, Brazil
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Iroezindu MO, Crowell TA, Ogoina D, Yinka-Ogunleye A. Human Mpox in People Living with HIV: Epidemiologic and Clinical Perspectives from Nigeria. AIDS Res Hum Retroviruses 2023; 39:593-600. [PMID: 37646422 DOI: 10.1089/aid.2023.0034] [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
Sub-Saharan Africa (SSA) is disproportionately affected by mpox and HIV. We described epidemiologic trends and clinical experiences in the management of mpox in people living with HIV (PLWH) in Nigeria and further examined how the rapidly accumulating body of knowledge from the 2022 global mpox outbreak might be explored to improve mpox care in PLWH in SSA. During the 2017/2018 Nigerian mpox outbreak, we reported that 9/40 (22.5%) hospitalized mpox patients with known HIV status were PLWH. In the 2022 global mpox outbreak, 52% of confirmed mpox cases with known HIV status were PLWH, predominantly sexual and gender minority groups. However, substantial missing data on HIV status of confirmed mpox cases highlights a critical gap in HIV testing as a component of mpox management. Before 2022, sexual activity was not commonly linked to mpox transmission, but this was identified as a major driver of transmission during the 2022 mpox outbreak. Notable sexual history observed in Nigerian mpox patients in 2017/2018 suggests that the contribution of sexual activity in human-to-human mpox transmission might have been underappreciated for years. Our cohort of PLWH with mpox, predominantly individuals with advanced or uncontrolled HIV, were significantly more likely to experience severe mpox manifestations and prolonged disease compared with those without HIV. This contrasts with the generally less remarkable differences in mpox presentation between people with and without HIV in Western countries, an observation that can be at least partially explained by more stable HIV disease. The unavailability of mpox antiviral drugs and vaccines in SSA highlights global inequity in mpox response, which requires an urgent attention. As mpox countermeasures become available in SSA, lessons learned from their use in Western countries could provide important guidance for care providers in SSA. Public health measures to mitigate stigmatization in PLWH with mpox is also critical.
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Affiliation(s)
- Michael O Iroezindu
- Clinical Research Center, HJF Medical Research International, Abuja, Nigeria
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Trevor A Crowell
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA
| | - Dimie Ogoina
- Infectious Disease Unit, Niger Delta University Teaching Hospital, Okolobiri, Nigeria
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Dubey T, Chakole S, Agrawal S, Gupta A, Munjewar PK, Sharma R, Yelne S. Enhancing Nursing Care in Monkeypox (Mpox) Patients: Differential Diagnoses, Prevention Measures, and Therapeutic Interventions. Cureus 2023; 15:e44687. [PMID: 37809174 PMCID: PMC10551575 DOI: 10.7759/cureus.44687] [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: 08/04/2023] [Accepted: 09/04/2023] [Indexed: 10/10/2023] Open
Abstract
Monkeypox (Mpox), a rare zoonotic viral infection caused by the monkeypox virus, has been gaining attention due to its potential for human-to-human transmission and its clinical resemblance to other poxvirus infections, such as smallpox and chickenpox. Enhancing nursing care for monkeypox patients is imperative to manage and contain its spread effectively. This review analyzes the key aspects of enhancing nursing care in monkeypox patients, focusing on differential diagnoses, prevention measures, and therapeutic interventions. Differential diagnosis is crucial in terms of the early recognition and management of monkeypox. Given its similarity to other poxvirus infections, a thorough assessment of clinical symptoms, travel history, and exposure to potential reservoir hosts is essential. Nursing professionals play a pivotal role in eliciting comprehensive patient histories and relaying this information to the medical team for accurate diagnosis. Prevention measures constitute a vital component of nursing care in monkeypox management. Implementing stringent infection prevention and control practices, including isolation protocols, personal protective equipment (PPE) usage, and hand hygiene, is imperative to curbing nosocomial transmission. Nurses are at the forefront of enforcing these measures, educating patients, families, and healthcare staff about their significance, and ensuring strict adherence. Therapeutic interventions in monkeypox largely focus on supportive care and symptom management. Nurses occupy a central role in administering antiviral medications, providing wound care for skin lesions, and monitoring patients for potential complications such as secondary bacterial infections. Psychosocial support is equally important, as patients often experience fear and anxiety due to the disease's contagious nature. Nursing professionals offer compassionate care, address patients' emotional needs, and facilitate communication between patients and their families. Enhancing nursing care for monkeypox entails a multifaceted approach involving differential diagnoses, prevention measures, and therapeutic interventions. Nursing professionals serve as frontline caregivers, pivotal in early diagnosis, effective prevention strategies, and comprehensive patient management. As the global healthcare community faces an influx of emerging infectious diseases, the lessons learned from managing monkeypox can contribute to the creation of a more resilient and responsive nursing workforce capable of effectively addressing future health challenges.
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Affiliation(s)
- Tanishq Dubey
- General Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Swarupa Chakole
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Suyash Agrawal
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Anannya Gupta
- Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pratiksha K Munjewar
- Medical Surgical Nursing, Smt. Radhikabai Meghe Memorial College of Nursing, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Ranjana Sharma
- Medical Surgical Nursing, Smt. Radhikabai Meghe Memorial College of Nursing, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Seema Yelne
- Nursing, Shalinitai Meghe College of Nursing, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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11
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Maronese CA, Avallone G, Aromolo IF, Spigariolo CB, Quattri E, Ramoni S, Carrera CG, Marzano AV. Mpox: an updated review of dermatological manifestations in the current outbreak. Br J Dermatol 2023; 189:260-270. [PMID: 37146166 DOI: 10.1093/bjd/ljad151] [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: 12/12/2022] [Revised: 04/27/2023] [Accepted: 04/28/2023] [Indexed: 05/07/2023]
Abstract
Mpox is a disease caused by a double-stranded DNA orthopoxvirus discovered in 1958. In 2022, an outbreak on an unprecedented scale marked its transition from neglected, zoonotic disease circulating almost exclusively within African borders to sexually transmitted infection (STI) of international concern. Although phylogenetic evidence suggests progressive evolution from the strain associated with the 2018 outbreak in Nigeria, epidemiological links with previous cases have still not been completely elucidated. Clinically, mpox presents with systemic symptoms, such as fever, headache, malaise and a characteristic cutaneous eruption, similar to that of cognate viruses (e.g. smallpox). Mpox pseudopustules evolve through several stages, including umbilication and crusting, and resolve in the span of 2-3 weeks. The hallmarks that set the 2022 outbreak apart from classic mpox were a disproportionate number of cases occurring in men who have sex with men, an often localized cutaneous picture and a significant burden in terms of concomitant STIs. Investigations into the disease pathogenesis, related immune response, clinical and dermoscopic features, in addition to studies aimed at defining novel management strategies, have advanced mpox knowledge considerably. Herein, recent findings on mpox are reviewed, with a keen focus on dermatological manifestations and their implications in the current diagnostic scenario, reinforcing the pivotal role of dermatologists in managing suspect cases and preventing further spread of the contagion.
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Affiliation(s)
- Carlo Alberto Maronese
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Gianluca Avallone
- Department of Medical Sciences, Dermatology Clinic, University of Turin, Turin, Italy
| | - Italo Francesco Aromolo
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Cristina Beatrice Spigariolo
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Eleonora Quattri
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Stefano Ramoni
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Carlo Giovanni Carrera
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Angelo Valerio Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
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12
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Gamo Guerrero M, Simón Gozalbo A, Martín Díaz M, Díez Madueño K, Del Río Pena E, De la Cueva P, Talaván T, Jiménez E, Torres J, Valencia J, Cuevas G, Bibiano C, Ryan P. Interdisciplinary management of mpox-related local complications: report on a series of cases. Front Med (Lausanne) 2023; 10:1184924. [PMID: 37324126 PMCID: PMC10267306 DOI: 10.3389/fmed.2023.1184924] [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: 03/12/2023] [Accepted: 05/11/2023] [Indexed: 06/17/2023] Open
Abstract
Monkeypox (mpox) is a viral zoonosis, and human-to-human transmission can result from close contact with the respiratory secretions and mucocutaneous lesions of an infected person. The prodromal phase is followed by an eruptive phase, with skin and/or mucosal lesions that progress through several stages at different sites. In this study, we describe the importance of interdisciplinary care management and follow-up of patients with complicated mpox. A cross-sectional study was conducted from May 2022 until August 2022 at a secondary hospital in Madrid (Spain). Out of 100 patients with mpox seen at this institution, we selected and analyzed 11 with local complications. All the patients were male at birth, and the mean age was 32 (30-42) years. The clinical manifestations included skin rash or mucosal lesions, fever, myalgia and lymphadenopathies. The most frequent local complications were pharyngitis associated with dysphagia, penile edema, infection of the mucocutaneous lesions, and ulceration of the genital lesions. A multidisciplinary team was created for the care of patients with complications secondary to mpox. The team comprised dermatologists and specialists in infectious diseases, preventive medicine, and emergency medicine. This approach improved the ability to diagnose and treat early with supportive, topical, and systemic treatment. In our center most of the cases were self-limiting, and none were life-threatening. An interdisciplinary response to a public health alert enhances the management of complex patients and should be implemented in successive outbreaks of mpox.
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Affiliation(s)
| | | | | | | | | | - Pablo De la Cueva
- Dermatology Service, Infanta Leonor Hospital, Madrid, Spain
- Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
| | - Tamar Talaván
- Local Laboratory, Infanta Leonor Hospital, Madrid, Spain
| | - Eva Jiménez
- Preventive Medicine Service, Infanta Leonor Hospital, Madrid, Spain
| | - Juan Torres
- Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
- Internal Medicine Service, Infanta Leonor Hospital, Madrid, Spain
| | - Jorge Valencia
- Infectious Diseases Unit, Internal Medicine Service, Infanta Leonor Hospital, Madrid, Spain
| | - Guillermo Cuevas
- Internal Medicine Service, Infanta Leonor Hospital, Madrid, Spain
- Infectious Diseases Unit, Internal Medicine Service, Infanta Leonor Hospital, Madrid, Spain
| | - Carlos Bibiano
- Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
- Emergency Service, Infanta Leonor Hospital, Madrid, Spain
| | - Pablo Ryan
- Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
- Internal Medicine Service, Infanta Leonor Hospital, Madrid, Spain
- Infectious Diseases Unit, Internal Medicine Service, Infanta Leonor Hospital, Madrid, Spain
- Biomedical Network Research Centre on Infectious Diseases (CIBERINFECT), Madrid, Spain
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13
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Amzat J, Kanmodi KK, Aminu K, Egbedina EA. School-based interventions on Mpox: A scoping review. Health Sci Rep 2023; 6:e1334. [PMID: 37313531 PMCID: PMC10259520 DOI: 10.1002/hsr2.1334] [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: 03/30/2023] [Revised: 05/23/2023] [Accepted: 06/01/2023] [Indexed: 06/15/2023] Open
Abstract
Background and Aims The 2022 multicountry mpox outbreak necessitated the declaration of mpox as a public health emergency. This is the first time a wide mpox spread and human-to-human transmission are recorded in several countries outside West and Central Africa. The outbreak reveals a strong need for wider intervention to increase awareness and control measures on mpox, especially in schools. This scoping review aims to summarize the existing evidence concerning school-based interventions on mpox globally. Methods The review methodology was based on the Arksey and O'Malley guidelines and it was reported in strict adherence with the PRISMA-ScR checklist. Ten databases were searched to retrieve literature relevant to the review topic. Thereafter, the retrieved literature were deduplicated and screened for inclusion into the review based on a set of eligibility criteria. Only one journal paper, a short communication on the national monkeypox outbreak in England, satisfied the selection criteria and was included in the review. Data extracted from the included paper were collated, summarized, and presented. Results The paper described how suspected cases of mpox infection were managed in some school settings through vaccination and self-isolation approaches and revealed a low (11%) mpox vaccination uptake rate in school-setting. The preventive methods adopted, such as the exclusion of exposed persons from school (in three school settings) and separation of those exposed those who were not in contact with the affected persons (one school setting), played a major role in the low transmission rate reported. This review also found a huge dearth of literature on school-based interventions on mpox despite its global spread. Conclusion With the call for a multisectoral approach in the fight against mpox, it pays to leverage on the potential of school settings in public health actions against mpox.
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Affiliation(s)
- Jimoh Amzat
- Department of SociologyUsmanu Danfodiyo UniversitySokotoNigeria
- Department of SociologyUniversity of JohannesburgJohannesburgSouth Africa
| | - Kehinde K. Kanmodi
- Faculty of DentistryUniversity of PuthisastraPhnom PenhCambodia
- Cephas Health Research Initiative IncIbadanNigeria
- School of Health and Life SciencesTeesside UniversityMiddlesbroughUK
| | - Kafayat Aminu
- Centre for Child and Adolescent Mental Health, University College HospitalIbadanNigeria
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14
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Spirito F, Guida A, Caponio VCA, Lo Muzio L. Monkeypox: A New Challenge for Global Health System? Life (Basel) 2023; 13:1250. [PMID: 37374034 DOI: 10.3390/life13061250] [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: 04/14/2023] [Revised: 05/16/2023] [Accepted: 05/23/2023] [Indexed: 06/29/2023] Open
Abstract
The COVID-19 pandemic, starting in 2020, has presented a major challenge in terms of early diagnosis and the subsequent containment and management of severe cases. The spread of viruses such as monkeypox in non-endemic countries is now creating new difficulties for healthcare professionals. Proper case definition and clinical examination are crucial for the early identification of suspected cases. For this reason, we performed a review of the literature in order to report the first signs, which are useful for healthcare providers for early case identification. Since 2022 to date, 86,930 laboratory-confirmed cases and 1051 probable cases have been reported worldwide, and of these, 116 were fatal cases and, for the first time, most of the cases were registered in countries that have not historically reported monkeypox and that lack direct or immediate epidemiological links to areas of West or Central Africa where the disease is endemic. Patients with Monkeypox experience prodromal symptoms, such as fever, fatigue, headache, muscle aches, and a rash after an incubation period of 5-21 days. The disease is usually self-limiting within 2-4 weeks but can lead to complications, such as pneumonia, encephalitis, kidney injury, and myocarditis in children, pregnant individuals, and those with weakened immune systems. The case-fatality ratio is between 1 and 10%. Today, prevention campaigns and the control of human monkeypox are the best weapons to prevent infection and stop transmission. Prevention strategies, such as avoiding contact with sick or dead animals, and the proper preparation of all foods containing animal meat or parts, should be adopted. Furthermore, close contact with infected people or contaminated materials should be avoided to prevent human-to-human transmission.
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Affiliation(s)
- Francesca Spirito
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli, 71122 Foggia, Italy
| | - Agostino Guida
- U.O.C. Odontostomatologia, A.O.R.N. "A. Cardarelli", 80131 Naples, Italy
| | - Vito Carlo Alberto Caponio
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli, 71122 Foggia, Italy
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli, 71122 Foggia, Italy
- Consorzio Interuniversitario Nazionale per la Bio-Oncologia, 66100 Chieti, Italy
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15
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Araoz-Salinas JM, Ortiz-Saavedra B, Ponce-Rosas L, Soriano-Moreno DR, Soriano-Moreno AN, Alave J, Gonzales-Zamora JA. Perceptions and Intention to Get Vaccinated against Mpox among the LGBTIQ+ Community during the 2022 Outbreak: A Cross-Sectional Study in Peru. Vaccines (Basel) 2023; 11:vaccines11051008. [PMID: 37243112 DOI: 10.3390/vaccines11051008] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 04/27/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
Vaccination against mpox can control the outbreak by targeting high-risk groups such as the LGBTIQ+ community. The aim of the study was to evaluate the perceptions and intentions to get vaccinated against mpox among the LGBTIQ+ community in Peru. We conducted a cross-sectional study from 1 November 2022 to 17 January 2023 in Peru. We included individuals over 18 years old, belonging to the LGBTIQ+ community, and residing in the departments of Lima and Callao. To evaluate the factors associated with the intention to be vaccinated, we used Poisson regression with robust variance to create a multivariate model. The study comprised 373 individuals who self-identified as members of the LGBTIQ+ community. The participants had a mean age of 31 years (SD ± 9), with 85.0% males and 75.3% reporting to be homosexual men. The majority (88.5%) expressed their intention to receive the vaccine against mpox. Believing that the vaccine is safe was associated with a higher intention to be vaccinated (aPR: 1.24; 95% CI: 1.02 to 1.50; p = 0.028). Our study population showed a high level of mpox vaccination intent. Educational campaigns reinforcing the concept of vaccine safety should be conducted to increase the intention and possibly the vaccination rate in the LGBTIQ+ community.
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Affiliation(s)
| | | | - Linda Ponce-Rosas
- Department of Medicine, Hamilton Medical Center, Dalton, GA 30720, USA
| | - David R Soriano-Moreno
- Unidad de Investigación Clínica y Epidemiológica, Escuela de Medicina, Universidad Peruana Unión, Lima 15464, Peru
| | - Anderson N Soriano-Moreno
- Unidad de Investigación Clínica y Epidemiológica, Escuela de Medicina, Universidad Peruana Unión, Lima 15464, Peru
| | - Jorge Alave
- Departamento de Medicina, Facultad de Medicina, Universidad Peruana Unión, Lima 15464, Peru
- Clinica Good Hope, Lima 15074, Peru
| | - Jose A Gonzales-Zamora
- Peruvian American Medical Society, Albuquerque, NM 87111, USA
- Division of Infectious Diseases, Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
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16
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Shamim MA, Satapathy P, Padhi BK, Veeramachaneni SD, Akhtar N, Pradhan A, Agrawal A, Dwivedi P, Mohanty A, Pradhan KB, Kabir R, Rabaan AA, Alotaibi J, Al Ismail ZA, Alsoliabi ZA, Al Fraij A, Sah R, Rodriguez-Morales AJ. Pharmacological treatment and vaccines in monkeypox virus: a narrative review and bibliometric analysis. Front Pharmacol 2023; 14:1149909. [PMID: 37214444 PMCID: PMC10196034 DOI: 10.3389/fphar.2023.1149909] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 04/25/2023] [Indexed: 05/24/2023] Open
Abstract
Mpox (earlier known as monkeypox) virus infection is a recognized public health emergency. There has been little research on the treatment options. This article reviews the specific drugs used to treat mpox virus infection and the vaccines used here. Instead of focusing on the mechanistic basis, this review narrates the practical, real-life experiences of individual patients of mpox virus disease being administered these medicines. We conducted a bibliometric analysis on the treatment of the mpox virus using data from several databases like PubMed, Scopus, and Embase. The research on this topic has grown tremendously recently but it is highly concentrated in a few countries. Cidofovir is the most studied drug. This is because it is indicated and also used off-label for several conditions. The drugs used for mpox virus infection include tecovirimat, cidofovir, brincidofovir, vaccinia immune globulin, and trifluridine. Tecovirimat is used most frequently. It is a promising option in progressive mpox disease in terms of both efficacy and safety. Brincidofovir has been associated with treatment discontinuation due to elevated hepatic enzymes. Cidofovir is also not the preferred drug, often used because of the unavailability of tecovirimat. Trifluridine is used topically as an add-on agent along with tecovirimat for ocular manifestations of mpox virus disease. No study reports individual patient data for vaccinia immune globulin. Though no vaccine is currently approved for mpox virus infection, ACAM 2000 and JYNNEOS are the vaccines being mainly considered. ACAM 2000 is capable of replicating and may cause severe adverse reactions. It is used when JYNNEOS is contraindicated. Several drugs and vaccines are under development and have been discussed alongside pragmatic aspects of mpox virus treatment and prevention. Further studies can provide more insight into the safety and efficacy of Tecovirimat in actively progressing mpox virus disease.
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Affiliation(s)
| | - Prakisini Satapathy
- Department of Virology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Bijaya Kumar Padhi
- Department of Community Medicine, School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Naushaba Akhtar
- Indian Council of Medical Research—Regional Medical Research Centre, Bhubaneswar, India
| | - Anindita Pradhan
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, India
| | - Abhimanyu Agrawal
- Department of Pharmacology, All India Institute of Medical Sciences, Bathinda, India
| | - Pradeep Dwivedi
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, India
- Centre of Excellence for Tribal Health, All India Institute of Medical Sciences, Jodhpur, India
| | - Aroop Mohanty
- All India Institute of Medical Sciences, Gorakhpur, India
| | | | - Russell Kabir
- School of Allied Health, Anglia Ruskin University, Essex, United Kingdom
| | - Ali A. Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| | - Jawaher Alotaibi
- Infectious Diseases Unit, King Faisal Specialist Hospital and Research Center, Department of Medicine, Riyadh, Saudi Arabia
| | - Zainab A. Al Ismail
- Long Term Care Department, Dhahran Long Term Hospital, Dhahran, Saudi Arabia
| | | | - Ali Al Fraij
- Medical Laboratories and Blood Bank Department, Jubail Health Network, Jubail, Saudi Arabia
| | - Ranjit Sah
- Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
- Harvard Medical School, Boston, MA, United States
- Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - Alfonso J. Rodriguez-Morales
- Faculty of Health Sciences, Universidad Científica del Sur, Lima, Peru
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon
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17
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Barboza JJ, León-Figueroa DA, Saldaña-Cumpa HM, Valladares-Garrido MJ, Moreno-Ramos E, Sah R, Bonilla-Aldana DK, Rodriguez-Morales AJ. Virus Identification for Monkeypox in Human Seminal Fluid Samples: A Systematic Review. Trop Med Infect Dis 2023; 8:tropicalmed8030173. [PMID: 36977174 PMCID: PMC10057446 DOI: 10.3390/tropicalmed8030173] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/09/2023] [Accepted: 02/14/2023] [Indexed: 03/17/2023] Open
Abstract
Public health officials around the world are extremely concerned about the global outbreak of monkeypox (MPX), which has been claimed to have originated in Africa. As a result, studies into the origins and reasons behind the outbreak’s rapid spread have been sped up. The goal of the current investigation is to determine whether the monkeypox virus (MPXV) is present in seminal fluid samples from MPX cases that have been verified. Up until 6 January 2023, PubMed, Scopus, Web of Science, Embase, and ScienceDirect databases were used to conduct a thorough evaluation of the literature. The search technique returned a total of 308 items. Fourteen studies reporting the presence of MPXV in the seminal fluid of MPX-confirmed cases were included after the duplicates (n = 158) and searches by title, abstract, and full text were eliminated. In 84 out of the 643 confirmed MPX cases (13.06% or n = 643), MPXV was discovered in seminal fluid. Reverse transcriptase polymerase chain reaction (RT-PCR) was used to identify MPXV, and samples taken from skin lesions (96.27%), pharynx or oropharynx (30.48%), and blood all had higher positivity rates than other samples (12.44%). Additionally, 99.85% of respondents were male with a mean age of 36, 98.45% engaged in MSM (men who have sex with men) sexual conduct, and human immunodeficiency virus (HIV) accounted for 56.9% of all STD cases. This study offers proof that MPXV can be found in the seminal fluid of MPX sufferers. Our data imply that MPXV transmission is a possibility in these samples and that MSM are more vulnerable to it. The creation of hygienic standards is essential for the early identification of MPX cases.
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Affiliation(s)
- Joshuan J. Barboza
- Escuela de Medicina, Universidad Cesar Vallejo, Trujillo 13007, Peru
- Correspondence: ; Tel.: +51-99-2108-520
| | - Darwin A. León-Figueroa
- Facultad de Medicina Humana, Universidad de San Martín de Porres, Chiclayo 15011, Peru
- Centro de Investigación en Atención Primaria en Salud, Universidad Peruana Cayetano Heredia, Lima 15102, Peru
| | - Hortencia M. Saldaña-Cumpa
- Facultad de Medicina Humana, Universidad de San Martín de Porres, Chiclayo 15011, Peru
- Centro de Investigación en Atención Primaria en Salud, Universidad Peruana Cayetano Heredia, Lima 15102, Peru
| | - Mario J. Valladares-Garrido
- South American Center for Education and Research in Public Health, Universidad Norbert Wiener, Lima 15108, Peru
- Oficina de Epidemiología, Hospital Regional Lambayeque, Chiclayo 14012, Peru
| | - Emilly Moreno-Ramos
- División de Revisiones Sistemáticas y Meta-Análisis, Tau-Relaped Group, Trujillo 13007, Peru
| | - Ranjit Sah
- Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu 44600, Nepal
- Department of Public Health Dentistry, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune 411018, Maharashtra, India
| | | | - Alfonso J. Rodriguez-Morales
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas-Institución Universitaria Visión de las Américas, Pereira 660003, Colombia
- Master of Clinical Epidemiology and Biostatistics, Universidad Cientifica del Sur, Lima 15067, Peru
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut 1102, Lebanon
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18
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Ortiz-Saavedra B, Montes-Madariaga ES, Cabanillas-Ramirez C, Alva N, Ricardo-Martínez A, León-Figueroa DA, Barboza JJ, Mohanty A, Padhi BK, Sah R. Epidemiologic Situation of HIV and Monkeypox Coinfection: A Systematic Review. Vaccines (Basel) 2023; 11:246. [PMID: 36851124 PMCID: PMC9965118 DOI: 10.3390/vaccines11020246] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/13/2023] [Accepted: 01/19/2023] [Indexed: 01/26/2023] Open
Abstract
The most recent monkeypox (Mpox) outbreak is mostly affecting men who have sex with men (MSM) who participate in high-risk sexual behaviors, which is typically the case among human immunodeficiency virus (HIV) carriers, according to clinical and epidemiological statistics. The objective of this research is to determine the epidemiological situation of HIV and smallpox co-infection. Until 1 October 2022, a thorough evaluation of the literature was conducted utilizing the databases PubMed, Embase, Scopus, and Web of Science. Studies were evaluated based on the criteria for selection. Fifty-three studies met the selection criteria. A total of 6345 confirmed cases of monkeypox were recorded, and 40.32% (n = 2558) of these cases also had HIV co-infection. In addition, 51.36% (n = 3259) of the men (91.44%; n = 5802), whose ages ranged from 18 to 71 years, exhibited MSM-specific sexual behaviors. Co-infection with these two viruses can be especially dangerous because it can exacerbate the symptoms of both diseases and make them more difficult to treat. People with HIV are more vulnerable to certain infections, including monkeypox, because their immune systems are weakened. Therefore, it is important that they take measures to prevent infection, such as avoiding contact with infected animals, risky behaviors, and maintaining good hygiene.
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Affiliation(s)
- Brando Ortiz-Saavedra
- Universidad Nacional de San Agustín de Arequipa, Arequipa 04000, Peru
- Unidad de Revisiones Sistemáticas y Meta-Análisis, Tau-Relaped Group, Trujillo 13001, Peru
| | - Elizbet S. Montes-Madariaga
- Universidad Nacional de San Agustín de Arequipa, Arequipa 04000, Peru
- Unidad de Revisiones Sistemáticas y Meta-Análisis, Tau-Relaped Group, Trujillo 13001, Peru
| | | | - Niza Alva
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima 15023, Peru
| | | | - Darwin A. León-Figueroa
- Unidad de Revisiones Sistemáticas y Meta-Análisis, Tau-Relaped Group, Trujillo 13001, Peru
- Facultad de Medicina Humana, Universidad de San Martín de Porres, Chiclayo 14012, Peru
| | - Joshuan J. Barboza
- Vicerrectorado de Investigación, Universidad Norbert Wiener, Lima 15046, Peru
| | - Aroop Mohanty
- Department of Microbiology, All India Institute of Medical Sciences, Gorakhpur 273001, India
| | - Bijaya Kumar Padhi
- Department of Community Medicine, School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Ranjit Sah
- Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu 44600, Nepal
- Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune 411018, India
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19
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Ophthalmic Features and Implications of Poxviruses: Lessons from Clinical and Basic Research. Microorganisms 2022; 10:microorganisms10122487. [PMID: 36557740 PMCID: PMC9781001 DOI: 10.3390/microorganisms10122487] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 12/10/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
Amidst the ongoing monkeypox outbreak, global awareness has been directed towards the prevention of viral transmission and case management, with the World Health Organization declaring the outbreak a public health emergency of international concern. Monkeypox virus is one of several species in the Orthopoxvirus genus, with other species of the genus including the variola, cowpox, mousepox, camelpox, raccoonpox, skunkpox, and volepox viruses. Although the nomenclature of these species is based on the animal host from which they were originally isolated, transmission from animals to humans has been reported with several species. The progression of disease, following an incubation period, typically consists of a prodromal phase with systemic flu-like symptoms. Various organ systems may be affected in addition to the formation of pathognomonic skin lesions. As monkeypox poses a continued public health concern, the ophthalmic sequelae of monkeypox virus, especially those leading to vision loss, warrant consideration as well. This review provides a comprehensive summary of the ophthalmic implications of poxviruses in clinical and laboratory settings reported in the literature, as well as areas of unmet need and future research.
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20
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Pharmacological Agents with Antiviral Activity against Monkeypox Infection. Int J Mol Sci 2022; 23:ijms232415941. [PMID: 36555584 PMCID: PMC9784635 DOI: 10.3390/ijms232415941] [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: 11/21/2022] [Revised: 12/06/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022] Open
Abstract
Monkeypox infection is caused by a virus of the genus Orthopoxvirus, a member of the Poxviridae family. Monkeypox virus is transmitted from individual to individual through contact with lesions, body fluids, and respiratory droplets. The infection caused by monkeypox is usually a self-limited disease with mild symptoms lasting 2 to 4 weeks. Monkeypox typically presents with fever, rash, and enlarged lymph nodes. New vaccines have recently been authorized for the prevention of monkeypox infection, whereas there are no specific pharmacological antiviral treatments for monkeypox infection. However, because the viruses which cause adult smallpox and monkeypox are similar, antiviral drugs developed in the past have also shown efficacy against monkeypox. In this review, we highlight the in vitro and clinical evidence found in the literature on the efficacy and safety of pharmacological agents with antiviral activity against monkeypox infection and the different regulatory aspects of countries.
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