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Yang X, Yang X, Jiang W, Luo N, Hu Y, Yang Y, Yang X, Hou L, Zhang J, Hu C, Lin J. A cross-sectional investigation of factors influencing mpox vaccine hesitancy for students in Southwest China. Hum Vaccin Immunother 2024; 20:2309704. [PMID: 38300140 PMCID: PMC10841021 DOI: 10.1080/21645515.2024.2309704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/21/2024] [Indexed: 02/02/2024] Open
Abstract
From July to September 2023, China reported over 1, 400 confirmed cases of mpox transmitted mainly through sexual contact between males. Meanwhile, the percentage of men who have sex with men at universities in southwestern China is increasing every year, which is likely to lead to a potential spread of mpox on campuses. Vaccination is an effective preventive measure against infectious diseases, this study examined the willingness of university students in Southwest China to receive the mpox vaccine and analyzed the factors influencing their decision. A cross-sectional survey was conducted among 7311 university students from 10 universities in Southwest China between August 13 and September 1, 2023. The survey revealed a hesitancy rate of 56.13% toward the mpox vaccine, with the most common reason being concerns about vaccine safety (1407/4104, 34.29%). Univariate analysis identified 13 variables that significantly differed between the vaccine acceptance and vaccine hesitancy groups. Multivariate logistic regression analyses indicated protective factors for vaccine hesitancy, such as sexually transmitted diseases, previous knowledge about mpox, frequent information about mpox, people can get reinfection of mpox, and worries about mpox endemic in China. Additionally, the confidence and convenience dimensions in the 3Cs model were identified as risk factors for mpox vaccine hesitancy. This study found a high rate of vaccine hesitancy among university students in Southwest China regarding the mpox vaccine. Collaboration between university and healthcare departments is recommended to address mpox vaccine hesitancy among college students, thereby promoting their willingness to receive the mpox vaccine.
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Affiliation(s)
- Xiu Yang
- Wound Healing Basic Research and Clinical Application Key Laboratory of LuZhou, School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Xuetao Yang
- Wound Healing Basic Research and Clinical Application Key Laboratory of LuZhou, School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Wenyi Jiang
- Wound Healing Basic Research and Clinical Application Key Laboratory of LuZhou, School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Na Luo
- Department of Operation Room, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Yibo Hu
- Department of Stomatology, School of Medicine, Nankai University, Tianjin, China
| | - Ya Yang
- Wound Healing Basic Research and Clinical Application Key Laboratory of LuZhou, School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Xidan Yang
- Wound Healing Basic Research and Clinical Application Key Laboratory of LuZhou, School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Lingli Hou
- Wound Healing Basic Research and Clinical Application Key Laboratory of LuZhou, School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Jingjing Zhang
- Wound Healing Basic Research and Clinical Application Key Laboratory of LuZhou, School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Congxia Hu
- Wound Healing Basic Research and Clinical Application Key Laboratory of LuZhou, School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
| | - Jihui Lin
- Wound Healing Basic Research and Clinical Application Key Laboratory of LuZhou, School of Nursing, Southwest Medical University, Luzhou, Sichuan, China
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Ogaz D, Enayat Q, Brown JRG, Phillips D, Wilkie R, Jayes D, Reid D, Hughes G, Mercer CH, Saunders J, Mohammed H. Mpox Diagnosis, Behavioral Risk Modification, and Vaccination Uptake among Gay, Bisexual, and Other Men Who Have Sex with Men, United Kingdom, 2022. Emerg Infect Dis 2024; 30:916-925. [PMID: 38573160 PMCID: PMC11060451 DOI: 10.3201/eid3005.230676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
During the 2022 multicountry mpox outbreak, the United Kingdom identified cases beginning in May. UK cases increased in June, peaked in July, then rapidly declined after September 2022. Public health responses included community-supported messaging and targeted mpox vaccination among eligible gay, bisexual, and other men who have sex with men (GBMSM). Using data from an online survey of GBMSM during November-December 2022, we examined self-reported mpox diagnoses, behavioral risk modification, and mpox vaccination offer and uptake. Among 1,333 participants, only 35 (2.6%) ever tested mpox-positive, but 707 (53%) reported behavior modification to avoid mpox. Among vaccine-eligible GBMSM, uptake was 69% (95% CI 65%-72%; 601/875) and was 92% (95% CI 89%-94%; 601/655) among those offered vaccine. GBMSM self-identifying as bisexual, reporting lower educational qualifications, or identifying as unemployed were less likely to be vaccinated. Equitable offer and provision of mpox vaccine are needed to minimize the risk for future outbreaks and mpox-related health inequalities.
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Monzón S, Varona S, Negredo A, Vidal-Freire S, Patiño-Galindo JA, Ferressini-Gerpe N, Zaballos A, Orviz E, Ayerdi O, Muñoz-Gómez A, Delgado-Iribarren A, Estrada V, García C, Molero F, Sánchez-Mora P, Torres M, Vázquez A, Galán JC, Torres I, Causse Del Río M, Merino-Diaz L, López M, Galar A, Cardeñoso L, Gutiérrez A, Loras C, Escribano I, Alvarez-Argüelles ME, Del Río L, Simón M, Meléndez MA, Camacho J, Herrero L, Jiménez P, Navarro-Rico ML, Jado I, Giannetti E, Kuhn JH, Sanchez-Lockhart M, Di Paola N, Kugelman JR, Guerra S, García-Sastre A, Cuesta I, Sánchez-Seco MP, Palacios G. Monkeypox virus genomic accordion strategies. Nat Commun 2024; 15:3059. [PMID: 38637500 PMCID: PMC11026394 DOI: 10.1038/s41467-024-46949-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 03/14/2024] [Indexed: 04/20/2024] Open
Abstract
The 2023 monkeypox (mpox) epidemic was caused by a subclade IIb descendant of a monkeypox virus (MPXV) lineage traced back to Nigeria in 1971. Person-to-person transmission appears higher than for clade I or subclade IIa MPXV, possibly caused by genomic changes in subclade IIb MPXV. Key genomic changes could occur in the genome's low-complexity regions (LCRs), which are challenging to sequence and are often dismissed as uninformative. Here, using a combination of highly sensitive techniques, we determine a high-quality MPXV genome sequence of a representative of the current epidemic with LCRs resolved at unprecedented accuracy. This reveals significant variation in short tandem repeats within LCRs. We demonstrate that LCR entropy in the MPXV genome is significantly higher than that of single-nucleotide polymorphisms (SNPs) and that LCRs are not randomly distributed. In silico analyses indicate that expression, translation, stability, or function of MPXV orthologous poxvirus genes (OPGs), including OPG153, OPG204, and OPG208, could be affected in a manner consistent with the established "genomic accordion" evolutionary strategies of orthopoxviruses. We posit that genomic studies focusing on phenotypic MPXV differences should consider LCR variability.
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Affiliation(s)
- Sara Monzón
- Unidad de Bioinformática, Unidades Centrales Científico Técnicas, Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Sarai Varona
- Unidad de Bioinformática, Unidades Centrales Científico Técnicas, Instituto de Salud Carlos III, 28029, Madrid, Spain
- Escuela Internacional de Doctorado de la UNED (EIDUNED), Universidad Nacional de Educación a Distancia (UNED), 2832, Madrid, Spain
| | - Anabel Negredo
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Santiago Vidal-Freire
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | | | | | - Angel Zaballos
- Unidad de Genómica, Unidades Centrales Científico Técnicas, Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Eva Orviz
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, 28040, Madrid, Spain
| | - Oskar Ayerdi
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, 28040, Madrid, Spain
| | - Ana Muñoz-Gómez
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, 28040, Madrid, Spain
| | | | - Vicente Estrada
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, 28040, Madrid, Spain
| | - Cristina García
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Francisca Molero
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Patricia Sánchez-Mora
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Montserrat Torres
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Ana Vázquez
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029, Madrid, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Juan-Carlos Galán
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034, Madrid, Spain
| | - Ignacio Torres
- Servicio de Microbiología, Hospital Clínico Universitario, Instituto de Investigación INCLIVA, 46010, Valencia, Spain
| | - Manuel Causse Del Río
- Unidad de Microbiología, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba, 14004, Córdoba, Spain
| | - Laura Merino-Diaz
- Unidad Clínico de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen del Rocío, 41013, Sevilla, Spain
| | - Marcos López
- Servicio de Microbiología y Parasitología, Hospital Universitario Puerta de Hierro Majadahonda, 28222, Madrid, Spain
| | - Alicia Galar
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, 28007, Madrid, Spain
| | - Laura Cardeñoso
- Servicio de Microbiología, Instituto de Investigación Sanitaria, Hospital Universitario de la Princesa, 28006, Madrid, Spain
| | - Almudena Gutiérrez
- Servicio de Microbiología y Parasitología Clínica, Hospital Universitario La Paz, 28046, Madrid, Spain
| | - Cristina Loras
- Servicio de Microbiología, Hospital General y Universitario, 13005, Ciudad Real, Spain
| | - Isabel Escribano
- Servicio de Microbiología, Hospital General Universitario Dr. Balmis, 03010, Alicante, Spain
| | | | | | - María Simón
- Servicio de Microbiología, Hospital Central de la Defensa "Gómez Ulla", 28947, Madrid, Spain
| | - María Angeles Meléndez
- Servicio de Microbiología y Parasitología, Hospital Universitario 12 de Octubre, 28041, Madrid, Spain
| | - Juan Camacho
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Laura Herrero
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Pilar Jiménez
- Unidad de Genómica, Unidades Centrales Científico Técnicas, Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - María Luisa Navarro-Rico
- Unidad de Genómica, Unidades Centrales Científico Técnicas, Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Isabel Jado
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Elaina Giannetti
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Jens H Kuhn
- Integrated Research Facility at Fort Detrick, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Frederick, MD, 21702, USA
| | - Mariano Sanchez-Lockhart
- United States Army Research Institute for Infectious Disease, Fort Detrick, Frederick, MD, 21702, USA
| | - Nicholas Di Paola
- United States Army Research Institute for Infectious Disease, Fort Detrick, Frederick, MD, 21702, USA
| | - Jeffrey R Kugelman
- United States Army Research Institute for Infectious Disease, Fort Detrick, Frederick, MD, 21702, USA
| | - Susana Guerra
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Global Health Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Departmento de Medicina Preventiva, Salud Publica y Microbiología, Universidad Autónoma de Madrid, 28029, Madrid, Spain
| | - Adolfo García-Sastre
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Global Health Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Department of Medicine, Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Isabel Cuesta
- Unidad de Bioinformática, Unidades Centrales Científico Técnicas, Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Maripaz P Sánchez-Seco
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Gustavo Palacios
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.
- Global Health Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.
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Rainey JJ, Lin XM, Murphy S, Velazquez-Kronen R, Do T, Hughes C, Harris AM, Maitland A, Gundlapalli AV. Deployment of the National Notifiable Diseases Surveillance System during the 2022-23 mpox outbreak in the United States-Opportunities and challenges with case notifications during public health emergencies. PLoS One 2024; 19:e0300175. [PMID: 38603766 PMCID: PMC11008850 DOI: 10.1371/journal.pone.0300175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 02/23/2024] [Indexed: 04/13/2024] Open
Abstract
Timely case notifications following the introduction of an uncommon pathogen, such as mpox, are critical for understanding disease transmission and for developing and implementing effective mitigation strategies. When Massachusetts public health officials notified the Centers for Disease Control and Prevention (CDC) about a confirmed orthopoxvirus case on May 17, 2023, which was later confirmed as mpox at CDC, mpox was not a nationally notifiable disease. Because existing processes for new data collections through the National Notifiable Disease Surveillance System were not well suited for implementation during emergency responses at the time of the mpox outbreak, several interim notification approaches were established to capture case data. These interim approaches were successful in generating daily case counts, monitoring disease transmission, and identifying high-risk populations. However, the approaches also required several data collection approvals by the federal government and the Council for State and Territorial Epidemiologists, the use of four different case report forms, and the establishment of complex data management and validation processes involving data element mapping and record-level de-duplication steps. We summarize lessons learned from these interim approaches to inform and improve case notifications during future outbreaks. These lessons reinforce CDC's Data Modernization Initiative to work in close collaboration with state, territorial, and local public health departments to strengthen case-based surveillance prior to the next public health emergency.
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Affiliation(s)
- Jeanette J. Rainey
- Division of Global Health Security, Global Health Center, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Xia Michelle Lin
- Detect and Monitor Division, Office of Public Health Data, Surveillance, and Technology, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Sylvia Murphy
- Detect and Monitor Division, Office of Public Health Data, Surveillance, and Technology, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Raquel Velazquez-Kronen
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH, United States of America
| | - Tuyen Do
- Office of the Director, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Christine Hughes
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Aaron M. Harris
- Detect and Monitor Division, Office of Public Health Data, Surveillance, and Technology, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Aaron Maitland
- Division of Health Interview Statistics, National Center of Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, United States of America
| | - Adi V. Gundlapalli
- Office of the Director, Office of Public Health Data, Surveillance, and Technology, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
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Cadmus S, Akinseye V, Besong M, Olanipekun T, Fadele J, Cadmus E, Ansumana R, Oluwayelu D, Odemuyiwa SO, Tomori O. Dynamics of Mpox infection in Nigeria: a systematic review and meta-analysis. Sci Rep 2024; 14:7368. [PMID: 38548826 PMCID: PMC10978922 DOI: 10.1038/s41598-024-58147-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 03/26/2024] [Indexed: 04/01/2024] Open
Abstract
The seasonal outbreaks of Mpox continue in most parts of West and Central Africa. In the past year, Nigeria had the highest number of reported cases. Here, we used the PRISMA guidelines to carry out a systematic review and meta-analysis of available evidence on Mpox in Nigeria to assess the prevalence, transmission pattern, diagnostic approach, and other associated factors useful for mitigating the transmission of the disease. All relevant observational studies in PubMed/MEDLINE, Embase, AJOL, Web of Science, Scopus and Google Scholar on Mpox in Nigeria were assessed within the last fifty years (1972 to 2022). In all, 92 relevant articles were retrieved, out of which 23 were included in the final qualitative analysis. Notably, most of the cases of Mpox in Nigeria were from the southern part of the country. Our findings showed a progressive spread from the southern to the northern region of the country. We identified the following factors as important in the transmission of Mpox in Nigeria; poverty, lack of basic healthcare facilities, and risk of exposure through unsafe sexual practices. Our findings reiterate the need to strengthen and expand existing efforts as well as establish robust multi-sectoral collaboration to understand the dynamics of Mpox Nigeria.
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Affiliation(s)
- Simeon Cadmus
- Department of Veterinary Public Health and Preventive Medicine, University of Ibadan, Ibadan, Nigeria.
- Damien Foundation Genomics and Mycobacteria Research and Training Centre, University of Ibadan, Ibadan, Nigeria.
- Centre for Control and Prevention of Zoonoses, University of Ibadan, Ibadan, Nigeria.
- Nigeria Institute of Medical Research, Yaba, Lagos, Nigeria.
| | - Victor Akinseye
- Damien Foundation Genomics and Mycobacteria Research and Training Centre, University of Ibadan, Ibadan, Nigeria
- Department of Chemical Sciences, Augustine University, Ilara-Epe, Lagos, Nigeria
| | - Matthias Besong
- Damien Foundation Genomics and Mycobacteria Research and Training Centre, University of Ibadan, Ibadan, Nigeria
- Federal Ministry of Agriculture and Food Security, Abuja, Nigeria
| | - Tobi Olanipekun
- Damien Foundation Genomics and Mycobacteria Research and Training Centre, University of Ibadan, Ibadan, Nigeria
| | - John Fadele
- Damien Foundation Genomics and Mycobacteria Research and Training Centre, University of Ibadan, Ibadan, Nigeria
| | - Eniola Cadmus
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Rashid Ansumana
- School of Community Health Sciences, Njala University, Bo, Sierra Leone
| | - Daniel Oluwayelu
- Centre for Control and Prevention of Zoonoses, University of Ibadan, Ibadan, Nigeria
- Department of Microbiology, University of Ibadan, Ibadan, Nigeria
| | - Solomon O Odemuyiwa
- Department of Veterinary Pathobiology, University of Missouri, Columbia, MO, USA
| | - Oyewale Tomori
- African Centre of Excellence for Genomics of Infectious Diseases, Redeemer's University, Ede, Osun State, Nigeria
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Jia Q, Xue L, Sui R, Huo J. Modelling the impact of human behavior using a two-layer Watts-Strogatz network for transmission and control of Mpox. BMC Infect Dis 2024; 24:351. [PMID: 38532346 DOI: 10.1186/s12879-024-09239-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 03/20/2024] [Indexed: 03/28/2024] Open
Abstract
PURPOSE This study aims to evaluate the effectiveness of mitigation strategies and analyze the impact of human behavior on the transmission of Mpox. The results can provide guidance to public health authorities on comprehensive prevention and control for the new Mpox virus strain in the Democratic Republic of Congo as of December 2023. METHODS We develop a two-layer Watts-Strogatz network model. The basic reproduction number is calculated using the next-generation matrix approach. Markov chain Monte Carlo (MCMC) optimization algorithm is used to fit Mpox cases in Canada into the network model. Numerical simulations are used to assess the impact of mitigation strategies and human behavior on the final epidemic size. RESULTS Our results show that the contact transmission rate of low-risk groups and susceptible humans increases when the contact transmission rate of high-risk groups and susceptible humans is controlled as the Mpox epidemic spreads. The contact transmission rate of high-risk groups after May 18, 2022, is approximately 20% lower than that before May 18, 2022. Our findings indicate a positive correlation between the basic reproduction number and the level of heterogeneity in human contacts, with the basic reproduction number estimated at 2.3475 (95% CI: 0.0749-6.9084). Reducing the average number of sexual contacts to two per week effectively reduces the reproduction number to below one. CONCLUSION We need to pay attention to the re-emergence of the epidemics caused by low-risk groups when an outbreak dominated by high-risk groups is under control. Numerical simulations show that reducing the average number of sexual contacts to two per week is effective in slowing down the rapid spread of the epidemic. Our findings offer guidance for the public health authorities of the Democratic Republic of Congo in developing effective mitigation strategies.
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Affiliation(s)
- Qiaojuan Jia
- College of Mathematical Sciences, Harbin Engineering University, 145 Nantong Street, Harbin, Heilongjiang, 150001, China
| | - Ling Xue
- College of Mathematical Sciences, Harbin Engineering University, 145 Nantong Street, Harbin, Heilongjiang, 150001, China.
| | - Ran Sui
- College of Mathematical Sciences, Harbin Engineering University, 145 Nantong Street, Harbin, Heilongjiang, 150001, China
| | - Junqi Huo
- College of Mathematical Sciences, Harbin Engineering University, 145 Nantong Street, Harbin, Heilongjiang, 150001, China
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7
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Brooks JT, Reynolds MG, Torrone E, McCollum A, Spicknall IH, Gigante CM, Li Y, Satheshkumar PS, Quilter LAS, Rao AK, O'Shea J, Guagliardo SAJ, Townsend M, Hutson CL. How the Orthodox Features of Orthopoxviruses Led to an Unorthodox Mpox Outbreak: What We've Learned, and What We Still Need to Understand. J Infect Dis 2024; 229:S121-S131. [PMID: 37861379 DOI: 10.1093/infdis/jiad465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/13/2023] [Accepted: 10/18/2023] [Indexed: 10/21/2023] Open
Abstract
Orthopoxviruses have repeatedly confounded expectations in terms of the clinical illness they cause and their patterns of spread. Monkeypox virus (MPXV), originally characterized in the late 1950s during outbreaks among captive primates, has been recognized since the 1970s to cause human disease (mpox) in West and Central Africa, where interhuman transmission has largely been associated with nonsexual, close physical contact. In May 2022, a focus of MPXV transmission was detected, spreading among international networks of gay, bisexual, and other men who have sex with men. The outbreak grew in both size and geographic scope, testing the strength of preparedness tools and public health science alike. In this article we consider what was known about mpox before the 2022 outbreak, what we learned about mpox during the outbreak, and what continued research is needed to ensure that the global public health community can detect, and halt further spread of this disease threat.
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Affiliation(s)
- John T Brooks
- Mpox Multinational Response, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mary G Reynolds
- Mpox Multinational Response, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Elizabeth Torrone
- Mpox Multinational Response, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Andrea McCollum
- Mpox Multinational Response, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ian H Spicknall
- Mpox Multinational Response, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Crystal M Gigante
- Mpox Multinational Response, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Yu Li
- Mpox Multinational Response, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Laura A S Quilter
- Mpox Multinational Response, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Agam K Rao
- Mpox Multinational Response, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jesse O'Shea
- Mpox Multinational Response, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sarah Anne J Guagliardo
- Mpox Multinational Response, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Michael Townsend
- Mpox Multinational Response, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Christina L Hutson
- Mpox Multinational Response, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Villa RD, Pentella MA, Benfer JL. A Laboratory-Developed Assay for Clade II Human Mpox Virus on the Panther Fusion Open Access System. J Infect Dis 2024; 229:S132-S136. [PMID: 37681583 DOI: 10.1093/infdis/jiad347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/10/2023] [Accepted: 08/11/2023] [Indexed: 09/09/2023] Open
Abstract
This paper describes the methods for developing and optimizing a laboratory-developed assay (LDA) for detecting clade II human mpox virus using the automated Panther Fusion platform and Open Access software. Various concentrations of reagents in a primer-probe mix were tested to optimize the LDA. The LDA was validated using 10 previously characterized positive and 10 negative human mpox samples, resulting in 95% accuracy and 100% precision. The LDA resulted in 100% specificity among previously tested HSV1-, HSV2-, and VZV-positive human samples. Several spiked media extensions were also validated and achieved 98% accuracy and 100% precision across all collection media types. The assay's limit of detection was calculated to be 1.475 copies/reaction, and the polymerase chain reaction efficiency resulted in 89.87% (slope, -3.5911; R2 = 0.9947). The methods described here can be applied to the rapid optimization and development of LDAs for many possible pathogens of public health importance.
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Fontán-Vela M, Hernando V, Olmedo C, Coma E, Martínez M, Moreno-Perez D, Lorusso N, Vázquez Torres M, Barbas del Buey JF, Roig-Sena J, Pastor E, Galmés Truyols A, Artigues Serra F, Sancho Martínez RM, Latasa Zamalloa P, Pérez Martínez O, Vázquez Estepa A, García Rojas AJ, Barreno Estévez AI, Sánchez-Migallón Naranjo A, Pérez Martín JJ, Peces Jiménez P, Morales Romero R, Castilla J, García Cenoz M, Huerta Huerta M, Boone ALD, Macías Ortiz MJ, Álvarez Río V, Rodríguez Recio MJ, Merino Díaz M, Berradre Sáenz B, Villegas-Moreno MT, Limia A, Diaz A, Monge S. Effectiveness of Modified Vaccinia Ankara-Bavaria Nordic Vaccination in a Population at High Risk of Mpox: A Spanish Cohort Study. Clin Infect Dis 2024; 78:476-483. [PMID: 37864849 PMCID: PMC10874271 DOI: 10.1093/cid/ciad645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 09/04/2023] [Accepted: 10/18/2023] [Indexed: 10/23/2023] Open
Abstract
BACKGROUND With more than 7500 cases reported since April 2022, Spain has experienced the highest incidence of mpox in Europe. From 12 July onward, the modified vaccinia Ankara-Bavaria Nordic (MVA-BN) smallpox vaccine was offered as pre-exposure prophylaxis for those receiving pre-exposure prophylaxis for human immunodeficiency virus (HIV-PrEP). Our aim was to assess the effectiveness of 1 dose of MVA-BN vaccine as pre-exposure prophylaxis against mpox virus (MPXV) infection in persons on HIV-PrEP. METHODS National retrospective cohort study between 12 July and 12 December 2022. Individuals aged ≥18 years receiving HIV-PrEP as of 12 July with no previous MPXV infection or vaccination were eligible. Each day, we matched individuals receiving a first dose of vaccine and unvaccinated controls of the same age and region. We used a Kaplan-Meier estimator, calculated risk ratios (RR) and vaccine effectiveness (VE = [1 - RR]x100). RESULTS We included 5660 matched pairs, with a median follow-up of 62 days (interquartile range, 24-97). Mpox cumulative incidence was 5.6 per 1000 (25 cases) in unvaccinated and 3.5 per 1000 (18 cases) in vaccinated. No effect was found during days 0-6 post-vaccination (VE, -38.3; 95% confidence interval [CI], -332.7 to 46.4), but VE was 65% at ≥7 days (95% CI, 22.9 to 88.0) and 79% at ≥14 days (95% CI, 33.3 to 100.0) post-vaccination. CONCLUSIONS One dose of MVA-BN vaccine offered protection against mpox in most-at-risk population shortly after the vaccination. Further studies need to assess the VE of a second dose and the duration of protection over time.
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Affiliation(s)
- Mario Fontán-Vela
- National Centre of Epidemiology, Institute of Health Carlos III, Community of Madrid, Spain
- Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares, Community of Madrid, Spain
| | - Victoria Hernando
- National Centre of Epidemiology, Institute of Health Carlos III, Community of Madrid, Spain
- CIBER on Infectious Diseases, Madrid, Spain
| | - Carmen Olmedo
- Vaccination Programme, General Directorate of Public Health, Ministry of Health, Madrid, Spain
| | - Ermengol Coma
- Primary Healthcare Information Systems, Health Institute of Catalonia, Catalonia, Spain
| | - Montse Martínez
- Preventive Medicine Service, General Sub-directorate for Health Promotion, Health Department, Secretariat of Public Health,Catalonia, Spain
| | - David Moreno-Perez
- Health and Consumption Department, General Directorate of Public Health and Pharmaceutical Management, Andalusia, Spain
| | - Nicola Lorusso
- Health and Consumption Department, General Directorate of Public Health and Pharmaceutical Management, Andalusia, Spain
| | - María Vázquez Torres
- Healthcare Department, General Sub-directorate of Health Prevention and Promotion, General Directorate of Public Health, Community of Madrid, Spain
| | - José Francisco Barbas del Buey
- General Sub-directorate of Public Health Surveillance, General Directorate of Public Health, Madrid, Community of Madrid, Spain
| | - Javier Roig-Sena
- Department of Universal Healthcare and Public Health, Epidemiological Surveillance Service, Valencian Community, Spain
| | - Eliseo Pastor
- Universal Healthcare and Public Health Department, Health Promotion and Prevention Programs Service, Valencian Community, Spain
| | - Antònia Galmés Truyols
- Disease Prevention Service, Health and Consumption Department, General Directorate of Public Health and Participation, Balearic Islands, Spain
| | - Francisca Artigues Serra
- Disease Prevention Service, Health and Consumption Department, General Directorate of Public Health and Participation, Balearic Islands, Spain
| | - Rosa María Sancho Martínez
- Epidemiology Unit, General Sub-directorate of Public Health and Addictions of Gipuzkoa, Basque Country, Spain
| | - Pello Latasa Zamalloa
- Epidemiology and Vaccination Service, General Directorate of Public Health, Basque Country, Spain
| | - Olaia Pérez Martínez
- Epidemiology Service, Health Department, General Directorate of Public Health, Galicia, Spain
| | - Ana Vázquez Estepa
- Epidemiology Service, Health Department, General Directorate of Public Health, Galicia, Spain
| | - Amós José García Rojas
- Prevention and Epidemiology Service, General Directorate of Public Health, Canarian Health Service, Canary Islands, Spain
| | - Ana Isabel Barreno Estévez
- Prevention and Epidemiology Service, General Directorate of Public Health, Canarian Health Service, Canary Islands, Spain
| | | | - Jaime Jesús Pérez Martín
- Vaccination Progamme, Prevention and Health Protection Service, Health Department, General Directorate of Public Health and Addictions, Murcia Region, Spain
| | - Pilar Peces Jiménez
- Epidemiology Service, Healthcare Department, General Directorate of Public Health, Castilla-La Mancha, Spain
| | - Raquel Morales Romero
- Epidemiology Service, Healthcare Department, General Directorate of Public Health, Castilla-La Mancha, Spain
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra – IdiSNA – CIBERESP, Pamplona, Spain
| | | | - Marta Huerta Huerta
- Vaccination Programme, Health Department, Epidemiological Surveillance Service, Principado de Asturias, Spain
| | - An Lieve Dirk Boone
- Vaccination Programme, Health Department, Epidemiological Surveillance Service, Principado de Asturias, Spain
| | - María José Macías Ortiz
- Vaccination Program, General Directorate of PublicHealth, Healthcare Service of Extremadura, Spain
| | - Virginia Álvarez Río
- Epidemiology Service, Healthcare Department, General Directorate of Public Health, Castilla y León, Spain
| | | | - María Merino Díaz
- Epidemiology and Healthcare Prevention Service, Health Department, General Directorate of Public Health, Consumption and Nursing, La Rioja, Spain
| | - Belén Berradre Sáenz
- Epidemiology and Healthcare Prevention Service, Health Department, General Directorate of Public Health, Consumption and Nursing, La Rioja, Spain
| | | | - Aurora Limia
- Vaccination Programme, General Directorate of Public Health, Ministry of Health, Madrid, Spain
| | - Asuncion Diaz
- National Centre of Epidemiology, Institute of Health Carlos III, Community of Madrid, Spain
- CIBER on Infectious Diseases, Madrid, Spain
| | - Susana Monge
- National Centre of Epidemiology, Institute of Health Carlos III, Community of Madrid, Spain
- CIBER on Infectious Diseases, Madrid, Spain
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Huang X, Lin Z, Qin J, Yu D, Zhang F, Fang G, Chen X, He J, Cen P, Li M, Zhang R, Luo T, Jiang J, An S, Liang H, Ye L, Liang B. Willingness to accept monkeypox vaccine and its correlates among men who have sex with men in Southern China: a web-based online cross-sectional study. Front Public Health 2024; 12:1289918. [PMID: 38384873 PMCID: PMC10879393 DOI: 10.3389/fpubh.2024.1289918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/15/2024] [Indexed: 02/23/2024] Open
Abstract
Background The May 2022 global outbreak of monkeypox (MPX) poses a threat to the health of men who have sex with men. However, there is limited data on the willingness of MSM to receive monkeypox vaccination in Southern China. This study aimed to assess the knowledge of MPX, concerns regarding MPX, and willingness to receive monkeypox vaccination, as well as their correlates, among MSM in China. Methods We conducted a Web-based online survey of MSM in Southern China from August to September 2022. Data were collected on the socio-demographic characteristics, knowledge, worries, concerns regarding MPX and willingness to receive monkeypox vaccination. Multivariate logistic regression was employed to explore the factors associated with willingness to receive monkeypox vaccination. Results A total of 1903 participants completed the survey. Among them, approximately 69.9% reported being aware of MPX awareness, 94.1% of the participants supported the promotion of monkeypox vaccination. The majority of participants (91.4%) expressed their willingness to receive monkeypox vaccination. Participants who considered monkeypox vaccination safe [adjusted odds ratio (aOR) = 4.82, 95% CI: 1.35-17.18], agreed on the necessity of government promotion of monkeypox vaccination in China (aOR = 6.03, 95% CI: 1.07-33.93), believed in prioritizing monkeypox vaccination for MSM (aOR = 5.01, 95% CI: 1.10-22.71), and had friends or sexual partners who had already received the monkeypox or smallpox vaccination (aOR = 10.37, 95% CI: 2.11-50.99) are more likely to be vaccinated. Conversely, married individuals (aOR = 0.13, 95% CI: 0.03-0.47), those engaging in anal sex 4-6 times per week in the past 3 months (aOR = 0.26, 95% CI: 0.09-0.77) expressed hesitancy toward monkeypox vaccination. Conclusion There was a high willingness to receive monkeypox vaccination among MSM in China. The hesitancy toward the monkeypox vaccine can be effectively mitigated by addressing concerns about its safety and potential adverse reactions. Moreover, increasing acceptance of the monkeypox vaccination among MSM and their peers is crucial, as social influence significantly impacts vaccine attitudes and behaviors.
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Affiliation(s)
- Xinju Huang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Zhifeng Lin
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Jiao Qin
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Dee Yu
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Fei Zhang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Ganggang Fang
- Kaiyuan Center for Disease Control and Prevention, Kaiyuan, Yunnan, China
| | - Xi Chen
- Sanya Center for Disease Control and Prevention, Sanya, Hainan, China
| | - Jinfeng He
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Ping Cen
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Mu Li
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Rongjing Zhang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Tong Luo
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Junjun Jiang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical BioResource Development and Application Co-constructed by the Province and Ministry, Life Science Institute, Guangxi Medical University, Nanning, Guangxi, China
| | - Sanqi An
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical BioResource Development and Application Co-constructed by the Province and Ministry, Life Science Institute, Guangxi Medical University, Nanning, Guangxi, China
| | - Hao Liang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical BioResource Development and Application Co-constructed by the Province and Ministry, Life Science Institute, Guangxi Medical University, Nanning, Guangxi, China
| | - Li Ye
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical BioResource Development and Application Co-constructed by the Province and Ministry, Life Science Institute, Guangxi Medical University, Nanning, Guangxi, China
| | - Bingyu Liang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical BioResource Development and Application Co-constructed by the Province and Ministry, Life Science Institute, Guangxi Medical University, Nanning, Guangxi, China
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11
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Cao Y, Fang W, Chen Y, Zhang H, Ni R, Pan G. Simulating the impact of optimized prevention and control measures on the transmission of monkeypox in the United States: A model-based study. J Med Virol 2024; 96:e29419. [PMID: 38293742 DOI: 10.1002/jmv.29419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 11/24/2023] [Accepted: 01/10/2024] [Indexed: 02/01/2024]
Abstract
This study aimed to develop a modified susceptible-exposed-infected-recovered (SEIR) model to evaluate monkeypox epidemics in the United States and explore more optimized prevention and control measures. To further assess the impact of public health measures on the transmission of monkeypox, different intervention scenarios were developed based on the classic SEIR model, considering reducing contact, enhancing vaccination, diagnosis delay, and environmental transmission risk, respectively. We evaluated the impact of different measures by simulating their spread in different scenarios. During the simulation period, 8709 people were infected with monkeypox. The simulation analysis showed that: (1) the most effective measures to control monkeypox transmission during the early stage of the epidemic were reducing contact and enhancing vaccination, with cumulative infections at 51.20% and 41.90% of baseline levels, respectively; (2) shortening diagnosis time would delay the peak time of the epidemic by 96 days; and (3) the risk of environmental transmission of monkeypox virus was relatively low. This study indirectly proved the effectiveness of the prevention and control measures, such as reducing contact, enhancing vaccination, shortening diagnosis time, and low risk of environmental transmission, which also provided an important reference and containment experience for nonepidemic countries.
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Affiliation(s)
- Yawen Cao
- Department of Epidemiology and Biostatistics, Anhui Medical University, Hefei, Anhui, China
| | - Wenbin Fang
- Department of Epidemiology and Biostatistics, Anhui Medical University, Hefei, Anhui, China
| | - Yingying Chen
- Department of Epidemiology and Biostatistics, Anhui Medical University, Hefei, Anhui, China
| | - Hengchuan Zhang
- Department of Epidemiology and Biostatistics, Anhui Medical University, Hefei, Anhui, China
| | - Ruyu Ni
- Department of Epidemiology and Biostatistics, Anhui Medical University, Hefei, Anhui, China
| | - Guixia Pan
- Department of Epidemiology and Biostatistics, Anhui Medical University, Hefei, Anhui, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, Hefei, Anhui, China
- Medical Data Processing Center of School of Public Health of Anhui Medical University, Anhui Medical University, Hefei, Anhui, China
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12
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Ejaz M, Jabeen M, Sharif M, Syed MA, Shah PT, Faryal R. Human monkeypox: An updated appraisal on epidemiology, evolution, pathogenesis, clinical manifestations, and treatment strategies. J Basic Microbiol 2024; 64:e2300455. [PMID: 37867205 DOI: 10.1002/jobm.202300455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/13/2023] [Accepted: 10/04/2023] [Indexed: 10/24/2023]
Abstract
Monkeypox (Mpox) is a zoonotic viral disease caused by the monkeypox virus (MPXV), a member of the Orthopoxvirus genus. The recent occurrence of Mpox infections has become a significant global issue in recent months. Despite being an old disease with a low mortality rate, the ongoing multicountry outbreak is atypical due to its occurrence in nonendemic countries. The current review encompasses a comprehensive analysis of the literature pertaining to MPXV, with the aim of consolidating the existing data on the virus's epidemiological, biological, and clinical characteristics, as well as vaccination and treatment regimens against the virus.
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Affiliation(s)
- Mohammad Ejaz
- Department of Microbiology, Government Postgraduate College Mandian, Abbottabad, Pakistan
- Department of Microbiology, Quaid-i-Azam University, Islamabad, Pakistan
| | - Momina Jabeen
- National Center for Bioinformatics, Quaid-i-Azam University, Islamabad, Pakistan
| | - Mehmoona Sharif
- Department of Microbiology, Quaid-i-Azam University, Islamabad, Pakistan
| | - Muhammad Ali Syed
- Department of Microbiology, The University of Haripur, Haripur, Pakistan
| | - Pir T Shah
- Institute of Biomedical Sciences, Shanxi University, Taiyuan, Shanxi, China
| | - Rani Faryal
- Department of Microbiology, Quaid-i-Azam University, Islamabad, Pakistan
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13
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Knudsen B, Høeg TB, Prasad V. Analysis of tweets discussing the risk of Mpox among children and young people in school (May-October 2022): a retrospective observational study. BMJ Paediatr Open 2024; 8:e002236. [PMID: 38296602 PMCID: PMC10831422 DOI: 10.1136/bmjpo-2023-002236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 11/29/2023] [Indexed: 02/03/2024] Open
Abstract
OBJECTIVE To determine the number of tweets discussing the risk of Mpox to children and young people in school and (1) determine accuracy, (2) for inaccurate tweets, determine if risk was minimised or exaggerated and (3) describe the characteristics of the accounts and tweets which contained accurate versus inaccurate information. DESIGN Retrospective observational study. SETTING Twitter advanced search in January 2023 of tweets spanning 18 May 2022-19 September 2022. PARTICIPANTS Accounts labelled as: MD, DO, nurse, pharmacist, physical therapist, other healthcare provider, PhD, MPH, Ed. degree, JD, health/medicine/public policy reporter (including students or candidates) who tweeted about the risk of Mpox to children and young people in school. EXPOSURES Tweets containing the keywords 'school' and 'mpox', 'pox', or 'monkeypox' from May to October 2022. MEASURES (1) The total and ratio of accurate versus inaccurate tweets, the latter further subdivided by exaggerating or minimising risk, and stratified by account author credential type. (2) The total likes, retweets and follower counts by accurate versus inaccurate tweets, by month and account credentials. (3) Twitter user exposure to inaccurate versus accurate tweets was estimated. RESULTS 262 tweets were identified. 215/262 (82%) were inaccurate and 215/215 (100%) of these exaggerated risks. 47/262 (18%) tweets were accurate. There were 163 (87%) unique authors of inaccurate tweets and 25 (13%) of accurate tweets. Among healthcare professionals, 86% (95/111) of tweets were inaccurate. Multiplying accuracy by followers and retweets, Twitter users were approximately 974× more likely to encounter inaccurate than accurate information. CONCLUSION Credentialed Twitter users were 4.6 times more likely to tweet inaccurate than accurate messages. We also demonstrated how incorrect tweets can be quickly amplified by retweets and popular accounts. In the case of Mpox in children and young people, incorrect information always exaggerated risks.
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Affiliation(s)
- Ben Knudsen
- The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Tracy Beth Høeg
- Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
- Clinical Research, University of Southern Denmark, Odense, Syddanmark, Denmark
| | - Vinay Prasad
- Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
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Adam PCG, Op de Coul ELM, Zantkuijl P, Xiridou M, Bos H, Blom C, Ketsuwan I, te Wierik MJM, David S, de Wit JBF. A survey-based assessment of rates and covariates of mpox diagnosis and vaccination provides evidence to refine eligibility criteria for mpox vaccination among gay, bisexual and other men who have sex with men in the Netherlands. Front Public Health 2024; 12:1194844. [PMID: 38351958 PMCID: PMC10861664 DOI: 10.3389/fpubh.2024.1194844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 01/04/2024] [Indexed: 02/16/2024] Open
Abstract
Background The 2022 multicountry mpox outbreaks predominantly affected gay, bisexual and other men who have sex with men (GBMSM) in non-endemic countries, including in the Netherlands. We conducted a survey-based assessment of the alignment between the risk factors associated with mpox diagnosis among GBMSM in the Netherlands and the eligibility criteria used in 2022 for vaccinating this group, with the aim to refine these criteria. Methods An online self-report survey was conducted among adult GBMSM in the Netherlands between 29 July and 30 August 2022, corresponding to the first month of the Dutch mpox vaccination campaign. GBMSM were recruited via advertisements on social media and gay dating apps. Participants reported on their sexual behaviour, mpox diagnosis, and/or (initial) mpox vaccination since the start of the outbreak. Covariables of mpox diagnosis and vaccination were assessed using logistic regression analyses. Results Of the 2,460 participants, 73 (3.0%, 95% CI 2.3-3.6%) were diagnosed with mpox and 485 (19.7%, 95% CI 18.1-21.3%) had received (initial) mpox vaccination. Using sample weighting, we estimated that, of the GBMSM population aged 18-80 years in the Netherlands, 1.1% (95% CI 0.7-1.6%) had been diagnosed with mpox and 7.8% (95% CI 6.8-8.9%) had received (initial) vaccination. HIV-PrEP use, living with HIV, reporting ≥20 sex partners in the past 12 months, and sex in sex venues/parties in the past 2 months were independent risk factors for mpox diagnosis. Except for sex in sex venues/parties, these variables were also independently associated with mpox vaccination. Conclusion This study provides novel evidence regarding the degree to which the 2022 eligibility criteria for mpox vaccination align with the risk factors for mpox among GBMSM in the Netherlands. The findings contribute to a refinement of the eligibility criteria for mpox vaccination, to which sex in sex venues/parties should be added.
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Affiliation(s)
- Philippe C. G. Adam
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, Australia
- Institute for Prevention and Social Research (IPSR Utrecht), Utrecht, Netherlands
- IPSR Bangkok, Bangkok, Thailand
| | | | | | - Maria Xiridou
- National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Hanna Bos
- Soa Aids Nederland, Amsterdam, Netherlands
| | - Cor Blom
- Soa Aids Nederland, Amsterdam, Netherlands
| | | | | | - Silke David
- National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - John B. F. de Wit
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, Netherlands
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Murayama H, Pearson CAB, Abbott S, Miura F, Jung SM, Fearon E, Funk S, Endo A. Accumulation of Immunity in Heavy-Tailed Sexual Contact Networks Shapes Mpox Outbreak Sizes. J Infect Dis 2024; 229:59-63. [PMID: 37402631 PMCID: PMC10786257 DOI: 10.1093/infdis/jiad254] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 06/06/2023] [Accepted: 06/30/2023] [Indexed: 07/06/2023] Open
Abstract
Many countries affected by the global outbreak of mpox in 2022 have observed a decline in cases. Our mathematical model accounting for heavy-tailed sexual partnership distributions suggests that mpox epidemics can hit the infection-derived herd immunity threshold and begin to decline, with <1% of sexually active men who have sex with men infected regardless of interventions or behavioral changes. We consistently found that many countries and US states experienced an epidemic peak, with cumulative cases of around 0.1% to 0.5% among men who have sex with men. The observed decline in cases may not necessarily be attributable to interventions or behavioral changes primarily.
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Affiliation(s)
- Hiroaki Murayama
- School of Medicine, International University of Health and Welfare, Narita, Japan
| | - Carl A B Pearson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
- South African DSI-NRF Centre of Excellence in Epidemiological Modelling and Analysis, Stellenbosch University, Stellenbosch, Republic of South Africa
| | - Sam Abbott
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Fuminari Miura
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
- Center for Marine Environmental Studies, Ehime University, Ehime, Japan
| | - Sung-mok Jung
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Elizabeth Fearon
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine
- Institute for Global Health, University College London, London, United Kingdom
| | - Sebastian Funk
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Akira Endo
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
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Guillén-Calvo L, Negredo A, Sánchez-Mora P, Molero P, Vázquez A, Cabrerizo M, Orviz E, Ledesma J, Estrada V, Tarragó D, Sánchez-Seco MP. Mpox, herpes, and enteroviruses: Differential diagnosis. J Med Virol 2024; 96:e29371. [PMID: 38235533 DOI: 10.1002/jmv.29371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 12/07/2023] [Accepted: 12/22/2023] [Indexed: 01/19/2024]
Affiliation(s)
- Laura Guillén-Calvo
- Arboviruses and Imported Viral Diseases Laboratory, National Center of Microbiology, Instituto de Salud Carlos III, Madrid, Spain
- CIBER Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Anabel Negredo
- Arboviruses and Imported Viral Diseases Laboratory, National Center of Microbiology, Instituto de Salud Carlos III, Madrid, Spain
- CIBER Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Patricia Sánchez-Mora
- Arboviruses and Imported Viral Diseases Laboratory, National Center of Microbiology, Instituto de Salud Carlos III, Madrid, Spain
- CIBER Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Paqui Molero
- Arboviruses and Imported Viral Diseases Laboratory, National Center of Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Vázquez
- Arboviruses and Imported Viral Diseases Laboratory, National Center of Microbiology, Instituto de Salud Carlos III, Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - María Cabrerizo
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Enterovirus Laboratory, National Center of Microbiology, Instituto de Salud Carlos III, Madrid, Spain
- Translational Research Network for Pediatric Infectious Diseases (RITIP, IdiPAZ), Madrid, Spain
| | - Eva Orviz
- Infectious Diseases and HIV Unit, Hospital Clínico San Carlos, Madrid, Spain
| | - Juan Ledesma
- Arboviruses and Imported Viral Diseases Laboratory, National Center of Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Vicente Estrada
- CIBER Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Infectious Diseases and HIV Unit, Hospital Clínico San Carlos, Madrid, Spain
| | - David Tarragó
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Herpesvirus Research Group, National Center of Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - María Paz Sánchez-Seco
- Arboviruses and Imported Viral Diseases Laboratory, National Center of Microbiology, Instituto de Salud Carlos III, Madrid, Spain
- CIBER Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
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Prins H, Coyer L, De Angelis S, Bluemel B, Cauchi D, Baka A. Evaluation of mpox contact tracing activities and data collection in EU/EEA countries during the 2022 multicountry outbreak in nonendemic countries. J Med Virol 2024; 96:e29352. [PMID: 38180437 DOI: 10.1002/jmv.29352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/04/2023] [Accepted: 12/17/2023] [Indexed: 01/06/2024]
Abstract
To control human-to-human mpox transmission during the 2022 outbreak, European Union (EU)/European Economic Area (EEA) countries conducted case investigation and contact tracing (CT). We aimed to provide an overview of CT activities, describe CT data collection practices, and identify related facilitators, barriers, and potential opportunities for improvement. Between April 03, 2023 and May 12, 2023, a survey was distributed to CT stakeholders in 30 EU/EEA countries, asking about mpox CT activities and data collection and requesting to rank enablers, barriers, and improvements for CT on a five-point Likert scale. The 139 respondents from 27 countries indicated having performed case investigations (96%, n = 133), backward CT (88%, n = 122), forward CT (87%, n = 121), and follow-up on contacts' outcomes (77%, n = 107). Sixty percent (n = 80/134) used standardized data collection forms and 73% (n = 91/124) used databases. The highest-rated enablers were clear guidelines (mean = 3.9), quick access to laboratory results (3.6), and sufficient expertise (3.6). Highly rated barriers were inability to contact contacts (3.0) or cases (2.5) and lack of staff (2.4). The most needed improvements were availability of staff (3.5), expertise on affected populations (3.4) and data reporting tools and systems (3.3). To improve CT of mpox and diseases with similar transmission patterns, EU/EEA countries should increase workforce capacity in public and sexual health, offer training on CT operations and communication with affected communities, and use common CT data collection tools and systems.
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Affiliation(s)
- Henrieke Prins
- ECDC Fellowship Programme, Field Epidemiology path (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
- Department of Infectious Disease Epidemiology, Robert Koch Institute (RKI), Berlin, Germany
| | - Liza Coyer
- ECDC Fellowship Programme, Field Epidemiology path (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
- State Institute for Health II, Task Force for Infectious Diseases (GI), Bavarian Health and Food Safety Authority (LGL), Munich, Germany
| | - Stefania De Angelis
- Emergency Preparedness and Response Section, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Benjamin Bluemel
- STI, Blood-Borne Viruses and TB Section, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Daniel Cauchi
- Emergency Preparedness and Response Section, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Agoritsa Baka
- Emergency Preparedness and Response Section, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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18
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Chiu KHY, Wong SC, Tam AR, Sridhar S, Yip CCY, Chan KH, Chew NFS, Man KKY, Chan WM, Ip JD, Chu AWH, Lo JYC, Hung IFN, Yuen KY, To KKW, Cheng VCC. The first case of monkeypox in Hong Kong presenting as infectious mononucleosis-like syndrome. Emerg Microbes Infect 2023; 12:2146910. [PMID: 36357955 PMCID: PMC9718374 DOI: 10.1080/22221751.2022.2146910] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Kelvin Hei-Yeung Chiu
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, People’s Republic of China
| | - Shuk-Ching Wong
- Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China
| | - Anthony Raymond Tam
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People’s Republic of China
| | - Siddharth Sridhar
- State Key Laboratory for Emerging Infectious Disease, Carol Yu Centre for Infection, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, People’s Republic of China,Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People’s Republic of China
| | - Cyril Chik-Yan Yip
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, People’s Republic of China
| | - Kwok-Hung Chan
- Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People’s Republic of China
| | - Nicholas Foo-Siong Chew
- Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People’s Republic of China
| | - Kenyon Ka-Yun Man
- Department of Radiology, Queen Mary Hospital, Hong Kong Special Administrative Region, People’s Republic of China
| | - Wan-Mui Chan
- Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People’s Republic of China
| | - Jonathan Daniel Ip
- Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People’s Republic of China
| | - Allen Wing-Ho Chu
- Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People’s Republic of China
| | - Janice Yee-Chi Lo
- Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region, China
| | - Ivan Fan-Ngai Hung
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People’s Republic of China,Department of Infectious Disease and Microbiology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province, People’s Republic of China
| | - Kwok-Yung Yuen
- State Key Laboratory for Emerging Infectious Disease, Carol Yu Centre for Infection, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, People’s Republic of China,Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People’s Republic of China,Department of Infectious Disease and Microbiology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province, People’s Republic of China,Centre for Virology, Vaccinology and Therapeutics, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China
| | - Kelvin Kai-Wang To
- State Key Laboratory for Emerging Infectious Disease, Carol Yu Centre for Infection, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, People’s Republic of China,Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, People’s Republic of China,Department of Infectious Disease and Microbiology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province, People’s Republic of China,Centre for Virology, Vaccinology and Therapeutics, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China.,Co-correspondence: Vincent Chi-Chung Cheng, Department of Microbiology, Queen Mary Hospital, Hong Kong, China. (+852-22552378, +852-28724555, E-mail: ) and Kelvin Kai-Wang To, Department of Microbiology, The University of Hong Kong, Hong Kong, China (+852-22552413, +852-28551241, E-mail: )
| | - Vincent Chi-Chung Cheng
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, People’s Republic of China,Co-correspondence: Vincent Chi-Chung Cheng, Department of Microbiology, Queen Mary Hospital, Hong Kong, China. (+852-22552378, +852-28724555, E-mail: ) and Kelvin Kai-Wang To, Department of Microbiology, The University of Hong Kong, Hong Kong, China (+852-22552413, +852-28551241, E-mail: )
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19
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Quispe AM, Castagnetto JM. Monkeypox in Latin America and the Caribbean: assessment of the first 100 days of the 2022 outbreak. Pathog Glob Health 2023; 117:717-726. [PMID: 37057838 PMCID: PMC10614714 DOI: 10.1080/20477724.2023.2201979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2023] Open
Abstract
During the 2022 monkeypox (mpox) epidemic's first 100 days, 99 non-endemic countries, including 25 Latin American and Caribbean (LAC) countries, reported >64,000 cases. We aim to assess the cases' introduction, epidemiological profile, initial response, transmission dynamics, and main challenges ahead among LAC countries during the first 100 days of the mpox 2022 epidemic. We used mixed methods, including desktop research and open data analysis. The 2022 mpox epidemic has progressed consistently through LAC, with Brazil and Peru combining for over 80% of the confirmed LAC cases. Although Brazil reports the highest mpox case counts (n = 4472), Peru reports the highest incidence (41 confirmed cases per 1 million inhabitants). Initially, LAC missed the opportunity to focus on the high-risk population, including the people living with HIV (PLHIV) and gay, bisexual, and men who have sex with men (GBMSM). Moreover, the main challenges ahead include stigmatization, vaccine inequity, barriers to accessing diagnostics, and complete isolation. Furthermore, we estimated that Colombia, Brazil, the United States, and Peru are the world frontrunners in mpox duplication time (estimated between 6.4 and 8.8) and effective reproductive number (estimated between 2.7 and 3.8). In addition, Brazil reported its first case of inverse zoonosis in a dog and Peru its first autochthonous MPXV lineage, B.1.6. LAC has become the epicenter of the 2022 mpox epidemic, with Brazil and Peru emerging as the new mpox hot zones. Therefore, LAC countries must join efforts to control this epidemic and overcome the challenges of vaccine inequity and stigmatization.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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21
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Singh V, Khan SA, Yadav SK, Akhter Y. Modeling Global Monkeypox Infection Spread Data: A Comparative Study of Time Series Regression and Machine Learning Models. Curr Microbiol 2023; 81:15. [PMID: 38006416 DOI: 10.1007/s00284-023-03531-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 10/19/2023] [Indexed: 11/27/2023]
Abstract
The global impact of COVID-19 has heightened concerns about emerging viral infections, among which monkeypox (MPOX) has become a significant public health threat. To address this, our study employs a comprehensive approach using three statistical techniques: Distribution fitting, ARIMA modeling, and Random Forest machine learning to analyze and predict the spread of MPOX in the top ten countries with high infection rates. We aim to provide a detailed understanding of the disease dynamics and model theoretical distributions using country-specific datasets to accurately assess and forecast the disease's transmission. The data from the considered countries are fitted into ARIMA models to determine the best time series regression model. Additionally, we employ the random forest machine learning approach to predict the future behavior of the disease. Evaluating the Root Mean Square Errors (RMSE) for both models, we find that the random forest outperforms ARIMA in six countries, while ARIMA performs better in the remaining four countries. Based on these findings, robust policy-making should consider the best fitted model for each country to effectively manage and respond to the ongoing public health threat posed by monkeypox. The integration of multiple modeling techniques enhances our understanding of the disease dynamics and aids in devising more informed strategies for containment and control.
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Affiliation(s)
- Vishwajeet Singh
- Directorate of Online Education, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, 576104, India
| | - Saif Ali Khan
- Department of Statistics, Babasaheb Bhimrao Ambedkar University, Vidya Vihar, Raebareli Road, Lucknow, Uttar Pradesh, 226025, India
| | - Subhash Kumar Yadav
- Department of Statistics, Babasaheb Bhimrao Ambedkar University, Vidya Vihar, Raebareli Road, Lucknow, Uttar Pradesh, 226025, India.
| | - Yusuf Akhter
- Department of Biotechnology, Babasaheb Bhimrao Ambedkar University, Vidya Vihar, Raebareli Road, Lucknow, Uttar Pradesh, 226025, India.
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22
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Ahmed SK, Abdulqadir SO, Omar RM, Hussein S, Qurbani K, Mohamed MG, Abubaker Blbas HT, Fahrni ML, Lazzarino AI. Knowledge, Attitudes, and Willingness of Healthcare Workers in Iraq's Kurdistan Region to Vaccinate against Human Monkeypox: A Nationwide Cross-Sectional Study. Vaccines (Basel) 2023; 11:1734. [PMID: 38140139 PMCID: PMC10747727 DOI: 10.3390/vaccines11121734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 12/24/2023] Open
Abstract
Although human monkeypox infections had not been recorded in the Kurdistan region of Iraq as of August 2023, the rapid growth of cases worldwide and the detection of monkeypox in neighboring Middle Eastern nations call for careful planning and timely response measures. Educating and empowering frontline healthcare workers (HCWs) so that they can act to curb the spread of monkeypox infections are core elements of primary prevention and protecting public health. Therefore, this study aimed to assess HCWs' knowledge and attitudes about monkeypox and their willingness to vaccinate against monkeypox. By employing a convenience sampling method, an online survey was disseminated via Google Forms between 1 November 2022 and 15 January 2023. The researchers utilized regression analyses to ascertain the factors associated with the three parameters: knowledge, attitude, and the willingness to vaccinate. A total of 637 HCWs were included in the analysis (ages ranged between 21 and 51 years). The mean overall scores were 8.18 of a max score of 16 (SD 3.37), 3.4 of 5 (SD 1.37), and 2.41 of 5 (SD 1.25) for knowledge, attitude, and willingness to vaccinate, respectively. A multivariate logistic regression analysis demonstrated that HCWs who had heard about monkeypox before 2022 rather than later had a higher level of knowledge (AOR: 4.85; 95% CI: 2.81-8.36; p < 0.001). In addition, those who had newly joined the workforce or had less than 1 year experience in practice had more positive attitudes about curbing monkeypox (AOR: 0.35; 95% CI: 0.20-0.59; p < 0.01) than those who practiced for longer. No significant predictors of willingness to vaccinate against monkeypox were identified. The research revealed that HCWs exhibited a relatively low level of monkeypox knowledge. They also had poor attitudes towards monkeypox vaccination and were therefore reluctant to receive the vaccines. Imparting knowledge about the infectious disease can cultivate better awareness and attitudes among HCWs as to their roles in mitigating the spread of an epidemic in the foreseeable future.
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Affiliation(s)
- Sirwan Khalid Ahmed
- Department of Adult Nursing, College of Nursing, University of Raparin, Rania, Sulaymaniyah 46012, Iraq;
- Ministry of Health, General Directorate of Health-Raparin, Rania, Sulaymaniyah 46012, Iraq
| | - Salar Omer Abdulqadir
- Department of Psychiatric and Mental Health Nursing, College of Nursing, University of Raparin, Rania, Sulaymaniyah 46012, Iraq
| | - Rukhsar Muhammad Omar
- Department of Kindergarten, College of Basic Education, University of Raparin, Rania, Sulaymaniyah 46012, Iraq
| | - Safin Hussein
- Department of Biology, College of Science, University of Raparin, Rania, Sulaymaniyah 46012, Iraq
| | - Karzan Qurbani
- Department of Biology, College of Science, University of Raparin, Rania, Sulaymaniyah 46012, Iraq
| | - Mona Gamal Mohamed
- Department of Adult Nursing, RAK College of Nursing, RAK Medical and Health Sciences University, Ras Al Khaimah 72603, United Arab Emirates
| | | | - Mathumalar Loganathan Fahrni
- Faculty of Pharmacy, Universiti Teknologi MARA (UiTM), Puncak Alam Campus, Selangor Branch, Puncak Alam 42300, Malaysia
| | - Antonio Ivan Lazzarino
- Department of Epidemiology and Biostatistics, Imperial College London, Norfolk Place, London W2 1PG, UK
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23
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O'Shea JG, Bonacci RA, Cholli P, Kimball A, Brooks JT. HIV and mpox: a rapid review. AIDS 2023; 37:2105-2114. [PMID: 37877274 PMCID: PMC10962215 DOI: 10.1097/qad.0000000000003684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Abstract
In this review, we discuss the history and epidemiology of mpox, prevention strategies, clinical characteristics and management, severity of mpox among persons with advanced HIV, and areas for future research relevant to persons with HIV.
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Affiliation(s)
- Jesse G O'Shea
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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24
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Martín-Iguacel R, Pericas C, Bruguera A, Rosell G, Martínez E, Díaz Y, Alonso L, Nomah DK, Blanco JL, Domingo P, Álvarez-López P, Linares MS, Vilades Laborda C, Mera A, Calzado Isbert S, Johansen IS, Miró JM, Casabona J, Llibre JM. Mpox: Clinical Outcomes and Impact of Vaccination in People with and without HIV: A Population-Wide Study. Microorganisms 2023; 11:2701. [PMID: 38004713 PMCID: PMC10673392 DOI: 10.3390/microorganisms11112701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/02/2023] [Accepted: 10/31/2023] [Indexed: 11/26/2023] Open
Abstract
We investigated differences in mpox clinical outcomes in people with HIV (PWH) and without HIV (PWoH) and the impact of vaccination in Catalonia, Spain. We used surveillance data and the PISCIS HIV cohort. We included all confirmed mpox cases (May-December 2022). Of 2122 mpox cases, the majority had mild disease, 56% were Spanish, and 24% were from Latin America. A total of 40% were PWH, with a median CD4+T-cell of 715 cells/μL; 83% had HIV-RNA < 50 copies/mL; and 1.8% CD4+T-cell < 200 cells/μL. PWH had no increased risk for complications, except those with CD4+T-cell < 200 cells/μL. PWH with CD4+T-cell < 200 cells/μL were more likely to be from Latin America, had more generalized exanthema, and required hospitalization more frequently (p = 0.001). Diagnosis of other sexually transmitted infections (STIs) was common, both at mpox diagnosis (17%) and two years before (43%). Dose-sparing smallpox intradermal vaccination was accompanied by a sharp decrease in mpox incidence in both populations (p < 0.0001). In conclusion, unless immunosuppressed, PWH were not at increased risk of severe disease or hospitalization. Mpox is a marker of high-risk sexual behavior and was associated with high HIV and STI rates, supporting the need for screening in all mpox cases. Ethnicity disparities demonstrate the need for interventions to ensure equitable healthcare access. Dose-sparing smallpox vaccination retained effectiveness.
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Affiliation(s)
- Raquel Martín-Iguacel
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, 08916 Badalona, Spain; (A.B.); (Y.D.); (L.A.); (D.K.N.); (J.C.)
- Department of Infectious Diseases, Odense University Hospital, 5000 Odense, Denmark;
| | - Carles Pericas
- Epidemiology Service, Public Health Agency of Barcelona, 08023 Barcelona, Spain;
- Department of Medicine, University of Barcelona, 08036 Barcelona, Spain
- Institute of Biomedical Research Hospital de la Santa Creu i Sant Pau (IIB Sant Pau), 08041 Barcelona, Spain;
| | - Andreu Bruguera
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, 08916 Badalona, Spain; (A.B.); (Y.D.); (L.A.); (D.K.N.); (J.C.)
- CIBER Epidemiologia y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Department of Paediatrics, Obstetrics and Gynecology and Preventive Medicine, Universitat Autònoma de Barcelona, 08916 Badalona, Spain
| | - Gemma Rosell
- Subdirecció General de Vigilància i Resposta a Alertes i Emergències de Salut Pública—ASPCAT, Teià, Cataluña, Spain;
| | - Erica Martínez
- Institute of Biomedical Research Hospital de la Santa Creu i Sant Pau (IIB Sant Pau), 08041 Barcelona, Spain;
- Subdirecció General de Vigilància i Resposta a Alertes i Emergències de Salut Pública—ASPCAT, Teià, Cataluña, Spain;
| | - Yesika Díaz
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, 08916 Badalona, Spain; (A.B.); (Y.D.); (L.A.); (D.K.N.); (J.C.)
- CIBER Epidemiologia y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Lucia Alonso
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, 08916 Badalona, Spain; (A.B.); (Y.D.); (L.A.); (D.K.N.); (J.C.)
- Fight Infections Foundation, Badalona, 08916 Barcelona, Spain
| | - Daniel Kwakye Nomah
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, 08916 Badalona, Spain; (A.B.); (Y.D.); (L.A.); (D.K.N.); (J.C.)
- Fundació Institut D’investigació en Ciències de la Salut Germans Trias I Pujol (IGTP), 08916 Badalona, Spain
| | - Jose Luis Blanco
- Hospital Clínic-Institut d’Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, 08916 Barcelona, Spain; (J.L.B.)
| | - Pere Domingo
- Infectious Diseases Unit, Hospital Universitari de la Santa Creu i Sant Pau, 08916 Barcelona, Spain;
| | - Patricia Álvarez-López
- Department of Infectious Diseases, Hospital Universitari de la Vall d’Hebron, 08916 Barcelona, Spain;
| | - Maria Saumoy Linares
- HIV and STD Unit, Infectious Disease Department, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, 08916 Barcelona, Spain;
| | - Consuelo Vilades Laborda
- Department of Internal Medicine, Hospital Universitari Tarragona Juan XXIII, Universitat Rovira i Virgili, Tarragona, Spain;
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Arantxa Mera
- Department of Internal Medicine, Hospital de Palamós, 17230 Girona, Spain;
| | - Sonia Calzado Isbert
- Department of Infectious Diseases, Parc Taulí University Hospital, Sabadell, 08916 Barcelona, Spain;
| | - Isik Somuncu Johansen
- Department of Infectious Diseases, Odense University Hospital, 5000 Odense, Denmark;
| | - José M. Miró
- Hospital Clínic-Institut d’Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, 08916 Barcelona, Spain; (J.L.B.)
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Jordi Casabona
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, 08916 Badalona, Spain; (A.B.); (Y.D.); (L.A.); (D.K.N.); (J.C.)
- Department of Paediatrics, Obstetrics and Gynecology and Preventive Medicine, Universitat Autònoma de Barcelona, 08916 Badalona, Spain
- Department of Internal Medicine, Hospital de Palamós, 17230 Girona, Spain;
| | - Josep M. Llibre
- Fight Infections Foundation, Badalona, 08916 Barcelona, Spain
- Infectious Diseases Department, University Hospital Germans Trias i Pujol, Badalona, 08916 Barcelona, Spain;
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Martínez de Victoria-Carazo J, García-Ceberino PM, de Salazar-González A, Faro-Míguez N, Fuentes-López A, Viñuela-González L, Palomares-Rodríguez J, Valero-Ubierna C, Ruíz-Villaverde R, García-García F, Hernández-Quero J, Ruíz-Sancho AL. Mpox Infection and Sexually Transmitted Infections: A Cross-Sectional Study from a Secondary Hospital in the May-September 2022 International Outbreak. AIDS Res Hum Retroviruses 2023; 39:604-609. [PMID: 37450341 DOI: 10.1089/aid.2023.0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023] Open
Abstract
The aims of this study were to describe the characteristics of patients infected by mpox in our setting, to determine the prevalence of mpox in samples that are classically used for diagnosing sexually transmitted infections (STIs) such as anal, urethral, pharyngeal, and urine, and to assess the prevalence of coinfection with STIs in the same samples. A cross-sectional study was conducted, collecting all confirmed cases of mpox between June and July 2022 using polymerase chain reaction. Sociodemographic data, HIV and other STI status, and prevalence of mpox and STIs in urethral, anal, pharyngeal, or urine samples were collected. Data from 22 patients were extracted, all of whom were men who have sex with men (MSM) and 54.5% were previously HIV positive. The median age was 43 years. All the skin samples were positive for mpox, followed by anal samples (n = 10, 45.5%). Mpox was isolated in 2 or more samples simultaneously in 12 (54%) cases. Nine (41%) patients were positive for an STI and four of them had more than one STIs (18.2%). Human mpox has been epidemiologically significant among MSM. Mpox should be investigated not only in skin lesions but also in samples classically used for STIs. Mpox, such as other STIs, shares ways of transmission and coinfection may be underdiagnosed.
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Affiliation(s)
| | | | | | - Naya Faro-Míguez
- Infectious Diseases Service, Hospital Universitario Clínico San Cecilio, Granada, Spain
| | - Ana Fuentes-López
- Microbiology Service, Hospital Universitario Clínico San Cecilio, Granada, Spain
| | | | | | - Carmen Valero-Ubierna
- Preventive Medicine and Public Health Service, Hospital Universitario Clínico San Cecilio, Granada, Spain
| | | | | | - José Hernández-Quero
- Infectious Diseases Service, Hospital Universitario Clínico San Cecilio, Granada, Spain
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26
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Charles H, Prochazka M, Murray J, Sexual Health Liaison Group U, Soni S, Haddow L, Beets K, Pilkington V, Low N, Candfield S, Jones R, Bleiker T, Dewsnap C, Phillips M, Phillips D. Surveillance of Mpox Cases Attending Sexual Health Services in England (SOMASS): design, implementation and initial findings from the SOMASS data collection tool, 2022. Sex Transm Infect 2023; 99:461-466. [PMID: 37202181 DOI: 10.1136/sextrans-2023-055755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 03/26/2023] [Indexed: 05/20/2023] Open
Abstract
OBJECTIVES We aimed to design and implement a data collection tool to support the 2022 mpox (monkeypox) outbreak, and to describe clinical and epidemiological data from individuals with mpox attending sexual health services (SHSs) in England. METHODS The UK Health Security Agency and the British Association for Sexual Health and HIV established the Surveillance of Mpox Cases Attending Sexual Health Services in England (SOMASS) system.Descriptive data were collected via a secure web-based data collection tool, completed by SHS clinicians following consultation with individuals with suspected mpox. Data were collected on patient demographics, clinical presentation and severity, exposures and behavioural characteristics. RESULTS As of 17 November 2022, 276 SOMASS responses were submitted from 31 SHSs in England.Where recorded, most (245 of 261; 94%) individuals identified as gay, bisexual or men who have sex with men (GBMSM), of whom two-thirds were HIV negative (170 of 257; 66%) and taking HIV pre-exposure prophylaxis (87 of 140; 62%), with a median age of 37 years (IQR: 30-43). Where known, thirty-nine per cent (63 of 161) had a concurrent sexually transmitted infection (STI) at the time of their mpox diagnosis.For 46% of individuals (127 of 276), dermatological lesions were the initial symptom. Lesions were mostly asymmetrical and polymorphic, predominately affecting the genital area and perianal areas.Nine per cent (24 of 276) of individuals were hospitalised. We report an association between receptive anal intercourse among GBMSM and proctitis (27 of 115; 24% vs 7 of 130; 5%; p<0.0001), and the presence of perianal lesions as the primary lesion site (46 of 115; 40% vs 25 of 130; 19%; p=0.0003). CONCLUSIONS We demonstrate multidisciplinary and responsive working to develop a robust data collection tool, which improved surveillance and strengthened the knowledge base. The SOMASS tool will allow data collection if mpox resurges in England. The model for developing the tool can be adapted to facilitate the preparedness and response to future STI outbreaks.
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Affiliation(s)
| | | | - Judith Murray
- Kingston Hospital NHS Foundation Trust, Kingston upon Thames, UK
| | | | - Suneeta Soni
- Claude Nicol Centre, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | - Lewis Haddow
- Kingston Hospital NHS Foundation Trust, Kingston upon Thames, UK
| | | | | | - Nicola Low
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Sophie Candfield
- Warwick Medical School, University of Warwick, Coventry, UK
- West Midlands health protection team, UK Health Security Agency, Birmingham, UK
| | - Rachael Jones
- Genitourinary and HIV Medicine, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | | | - Claire Dewsnap
- Genitourinary Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Matt Phillips
- North Cumbria Integrated Care NHS Foundation Trust, Penrith, UK
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Masood S, Alkubaisi NA, Aslam M, Salman M, Baraka MA, Mustafa ZU, Mallhi TH, Khan YH, Meyer JC, Godman B. Knowledge of Human Monkeypox Infection among Final Year Medical, Pharmacy, and Nursing Students: A Multicenter, Cross-Sectional Analysis from Pakistan. Healthcare (Basel) 2023; 11:2777. [PMID: 37893851 PMCID: PMC10606159 DOI: 10.3390/healthcare11202777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/22/2023] [Accepted: 09/26/2023] [Indexed: 10/29/2023] Open
Abstract
The World Health Organization (WHO) declared the monkeypox outbreak a public health emergency in June 2022. In Pakistan, positive cases of monkeypox were reported in April 2023. Healthcare workers (HCWs) are considered as a front-line force to combat such outbreaks. A questionnaire-based cross-sectional study was conducted among 11 public sector educational institutions in Punjab, Pakistan, during May and June 2023 among final year medical, pharmacy, and nursing students concerning their knowledge of monkeypox. This included the signs/symptoms of monkeypox. Healthcare students were chosen as they are the HCWs of tomorrow. A total of 389 healthcare students participated in the study, with a mean age of 23.17 ± 1.72 years, and the majority were female. The mean knowledge score was 17.69 ± 4.55 (95% CI 17.24-18.14) out of a maximum total knowledge score of 26 (each correct answer was given a score of 1). The proportion of students with good, moderate, and poor knowledge was 21.6%, 43.2%, and 35.2%, respectively. Age (p = 0.017), gender (p < 0.001), and education (p < 0.001) had a significant impact on the knowledge score. In the multivariate linear regression model, education was the only significant factor linked to knowledge scores. Overall, the majority of future HCWs had moderate knowledge of monkeypox. Consequently, educational activities are needed to improve monkeypox-related knowledge among future HCWs. Furthermore, emerging infectious diseases should be routinely incorporated into HCW curricula.
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Affiliation(s)
- Sahabia Masood
- Department of Medicine, University Medical and Dental College Faisalabad, Faisalabad 38000, Pakistan
| | - Noorah A Alkubaisi
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Maryam Aslam
- Basic Health Unit (BHU), 554GB, Tehsil Tandlianwala, Faisalabad 38000, Pakistan
| | - Muhammad Salman
- Institute of Pharmacy, Faculty of Pharmaceutical and Allied Health Sciences, Lahore College for Women University, Lahore 54000, Pakistan
| | - Mohamed A Baraka
- Department of Pharmacy, Fatima College of Health Sciences, Abu Dhabi P.O. Box 3798, United Arab Emirates
- Clinical Pharmacy Department, Faculty of Pharmacy, Al-Azhar University, Cairo 11651, Egypt
| | - Zia Ul Mustafa
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor 11800, Penang, Malaysia
- Department of Pharmacy Services, District Headquarter (DHQ) Hospital, Pakpattan 57400, Pakistan
| | - Tauqeer Hussain Mallhi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka 72388, Saudi Arabia
| | - Yusra Habib Khan
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka 72388, Saudi Arabia
| | - Johanna C Meyer
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria 0208, South Africa
| | - Brian Godman
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria 0208, South Africa
- Strathclyde Institute of Pharmacy and Biomedical Science (SIPBS), University of Strathclyde, Glasgow G4 0RE, UK
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman P.O. Box 346, United Arab Emirates
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28
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Zhang D, Jin H, Sun Y, Yang Y, Li R, Li W, Zhang X, Li S, Chen Y, Wang Q, Pan Y. Genetic Features of 84 Genomes of Monkeypox Virus in Recent Circulation - Beijing Municipality, China, 2023. China CDC Wkly 2023; 5:918-921. [PMID: 37970070 PMCID: PMC10630903 DOI: 10.46234/ccdcw2023.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 10/07/2023] [Indexed: 11/17/2023] Open
Abstract
The first indigenous incidence of Mpox (previously known as monkeypox) within Chinese mainland was documented in May 2023, with subsequent local and imported cases identified. A comprehensive understanding of the Mpox virus's (MPXV) characteristics within Beijing remains incomplete. In this study, 84 MPXV genomes from 82 local incidents and two imported instances, detected between May and July 2023, were analyzed. All MPXV strains fell within lineage C.1 of the West African clade, displaying limited genetic heterogeneity, encompassing 76-87 nucleotide substitutions and holding nucleotide identities between 99.996% and 100%. Phylogenetic exploration indicated that all genomes exhibited high homology to those presently prevalent in neighboring East Asian and Southeast Asian regions. Forty-six distinct haplotypes were identified among the strains, with 36.90% of genomes corresponding to four common haplotypes, suggesting repeated cross-regional introductions and restrained distribution via recurrent local transmission. These findings elucidate the genetic diversity and phylogenesis of MPXVs during their nascent transmission within Beijing and provide vital information to enhance future Mpox containment strategies.
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Affiliation(s)
- Daitao Zhang
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Haoyuan Jin
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Yulan Sun
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Yang Yang
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Renqing Li
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Weihong Li
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Xin Zhang
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Shuang Li
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Yanwei Chen
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Quanyi Wang
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Yang Pan
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, China
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29
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Momin ZK, Lee A, Vandergriff TW, Bowling JE, Chamseddin B, Dominguez A, Hosler GA, Wang RC, Kitchell E. A plague passing over: Clinical features of the 2022 mpox outbreak in patients of color living with HIV. HIV Med 2023; 24:1056-1065. [PMID: 37336551 PMCID: PMC10592586 DOI: 10.1111/hiv.13517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 05/12/2023] [Indexed: 06/21/2023]
Abstract
INTRODUCTION Compared with previous geographically localized outbreaks of monkeypox (MPOX), the scale of the 2022 global mpox outbreak has been unprecedented, yet the clinical features of this outbreak remain incompletely characterized. METHODS We identified patients diagnosed with mpox by polymerase chain reaction (PCR; n = 36) from July to September 2022 at a single, tertiary care institution in the USA. Demographics, clinical presentation, infection course, and histopathologic features were reviewed. RESULTS AND CONCLUSION Men who have sex with men (89%) and people living with HIV (97%) were disproportionately affected. While fever and chills (56%) were common, some patients (23%) denied any prodromal symptoms. Skin lesions showed a wide range of morphologies, including papules and pustules, and lesions showed localized, not generalized, spread. Erythema was also less appreciable in skin of colour patients (74%). Atypical clinical features and intercurrent skin diseases masked the clinical recognition of several cases, which were ultimately diagnosed by PCR. Biopsies showed viral cytopathic changes consistent with Orthopoxvirus infections. All patients in this case series recovered without complications, although six patients (17%) with severe symptoms were treated with tecovirimat without complication.
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Affiliation(s)
- Zoha K. Momin
- Department of Dermatology, UT Southwestern Medical Center, Dallas, TX, U.S.A
| | - Aleuna Lee
- Department of Dermatology, UT Southwestern Medical Center, Dallas, TX, U.S.A
| | - Travis W. Vandergriff
- Department of Dermatology, UT Southwestern Medical Center, Dallas, TX, U.S.A
- Department of Pathology, UT Southwestern Medical Center, Dallas, TX, U.S.A
| | - Jason E. Bowling
- Department of Internal Medicine, UT Health Science Center, San Antonio, TX, U.S.A
| | - Bahir Chamseddin
- Department of Dermatology, UT Southwestern Medical Center, Dallas, TX, U.S.A
| | - Arturo Dominguez
- Department of Dermatology, UT Southwestern Medical Center, Dallas, TX, U.S.A
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, U.S.A
| | - Gregory A. Hosler
- Department of Dermatology, UT Southwestern Medical Center, Dallas, TX, U.S.A
- Department of Pathology, UT Southwestern Medical Center, Dallas, TX, U.S.A
- ProPath Dermatopathology, Dallas, TX, U.S.A
| | - Richard C. Wang
- Department of Dermatology, UT Southwestern Medical Center, Dallas, TX, U.S.A
| | - Ellen Kitchell
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, U.S.A
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30
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Shang W, Cao G, Wu Y, Kang L, Wang Y, Gao P, Liu J, Liu M. Spatiotemporal cluster of mpox in men who have sex with men: A modeling study in 83 countries. J Med Virol 2023; 95:e29166. [PMID: 37822046 DOI: 10.1002/jmv.29166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/11/2023] [Accepted: 09/30/2023] [Indexed: 10/13/2023]
Abstract
Mpox outbroke globally during 2022-2023, with more than 90% of cases occurring in men who have sex with men (MSM). However, the spatiotemporal distribution of mpox is not well established yet. This study aimed to explore the spatiotemporal clustering of mpox cases in MSM worldwide. We obtained the numbers of mpox cases from Our World in Data, the number of MSM from the Joint United Nations Programme on HIV/AIDS (UNAIDS), UNAIDS DATA 2021 and UNAIDS Global AIDS Update 2022 and literature. We evaluated the spatiotemporal cluster of mpox in MSM using retrospective space-time analyses method. The total number of mpox cases was 85 795 during May 1, 2022 to March 31, 2023. The most likely cluster was Spain (likelihood ratio = 4764.97; p < 0.001), with a cluster period from July 26 to August 14, 2022. There were 11 secondary clusters, which included 46 countries located in western Europe, eastern and northern South America, northern Europe, Canada, Central Africa, southern and central Europe, Latin America, Turkey, Dominican Republic, New Zealand, and Australia. The findings may inform current and future control strategies of mpox and might provide references for the identification of the spatiotemporal distribution of new and emerging infectious diseases in specific populations.
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Affiliation(s)
- Weijing Shang
- School of Public Health, Peking University, Beijing, China
| | - Guiying Cao
- School of Public Health, Peking University, Beijing, China
| | - Yu Wu
- School of Public Health, Peking University, Beijing, China
| | - Liangyu Kang
- School of Public Health, Peking University, Beijing, China
| | - Yaping Wang
- School of Public Health, Peking University, Beijing, China
| | - Peng Gao
- School of Public Health, Peking University, Beijing, China
| | - Jue Liu
- School of Public Health, Peking University, Beijing, China
| | - Min Liu
- School of Public Health, Peking University, Beijing, China
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31
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Andrei G, Snoeck R. Differences in pathogenicity among the mpox virus clades: impact on drug discovery and vaccine development. Trends Pharmacol Sci 2023; 44:719-739. [PMID: 37673695 DOI: 10.1016/j.tips.2023.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 08/11/2023] [Accepted: 08/11/2023] [Indexed: 09/08/2023]
Abstract
Since May 2022, mpox virus (MPXV) has attracted considerable attention due to a multi-country outbreak. Marked differences in epidemiology, transmission, and pathology between the 2022 global mpox outbreak (clade IIb) and classical mpox disease, endemic in Africa (clades I and IIa) have been highlighted. MPXV genome analysis has identified the genomic changes characterizing clade IIb and the drivers of MPXV rapid evolution. Although mpox cases have largely declined, MPXV cryptic transmission and microevolution continues, which may lead to an MPXV of unpredictable pathogenicity. Vaccines and antivirals developed against variola virus, the agent that caused the extinguished plague smallpox, have been used to contain the 2022 mpox outbreak. In this review article, recent findings on MPXV origin and evolution and relevant models able to recapitulate differences in MPXV pathogenicity, which are important for drug and vaccine development, are discussed.
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Affiliation(s)
- Graciela Andrei
- Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium.
| | - Robert Snoeck
- Laboratory of Virology and Chemotherapy, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
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32
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Borges V, Duque MP, Martins JV, Vasconcelos P, Ferreira R, Sobral D, Pelerito A, de Carvalho IL, Núncio MS, Borrego MJ, Roemer C, Neher RA, O'Driscoll M, Rocha R, Lopo S, Neves R, Palminha P, Coelho L, Nunes A, Isidro J, Pinto M, Santos JD, Mixão V, Santos D, Duarte S, Vieira L, Martins F, Machado J, Veríssimo VC, Grau B, Peralta-Santos A, Neves J, Caldeira M, Pestana M, Fernandes C, Caria J, Pinto R, Póvoas D, Maltez F, Sá AI, Salvador MB, Teófilo E, Rocha M, Moneti V, Duque LM, E Silva FF, Baptista T, Vasconcelos J, Casanova S, Mansinho K, Alves JV, Alves J, Silva A, Alpalhão M, Brazão C, Sousa D, Filipe P, Pacheco P, Peruzzu F, de Jesus RP, Ferreira L, Mendez J, Jordão S, Duarte F, Gonçalves MJ, Pena E, Silva CN, Guimarães AR, Tavares M, Freitas G, Cordeiro R, Gomes JP. Viral genetic clustering and transmission dynamics of the 2022 mpox outbreak in Portugal. Nat Med 2023; 29:2509-2517. [PMID: 37696933 PMCID: PMC10579057 DOI: 10.1038/s41591-023-02542-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 08/08/2023] [Indexed: 09/13/2023]
Abstract
Pathogen genome sequencing during epidemics enhances our ability to identify and understand suspected clusters and investigate their relationships. Here, we combine genomic and epidemiological data of the 2022 mpox outbreak to better understand early viral spread, diversification and transmission dynamics. By sequencing 52% of the confirmed cases in Portugal, we identified the mpox virus sublineages with the highest impact on case numbers and fitted them into a global context, finding evidence that several international sublineages probably emerged or spread early in Portugal. We estimated a 62% infection reporting rate and that 1.3% of the population of men who have sex with men in Portugal were infected. We infer the critical role played by sexual networks and superspreader gatherings, such as sauna attendance, in the dissemination of mpox virus. Overall, our findings highlight genomic epidemiology as a tool for the real-time monitoring and control of mpox epidemics, and can guide future vaccine policy in a highly susceptible population.
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Affiliation(s)
- Vítor Borges
- Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Mariana Perez Duque
- Epidemiology and Statistics Division, Directorate-General of Health, Lisbon, Portugal
- Pathogen Dynamics Group, Department of Genetics, University of Cambridge, Cambridge, United Kingdom
| | - João Vieira Martins
- Epidemiology and Statistics Division, Directorate-General of Health, Lisbon, Portugal
| | - Paula Vasconcelos
- Public Health Emergency Centre, Directorate-General of Health, Lisbon, Portugal
| | - Rita Ferreira
- Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Daniel Sobral
- Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Ana Pelerito
- Emergency Response and Biopreparedness Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Isabel Lopes de Carvalho
- Emergency Response and Biopreparedness Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Maria Sofia Núncio
- Emergency Response and Biopreparedness Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Maria José Borrego
- National Reference Laboratory for Sexually Transmitted Infections, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Cornelius Roemer
- Biozentrum, University of Basel, Basel, Switzerland
- Swiss Institute of Bioinformatics, Basel, Switzerland
| | - Richard A Neher
- Biozentrum, University of Basel, Basel, Switzerland
- Swiss Institute of Bioinformatics, Basel, Switzerland
| | - Megan O'Driscoll
- Pathogen Dynamics Group, Department of Genetics, University of Cambridge, Cambridge, United Kingdom
| | - Raquel Rocha
- National Reference Laboratory for Sexually Transmitted Infections, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Sílvia Lopo
- National Reference Laboratory for Sexually Transmitted Infections, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Raquel Neves
- National Reference Laboratory for Sexually Transmitted Infections, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Paula Palminha
- National Reference Laboratory for Sexually Transmitted Infections, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Luís Coelho
- Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Alexandra Nunes
- Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
- Veterinary and Animal Research Centre (CECAV), Faculty of Veterinary Medicine, Lusófona University, Lisbon, Portugal
| | - Joana Isidro
- Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Miguel Pinto
- Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - João Dourado Santos
- Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Verónica Mixão
- Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Daniela Santos
- Technology and Innovation Unit, Department of Human Genetics, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Silvia Duarte
- Technology and Innovation Unit, Department of Human Genetics, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Luís Vieira
- Technology and Innovation Unit, Department of Human Genetics, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Fátima Martins
- Technical Board, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Jorge Machado
- Department Coordination, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Vítor Cabral Veríssimo
- Epidemiology and Statistics Division, Directorate-General of Health, Lisbon, Portugal
- Public Health Unit, ACES Cascais, ARSLVT, Cascais, Portugal
| | - Berta Grau
- Epidemiology and Statistics Division, Directorate-General of Health, Lisbon, Portugal
- Public Health Emergency Centre, Directorate-General of Health, Lisbon, Portugal
- ECDC Fellowship Programme, Field Epidemiology path (EPIET), European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
- Directorate of Information and Analysis, Directorate-General of Health, Lisbon, Portugal
| | - André Peralta-Santos
- Directorate of Information and Analysis, Directorate-General of Health, Lisbon, Portugal
- Comprehensive Health Research Centre (CHRC), Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - José Neves
- Serviço de Dermatovenereologia, Consulta de DST, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - Margarida Caldeira
- Serviço de Dermatovenereologia, Consulta de DST, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - Mafalda Pestana
- Serviço de Dermatovenereologia, Consulta de DST, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - Cândida Fernandes
- Serviço de Dermatovenereologia, Consulta de DST, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - João Caria
- Serviço de Doenças Infeciosas, Hospital de Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - Raquel Pinto
- Serviço de Doenças Infeciosas, Hospital de Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - Diana Póvoas
- Serviço de Doenças Infeciosas, Hospital de Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
- Instituto Gulbenkian de Ciência, Oeiras, Portugal
| | - Fernando Maltez
- Serviço de Doenças Infeciosas, Hospital de Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - Ana Isabel Sá
- Unidade de Doenças Sexualmente Transmissíveis da Lapa, Lisbon, Portugal
| | | | - Eugénio Teófilo
- GAT - Grupo de Ativistas em Tratamentos, Av. Paris, Lisbon, Portugal
| | - Miguel Rocha
- GAT - Grupo de Ativistas em Tratamentos, Av. Paris, Lisbon, Portugal
| | - Virginia Moneti
- GAT - Grupo de Ativistas em Tratamentos, Av. Paris, Lisbon, Portugal
| | - Luis Miguel Duque
- GAT - Grupo de Ativistas em Tratamentos, Av. Paris, Lisbon, Portugal
| | | | - Teresa Baptista
- GAT - Grupo de Ativistas em Tratamentos, Intendente, Lisbon, Portugal
| | - Joana Vasconcelos
- Serviço de Doenças Infeciosas e Medicina Tropical, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - Sara Casanova
- Serviço de Doenças Infeciosas e Medicina Tropical, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - Kamal Mansinho
- Serviço de Doenças Infeciosas e Medicina Tropical, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - João Vaz Alves
- Serviço de Doenças Infeciosas e Medicina Tropical, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - João Alves
- Serviço de Dermatovenereologia, Hospital Garcia de Orta, Almada, Portugal
| | - António Silva
- Serviço de Dermatovenereologia, Hospital Garcia de Orta, Almada, Portugal
| | - Miguel Alpalhão
- Dermatology Department, Centro Hospitalar Universitário Lisboa Norte EPE, Lisbon, Portugal
- Dermatology Research Unit (PFilipe Lab), Instituto de Medicina Molecular João Lobo Antunes, University of Lisbon, Lisbon, Portugal
- Dermatology University Clinic, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Cláudia Brazão
- Dermatology Department, Centro Hospitalar Universitário Lisboa Norte EPE, Lisbon, Portugal
| | - Diogo Sousa
- Dermatology Department, Centro Hospitalar Universitário Lisboa Norte EPE, Lisbon, Portugal
| | - Paulo Filipe
- Dermatology Department, Centro Hospitalar Universitário Lisboa Norte EPE, Lisbon, Portugal
- Dermatology Research Unit (PFilipe Lab), Instituto de Medicina Molecular João Lobo Antunes, University of Lisbon, Lisbon, Portugal
- Dermatology University Clinic, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Patrícia Pacheco
- Serviço de Infeciologia, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
| | - Francesca Peruzzu
- Serviço de Infeciologia, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
| | | | - Luís Ferreira
- Serviço Infeciologia do CHUP, Largo Professor Abel Salazar, Porto, Portugal
| | - Josefina Mendez
- Serviço Infeciologia do CHUP, Largo Professor Abel Salazar, Porto, Portugal
| | - Sofia Jordão
- Serviço de Doenças Infeciosas, Hospital Pedro Hispano - ULS Matosinhos, Matosinhos, Portugal
| | - Frederico Duarte
- Serviço de Doenças Infeciosas, Hospital Pedro Hispano - ULS Matosinhos, Matosinhos, Portugal
| | - Maria João Gonçalves
- Serviço de Doenças Infeciosas, Hospital Pedro Hispano - ULS Matosinhos, Matosinhos, Portugal
| | - Eduarda Pena
- Serviço de Doenças Infeciosas, Hospital Pedro Hispano - ULS Matosinhos, Matosinhos, Portugal
| | - Claúdio Nunes Silva
- Serviço de Doenças Infeciosas, Centro Hospitalar Universitário de São João, Porto, Portugal
| | | | - Margarida Tavares
- Serviço de Doenças Infeciosas, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Graça Freitas
- National Health Authority, Directorate-General of Health, Lisbon, Portugal
| | - Rita Cordeiro
- Emergency Response and Biopreparedness Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - João Paulo Gomes
- Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal.
- Veterinary and Animal Research Centre (CECAV), Faculty of Veterinary Medicine, Lusófona University, Lisbon, Portugal.
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Bruno G, Buccoliero GB. Antivirals against Monkeypox (Mpox) in Humans: An Updated Narrative Review. Life (Basel) 2023; 13:1969. [PMID: 37895350 PMCID: PMC10608433 DOI: 10.3390/life13101969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/23/2023] [Accepted: 09/25/2023] [Indexed: 10/29/2023] Open
Abstract
As of 29 August 2023, a total of 89,596 confirmed cases of Mpox (monkeypox) have been documented across 114 countries worldwide, with 157 reported fatalities. The Mpox outbreak that transpired in 2022 predominantly affected young men who have sex with men (MSM). While most cases exhibited a mild clinical course, individuals with compromised immune systems, particularly those living with HIV infection and possessing a CD4 count below 200 cells/mm3, experienced a more severe clinical trajectory marked by heightened morbidity and mortality. The approach to managing Mpox is primarily symptomatic and supportive. However, in instances characterized by severe or complicated manifestations, the utilization of antiviral medications becomes necessary. Despite tecovirimat's lack of official approval by the FDA for treating Mpox in humans, a wealth of positive clinical experiences exists, pending the outcomes of ongoing clinical trials. Brincidofovir and cidofovir have also been administered in select cases due to the unavailability of tecovirimat. Within the scope of this narrative review, our objective was to delve into the clinical attributes of Mpox and explore observational studies that shed light on the utilization of these antiviral agents.
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Affiliation(s)
- Giuseppe Bruno
- Infectious Diseases Unit, San Giuseppe Moscati Hospital, Azienda Sanitaria Locale Taranto, 74121 Taranto, Italy;
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Salvo PF, Farinacci D, Lombardi F, Ciccullo A, Tamburrini E, Santangelo R, Borghetti A, Di Giambenedetto S. Clinical presentation of human monkeypox virus infection during the 2022 outbreak: descriptive case series from a large italian Research Hospital. Virol J 2023; 20:214. [PMID: 37723564 PMCID: PMC10506307 DOI: 10.1186/s12985-023-02178-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 09/05/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND In May 2022, a new case of Monkeypox Virus (MPX) was reported in a non-endemic area, the United Kingdom, and since then, the number of confirmed cases in Europe has been increasing until WHO, on May 10 2023, declared that MPOX is no longer a public health emergency of international concern. We aimed to describe the clinical and microbiological characteristics of sixteen patients with a confirmed diagnosis of MPX followed by a single Italian clinical centre, the Fondazione Policlinico Universitario Agostino Gemelli, between May 20 and August 30. MATERIALS AND METHODS A prospective observational study has been conducted, collecting microbiological samples during the time of the infection, as well as epidemiological and clinical data of the patients. All patients provided written informed consent. RESULTS During clinical practice, 16 individuals presenting with consistent symptoms tested positive for MPX on a polymerase chain reaction. All patients were men having sex with men (MSM). The most frequent clinical presentation was a vesicular erythematous cutaneous rash, mainly distributed on the genital and perianal area, but also regarding limbs, face, neck, chest and back in some of the patients. Systemic symptoms, such as fever or lymphadenopathy, involved eight patients. The symptom most frequently reported by patients was pruritus in the area of the vesicles. Thirteen patients also reported pain. Nine patients were HIV-1 coinfected, but no significant differences have been observed compared to other cohort patients. The median time between the onset of symptoms and the healing was 19.5 days (IQR 14.0-20.3). CONCLUSIONS Our cohort of patients presented a mild manifestation of the disease with no complications and no need for antiviral therapy nor hospitalization. This population seems different from the ones reported in the literature during the previous outbreaks in endemic areas in epidemiological data and clinical manifestations but also from a cohort of patients described in the literature from the 2022 outbreak, suggesting the importance for healthcare workers to keep in mind the possibility of an MPX infection in the differential diagnosis of patients presenting with consistent symptoms, even in non-endemic areas, to ensure efficient isolation of the patient for infection control purposes and effective management of the infection preventing the development of MPOX-related complications.
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Affiliation(s)
- Pierluigi Francesco Salvo
- Department of Safety and Bioethics, Section of Infectious Diseases, Catholic University of Sacred Heart, Rome, Italy.
| | - Damiano Farinacci
- Fondazione Policlinico Universitario A.Gemelli IRCCS, Infectious Diseases, Rome, Italy
| | - Francesca Lombardi
- Department of Safety and Bioethics, Section of Infectious Diseases, Catholic University of Sacred Heart, Rome, Italy
| | - Arturo Ciccullo
- Infectious Diseases Unit, San Salvatore Hospital, L'Aquila, Italy
| | - Enrica Tamburrini
- Department of Safety and Bioethics, Section of Infectious Diseases, Catholic University of Sacred Heart, Rome, Italy
- Fondazione Policlinico Universitario A.Gemelli IRCCS, Infectious Diseases, Rome, Italy
| | - Rosaria Santangelo
- Department of Basic Biotechnological, Clinical Intensivological and Perioperative Sciences, Catholic University of Sacred Heart, Rome, Italy
- Department of Infectology and Laboratory Sciences, Policlinico Universitario A.Gemelli IRCCS, Rome, Italy
| | - Alberto Borghetti
- Fondazione Policlinico Universitario A.Gemelli IRCCS, Infectious Diseases, Rome, Italy
| | - Simona Di Giambenedetto
- Department of Safety and Bioethics, Section of Infectious Diseases, Catholic University of Sacred Heart, Rome, Italy
- Fondazione Policlinico Universitario A.Gemelli IRCCS, Infectious Diseases, Rome, Italy
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Basu K, Krugliak M, Arkin IT. Viroporins of Mpox Virus. Int J Mol Sci 2023; 24:13828. [PMID: 37762131 PMCID: PMC10530900 DOI: 10.3390/ijms241813828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/17/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
Mpox or monkeypox virus (MPXV) belongs to the subclass of Poxviridae and has emerged recently as a global threat. With a limited number of anti-viral drugs available for this new virus species, it is challenging to thwart the illness it begets. Therefore, characterizing new drug targets in the virus may prove advantageous to curbing the disease. Since channels as a family are excellent drug targets, we have sought to identify viral ion channels for this virus, which are instrumental in formulating channel-blocking anti-viral drugs. Bioinformatics analyses yielded eight transmembranous proteins smaller or equal to 100 amino acids in length. Subsequently, three independent bacteria-based assays have pointed to five of the eight proteins that exhibit ion channel activity. Finally, we propose a tentative structure of four ion channels from their primary amino acid sequences, employing AlphaFold2 and molecular dynamic simulation methods. These results may represent the first steps in characterizing MPXV viroporins en route to developing blockers that inhibit their function.
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Affiliation(s)
| | | | - Isaiah T. Arkin
- Department of Biological Chemistry, The Alexander Silberman Institute of Life Sciences, The Hebrew University of Jerusalem, Edmond J. Safra Campus, Jerusalem 91904, Israel; (K.B.); (M.K.)
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Ndodo N, Ashcroft J, Lewandowski K, Yinka-Ogunleye A, Chukwu C, Ahmad A, King D, Akinpelu A, Maluquer de Motes C, Ribeca P, Sumner RP, Rambaut A, Chester M, Maishman T, Bamidele O, Mba N, Babatunde O, Aruna O, Pullan ST, Gannon B, Brown CS, Ihekweazu C, Adetifa I, Ulaeto DO. Distinct monkeypox virus lineages co-circulating in humans before 2022. Nat Med 2023; 29:2317-2324. [PMID: 37710003 PMCID: PMC10504077 DOI: 10.1038/s41591-023-02456-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 06/12/2023] [Indexed: 09/16/2023]
Abstract
The 2022 global mpox outbreak raises questions about how this zoonotic disease established effective human-to-human transmission and its potential for further adaptation. The 2022 outbreak virus is related to an ongoing outbreak in Nigeria originally reported in 2017, but the evolutionary path linking the two remains unclear due to a lack of genomic data between 2018, when virus exportations from Nigeria were first recorded, and 2022, when the global mpox outbreak began. Here, 18 viral genomes obtained from patients across southern Nigeria in 2019-2020 reveal multiple lineages of monkeypox virus (MPXV) co-circulated in humans for several years before 2022, with progressive accumulation of mutations consistent with APOBEC3 activity over time. We identify Nigerian A.2 lineage isolates, confirming the lineage that has been multiply exported to North America independently of the 2022 outbreak originated in Nigeria, and that it has persisted by human-to-human transmission in Nigeria for more than 2 years before its latest exportation. Finally, we identify a lineage-defining APOBEC3-style mutation in all A.2 isolates that disrupts gene A46R, encoding a viral innate immune modulator. Collectively, our data demonstrate MPXV capacity for sustained diversification within humans, including mutations that may be consistent with established mechanisms of poxvirus adaptation.
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Affiliation(s)
| | - Jonathan Ashcroft
- UK Public Health Rapid Support Team, UK Health Security Agency/London School of Hygiene & Tropical Medicine, London, UK
| | - Kuiama Lewandowski
- UK Health Security Agency, Research & Evaluation Services, Porton Down, UK
| | | | | | - Adama Ahmad
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - David King
- CBR Division, Defence Science and Technology Laboratory, Salisbury, UK
| | | | - Carlos Maluquer de Motes
- Department of Microbial Sciences, School of Biosciences and Medicine, University of Surrey, Guildford, UK
| | - Paolo Ribeca
- UK Health Security Agency, London, UK
- Biomathematics and Statistics Scotland, Edinburgh, UK
| | - Rebecca P Sumner
- Department of Microbial Sciences, School of Biosciences and Medicine, University of Surrey, Guildford, UK
| | - Andrew Rambaut
- Institute of Evolutionary Biology, University of Edinburgh, Edinburgh, UK
| | - Michael Chester
- CBR Division, Defence Science and Technology Laboratory, Salisbury, UK
| | - Tom Maishman
- CBR Division, Defence Science and Technology Laboratory, Salisbury, UK
| | | | - Nwando Mba
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | | | - Olusola Aruna
- UK Health Security Agency, International Health Regulations (IHR) Strengthening Project, British High Commission, Abuja, Nigeria
| | - Steven T Pullan
- UK Health Security Agency, Research & Evaluation Services, Porton Down, UK
| | - Benedict Gannon
- UK Public Health Rapid Support Team, UK Health Security Agency/London School of Hygiene & Tropical Medicine, London, UK
| | | | | | | | - David O Ulaeto
- CBR Division, Defence Science and Technology Laboratory, Salisbury, UK.
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Sun YQ, Chen JJ, Liu MC, Zhang YY, Wang T, Che TL, Li TT, Liu YN, Teng AY, Wu BZ, Hong XG, Xu Q, Lv CL, Jiang BG, Liu W, Fang LQ. Mapping global zoonotic niche and interregional transmission risk of monkeypox: a retrospective observational study. Global Health 2023; 19:58. [PMID: 37592305 PMCID: PMC10436417 DOI: 10.1186/s12992-023-00959-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 07/31/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND Outbreaks of monkeypox have been ongoing in non-endemic countries since May 2022. A thorough assessment of its global zoonotic niche and potential transmission risk is lacking. METHODS We established an integrated database on global monkeypox virus (MPXV) occurrence during 1958 - 2022. Phylogenetic analysis was performed to examine the evolution of MPXV and effective reproductive number (Rt) was estimated over time to examine the dynamic of MPXV transmissibility. The potential ecological drivers of zoonotic transmission and inter-regional transmission risks of MPXV were examined. RESULTS As of 24 July 2022, a total of 49 432 human patients with MPXV infections have been reported in 78 countries. Based on 525 whole genome sequences, two main clades of MPXV were formed, of which Congo Basin clade has a higher transmissibility than West African clade before the 2022-monkeypox, estimated by the overall Rt (0.81 vs. 0.56), and the latter significantly increased in the recent decade. Rt of 2022-monkeypox varied from 1.14 to 4.24 among the 15 continuously epidemic countries outside Africa, with the top three as Peru (4.24, 95% CI: 2.89-6.71), Brazil (3.45, 95% CI: 1.62-7.00) and the United States (2.44, 95% CI: 1.62-3.60). The zoonotic niche of MPXV was associated with the distributions of Graphiurus lorraineus and Graphiurus crassicaudatus, the richness of Rodentia, and four ecoclimatic indicators. Besides endemic areas in Africa, more areas of South America, the Caribbean States, and Southeast and South Asia are ecologically suitable for the occurrence of MPXV once the virus has invaded. Most of Western Europe has a high-imported risk of monkeypox from Western Africa, whereas France and the United Kingdom have a potential imported risk of Congo Basin clade MPXV from Central Africa. Eleven of the top 15 countries with a high risk of MPXV importation from the main countries of 2022-monkeypox outbreaks are located at Europe with the highest risk in Italy, Ireland and Poland. CONCLUSIONS The suitable ecological niche for MPXV is not limited to Africa, and the transmissibility of MPXV was significantly increased during the 2022-monkeypox outbreaks. The imported risk is higher in Europe, both from endemic areas and currently epidemic countries. Future surveillance and targeted intervention programs are needed in its high-risk areas informed by updated prediction.
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Affiliation(s)
- Yan-Qun Sun
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, 20 Dong-Da Street, Fengtai District, Beijing, 100071, China
- Nanjing Municipal Center for Disease Control and Prevention, Affiliated Nanjing Center for Disease Control and Prevention of Nanjing Medical University, Nanjing, China
| | - Jin-Jin Chen
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, 20 Dong-Da Street, Fengtai District, Beijing, 100071, China
| | - Mei-Chen Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, 20 Dong-Da Street, Fengtai District, Beijing, 100071, China
- School of Public Health, Anhui Medical University, Hefei, 230032, China
| | - Yuan-Yuan Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, 20 Dong-Da Street, Fengtai District, Beijing, 100071, China
| | - Tao Wang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, 20 Dong-Da Street, Fengtai District, Beijing, 100071, China
| | - Tian-Le Che
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, 20 Dong-Da Street, Fengtai District, Beijing, 100071, China
| | - Ting-Ting Li
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, 20 Dong-Da Street, Fengtai District, Beijing, 100071, China
- School of Public Health, Guizhou Medical University, Guiyang, 550025, China
| | - Yan-Ning Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, 20 Dong-Da Street, Fengtai District, Beijing, 100071, China
| | - Ai-Ying Teng
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, 20 Dong-Da Street, Fengtai District, Beijing, 100071, China
| | - Bing-Zheng Wu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, 20 Dong-Da Street, Fengtai District, Beijing, 100071, China
| | - Xue-Geng Hong
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, 20 Dong-Da Street, Fengtai District, Beijing, 100071, China
| | - Qiang Xu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, 20 Dong-Da Street, Fengtai District, Beijing, 100071, China
| | - Chen-Long Lv
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, 20 Dong-Da Street, Fengtai District, Beijing, 100071, China
| | - Bao-Gui Jiang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, 20 Dong-Da Street, Fengtai District, Beijing, 100071, China
| | - Wei Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, 20 Dong-Da Street, Fengtai District, Beijing, 100071, China.
| | - Li-Qun Fang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, 20 Dong-Da Street, Fengtai District, Beijing, 100071, China.
- School of Public Health, Anhui Medical University, Hefei, 230032, China.
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Zhou Y, Chen Z. Mpox: a review of laboratory detection techniques. Arch Virol 2023; 168:221. [PMID: 37543543 PMCID: PMC10404179 DOI: 10.1007/s00705-023-05848-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 07/04/2023] [Indexed: 08/07/2023]
Abstract
Mpox (formerly monkeypox) is a zoonotic disease caused by monkeypox virus (MPXV), which, like smallpox, is characterised by skin rashes. While the world is currently grappling with the coronavirus disease 2019 pandemic, the appearance of MPXV has presented a global threat and raised concerns worldwide. Since May 2022, MPXV has spread rapidly in non-endemic mpox areas. As of 27 June 2023, the virus has spread to more than 112 countries and regions, with over 88,060 laboratory-confirmed cases and 147 deaths. Thus, measures to control the mpox epidemic are urgently needed. As the principal methods for identifying and monitoring mpox, laboratory detection techniques play an important role in mpox diagnosis. This review summarises the currently-used laboratory techniques for MPXV detection, discusses progress in improving these methods, and compares the benefits and limitations of various diagnostic detection methods. Currently, nucleic acid amplification tests, such as the polymerase chain reaction, are the most commonly used. Immunological methods have also been applied to diagnose the disease, which can help us discover new features of MPXV, improve diagnostic accuracy, track epidemic trends, and guide future prevention and control strategies, which are also vital for controlling mpox epidemics. This review provides a resource for the scientific community and should stimulate more research and development in alternative diagnostics to be applied to this and future public health crises.
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Affiliation(s)
- Yunfan Zhou
- School of Medicine, Guangzhou Higher Education Mega Centre, South China University of Technology, Panyu District, Guangzhou, 510006, China.
| | - Zixin Chen
- School of Medicine, Guangzhou Higher Education Mega Centre, South China University of Technology, Panyu District, Guangzhou, 510006, China
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Jiao K, Xu Y, Huang S, Zhang Y, Zhou J, Li Y, Xiao Y, Ma W, He L, Ren X, Dai Z, Sun J, Li Q, Cheng F, Liang W, Luo S. Mpox risk perception and associated factors among Chinese young men who have sex with men: Results from a large cross-sectional survey. J Med Virol 2023; 95:e29057. [PMID: 37635623 DOI: 10.1002/jmv.29057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 08/01/2023] [Accepted: 08/14/2023] [Indexed: 08/29/2023]
Abstract
The mpox outbreak since 2022 had attacked the community of men who have sex with men (MSM) heavily. This large cross-sectional study investigated the levels and associated factors of mpox risk perception among young MSM (YMSM) aged 18-29 years in six provincial regions of China in September 2022. The participants were recruited via facility-based sampling. Mpox risk perception was measured by perceived susceptibility and perceived severity of mpox. Geodetector was used to measure stratified heterogeneity of mpox risk perception. Univariate and multivariable linear regressions were used to examine the factors associated with mpox risk perception. A total of 2493 participants were included with a mean age of 24.6 years. The proportion of perceiving a susceptibility of mpox under different scenarios ranged 3.7%-17.0% and that of perceiving a severity of mpox ranged 81.6%-83.2%. Stratified heterogeneity of perceived susceptibility, perceived severity, and overall perceived risk of mpox were observed in several characteristics such as study sites, monthly income, risk behaviors, and psychosocial factors. Multivariable regression showed the level of mpox risk perception was positively associated with having in-person gathering activities (ba = 0.457, 95% CI: 0.208, 0.705), history of HIV infection (ba = 0.431, 95% CI: 0.028, 0.834), depressive symptoms (ba = 0.069, 95% CI: 0.049, 0.090), and self-stigma to MSM identity (ba = 0.047, 95% CI: 0.024, 0.071). The Chinese YMSM showed a high level of perceived severity of mpox but a low level of perceived susceptibility. It is warranted to strengthen targeted risk communication of mpox, develop comprehensive and unstigmatized health messages, and provide mental health support for YMSM.
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Affiliation(s)
- Kedi Jiao
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Yutong Xu
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Siwen Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Yuhang Zhang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Jingtao Zhou
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Yan Li
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Yongkang Xiao
- Department of Acute Infectious Diseases Control and Prevention, Anhui Provincial Center for Disease Control and Prevention, Hefei, Anhui, China
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Lin He
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Xianlong Ren
- Department of AIDS/STD Control and Prevention, Beijing Center for Disease Control and Prevention, Beijing, China
| | - Zhen Dai
- Department of AIDS/STD Control and Prevention, Chengdu Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Jiaruo Sun
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Qingyu Li
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Feng Cheng
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Wannian Liang
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Sitong Luo
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
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Vanhamel J, Laisnez V, Liesenborghs L, Brosius I, Berens-Riha N, Vanbaelen T, Kenyon C, Vercauteren K, Laga M, Hammami N, Lambricht O, Mahieu R, Lecompte A, Vanden Berghe W, Vuylsteke B. Understanding sexual transmission dynamics and transmission contexts of monkeypox virus: a mixed-methods study of the early outbreak in Belgium (May-June 2022). Sex Transm Infect 2023; 99:330-336. [PMID: 36396173 PMCID: PMC10439260 DOI: 10.1136/sextrans-2022-055601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/31/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The available epidemiological and clinical evidence from the currently ongoing monkeypox (MPX) outbreak in non-endemic areas suggests an important factor of sexual transmission. However, limited information on the behaviour and experiences of individuals with an MPX infection has to date been provided. We aimed to describe the initial phase of the MPX outbreak in Belgium, and to provide a more in-depth description of sexual behaviour and transmission contexts. METHODS We used routine national surveillance data of 139 confirmed MPX cases with date of symptom onset until 19 June 2022, complemented with 12 semistructured interviews conducted with a subsample of these cases. RESULTS Sexualised environments, including large festivals and cruising venues for gay men, were the suspected exposure setting for the majority of the cases in the early outbreak phase. In-depth narratives of sexual behaviour support the hypothesis of MPX transmission through close physical contact during sex. Despite awareness of the ongoing MPX outbreak, low self-perceived risk of MPX acquisition and confusing initial signs and symptoms for other STIs or skin conditions delayed early detection of an MPX infection. In addition, we describe relevant contextual factors beyond individual behaviour, related to sexual networks, interpersonal interactions and health systems. Some of these factors may complicate early MPX detection and control efforts. CONCLUSION Our results highlight the role of sexual contact and networks in the transmission of MPX during the early phase of the outbreak in Belgium. Risk communication messages should consistently and transparently state the predominant sexual transmission potential of MPX virus, and prevention and control measures must be adapted to reflect multilevel factors contributing to MPX transmission risk.
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Affiliation(s)
- Jef Vanhamel
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Valeska Laisnez
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- ECDC Fellowship Programme, Field Epidemiology Path (EPIET), European Centre for Disease Prevention and Control, Solna, Sweden
| | - Laurens Liesenborghs
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Isabel Brosius
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Nicole Berens-Riha
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Thibaut Vanbaelen
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Chris Kenyon
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Koen Vercauteren
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Marie Laga
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Naïma Hammami
- Department of Infectious Disease Prevention and Control, Agency for Care and Health, Flemish Region, Brussels, Belgium
| | - Oriane Lambricht
- Agence pour une Vie de Qualité (AVIQ), Walloon Region, Charleroi, Belgium
| | - Romain Mahieu
- Department of Infectious Disease Prevention, Brussels Capital Region, Brussels, Belgium
| | - Amaryl Lecompte
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Wim Vanden Berghe
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Bea Vuylsteke
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
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Kollepara PK, Chisholm RH, Miller JC. Heterogeneity in network structure switches the dominant transmission mode of infectious diseases. PNAS Nexus 2023; 2:pgad227. [PMID: 37533729 PMCID: PMC10393287 DOI: 10.1093/pnasnexus/pgad227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 06/20/2023] [Accepted: 06/29/2023] [Indexed: 08/04/2023]
Abstract
Several recent emerging diseases have exhibited both sexual and nonsexual transmission modes (Ebola, Zika, and mpox). In the recent mpox outbreaks, transmission through sexual contacts appears to be the dominant mode of transmission. Motivated by this, we use an SIR-like model to argue that an initially dominant sexual transmission mode can be overtaken by casual transmission at later stages, even if the basic casual reproduction number is less than one. Our results highlight the risk of intervention designs which are informed only by the early dynamics of the disease.
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Affiliation(s)
- Pratyush K Kollepara
- Department of Mathematical and Physical Sciences, La Trobe University, Plenty Rd and Kingsbury Dr, Melbourne, 3086 VIC, Australia
| | - Rebecca H Chisholm
- Department of Mathematical and Physical Sciences, La Trobe University, Plenty Rd and Kingsbury Dr, Melbourne, 3086 VIC, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Grattan St, Melbourne, 3010 VIC, Australia
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Abstract
PURPOSE OF REVIEW The risk of nosocomial transmission of mpox during the 2022 global outbreak is not well described. We evaluated reports of exposures to healthcare personnel (HCP) and patients in healthcare settings and risk of transmission. RECENT FINDINGS Reported nosocomial transmission of mpox has been rare and associated primarily with sharps injuries and breaches in transmission-based precautions. SUMMARY Currently recommended infection control practices, including the use of standard and transmission-based precautions in the care of patients with known or suspected mpox are highly effective. Diagnostic sampling should not involve the use of needles or other sharp instruments.
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Affiliation(s)
- Kimon C Zachary
- Regional Emerging Special Pathogens Treatment Center
- Infection Control Unit
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital
- Harvard Medical School
| | - Lisa L Philpotts
- Treadwell Library, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Erica S Shenoy
- Regional Emerging Special Pathogens Treatment Center
- Infection Control Unit
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital
- Harvard Medical School
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43
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Azarkish F, Janghorban R. Can monkeypox be a sexually transmitted infection? J Res Med Sci 2023; 28:61. [PMID: 38024516 PMCID: PMC10668216 DOI: 10.4103/jrms.jrms_439_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 12/01/2023]
Affiliation(s)
- Fatemeh Azarkish
- Tropical and Communicable Diseases Research Center, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Roksana Janghorban
- Department of Midwifery, Maternal-Fetal Medicine Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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Kasuya F, Negishi A, Kumagai R, Yoshida I, Murakami K, Fujiwara T, Hasegawa M, Harada S, Amano A, Inada M, Saito S, Morioka S, Ohmagari N, Sugishita Y, Miyake H, Nagashima M, Sadamasu K, Yoshimura K. Genetic Characteristics of the Virus Detected in the First Mpox Imported Case in Tokyo, Japan. Jpn J Infect Dis 2023; 76:259-262. [PMID: 37005274 DOI: 10.7883/yoken.jjid.2022.546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
Mpox, caused by the mpox virus (MPXV), produces symptoms similar to those of smallpox when transmitted to humans. Since 1970, this disease has been endemic, particularly in Africa. However, since May 2022, the number of patients without a history of travel to endemic areas has increased rapidly globally. Under these circumstances, in July 2022, two different real-time PCR methods were used on specimens brought to the Tokyo Metropolitan Institute of Public Health. MPXV was detected in the skin samples, and it was inferred that the virus was a West African strain. Furthermore, a more detailed analysis of the genetic characteristics of the detected MPXV using next-generation sequencing revealed that the MPXV detected in Tokyo was strain B.1, which corresponds to the same strain that is prevalent in Europe and the USA. This suggests that mpox reported for the first time in Japan was imported and related to outbreaks in Europe and the USA. Therefore, it is necessary to continue monitoring outbreaks in Japan in conjunction with global epidemics.
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Affiliation(s)
- Fumi Kasuya
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Japan
| | - Akane Negishi
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Japan
| | - Ryota Kumagai
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Japan
| | - Isao Yoshida
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Japan
| | - Kou Murakami
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Japan
| | - Takushi Fujiwara
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Japan
| | - Michiya Hasegawa
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Japan
| | - Sachiko Harada
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Japan
| | - Arisa Amano
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Japan
| | - Makoto Inada
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Sho Saito
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Shinichiro Morioka
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Yoshiyuki Sugishita
- Infectious Disease Control Division, Bureau of Social Welfare and Public Health, Tokyo Metropolitan Government, Japan
| | - Hirofumi Miyake
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Japan
| | - Mami Nagashima
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Japan
| | - Kenji Sadamasu
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Japan
| | - Kazuhisa Yoshimura
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Japan
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Torres TS, Silva MST, Coutinho C, Hoagland B, Jalil EM, Cardoso SW, Moreira J, Magalhaes MA, Luz PM, Veloso VG, Grinsztejn B. Evaluation of Mpox Knowledge, Stigma, and Willingness to Vaccinate for Mpox: Cross-Sectional Web-Based Survey Among Sexual and Gender Minorities. JMIR Public Health Surveill 2023; 9:e46489. [PMID: 37459174 PMCID: PMC10411424 DOI: 10.2196/46489] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/30/2023] [Accepted: 06/20/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND The 2022 multicountry mpox outbreak positioned the condition as a public health emergency of international concern. By May 2023, Brazil ranked second globally in the cumulative number of mpox cases and deaths. The higher incidence of mpox among gay and other men who have sex with men in the current mpox outbreak deepens the stigma and discrimination against sexual and gender minorities (SGM). This might worsen the structural barriers impacting access to health services, which ultimately leads to undertesting and underreporting of cases. There are no data available on mpox knowledge and stigma in Latin America. OBJECTIVE We aimed to evaluate mpox knowledge, stigma, and willingness to vaccinate for mpox among SGM, and to describe sociodemographic and behavioral characteristics according to self-reported mpox diagnosis. METHODS A cross-sectional, internet-based survey was conducted in a convenience sample of adults (aged >18 years) living in Brazil recruited through advertisements on dating apps, social media, referral institutions for infectious diseases websites, and mass media (October-November 2022). We compared participants' characteristics according to self-reported mpox diagnosis using chi-square test or Fisher exact test for qualitative variables and Kruskal-Wallis test for quantitative variables. RESULTS We enrolled 6236 participants: 5685 (91.2%) were cisgender men; 6032 (96.7%) were gay, bisexual, or pansexual; 3877 (62.2%) were White; 4902 (78.7%) had tertiary education; and 4070 (65.2%) reported low or middle income. Most participants (n=5258, 84.4%) agreed or strongly agreed that "LGBTQIA+ individuals are being discriminated and stigmatized due to mpox." Mpox awareness was 96.9% (n=6044), and 5008 (95.1%) were willing to get vaccinated for mpox. Overall, 324 (5.2%) reported an mpox diagnosis. Among these, 318 (98.1%) reported lesions, 178 (56%) local pain, and 316 (99.4%) sought health care. Among participants not reporting a diagnosis, 288 (4.9%) had a suspicious lesion, but only 158 (54.9%) of these had sought health care. Compared to participants with no diagnosis, those reporting an mpox diagnosis were younger (P<.001), reported more sex partners (P<.001), and changes in sexual behavior after mpox onset (P=.002). Moreover, participants diagnosed with mpox reported more frequently being tested for HIV in the prior 3 months (P<.001), living with HIV (P<.001), currently using HIV pre-exposure prophylaxis (P<.001), and previous sexually transmitted infection diagnosis (P<.001). CONCLUSIONS Our results point to high mpox knowledge and willingness to vaccinate among SGM in Brazil. Participants self-reporting mpox diagnosis more frequently reported to be living with HIV, STI diagnosis, and current pre-exposure prophylaxis use, highlighting the importance of an mpox assessment that includes comprehensive sexual health screenings. Efforts to decrease stigma related to mpox among SGM are necessary to avoid mpox underdiagnosis.
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Affiliation(s)
- Thiago Silva Torres
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Carolina Coutinho
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Brenda Hoagland
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Emilia Moreira Jalil
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Sandra Wagner Cardoso
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Monica Avelar Magalhaes
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz (ICICT-Fiocruz), Rio de Janeiro, Brazil
| | - Paula Mendes Luz
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Valdilea G Veloso
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Beatriz Grinsztejn
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
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Zhou J, Wang X, Zhou Z, Wang S. Insights into the Evolution and Host Adaptation of the Monkeypox Virus from a Codon Usage Perspective: Focus on the Ongoing 2022 Outbreak. Int J Mol Sci 2023; 24:11524. [PMID: 37511283 PMCID: PMC10380431 DOI: 10.3390/ijms241411524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
The exceptionally widespread outbreak of human monkeypox, an emerging zoonosis caused by the monkeypox virus (MPXV), with more than 69,000 confirmed cases in 100 non-endemic countries since 2022, is a major public health concern. Codon usage patterns reflect genetic variation and adaptation to new hosts and ecological niches. However, detailed analyses of codon usage bias in MPXV based on large-scale genomic data, especially for strains responsible for the 2022 outbreak, are lacking. In this study, we analyzed codon usage in MPXV and its relationship with host adaptation. We confirmed the ongoing outbreak of MPXVs belonging to the West Africa (WA) lineage by principal component analysis based on their codon usage patterns. The 2022 outbreak strains had a relatively low codon usage bias. Codon usage of MPXVs was shaped by mutation and natural selection; however, different from past strains, codon usage in the 2022 outbreak strains was predominantly determined by mutation pressure. Additionally, as revealed by the codon adaptation index (CAI), relative codon deoptimization index (RCDI), and similarity index (SiD) analyses, the codon usage patterns of MPXVs were also affected by their hosts. In particular, the 2022 outbreak strains showed slightly but significantly greater adaptation to many primates, including humans, and were subjected to stronger selection pressure induced by hosts. Our results suggest that MPXVs contributing to the 2022 outbreak have unique evolutionary features, emphasizing the importance of sustained monitoring of their transmission and evolution.
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Affiliation(s)
- Jianglin Zhou
- Bioinformatics Center of AMMS, Beijing 100850, China
| | - Xuejun Wang
- Bioinformatics Center of AMMS, Beijing 100850, China
| | - Zhe Zhou
- Bioinformatics Center of AMMS, Beijing 100850, China
| | - Shengqi Wang
- Bioinformatics Center of AMMS, Beijing 100850, China
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Ghosh N, Chacko L, Vallamkondu J, Banerjee T, Sarkar C, Singh B, Kalra RS, Bhatti JS, Kandimalla R, Dewanjee S. Clinical Strategies and Therapeutics for Human Monkeypox Virus: A Revised Perspective on Recent Outbreaks. Viruses 2023; 15:1533. [PMID: 37515218 PMCID: PMC10384767 DOI: 10.3390/v15071533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/03/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
An enveloped double-stranded DNA monkeypox virus (MPXV) is a causative agent of the zoonotic viral disease, human monkeypox (HMPX). MPXV belongs to the genus Orthopoxviridae, a family of notorious smallpox viruses, and so it shares similar clinical pathophysiological features. The recent multicountry HMPX outbreak (May 2022 onwards) is recognized as an emerging global public health emergency by the World Health Organization, shunting its endemic status as opined over the past few decades. Re-emergence of HMPX raises concern to reassess the present clinical strategy and therapeutics as its outbreak evolves further. Keeping a check on these developments, here we provide insights into the HMPX epidemiology, pathophysiology, and clinical representation. Weighing on its early prevention, we reviewed the strategies that are being enrolled for HMPX diagnosis. In the line of expanded MPXV prevalence, we further reviewed its clinical management and the diverse employed preventive/therapeutic strategies, including vaccines (JYNNEOS, ACAM2000, VIGIV) and antiviral drugs/inhibitors (Tecovirimat, Cidofovir, Brincidofovir). Taken together, with a revised perspective of HMPX re-emergence, the present report summarizes new knowledge on its prevalence, pathology, and prevention strategies.
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Affiliation(s)
- Nilanjan Ghosh
- Molecular Pharmacology Research Laboratory, Department of Pharmaceutical Technology, Jadavpur University, Kolkata 700032, West Bengal, India
| | - Leena Chacko
- BioAnalytical Laboratory, Meso Scale Discovery, Rockville, MD 20850-3173, USA
| | | | - Tanmoy Banerjee
- Molecular Pharmacology Research Laboratory, Department of Pharmaceutical Technology, Jadavpur University, Kolkata 700032, West Bengal, India
| | - Chandrima Sarkar
- Advanced Pharmacognosy Research Laboratory, Department of Pharmaceutical Technology, Jadavpur University, Kolkata 700032, West Bengal, India
| | - Birbal Singh
- ICAR-Indian Veterinary Research Institute (IVRI), Regional Station, Palampur 176061, Himachal Pradesh, India
| | - Rajkumar Singh Kalra
- Okinawa Institute of Science and Technology, Graduate University (OIST), Onna-son, Okinawa 904-0495, Japan
| | - Jasvinder Singh Bhatti
- Laboratory of Translational Medicine and Nanotherapeutics, Department of Human Genetics and Molecular Medicine, School of Health Sciences, Central University of Punjab, Bathinda 151001, Punjab, India
| | - Ramesh Kandimalla
- Department of Biochemistry, Kakatiya Medical College, Warangal 506007, Telangana, India
| | - Saikat Dewanjee
- Advanced Pharmacognosy Research Laboratory, Department of Pharmaceutical Technology, Jadavpur University, Kolkata 700032, West Bengal, India
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Yagüe-Pasamón R. [Monkeypox and men who have sex with men: we need to treat it with a destigmatizing perspective.]. Rev Esp Salud Publica 2023; 97:e202307059. [PMID: 37403538 PMCID: PMC10541261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 05/24/2023] [Indexed: 07/06/2023] Open
Abstract
Monkeypox is a zoonosis, which is transmitted by direct and close contact, and has recently produced a large epidemic outbreak in non-endemic areas, classified as a Public Health Emergency of international concern by the World Health Organization. The global doubting and delayed response, and the stigmatizing approach to men who have sex with men promoted by public opinion, some scientists, socio-political agents, and the media, could be some of the reasons why the epidemic has not yet been contained. The stigma around the disease produces severe injuries to its victims and obstructs actions aimed at controlling the disease, as occurred with HIV in the past. To limit stigma and contain the outbreak, scientists should lead the diffusion of scientifically validated information, educate the population about prevention, symptoms, how to react in case of suspicion and the importance of not contributing to others' stigmatization. Interventions must also be conducted on victims of stigma to counter act its consequences and encourage their self-efficacy. Public health interventions should be carried out in collaboration with political and social actors to integrate evidence into regulations and procedures and facilitate public health interventions. Experts should also work together with the media to facilitate proper health communication and warn about bad practices. Similarly, the relationship between organizations and health professionals and stigmatized individuals must be improved to optimize their access and retention in health systems. The objective of this study was to review the stigmatizing response of some political agents, the media and social opinion to the Monkeypox epidemic, to highlight the consequences of stigma on the patients and the control of the disease. And to establish a series of recommendations to treat this situation effectively through a non-stigmatizing approach.
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Affiliation(s)
- Rubén Yagüe-Pasamón
- Programa de Doctorado en Ciencias de la Salud y del Deporte; Universidad de ZaragozaUniversidad de ZaragozaZaragozaSpain
- Unidad de Cuidados Intensivos Coronaria; Hospital Universitario Miguel ServetHospital Universitario Miguel ServetZaragozaSpain
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49
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Abstract
The emergence and rapid spread of the monkeypox virus (MPXV) to non-endemic countries has brought this once obscure pathogen to the forefront of global public health. Given the range of conditions that cause similar skin lesions, and because the clinical manifestation may often be atypical in the current mpox outbreak, it can be challenging to diagnose patients based on clinical signs and symptoms. With this perspective in mind, laboratory-based diagnosis assumes a critical role for the clinical management, along with the implementation of countermeasures. Here, we review the clinical features reported in mpox patients, the available laboratory tests for mpox diagnosis, and discuss the principles, advances, advantages, and drawbacks of each assay. We also highlight the diagnostic platforms with the potential to guide ongoing clinical response, particularly those that increase diagnostic capacity in low- and middle-income countries. With the outlook of this evolving research area, we hope to provide a resource to the community and inspire more research and the development of diagnostic alternatives with applications to this and future public health crises.
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Affiliation(s)
| | - Alain Kohl
- MRC-University of Glasgow Centre for Virus Research, Glasgow G61 1QH, UK
| | - Lindomar Pena
- Department of Virology, Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz), 50670-420 Recife, Pernambuco, Brazil
| | - Keith Pardee
- Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto ON M5S 3M2, Canada
- Department of Mechanical and Industrial Engineering, University of Toronto, Toronto ON M5S 3G8, Canada
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50
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Abstract
The COVID-19 pandemic galvanized the field of virus genomic surveillance, demonstrating its utility for public health. Now, we must harness the momentum that led to increased infrastructure, training, and political will to build a sustainable global genomic surveillance network for other epidemic and endemic viruses. We suggest a generalizable modular sequencing framework wherein users can easily switch between virus targets to maximize cost-effectiveness and maintain readiness for new threats. We also highlight challenges associated with genomic surveillance and when global inequalities persist. We propose solutions to mitigate some of these issues, including training and multilateral partnerships. Exploring alternatives to clinical sequencing can also reduce the cost of surveillance programs. Finally, we discuss how establishing genomic surveillance would aid control programs and potentially provide a warning system for outbreaks, using a global respiratory virus (RSV), an arbovirus (dengue virus), and a regional zoonotic virus (Lassa virus) as examples.
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Affiliation(s)
- Verity Hill
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA.
| | - George Githinji
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya; Department of Biochemistry and Biotechnology, Pwani University, Kilifi, Kenya
| | - Chantal B F Vogels
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA; Yale Institute for Global Health, Yale University, New Haven, CT, USA
| | - Ana I Bento
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA; The Rockefeller Foundation, New York, NY, USA
| | - Chrispin Chaguza
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA; Yale Institute for Global Health, Yale University, New Haven, CT, USA
| | - Christine V F Carrington
- Department of Preclinical Sciences, The University of the West Indies, St. Augustine Campus, St. Augustine, Trinidad and Tobago
| | - Nathan D Grubaugh
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA; Yale Institute for Global Health, Yale University, New Haven, CT, USA; Department of Ecology and Evolutionary Biology, Yale University, New Haven, CT, USA; Public Health Modeling Unit, Yale School of Public Health, New Haven, CT, USA.
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