Metanalysis of Vaccine Efficacy for Monkeypox According to Clinical Criteria of History Taking, Clinical Features and Laboratory Investigation

Monkeypox virus is DNA virus of Orthopoxvirus. The Monkeypox is zoonosis disease first diagnosed in the Democratic Republic of the Congo in 1970 and originally transmitted from Vertebrate Reservoir. In 1796, Edward Jenner was the first physician achieved vaccine and prove its efficacy through exposing James Phipps to smallpox after immunization. The current study revises the vaccine efficacy and mortality rate of monkeypox. It is mainly transmitted from Squirrels to human and cause mortality rate ranging from 2.7 to 10.1%. Globally, it estimated 4.4% the mortality rate of Monkeypox cases. Based on current review study, the effectiveness of smallpox vaccine in preventing the monkeypox is quite variable due to several selective clinical cases criteria such as history taking and clinical features and laboratory investigation, which modify the statistical result of the vaccine efficacy. The current study clarifies the faults of calculation by eliminating several reasons and estimating the effectiveness of vaccine in the household and find it to be 16.3% whereas total Vaccine efficacy is 0.6%. Using preventive measures are the first line to avoid infection therefore healthcare workers must adhere to infection control precautions. A current study warns scientists to create monkeypox vaccine rather than depending on smallpox vaccine effectiveness due to lacking of current vaccine effectiveness evidence and treatment.

Molusco contagioso del párpado: manifestación cutánea de inmunosupresión / Eyelid molluscum contagiosum: Cutaneous manifestation of immunosuppression

Resumen El molusco contagioso es una infección viral cutánea, usualmente benigna y autolimitada, causada por un virus del género Molluscipoxvirus. Es más frecuente en niños, adultos jóvenes sexualmente activos e inmunosuprimidos. La lesión clínica característica es una pápula umbilicada eucrómica o de tono perlado, que se disemina rápidamente y puede afectar cualquier superficie muco-cutánea, aunque la localización en los párpados es atípica. Se presentan dos casos de pacientes jóvenes inmunosuprimidos, con moluscos contagiosos palpebrales, en quienes el diagnóstico clínico inicial fue incorrecto. Se enfatiza la importancia de diagnosti car oportunamente las lesiones papulares que afectan la piel del párpado ya que la presencia de molusco contagioso en esta zona se considera una manifestación cutánea de inmunosupresión.

Abstract Molluscum contagiosum is a cutaneous viral infection, usually benign and self-limited, caused by the molluscum contagiosum virus, of the genus Molluscipoxvirus. It is more common in pediatric population, sexually active young people and immunosuppressed patients. Clinical presentation is characterized by umbilicated white to flesh-colored or pearly papules, which rapidly spread and can affect any muco-cutaneous membrane. Although the eyelid presentation is atypical, we herein present two young, immunosuppressed patients, with diagnosis of palpebral molluscum contagiosum, in which the initial clinical diagnosis was wrong. We emphasize the importance in making a timely diagnosis of papular lesions localized on the eyelids and the correlation of these lesions as a cutaneous manifestation of immunosuppression.

Molusco contagioso como complicação de tatuagem: um relato de caso e revisão da literatura / Molluscum contagiosum as a tattoo complication: a case report and literature review

A tatuagem é uma prática antiga e muito popular atualmente. Os pigmentos utilizados mudaram com o tempo, mas continuam apresentando composições variadas e pouco regulamentadas. Há inúmeros casos descritos de efeitos adversos pós-tatuagem, em sua maioria infecciosos, e reações de hipersensibilidade. Relatamos o caso de uma mulher de 64 anos, hígida, com pápulas nas sobrancelhas um mês após realizar micropigmentação. A biópsia excisional fez o diagnóstico de molusco contagioso, e o tratamento foi realizado com curetagem das lesões. Na literatura, existem poucos relatos de disseminação de molusco contagioso causada por tatuagem.

Tattooing is an ancient practice and very popular nowadays. The pigments used have changed over time but still present varied and poorly regulated compositions. There are many described cases of adverse effects after tattooing, mainly infectious and hypersensitivity reactions. We report the case of a 64-yearold woman, healthy, with papules on her eyebrows one month after performing micropigmentation. The excisional biopsy diagnosed molluscum contagiosum, and the lesions were curetted. There are few reports in the literature of the spread of molluscum contagiosum caused by tattooing

Vaccinia zoonótica en Colombia: evidencia acumulativa de la emergencia de los poxvirus en el mundo / Zoonotic vaccinia in Colombia: Cumulative evidence of the emergence of poxviruses in the world

RESUMEN La reciente ocurrencia de infecciones por el virus vaccinia en animales y humanos en distintos lugares de la geografía colombiana, sumadas a otras por éste y por otros virus pertenecientes al género Orthopoxvirus (familia Poxviridae), ocurridas en algunos países de Suramérica, África, Asia y Europa se convierten en evidencia de la inminente emergencia y re-emergencia de este género, con características biológicas y epidemiológicas que le confieren gran interés para la salud pública del mundo, como lo fue en el pasado una de sus especies representativas: el virus de la viruela. Esta emergencia y re-emergencia parecen estar relacionadas con la suspensión en las décadas de los 70s y 80s de las campañas de vacunación contra la viruela, las cuales; insospechadamente estuvieron protegiendo a la población, no únicamente contra este virus, sino contra otros del mismo género. En el presente artículo se hace una revisión de la biología y epidemiología de los principales miembros del género Orthopoxvirus, su presentación clínica, antecedentes históricos, contexto social, e impacto en la salud pública mundial en el pasado, presente y a futuro.(AU)

ABSTRACT The recent occurrence of vaccinia virus infections in humans and animals in Colombia, together with that reported for this and other species of the genus Orthopoxvirus in some South American, African, Asian and European countries, is supporting evidence of the emergence and re-emergence of the genus. This fact has become of great interest for public health around the world due to its biological and an epidemiological features, as was in the past the variola virus, one of its representatives. The emergence and re-emergence of the genus Orthopoxvirus may be a consequence of stopping vaccination against the variola virus in the 1970s and 1980s. This vaccination unsuspectedly induced cross-protective immunity to other species of that genus. This is a review of the history, biology and epidemiology of the main species of the genus Orthopoxvirus, together with its clinical presentation, social context and public health impact in the past, present and future.(AU)

Genome Wide Identification and Analysis of Microsatellite Repeats in the Largest DNA Viruses (Poxviridae Family): An Insilico Approach

Background: Microsatellites also known as simple sequence repeats (SSRs), which is also called as junk DNA, mainly used as a neutral genetic marker, presented across coding and non-coding regions of prokaryotes, eukaryotes, and viruses. They are subjects of different fields, such as gene mapping, population genetics, DNA fingerprinting, forensic studies and evolution. Aim: The presented study is focused on the evolutionary relationship between poxviruses for the identification and systematic analysis of the nature and distribution of complex microsatellites, presenting in large DNA viral genomes of poxviruses (Poxviridae family) in vertebrates and invertebrates. Materials and Methods: Genome sequences of seventeen species from the Poxviridae family were assessed by the National Center for Biotechnology (NCBI). The microsatellite was extracted using IMEx software, and statistical analysis was performed using Microsoft office Excel 2007. Furthermore, the molecular evolutionary analyses of poxviruses were conducted using MEGA6. Results: In the current study, we screened 17 vertebrate and invertebrates of pox viral genomes and a total of 8539 SSRs which revealed a total of 2387 cSSRs distributed across all the genomes. From the sequences, poly A or poly T mononucleotide prevailed over a poly G or poly C. Among the identified motifs dinucleotides 51.73% which were the most common types of repeats followed by mononucleotides 36.12%, trinucleotides 11.28%, tetranucleotides 0.56%, pentanucleotides 0.10%, and hexanucleotides 0.21%. Polymorphism increases with genome length and decreasing GC content of repeat motifs for dinucleotides, trinucleotides, and tetranucleotides.  This result may help genome-wide evolutionary and quantitative analysis like genome size or GC content which has an influence on the number, simple and compound microsatellite of relative abundance and relative densities. Conclusion: We conclude that largest DNA virus of invertebrates show a higher percentage of microsatellites and repeat motif than the vertebrate poxviruses. The genome size and GC content is an important factor in affecting the occurrence of repeat motif as well microsatellites, in vertebrate and invertebrate poxviruses. The analysis on the phylogenetic relationships and microsatellites in vertebrates and invertebrates, as well the pattern of their evolution, may help to understand (the understanding) of poxviruses in the course of natural evolution.

Bovine Vaccinia in dairy cattle and suspicion of vesicular disease on milkers in Brazil / Vaccinia bovina em gado leiteiro e suspeita de doença vesicular em ordenhadores no Brasil

ABSTRACT: Bovine vaccinia (BV) is a vesicular disease induced by the Vaccinia virus (VACV) that affects milk production and is an occupational zoonosis. This research had the following objectives: (i) detection of VACV by qPCR in cattle with clinical suspicion of vesicular disease; (ii) symptoms characterization in animals and milkers with clinical suspicion of the disease and virus detection in humans; and (iii) identification of risk factors for infections of VACV in herds from several Brazilian states. A total of 471 bovine epithelial samples from dairy farms, in 15 Brazilian states, were evaluated between 2007 and 2012. The samples were tested by quantitative PCR (qPCR) using SYBR Green® reagents, validated with a lower limit of detection of 100 TCID50/50µL (1.7x100 viral particles), and 45.1% of VACV positive samples were detected. Using official forms for epidemiological investigation (FORM-IN), the risk factors for VACV infections in cattle were determined to be farms with a lack of technological facilities (P=0.029) and the presence of rodents (P=0.001). There was an effect of seasonality in cattle with a higher occurrence of BV during the dry season. A total of 420 epidemiological questionnaires were applied at public health care centers, where 100% of the milkers had vesicular lesions on their hands (98.1%) and on their arms (6.9%). The most frequent clinical symptoms in humans were: local swelling (74.2%), headache (20.7%), fever (10.4%) and inguinal lymphadenopathy (74.2%). Only 19.98% of milkers aged between 39 and 58 years were seroreactive to VACV and were immunized with the human anti-smallpox vaccine. There was an increase in the frequency of BV in older individuals due to their natural decrease in specific immunity. It has been shown that the implementation of zootechnical management techniques and health planning are important for the prevention of BV in animals and humans.

RESUMO: Vaccinia bovina (VB) é uma doença vesicular induzida pelo Vaccinia virus (VACV) que afeta a produção de leite e é uma zoonose ocupacional. Este trabalho teve os seguintes objetivos: (i) detecção de VACV por qPCR em bovinos com suspeita clínica de doença vesicular; (ii) caracterização dos sintomas apresentados por animais e ordenhadores com suspeita clínica da doença e detecção do vírus em humanos; e (iii) identificação de fatores de risco para infecção por VACV em rebanhos de vários estados brasileiros. Um total de 471 amostras de epitélio bovino de fazendas leiteiras, em 15 estados brasileiros, foram avaliados entre 2007 e 2012. As amostras foram testadas por PCR quantitativa (qPCR) usando reagentes SYBR Green®, validados com um limite inferior de detecção de 100TCID50/50μL (1,7x100 partículas virais) e 45,1% das amostras positivas de VACV foram detectadas. Usando formulários oficiais de investigação epidemiológica (FORM-IN), os fatores de risco para infecções por VACV em bovinos foram determinados como fazendas com falta de instalações tecnológicas (P=0,029) e presença de roedores (P=0,001). Houve um efeito da sazonalidade no gado com maior ocorrência de VB durante a estação seca. Um total de 420 questionários epidemiológicos foram aplicados nos centros públicos de saúde, onde 100% dos ordenhadores apresentaram lesões vesiculares nas mãos (98,1%) e nos braços (6,9%). Os sintomas clínicos mais frequentes em humanos foram: inchaço local (74,2%), cefaleia (20,7%), febre (10,4%) e linfadenopatia inguinal (74,2%). Apenas 19,98% dos produtores de leite com idade entre 39 e 58 anos foram sororreagentes ao VACV e foram imunizados com a vacina contra a varíola humana. Houve um aumento na frequência de BV em indivíduos mais velhos devido à sua diminuição natural na imunidade específica. Demonstrou-se que a implementação de técnicas de gestão zootécnica e planejamento sanitário são importantes para a prevenção da VB em animais e seres humanos.

First phylogenetic analysis of avipoxvirus (APV) in Brazil / Primeira análise filogenética de avipoxvirus (APV) no Brasil

This study represents the first phylogenetic analysis of avian poxvirus recovered from turkeys in Brazil. The clinical disorders related to fowlpox herein described occurred in a turkey housing system. The birds displaying characteristic pox lesions which were observed on the neck, eyelids and beak of the turkeys. Four affected turkeys were randomly chosen, euthanized and necropsied. Tissues samples were submitted for histopathological analysis and total DNA was further extracted, amplified by conventional PCR, sequenced and phylogenetically analyzed. Avian poxviruses specific PCR was performed based on P4b core protein gene sequence. The histological analysis revealed dermal inflammatory process, granulation tissue, hyperplasia of epithelial cells and inclusion bodies. The P4b gene was detected in all samples. Sequencing revealed a 100% nucleotide and amino acid sequence identity among the samples, and the sequences were deposited in GenBank®. The four Avian poxviruses fragments sequenced in this study clustered along the A1 clade of avipoxviruses, and were classified as Avipoxvirus (APV). Additional studies, such as virus isolation, PCR and sequencing includinga large number of specimens from the Brazilian turkey production must be conducted due to the hazardous risk that poxvirus infections may cause to the Brazilian poultry production scenario, given that Brazil's turkey production attracts attention due to its economic importance worldwide. Our findings point to the need to identify the prevalence of APV in Brazilian turkey production, to perform risk assessment studies and continued surveillance of APV infections in both wild and commercial avian species.

Este trabalho representa a primeira análise filogenética de Poxvirus aviário detectado em perus no Brasil. Os distúrbios clínicos relacionados com bouba aviária aqui descritos ocorreram em um sistema de alojamento de perus. As aves apresentaram lesões características de varíola observadas no pescoço, pálpebras e bico das aves. Quatro perus com sinais característicos foram escolhidos aleatoriamente, sacrificados e submetidos à autópsia. Amostras de tecido foram submetidas à análise histopatológica e o DNA total foi extraído, amplificado por PCR convencional e os amplicons foram sequenciados e analisados ​​filogeneticamente. A PCR específica para Poxvírus aviário foi realizada com base na seqüência do gene da proteína do núcleo P4b. A análise histológica revelou um processo inflamatório dérmico, tecido de granulação, hiperplasia de células epiteliais e corpúsculos de inclusão. O gene P4b foi detectado em todas as amostras. O sequenciamento revelou uma identidade entre nucleotídeos e aminoácido de 100% entre as amostras e as sequências foram depositadas no GenBank®. Os quatro fragmentos de poxvírus aviário sequenciado neste estudo foram agrupados no clado A1 de avipoxvirus e foram classificados como Avipoxvirus (APV). Estudos adicionais, como isolamento viral, PCR e sequenciamento, incluindo um grande número de perus da produção brasileira devem ser conduzidos devido ao grave risco que a infecção por poxvírus pode causar ao cenário de produção avícola brasileira, tendo em vista que a produção brasileira de perus atrai atenção devido a sua importância mundial. Nossos resultados apontam para a necessidade de identificar a prevalência da APV na produção de peru no Brasil, para realizar estudos de avaliação de risco e continuada monitoração de infecções por APV nas espécies de aves comerciais e silvestres.

Viral vectors for vaccine applications

Traditional approach of inactivated or live-attenuated vaccine immunization has resulted in impressive success in the reduction and control of infectious disease outbreaks. However, many pathogens remain less amenable to deal with the traditional vaccine strategies, and more appropriate vaccine strategy is in need. Recent discoveries that led to increased understanding of viral molecular biology and genetics has rendered the used of viruses as vaccine platforms and as potential anti-cancer agents. Due to their ability to effectively induce both humoral and cell-mediated immune responses, viral vectors are deemed as an attractive alternative to the traditional platforms to deliver vaccine antigens as well as to specifically target and kill tumor cells. With potential targets ranging from cancers to a vast number of infectious diseases, the benefits resulting from successful application of viral vectors to prevent and treat human diseases can be immense.

Molusco contagioso em tatuagem / Molluscum contagiosum on tattoo

Molusco contagioso é uma dermatovirose causada por poxvírus e caracterizada por erupção benigna e autolimitada de uma ou múltiplas pápulas esféricas e brilhantes. A transmissão habitualmente ocorre por contato direto com indivíduos infectados. Relata-se caso de doente masculino, 22 anos, com história de surgimento de numerosas pápulas umbilicadas localizadas estritamente sobre a região de uma tatuagem. Exame histopatológico de uma das pápulas confirmou a hipótese clínica de molusco contagioso. Os autores descrevem uma manifestação pouco frequente da disseminação desse vírus em tatuagens e apresentam uma revisão da literatura, enfatizando as vias de transmissão e a terapêutica do molusco contagioso.

Molluscum contagiosum is a disease caused by a poxvirus characterized by benign self-limited eruption of single or multiple cutaneous spherical and pearly papules. Transmission usually occurs by direct contact with infected hosts. It is reported the case of a 22-year-old Caucasian male who presented characteristic pearly and umbilicated papules strictly located on the region of a tattoo. Histopathologic exam confirmed the diagnosis of molluscum contagiosum. The authors describe an uncommomn manifestation of dissemination of this virus in tattoos and also present a literature review emphasizing the transmission pathways and treatment of Molluscum contagiosum.

Clinical signs, diagnosis, and case reports of Vaccinia virus infections

Vaccinia virus is responsible for a zoonosis that usually affects cattle and human beings in Brazil. The initial clinical signs of the infection are focal red skin areas, fever, and general symptoms similar to those of a cold. Then, pustules and ulcerated lesions surrounded by edema and erythema follow, as well as local lymphadenopathy that can last for weeks. Cure and healing of the lesions occur over several weeks, leaving a typical scar in the skin of people and animals affected. The infection definitive diagnosis is made through morphological characterization of the virus by use of electron microscopy, followed by PCR for specific viral genes. Since 1963, circulating orthopoxviruses in infectious outbreaks in several regions of Brazil have been reported. Later, the etiological agent of those infections was characterized as samples of Vaccinia virus. In addition, the widespread use of those viruses in research laboratories and mass vaccination of militaries have contributed to increase the cases of those infections worldwide. Thus, several epidemiological and clinical studies are required, as well as studies of viral immunology, public health, and economic impact, because little is known about those Vaccinia virus outbreaks in Brazil.

Ectima contagioso em ovinos e caprinos no semi-árido da Paraíba / Contagious echtyma in sheep and goats in the semiarid of Paraíba, Brazil

Descrevem-se dez surtos de ectima contagioso em caprinos e dois em ovinos no semi-árido da Paraíba. Os animais jovens foram os mais afetados, mas em oito surtos animais adultos também foram afetados, principalmente cabras lactantes que apresentavam lesões no úbere. Em nenhum dos rebanhos afetados havia antecedentes de vacinação contra ectima contagioso. Histologicamente a epiderme apresentava acantose com hiperplasia pseudoepiteliomatosa e com múltiplos focos de degeneração hidrópica formando vesículas ou pústulas. Inclusões intracitoplasmáticas eosinofílicas foram observadas em queratinócitos. Havia restos celulares necróticos formando crostas, hiperqueratose e microabscessos intracorneais ou extensas áreas ulceradas. Na derme observou-se infiltrado inflamatório mononuclear difuso. Também foi registrado um caso humano em um pesquisador que tinha administrado planta por via oral a um caprino que, posteriormente, apresentou lesões de ectima contagioso. Neste caso, também foram observadas lesões características em uma biopsia e o vírus foi identificado por microscopia eletrônica. Conclui-se que a doença é endêmica no semi-árido e que é necessária a vacinação sistemática dos rebanhos para diminuir os prejuízos econômicos causados pela mesma. A utilização de luvas para o manuseio de animais afetados é necessária para evitar casos humanos da enfermidade.

Ten outbreaks of contagious ecthyma in goats and two in sheep in the semiarid of Paraíba State are reported. Young animals were more frequently affected, but in 8 outbreaks adult animals were also affected, mainly lactating goats which developed udder lesions. None of the affected flocks had been vaccinated. Upon histologic examination the epidermis showed acanthosis with pseudoepitheliomatous hyperplasia and multifocal ballooning degeneration forming vesicles or pustules. Eosinophilic inclusion bodies were observed in keratinocytes. Crust of necrotic cells, hyperkeratosis, and intracorneal microabscesses or large ulcerated areas were also observed. Severe diffuse infiltration by mononuclear cells was observed in the dermis. A human case was observed in an investigator that was feeding a goat that later appeared with lesions of the disease. In this case, the virus was identified by electron microscopy of a skin biopsy. These results show that contagious ecthyma is endemic in Northeastern Brazil and therefore systematic vaccination of the flocks is necessary to control the disease. The use of gloves to handle affected animals is advisable to minimize the risk of human exposure.