A review of the epidemiology, diagnosis, treatment, vaccines and economic impact of human monkeypox (Mpox) outbreaks

The current monkeypox outbreak is a public health emergency of international concern and is coming in the wake of the SARS-CoV-2 pandemic. Human monkeypox is a viral zoonotic infection caused by monkeypox virus, an enveloped double-stranded DNA virus of the genus Orthopoxvirus and family Poxviridae that also contain smallpox, cowpox, Orf, and vaccinia viruses. Online databases including PubMed, Google Scholar and Web of Science were searched to obtain relevant publications on the epidemiology, treatment, vaccines and the economic impacts of the current monkeypox (Mpox) outbreak.

Pandemy or a new STI - monkeypox cases at the semmelweis university department of dermatology, venereology and dermatooncology

After the global pandemic caused by the coronavirus, another epidemic began to unfold, which again induced fear in the population. This new epidemic is caused by the monkeypox virus and originated in Africa. It mainly spreads among MSM (men who have sex with men) population, so it can be interpreted as a new type of sexually transmitted infection.

Animal diseases - current developments

The health of domesticated animals and wild animals is frequently threatened by animal illnesses. It typically receives less attention and information than illnesses that also impact humans, including the Corona virus. To be able to respond quickly, it is crucial to understand the epidemic's progression and transmission vectors. Numerous new diseases have been reported in the news over the past 20 years, the majority of which having an animal source (zoonoses). Examples from recent times include the West Nile virus, SARS, avian influenza, and monkeypox. Some developing diseases impact both humans and animals, whereas others only affect either animals or humans. All of these emerging or reemerging illnesses, however, have societal repercussions that are frequently connected to regional and global economy. Understanding the effects of newly emerging animal diseases is crucial, as is promoting closer veterinarian and medical professional collaboration, particularly in rural regions. The index cases for newly developing diseases may be illnesses that affect agricultural laborers.

Monkeypox (mpox) is a new problem on a global scale for humanity.

Purpose - to draw attention to an infection that was little known, but has now become a global problem for society;to familiarize readers with the peculiarities of the 2022 monkeypox outbreak and to increase the level of alertness of doctors to this disease. Monkeypox is a global problem because the disease is spreading rapidly, covering 111 countries. Three cases were diagnosed in Ukraine. It is predominantly a self-limited infection, but there are severe and deadly complications. The lethality of this disease ranges from 0% to 11%. The course of the disease is more severe in children and people with reduced immunity. Vertical transmission of the virus from mother to child is possible, resulting in congenital monkeypox. Monkeypox is a zoonotic disease and its natural reservoir is not exactly known, but rodents are most likely to act. In most cases, person-to-person transmission of the virus occurs through close skin to skin contact, often during sexual intercourse. At the beginning of the outbreak 98% of cases of disease were was diagnosed in homo- and bisexuals. Airborne transmission is also possible. Infection is possible through close contact with infectious skin lesions. Clinically, the initial period resembles influenza, but lymphadenopathy is characteristic, which is considered a pathognomonic symptom of mpox. The rash is similar to that of chickenpox, but with more prevalent location on palms and soles than in chickenpox. In the presence of a vesicular rash in a patient, it is necessary to exclude monkeypox. PCR diagnostics of the virus in samples of vesicles or crusts has the greatest diagnostic value. Hygienic skin care is important. Antiviral drugs (tecovirimat, brincidofovir) are recommended only in severe cases. To reduce the spread of infection, international rules apply as for other infections, such as COVID-19. The monkeypox virus vaccine is recommended primarily for groups at risk of infection, including medical personnel who may come into contact with the patient or samples for laboratory testing. Being aware for this infection, following international health regulations, it is possible to prevent the further spread of monkeypox.Copyright © 2023 Tomsk State University. All rights reserved.

5th International Conference on Tropical Medicine and Infectious Diseases 2022 (ICTMID 2022), Ipoh, Malaysia, 23-25 August 2022

This proceedings contains 112 s that cover a wide range of topics related to microbiology. The s cover a wide range of topics related to microbiology, including new paradigms in a microbe-threatened world, the human-animal spillover of SARS-CoV-2 and its implications for public health, preparing for the next pandemic, antimicrobial resistance and the fight against it. Furthermore, tuberculosis, monkeypox, and their potential threat on a global scale are also discussed. The presentations also cover a variety of other topics, such as vaccines and vaccinations, COVID-19 vaccines, addressing vaccine hesitancy, key issues related to the COVID-19 healthcare system, regional support for outbreak preparedness, enhancing regional health security in Asia through genomic surveillance, the role of molecular diagnostic capacity in COVID-19 control, antimicrobial resistance in COVID-19 times, paediatric nosocomial infections, prescription ethics from a primary care perspective, the BCG vaccine and its relevance in the prevention of tuberculosis and beyond, tuberculosis as a forgotten pandemic, vector-borne diseases during COVID-19, the role of media advocacy in vector-borne diseases control and management, engaging communities in tackling vector-borne diseases, the way forward in managing mental health in the COVID-19 endemic phase, the spread of zoonotic diseases, and whole genome sequencing of SARS-CoV-2: clinical applications and experience.

Molecular detection of monkeypox and related viruses: challenges and opportunities.

The recent widespread emergence of monkeypox (mpox), a rare and endemic zoonotic disease by monkeypox virus (MPXV), has made global headlines. While transmissibility (R0 ≈ 0.58) and fatality rate (0-3%) are low, as it causes prolonged morbidity, the World Health Organization has declared monkeypox as a public health emergency of international concern. Thus, effective containment and disease management require quick and efficient detection of MPXV. In this bioinformatic overview, we summarize the numerous molecular tests available for MPXV, and discuss the diversity of genes and primers used in the polymerase chain reaction-based detection. Over 90 primer/probe sets are used for the detection of poxviruses. While hemagglutinin and A-type inclusion protein are the most common target genes, tumor necrosis factor receptor and complement binding protein genes are frequently used for distinguishing Clade I and Clade II of MPXV. Problems and possibilities in the detection of MPXV have been discussed.

A compilation answering 50 questions on monkeypox virus and the current monkeypox outbreak.

The current monkeypox disease (MPX) outbreak constitutes a new threat and challenge for our society. With more than 55,000 confirmed cases in 103 countries, World Health Organization declared the ongoing MPX outbreak a Public Health Emergency of International Concern (PHEIC) on July 23, 2022. The current MPX outbreak is the largest, most widespread, and most serious since the diagnosis of the first case of MPX in 1970 in the Democratic Republic of the Congo (DRC), a country where MPX is an endemic disease. Throughout history, there have only been sporadic and self-limiting outbreaks of MPX outside Africa, with a total of 58 cases described from 2003 to 2021. This figure contrasts with the current outbreak of 2022, in which more than 55,000 cases have been confirmed in just 4 months. MPX is, in most cases, self-limiting; however, severe clinical manifestations and complications have been reported. Complications are usually related to the extent of virus exposure and patient health status, generally affecting children, pregnant women, and immunocompromised patients. The expansive nature of the current outbreak leaves many questions that the scientific community should investigate and answer in order to understand this phenomenon better and prevent new threats in the future. In this review, 50 questions regarding monkeypox virus (MPXV) and the current MPX outbreak were answered in order to provide the most updated scientific information and to explore the potential causes and consequences of this new health threat.

Increasing polio coverage with safer vaccines: a pressing need in Latin America

Given the actual risk of poliomyelitis outbreaks in the region due to poliovirus derived from the Sabin vaccine or the importation of wild poliovirus, the Latin American Society of Pediatric Infectious Diseases commissioned an ad hoc group of experts from the institution's Vaccines and Biologicals Committee, to draft an official position paper on the urgent need to increase immunization levels against the disease in the region and incorporate inactivated polio vaccine exclusive schedules in all national immunization programs. This publication discusses the main conclusions and recommendations generated as a result of such activity.Copyright © 2022, Sociedad Chilena de Infectologia. All rights reserved.

Comprehensive update on the monkeypox outbreak.

Monkeypox (MPX) was first reported in 1970 in humans and outbreaks were restricted and highly localised to endemic regions of western and central Africa. However, after the first reported case in the UK in early May, 2022, the pattern of epidemic spreading in the geographical regions was much larger compared to past, posing a risk MPX might become entrenched beyond endemic areas. This virus is less transmissible than SARS-CoV-2, as it transmitted mainly through personal, close, often skin-to-skin contact with infectious MPX rash, body fluids, or scabs from an individual with MPX. Infections usually present with chills, fever, fatigue, muscle aches, headache, sore throat, skin lesions, and lymphadenopathy. Currently, there are no antivirals approved for MPX. However, an antiviral drug called "tecovirimat," approved for the treatment of smallpox, has been made accessible to treat MPX. Moreover, to prevent MPX, there are two vaccines available which are approved by FDA: Bavarian Nordic JYNNEOS, and ACAM2000 vaccine. Contact tracing is absent in case of MPX outbreak and there is lack of information from the data systems in rapid manner. Additionally, test capacity needs to be increased. Like SARS-CoV-2, global MPX outbreak demand for vaccines far exceeds availability.

A Review on Recent Monkey Pox Outbreak in 2022

Monkey pox, a zoonotic disease with clinical symptoms resembling smallpox, unexpectedly broke out and spread over the world after the outbreak of COVID-19, severely affecting several of the continents of the world. Monkey pox is currently a member of the genus otrhopox virus, which is a member of the sub family chorodoxvirinae. According to the available knowledge, small mammals and rodents have all been identified as potential sources of the monkey [ox virus]. The disease is characterized by a short febrile illness with lymphadenopathy followed by a rash which spreads centrifugally and passes through phases of macules, papules, vesicles, and pustules. Recovery occurs in most patients within 2-4 wk. Complications are more likely in children, pregnant women, and the immunocompromised. Specific diagnosis is by detection of viral DNA by PCR.Tecovirimat, brincidofovir, and cidofoviir are the medications used to treat monkey pox, immunoglobulin and new compounds are the vaccinations. This review will introduce a general overview of MPXV and describe the epidemiology, clinical features, evaluation, and treatment of monkey pox patients.Copyright © Journal of Global Trends in Pharmaceutical Sciences.

The Emergence of Mpox: Epidemiology and Current Therapeutic Options.

The world recently witnessed the emergence of new epidemic outbreaks like COVID-19 and mpox. The 2022 outbreak of mpox amid COVID-19 presents an intricate situation and requires strategies to combat the status quo. Some of the challenges to controlling an epidemic include present knowledge of the disease, available treatment options, appropriate health infrastructures facilities, current scientific methods, operations concepts, availability of technical staff, financial funds, and lastly international policies to control an epidemic state. These insufficiencies often hinder the control of disease spread and jeopardize the health of countless people. Also, disease outbreaks often put a huge burden on the developing economies. These countries are the worst affected and are immensely dependent on assistance provided from the larger economies to control such outbreaks. The first case of mpox was reported in the 1970s and several outbreaks were detected thereafter in the endemic areas eventually leading to the recent outbreak. Approximately, more than 80,000 individuals were infected, and 110 countries were affected by this outbreak. Yet, no definite vaccines and drugs are available to date. The lack of human clinical trials affected thousands of individuals in availing definite disease management. This paper focuses on the epidemiology of mpox, scientific concepts, and treatment options including future treatment modalities for mpox.

A Review of the Recent Monkeypox Outbreak in 2022.

The coincidence of the monkeypox outbreak with the coronavirus disease 2019 (COVID-19) pandemic raises a global concern about a potential new pandemic and the possible consequences. As the World Health Organization declared the international monkeypox outbreak a global emergency, there is apprehension about the complications and mortality of monkeypox infection. The monkeypox virus is a zoonosis: a disease that is transmitted from animals to humans. It is an enveloped double-stranded DNA virus that belongs to the Orthopoxvirus genus. Human-to-human transmission occurs with close contact with respiratory secretions, sores on an infected person's skin, or contaminated items like clothing. Monkeypox is endemic in regions of Africa, however, because of smallpox eradication and a decrease in vaccination efforts, this led to an outbreak in the United States of America in 2003 and a new world outbreak in 2022. Most patients experience prodromal sickness with fever, malaise, and enlarged lymph nodes before developing a rash. In addition to skin lesions, individuals may also experience secondary skin and/or soft tissue infection, pneumonitis, ocular problems, and encephalitis. There is an increased risk of infection among men who have sex with men and human immunodeficiency virus infection (HIV) patients. The polymerase chain reaction is the gold standard for diagnosis. Management is usually supportive but some cases may require tecovirimat. This is a comprehensive review of monkeypox virus epidemiology, clinical features, and the most up-to-date, effective management and prevention.

Summary of global surveillance data of infectious diseases in January 2023

In January 2023, a total of 64 infectious diseases were reported globally, affecting 235 countries and regions. Except for influenza, the top five infectious diseases affecting greatest number of countries and regions were COVID-19 (235), monkeypox (110), dengue fever (31), measles (27) and cholera (15). The top five infectious diseases with highest case fatality rates were Nipah virus disease (62.5%), Ebola virus disease (47.0%), Crimean-Congo haemorrhagic fever (37.5%), Lassa fever (15.1%) and West Nile fever (7.6%). The top five infectious diseases with greatest number of deaths were COVID-19, malaria, cholera, measles and dengue fever. The prevalent infectious diseases in Asia were COVID-19, cholera and dengue fever, the prevalent infectious diseases in Africa were COVID-19, cholera, yellow fever, Lassa fever, malaria and monkeypox, the prevalent infectious diseases in America were COVID-19, cholera, monkeypox, dengue fever and chikungunya fever, the prevalent infectious disease in Europe were COVID-19, monkeypox and invasive group A streptococcus infection.

Monkeypox virus: phylogenomics, host-pathogen interactome and mutational cascade.

While the world is still recovering from the Covid-19 pandemic, monkeypox virus (MPXV) awaits to cause another global outbreak as a challenge to all of mankind. However, the Covid-19 pandemic has taught us a lesson to speed up the pace of viral genomic research for the implementation of preventive and treatment strategies. One of the important aspects of MPXV that needs immediate insight is its evolutionary lineage based on genomic studies. Utilizing high-quality isolates from the GISAID (Global Initiative on Sharing All Influenza Data) database, primarily sourced from Europe and North America, we employed a SNP-based whole-genome phylogeny method and identified four major clusters among 628 MPXV isolates. Our findings indicate a distinct evolutionary lineage for the first MPXV isolate, and a complex epidemiology and evolution of MPXV strains across various countries. Further analysis of the host-pathogen interaction network revealed key viral proteins, such as E3, SPI-2, K7 and CrmB, that play a significant role in regulating the network and inhibiting the host's cellular innate immune system. Our structural analysis of proteins E3 and CrmB revealed potential disruption of stability due to certain mutations. While this study identified a large number of mutations within the new outbreak clade, it also reflected that we need to move fast with the genomic analysis of newly detected strains from around the world to develop better prevention and treatment methods.

Prospect of Vaccinia virus vector vaccine for wildlife

Against a pandemic of emerged infectious disease, COVID-19, new generation vaccines based on nucleic acids or recombinant viruses, which had not been used as vaccines in humans, have been inoculated and shown to be successful. They are, however, heat-labile and need a cold-chain including deep-freezers for storage and transportation. Vaccinia virus (VAC) vector vaccine (VACV) is a pioneer of new generation of vaccines constructed by using molecular biological technology. VACV, which has contributed to eradication of smallpox, has excellent characteristics of vaccinia virus such as a high heat-stability and long-lasting immunological effects. It is possible to distinguish the immunological responses of vaccination from those of natural infections. We started our developmental researches 35 years ago, using attenuated VAC strains established in Japan. In this article, we first describe the early researches of VACVs;development of two VACVs for Bovine leukemia virus and Rinderpest morbillivirus antigens and their protective immunity in large mammals, sheep and cows. Second, application of VACV is described;Rabies-VACV, which has already been licensed, used in the field in Europe and USA, and resulted in a prominent decrease of rabies. Then, current status of VACV research is described;non-replicating VACVs in mammalian cells have been developed as new-generation and ultimately-safe vaccines. We discuss the possibility of future application of VACV for wildlife.

Summary of global surveillance data of infectious diseases in December 2022

In December 2022, a total of 68 infectious diseases were reported globally, affecting 235 countries and regions. Except for influenza, the top five infectious diseases affecting greatest number of countries and regions were COVID-19 (235), monkeypox (110), dengue fever (28), measles (27) and cholera (14). The top five infectious diseases with highest case fatality rates were Ebola virus disease (47.0%), Rift Valley fever (44.2%), Crimean-Congo haemorrhagic fever (40.0%), Lassa fever (17.6%) and West Nile fever (7.6%). The top five infectious diseases with greatest number of deaths were COVID-19, malaria, cholera, dengue fever and measles. The prevalent infectious diseases in Asia were COVID-19, cholera and dengue fever, the prevalent infectious diseases in Africa were COVID-19, cholera, yellow fever, Lassa fever, monkeypox, malaria and measles, the prevalent infectious diseases in America were COVID-19, cholera, monkeypox, dengue fever and chikungunya fever, the prevalent infectious disease in Europe were COVID-19, monkeypox and invasive group A streptococcus infection.

Enhancing vaccination of key populations: lessons and actions

Vaccination is effective in preventing the increase of disease, especially emerging infectious diseases (EIDs), and it is particularly important for people in close contact with infected sources and susceptible populations who are at increased risk of getting infectious diseases due to behavior, occupation or health. Despite targeted vaccination guidelines, inadequate vaccination of the key populations fails to receive widespread attention, resulting in a high-risk transition of disease from key populations to general populations. Strengthening the vaccination of the susceptible groups can effectively block the spread of pathogens to general populations, and reduce the consumption of medical resources in universal vaccination, which has significant economic value. In this review, we describe the prevalence of EIDs, analyze the experience and lessons of infectious disease vaccination in key populations through several cases, and further explore the causes for the decline in vaccination rates of key populations. According to the trends of EIDs, a plan to strengthen the vaccination of key populations is proposed to effectively prevent the transition of EIDs from key populations to general populations.

Preventing monkeypox outbreaks: Focus on diagnosis, care, treatment, and vaccination.

The first human case of monkeypox virus (Mpox) was reported in 1970. In the years after 1970, human infection with Mpox and human-to-human transmission was not widely observed, and more cases were seen in endemic areas. In that year, Mpox spread was confirmed through the export of infected animals to other parts of the world. Every few years, sporadic infections were reported in different parts of the world from human contamination and human-to-human transmission. In recent years, with the slow decline of the COVID-19 pandemic, the outbreak of Mpox was observed in many countries of the world. To deal with the spread of this viral infection, we need to know the ways to diagnose the infection, treat the infection, care for the patients, and implement a wide program of vaccination. Currently, there are no specific drugs available for this virus, but according to previous studies related to smallpox, drugs such as tecovirimat, cidofovir, and brincidofovir, which were used for smallpox and other orthopoxviruses in the past, can be considered to deal with Mpox. Also, some vaccines such as JYNNEOS, IMVAMUNE, and MoVIHvax that have been used against smallpox can be useful to some extent in preventing Mpox.

Epidemiological Review on Monkeypox.

The significant increase in monkeypox cases that was reported at the beginning of 2022 was notable. The resurgence of viral zoonosis is especially concerning, given the current and recent COVID-19 epidemic. There are worries that a new pandemic may be beginning due to the virus that causes monkeypox spreading so quickly. This article aimed to provide an overview of the epidemiology, pathogenesis, and clinical symptoms of monkeypox. It has been known that monkeypox was primarily prevalent in Central and West Africa, but in recent years, cases of monkeypox infections have been reported around the world. The transmission of the infection to humans has been connected to exposure to a diseased animal or person's excretions and secretions. Various studies indicate that monkeypox clinically manifests as fever, fatigue, and a rash of smallpox-like lesions and can cause various complications, including pneumonia, encephalitis, and sepsis, which, when not properly managed, can lead to death. Those living in remote and forested areas, taking care of individuals infected with monkeypox, and trading and taking care of exotic animals are some of the risk factors for monkeypox. Men having sex with men are also at higher risk of contracting monkeypox. When dealing with individuals who have high-risk factors and come with new-onset progressive rashes, it is necessary for clinicians to highly suspect monkeypox. This review will serve as reference material and a supplement to the existing literature that will assist in the proper management and prevention of monkeypox.