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1.
Euro Surveill ; 27(32)2022 Aug.
Article in English | MEDLINE | ID: covidwho-1993732

ABSTRACT

Monkeypox was declared a public health emergency of international concern by the World Health Organization (WHO) on 23 July 2022. Between 1 January and 23 July 2022, 16,016 laboratory confirmed cases of monkeypox and five deaths were reported to WHO from 75 countries on all continents. Public health authorities are proactively identifying cases and tracing their contacts to contain its spread. As with COVID-19, PCR is the only method capable of being deployed at sufficient speed to provide timely feedback on any public health interventions. However, at this point, there is little information on how those PCR assays are being standardised between laboratories. A likely reason is that testing is still limited on a global scale and that detection, not quantification, of monkeypox virus DNA is the main clinical requirement. Yet we should not be complacent about PCR performance. As testing requirements increase rapidly and specimens become more diverse, it would be prudent to ensure PCR accuracy from the outset to support harmonisation and ease regulatory conformance. Lessons from COVID-19 should aid implementation with appropriate material, documentary and methodological standards offering dynamic mechanisms to ensure testing that most accurately guides public health decisions.


Subject(s)
COVID-19 , Monkeypox , Animals , COVID-19 Testing , Humans , Monkeypox/diagnosis , Monkeypox/epidemiology , Monkeypox virus/genetics , Polymerase Chain Reaction/methods , World Health Organization
4.
Lancet Infect Dis ; 22(8): 1153-1162, 2022 08.
Article in English | MEDLINE | ID: covidwho-1972395

ABSTRACT

BACKGROUND: Cases of human monkeypox are rarely seen outside of west and central Africa. There are few data regarding viral kinetics or the duration of viral shedding and no licensed treatments. Two oral drugs, brincidofovir and tecovirimat, have been approved for treatment of smallpox and have demonstrated efficacy against monkeypox in animals. Our aim was to describe the longitudinal clinical course of monkeypox in a high-income setting, coupled with viral dynamics, and any adverse events related to novel antiviral therapies. METHODS: In this retrospective observational study, we report the clinical features, longitudinal virological findings, and response to off-label antivirals in seven patients with monkeypox who were diagnosed in the UK between 2018 and 2021, identified through retrospective case-note review. This study included all patients who were managed in dedicated high consequence infectious diseases (HCID) centres in Liverpool, London, and Newcastle, coordinated via a national HCID network. FINDINGS: We reviewed all cases since the inception of the HCID (airborne) network between Aug 15, 2018, and Sept 10, 2021, identifying seven patients. Of the seven patients, four were men and three were women. Three acquired monkeypox in the UK: one patient was a health-care worker who acquired the virus nosocomially, and one patient who acquired the virus abroad transmitted it to an adult and child within their household cluster. Notable disease features included viraemia, prolonged monkeypox virus DNA detection in upper respiratory tract swabs, reactive low mood, and one patient had a monkeypox virus PCR-positive deep tissue abscess. Five patients spent more than 3 weeks (range 22-39 days) in isolation due to prolonged PCR positivity. Three patients were treated with brincidofovir (200 mg once a week orally), all of whom developed elevated liver enzymes resulting in cessation of therapy. One patient was treated with tecovirimat (600 mg twice daily for 2 weeks orally), experienced no adverse effects, and had a shorter duration of viral shedding and illness (10 days hospitalisation) compared with the other six patients. One patient experienced a mild relapse 6 weeks after hospital discharge. INTERPRETATION: Human monkeypox poses unique challenges, even to well resourced health-care systems with HCID networks. Prolonged upper respiratory tract viral DNA shedding after skin lesion resolution challenged current infection prevention and control guidance. There is an urgent need for prospective studies of antivirals for this disease. FUNDING: None.


Subject(s)
Monkeypox , Adult , Animals , Antiviral Agents/therapeutic use , Child , Female , Humans , Male , Monkeypox/diagnosis , Monkeypox/drug therapy , Monkeypox/epidemiology , Prospective Studies , Retrospective Studies , United Kingdom/epidemiology
5.
Lancet ; 400(10349): 337, 2022 07 30.
Article in English | MEDLINE | ID: covidwho-1972386
6.
J Korean Med Sci ; 37(29): e239, 2022 Jul 25.
Article in English | MEDLINE | ID: covidwho-1963383

ABSTRACT

In June 2022, the first monkeypox case was reported as imported into Korea. The general public asked whether they should get vaccinated against monkeypox because of the recent COVID-19 vaccination experience. As of the current monkeypox outbreak situation, a ring vaccination strategy for the high-risk group is more appropriate than the mass population vaccination with smallpox vaccines. Therefore, identifying the proper target group by available vaccines based on the risk and benefit analysis is a key issue of the vaccination program. In addition, the target group should be reviewed by the epidemiological situation of the jurisdiction along with the updated evidence of the monkeypox virus on transmission dynamics, severity, and fatality.


Subject(s)
COVID-19 , Monkeypox , Animals , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Humans , Monkeypox/epidemiology , Monkeypox/prevention & control , Monkeypox virus , Vaccination
8.
Mil Med Res ; 9(1): 29, 2022 06 13.
Article in English | MEDLINE | ID: covidwho-1951383
9.
Nature ; 607(7917): 17-18, 2022 07.
Article in English | MEDLINE | ID: covidwho-1931356
11.
Viruses ; 14(6)2022 06 13.
Article in English | MEDLINE | ID: covidwho-1911627

ABSTRACT

Several neglected infectious pathogens, such as the monkeypox virus (MPXV), have re-emerged in the last few decades, becoming a global health burden. Despite the incipient vaccine against MPXV infection, the global incidence of travel-related outbreaks continues to rise. About 472 confirmed cases have been reported in 27 countries as of 31 May 2022, the largest recorded number of cases outside Africa since the disease was discovered in the early 1970s.


Subject(s)
COVID-19 , Monkeypox , Animals , COVID-19/epidemiology , Disease Outbreaks , Humans , Monkeypox/epidemiology , Monkeypox virus , Pandemics/prevention & control , Travel , Travel-Related Illness
13.
J Autoimmun ; 131: 102855, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1907255

ABSTRACT

Following two reports of monkeypox virus infection in individuals who returned from Nigeria to the USA, one who returned to Texas (July 2021) and the other to the Washington, DC area (November 2021), the number of monkeypox infection have dramatically increased. This sounded an alarm of potential for spreading of the virus throughout the USA. During 2022, there was a report of monkeypox virus infection (May 6, 2022) in a British national following a visit to Nigeria who developed readily recognizable signs and symptoms of monkeypox virus infection. Soon following this report, case numbers climbed. By June 10, 2022, more than 1,500 cases were reported in 43 countries, including Europe and North America. While the prevalence of the monkeypox virus is well known in central and western Africa, its presence in the developed world has raised disturbing signs for worldwide spread. While infection was reported during the past half-century, starting in the Democratic Republic of Congo in 1970, in the United States, only sporadic monkeypox cases have been reported. All cases have been linked to international travel or through African animal imports. The monkeypox virus is transmitted through contact with infected skin, body fluids, or respiratory droplets. The virus spreads from oral and nasopharyngeal fluid exchanges or by intradermal injection; then rapidly replicates at the inoculation site with spreads to adjacent lymph nodes. Monkeypox disease begins with constitutional symptoms that include fever, chills, headache, muscle aches, backache, and fatigue. Phylogenetically the virus has two clades. One clade emerged from West Africa and the other in the Congo Basin of Central Africa. During the most recent outbreak, the identity of the reservoir host or the primary carriage remains unknown. African rodents are the suspected intermediate hosts. At the same time, the Centers for Disease Control (CDC) affirmed that there are no specific treatments for the 2022 monkeypox virus infection; existing antivirals shown to be effective against smallpox may slow monkeypox spread. A smallpox vaccine JYNNEOS (Imvamune or Imvanex) may also be used to prevent infection. The World Health Organization (WHO), has warned that the world could be facing a formidable infectious disease challenge in light of the current status of worldwide affairs. These affairs include the SARS-COVID-19 pandemic and the Ukraine-Russia war. In addition, the recent rise in case of numbers worldwide could continue to pose an international threat. With this in mind, strategies to mitigate the spread of monkeypox virus are warranted.


Subject(s)
COVID-19 , Monkeypox , Animals , Disease Outbreaks , Humans , Monkeypox/epidemiology , Monkeypox virus , Pandemics
15.
BMJ ; 377: o1489, 2022 06 16.
Article in English | MEDLINE | ID: covidwho-1901971
17.
Lancet Infect Dis ; 22(7): 913, 2022 07.
Article in English | MEDLINE | ID: covidwho-1900325
20.
Lancet ; 399(10343): 2254-2255, 2022 06 18.
Article in English | MEDLINE | ID: covidwho-1900295
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