Human Monkeypox: Current State of Knowledge and Implications for the Future.

The zoonosis human monkeypox (MPX) was discovered in 1970, twelve years after the discovery of monkeypox virus (MPXV) in a Danish laboratory in 1958. Historically confined to West Africa (WA) and the Congo basin (CB), new epidemics in Sudan and the United States of America (USA) have fuelled new research highlighting environmental factors contributing to the expanded geographical spread of monkeypox virus (MPXV). A systematic literature review was conducted in MEDLINE® (Ovid), MEDLINE® (PubMed) and Google Scholar databases using the search terms: monkeypox, MPXV and "human monkeypox". The literature revealed MPX has classic prodromal symptoms followed by a total body rash. The sole distinguishing clinical characteristic from other pox-like illnesses is the profound lymphadenopathy. Laboratory diagnosis of MPX is essential, a suitable test for endemic areas is under development but not yet available. For the time being anti-poxvirus antibodies in an unvaccinated individual with a history of severe illness and rash can suggest MPX infection. The reservoir host remains elusive yet the rope squirrel and Gambian pouched rat appear to be the most likely candidates. Transmission includes fomite, droplet, direct contact with infected humans or animals and consumption of infected meat. Though smallpox vaccination is protective against MPXV, new non-immune generations contribute to increasing incidence. Environmental factors are increasing the frequency of contact with potential hosts, thus increasing the risk of animal-to-human transmission. Increased risk of transmission through globalisation, conflict and environmental influences makes MPX a more realistic threat to previously unaffected countries. Health worker training and further development and accessibility of suitable diagnostic tests, vaccinations and anti-viral treatment is becoming increasingly necessary.

The cost of standing strong for replacement.

The testimonies of these individuals largely speak for themselves. The responses point to the importance of specific institutions or research groups that focus on the development and use of alternatives, and these should, of course, be better supported. Those who find themselves outside such institutions or teams, are more likely to feel stranded and isolated. Then again, Liz did have the support of a research group dedicated to replacement, but she has still had a significant struggle to find funding. The interviews with some of these particular young researchers indeed pointed toward a tangible 'cost' in terms of having to steer their career on the often difficult path toward the use of non-animal based methods.

Imitation of hierarchical action structure by young children.

To provide the first systematic test of whether young children will spontaneously perceive and imitate hierarchical structure in complex actions, a task was devised in which a set of 16 elements can be modelled through either of two different, hierarchically organized strategies. Three-year-old children showed a strong and significant tendency to copy whichever of the two hierarchical approaches they witnessed an adult perform. Responses to an element absent in demonstrations, but present at test, showed that children did not merely copy the chain of events they had witnessed, but acquired hierarchically structured rules to which the new element was assimilated. Consistent with this finding, children did not copy specific sequences of actions at lower hierarchical levels.