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International Journal of Environmental... Nov 2022Monkeypox is a zoonotic infectious disease belonging to the orthopoxvirus family that has predominantly occurred in West and Central Africa since it was initially... (Review)
Review
Monkeypox is a zoonotic infectious disease belonging to the orthopoxvirus family that has predominantly occurred in West and Central Africa since it was initially discovered in 1958. In May 2022, a global outbreak of monkeypox began to occur on an international scale, with case numbers still rising as this review is being written. This mini review sought to analyze the existing literature on monkeypox published from 2017 onward to provide epidemiological context to current outbreaks. PubMed and Google Scholar databases were used to gather both peer-reviewed and grey literature on the routes of transmission, case definitions, clinical characteristics, diagnosis, management, prevention, vaccination, and epidemiology of monkeypox. Epidemiological studies indicate that the age of onset of monkeypox has increased over time. Antivirals, such as Tecovirimat and Brincidofovir, are recommended to manage confirmed cases of monkeypox. Although mass vaccination is not currently recommended, the smallpox vaccine can be used as a preventative measure for at-risk groups, such as men who have sex with men and frontline healthcare workers. Further peer-reviewed research addressing animal reservoirs and sexual transmission dynamics is needed.
Topics: Humans; Animals; Male; Orthopoxvirus; Homosexuality, Male; Sexual and Gender Minorities; Mpox (monkeypox); Zoonoses; Communicable Diseases
PubMed: 36497758
DOI: 10.3390/ijerph192315684 -
Clinical Microbiology and Infection :... Dec 2023The 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... (Review)
Review
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.
Topics: Animals; Humans; Smallpox; Mpox (monkeypox); Variola virus; Zoonoses; Disease Outbreaks
PubMed: 37574113
DOI: 10.1016/j.cmi.2023.08.008 -
European Journal of Internal Medicine Oct 2022As of August 5, 2022, >26,000 cases of monkeypox have been diagnosed worldwide and the steep increase of cases has spurred renewed concern about the risk for another... (Review)
Review
As of August 5, 2022, >26,000 cases of monkeypox have been diagnosed worldwide and the steep increase of cases has spurred renewed concern about the risk for another viral pandemic. In this narrative review, we address etiology, epidemiology and virology of monkeypox, describing routes of transmission and modes of spread. We also describe the current clinical presentation of monkeypox, focusing on circumstances where the disease should be suspected, and the methods to diagnose it. Finally, we briefly describe available treatments and strategies for active immune prophylaxis.
Topics: Humans; Mpox (monkeypox); Monkeypox virus; Physicians
PubMed: 35999095
DOI: 10.1016/j.ejim.2022.08.022 -
Medecine Et Sante Tropicales Feb 2017This article reviews the different types of poxvirus infections. Smallpox, although eradicated, must continue to be monitored because of the potential risk of accidental... (Review)
Review
This article reviews the different types of poxvirus infections. Smallpox, although eradicated, must continue to be monitored because of the potential risk of accidental or voluntary (by bioterrorism) reintroduction. Monkeypox and cowpox viruses are considered to be emergent today ; their high risk of dissemination is due to the increase in international transport as well as trends for new animals as pets and the loss of vaccinal protection against smallpox. Molluscum contagiosum (molluscipoxvirus) causes mild infections, is particularly frequent in children ; in adults it is a marker of the risk of sexually transmitted infections and can, in cases with profuse lesions, reveal AIDS.
Topics: Humans; Mpox (monkeypox); Poxviridae Infections
PubMed: 28406414
DOI: 10.1684/mst.2017.0653 -
Current Opinion in Virology Dec 2022Poxviruses are a diverse family of double-stranded DNA viruses that cause mild-to-severe disease in selective hosts, including humans. Although most poxviruses are... (Review)
Review
Poxviruses are a diverse family of double-stranded DNA viruses that cause mild-to-severe disease in selective hosts, including humans. Although most poxviruses are restricted to their hosts, some members can leap host species and cause zoonotic diseases and, therefore, are genuine threats to human and animal health. The recent global spread of monkeypox in humans suggests that zoonotic poxviruses can adapt to a new host, spread rapidly in the new host, and evolve to better evade host innate barriers. Unlike many other viruses, poxviruses express an extensive repertoire of self-defense proteins that play a vital role in the evasion of host innate and adaptive immune responses in their newest host species. The function of these viral immune modulators and host-specific cytokine responses can result in different host tropism and poxvirus disease progression. Here, we review the role of different cytokines that control poxvirus host tropism and adaptation.
Topics: Animals; Humans; Viral Tropism; Cytokines; Viral Proteins; Poxviridae; Poxviridae Infections
PubMed: 36427482
DOI: 10.1016/j.coviro.2022.101286 -
The American Journal of Emergency... Nov 2022Monkeypox is an emerging viral disease that has been declared a global health emergency. While this disease has been present for over 50 years, the recent surge in cases... (Review)
Review
INTRODUCTION
Monkeypox is an emerging viral disease that has been declared a global health emergency. While this disease has been present for over 50 years, the recent surge in cases and expanding knowledge of this has prompted a need for a focused review for practicing clinicians.
OBJECTIVE
This narrative review provides a focused overview of the epidemiology, presentation, evaluation, and management of monkeypox for emergency clinicians.
DISCUSSION
Monkeypox is an orthopoxvirus endemic to central and western Africa. An outbreak in May and June 2022 across Asia, Europe, North America, and South America was declared a global health emergency in July 2022. The disease can be transmitted via contact with an infected animal or human, as well as contact with a contaminated material. The disease presents with a prodromal flu-like illness and lymphadenopathy. A rash spreading in a centrifugal manner involving the oral mucosa, face, palms, and soles is typical. Lesions progress along various stages. Complications such as bacterial skin infection, pneumonitis, ocular conditions, and encephalitis are uncommon. Confirmation typically includes polymerase chain reaction testing. The majority of patients improve with symptomatic therapy, and as of July 2022, there are no United States Food and Drug Administration-approved treatments specifically for monkeypox. However, antiviral treatment should be considered for several patient populations at risk for severe outcomes.
CONCLUSION
An understanding of the presentation, evaluation, and management of monkeypox is essential for emergency clinicians to ensure appropriate diagnosis and treatment of this emerging disease.
Topics: Humans; United States; Animals; Mpox (monkeypox); Monkeypox virus; Exanthema; Antiviral Agents; Emergency Medicine
PubMed: 36030595
DOI: 10.1016/j.ajem.2022.08.026 -
Microbial Pathogenesis Dec 2022The detection of >400 Monkeypox virus cases in the month of May 2022 and increase to 57,527. confirmed cases by September 9th 2022, across the world, emphasizes the need... (Review)
Review
The detection of >400 Monkeypox virus cases in the month of May 2022 and increase to 57,527. confirmed cases by September 9th 2022, across the world, emphasizes the need of new therapeutics for this emerging viral epidemic in humans. Largely the cases seen in Europe, Australia and America are among men who have sex with men making transmission through intimate contact with infectious skin lesions the likely mode of transmission. This implies that this high human-to-human transmission observed in the young Caucasian clusters, and the probable community transmission without any history of travelling to endemic areas would suggest that the epidemic is likely to be sustained human-to-human transmission and unlikely one that would be a short-lasting epidemic. This might necessitate the need for new therapeutic approaches and agents for prophylaxis and treatment of acute infections which is the focus of this review article.
Topics: Male; Humans; Mpox (monkeypox); Antiviral Agents; Homosexuality, Male; Sexual and Gender Minorities; Vaccines
PubMed: 36182078
DOI: 10.1016/j.micpath.2022.105799 -
International Immunopharmacology Dec 2022Monkeypox is a zoonotic illness caused by the monkeypox virus (MPXV) that has a similar etiology to smallpox. The first case of monkeypox was reported in Western and... (Review)
Review
Monkeypox is a zoonotic illness caused by the monkeypox virus (MPXV) that has a similar etiology to smallpox. The first case of monkeypox was reported in Western and Central Africa in 1971, and in 2003, there was an outbreak of monkeypox viruses outside Africa. According to the World Health Organization (WHO) and Center for Disease Control and Prevention (CDC), monkeypox is transmitted through direct contact with infected animals or persons exposed to infectious sores, scabs, or body fluids. Also, intimate contact between people during sex, kissing, cuddling, or touching parts of the body can result in the spreading of this disease. The use of the smallpox vaccine against monkeypox has several challenges and hence anti-virals such as cidofovir, brincidofovir, and tecovirimat have been used for the symptomatic relief of patients and reversing the lesion formation on the skin. Despite the recent outbreak of monkeypox most especially in hitherto non-endemic countries, there is still a lack of definitive treatment for monkeypox. In the present review, emphasis was focused on etiopathology, transmission, currently available therapeutic agents, and future targets that could be explored to halt the progression of monkeypox. From our review we can postulate that owing to the lack of a definitive cure to this reemerging disorder, there is a need for general awareness about the transmission as well as to develop appropriate diagnostic procedures, immunizations, and antiviral medication.
Topics: Animals; Mpox (monkeypox); Monkeypox virus; Smallpox Vaccine; Cidofovir; Antiviral Agents
PubMed: 36330915
DOI: 10.1016/j.intimp.2022.109382 -
Transboundary and Emerging Diseases Jun 2017Lumpy skin disease, sheeppox and goatpox are high-impact diseases of domestic ruminants with a devastating effect on cattle, sheep and goat farming industries in endemic... (Review)
Review
Lumpy skin disease, sheeppox and goatpox are high-impact diseases of domestic ruminants with a devastating effect on cattle, sheep and goat farming industries in endemic regions. In this article, we review the current geographical distribution, economic impact of an outbreak, epidemiology, transmission and immunity of capripoxvirus. The special focus of the article is to scrutinize the use of currently available vaccines to investigate the resource needs and challenges that will have to be overcome to improve disease control and eradication, and progress on the development of safer and more effective vaccines. In addition, field evaluation of the efficacy of the vaccines and the genomic database available for poxviruses are discussed.
Topics: Animals; Capripoxvirus; Disease Outbreaks; Poxviridae Infections
PubMed: 26564428
DOI: 10.1111/tbed.12444 -
Cleveland Clinic Journal of Medicine Mar 2023The monkeypox (mpox) epidemic was declared a global health emergency in July 2022. The mpox virus belongs to the same virus family as the smallpox, or variola virus, but... (Review)
Review
The monkeypox (mpox) epidemic was declared a global health emergency in July 2022. The mpox virus belongs to the same virus family as the smallpox, or variola virus, but the infection is a less lethal threat than smallpox. Nevertheless, its relationship to smallpox is a worldwide concern, as is the discontinuation of universal smallpox vaccinations since the 1980s. Newer therapies and vaccines are available for both infections, including 2 antiviral drugs that can be used under certain conditions. Two vaccines have been developed for mpox prevention, but clarity is needed on when and how to use them. Preventive public health measures and prioritization of resources for managing infectious disease are concerns.
Topics: Humans; Smallpox; Variola virus; Mpox (monkeypox); Antiviral Agents; Epidemics
PubMed: 36858615
DOI: 10.3949/ccjm.90a.22067