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Andes Pediatrica : Revista Chilena de... Apr 2024Molluscum contagiosum (MC) is a common viral infection in children, immunocompromised, and sexually active adults. Its usual clinical presentation is 2-5 mm, whitish or... (Review)
Review
Molluscum contagiosum (MC) is a common viral infection in children, immunocompromised, and sexually active adults. Its usual clinical presentation is 2-5 mm, whitish or skin-colored papules, with a shiny surface and central umbilication, generally clustered and randomly distributed over the skin surface. Dermoscopy reveals yellowish-white polylobulated structures with peripheral telangiectasia. Diagnosis is usually clinical supported by dermoscopy. However, in some cases, inflammatory manifestations can be associated with this infection and can mimic other dermatological conditions, making the diagnosis difficult and leading to unnecessary treatments. The objective of this article is to describe the main skin reactions associated with MC infection in order to provide a diagnostic and initial management tool for clinicians dealing with these conditions. Reported manifestations include the BOTE sign, perilesional eczema, Gianotti-Crosti syndrome-like reaction, ID reaction, erythema annulare centrifugum, erythema multiforme, folliculitis, white halo, and atypical manifestations (giant, disseminated, necrotic, polypoidal, and nodular lesions, pseudocysts, abscesses). In pediatric patients with the clinical manifestations described above, infection by molluscum contagiosum pox virus should be considered among the differential diagnoses, and referral to a dermatologist should be made in selected cases.
Topics: Humans; Molluscum Contagiosum; Child; Diagnosis, Differential; Dermoscopy; Skin Diseases
PubMed: 38801360
DOI: 10.32641/andespediatr.v95i2.5034 -
Emerging Microbes & Infections Dec 2023The first locally acquired case in the Chinese mainland was reported on May 31, 2023, lagging behind other countries. In this study, we aimed to examine the early...
The first locally acquired case in the Chinese mainland was reported on May 31, 2023, lagging behind other countries. In this study, we aimed to examine the early clinical and epidemiological characteristics of the earliest cases of Mpox in Beijing, China. Additionally, we investigated the sequence and transmission patterns of the Mpox virus (MPXV). We analyzed 37 reported cases of Mpox in Beijing from May 31, 2023 to June 21, 2023. The age range of the subjects was 24-51 years. Thirty-six cases (97.3%) were identified in men who have sex with men (MSM), and 19 cases (51.4%) tested positive for the human immunodeficiency virus. Thirty-three cases were symptomatic, while four were asymptomatic. Skin lesions were observed in 32 cases (97.0%), fever in 26 (78.8%), and swollen lymph nodes in 17 (51.5%). Rash typically appeared in the genital or perianal area 1-3 days before fever onset, with a minimum incubation period of 2 days. For individuals with skin rashes, the skin lesion samples showed 100% positivity and low Ct values. There were high oropharyngeal swab (75.8%) and blood (84.6%) positivity rates. All MPXV strains belonged to the B.1.3 branch of the West African lineage. These strains carried 76-86 nucleotide substitutions compared with the reference human MPXV genome, and genetic diversity was observed. Our findings provide the first insights into the landscape of early transmission of Mpox in Beijing and help inform policy formulation in the Chinese mainland.
Topics: Male; Humans; Young Adult; Adult; Middle Aged; Beijing; Homosexuality, Male; Mpox (monkeypox); Sexual and Gender Minorities; China; Fever
PubMed: 37649257
DOI: 10.1080/22221751.2023.2254407 -
Iranian Journal of Medical Sciences Jan 2024Monkeypox is an infectious and contagious zoonotic disease caused by the Orthopoxvirus species and was first identified in Africa. Recently, this infectious disease has... (Review)
Review
Monkeypox is an infectious and contagious zoonotic disease caused by the Orthopoxvirus species and was first identified in Africa. Recently, this infectious disease has spread widely in many parts of the world. Fever, fatigue, headache, and rash are common symptoms of monkeypox. The presence of lymphadenopathy is another prominent and key symptom of monkeypox, which distinguishes this disease from other diseases and is useful for diagnosing the disease. This disease is transmitted to humans through contact with or eating infected animals as well as objects infected with the virus. One of the ways to diagnose this disease is through PCR testing of lesions and secretions. To prevent the disease, vaccines such as JYNNEOS and ACAM2000 are available, but they are not accessible to all people in the world, and their effectiveness and safety need further investigation. However, preventive measures such as avoiding contact with people infected with the virus and using appropriate personal protective equipment are mandatory. The disease therapy is based on medicines such as brincidofovir, cidofovir, and Vaccinia Immune Globulin Intravenous. The injectable format of tecovirimat was approved recently, in May 2022. Considering the importance of clinical care in this disease, awareness about the side effects of medicines, nutrition, care for conjunctivitis, skin rash, washing and bathing at home, and so on can be useful in controlling and managing the disease.
Topics: Humans; Animals; Mpox (monkeypox); Administration, Intravenous; Africa; Benzamides; Cidofovir; Exanthema
PubMed: 38322157
DOI: 10.30476/IJMS.2022.96738.2837 -
Journal of Virological Methods Nov 2023Quantification of mpox virus (MPXV) across different human body anatomical sites can provide insights about the most likely transmission routes, so methods able to...
Quantification of mpox virus (MPXV) across different human body anatomical sites can provide insights about the most likely transmission routes, so methods able to release absolute and exact quantitative values of MPXV DNA are crucial. Here, we optimized a new QIAcuity digital PCR (dPCR) protocol for the detection and quantification of MPXV DNA in clinical samples and assessed the performance of the assay by comparing the results obtained in 144 biological samples with those resulting from the use of an in-house real-time PCR (qPCR). Overall, the concordance between the two assays was 95%, with samples identified concordantly as MPXV DNA positive and having a mean number of copies per μl of 1708 (95% CI: 107-2830 copies/μl). The remaining samples gave discordant results, with 5 out of 7 detected with the QIAcuity dPCR assay but not with the in-house qPCR. MPXV DNA levels measured by QIAcuity dPCR were strongly correlated with the Ct values detected by in-house qPCR and with those detected by another dPCR assay previously developed in our laboratories. The QIAcuity dPCR assay may be a robust and easy-to-perform method for MPXV DNA quantification in several biological samples.
Topics: Humans; Biological Assay; DNA, Viral; Laboratories; Real-Time Polymerase Chain Reaction; Mpox (monkeypox); Monkeypox virus
PubMed: 37625622
DOI: 10.1016/j.jviromet.2023.114802 -
Journal of Medical Virology Aug 2023The impact and frequency of infectious disease outbreaks demonstrate the need for timely genomic surveillance to inform public health responses. In the largest known...
The impact and frequency of infectious disease outbreaks demonstrate the need for timely genomic surveillance to inform public health responses. In the largest known outbreak of mpox, genomic surveillance efforts have primarily focused on high-incidence nations in Europe and the Americas, with a paucity of data from South-East Asia and the Western Pacific. Here we analyzed 102 monkeypox virus (MPXV) genomes sampled from 56 individuals in Melbourne, Australia. All genomes fell within the 2022 MPXV outbreak lineage (B.1), with likely onward local transmission detected. We observed within-host diversity and instances of co-infection, and highlight further examples of structural variation and apolipoprotein B editing complex-driven micro-evolution in the current MPXV outbreak. Updating our understanding of MPXV emergence and diversification will inform public health measures and enable monitoring of the virus' evolutionary trajectory throughout the mpox outbreak.
Topics: Humans; Monkeypox virus; Mpox (monkeypox); Genomics; Disease Outbreaks; Australia
PubMed: 37565686
DOI: 10.1002/jmv.29029 -
International Journal of Antimicrobial... Feb 2024To investigate the pharmacokinetics (PK) of tecovirimat in subjects with Mpox. (Observational Study)
Observational Study
OBJECTIVE
To investigate the pharmacokinetics (PK) of tecovirimat in subjects with Mpox.
METHODS
This monocentric, prospective, observational study enrolled subjects with Mpox who received standard treatment with oral tecovirimat. Plasma samples for PK assessment were collected at steady state (5-8 days after initiation of antiviral therapy), before and 3, 5, 7 and 12 h after tecovirimat administration. Drug concentrations were determined by validated liquid chromatography coupled with tandem mass spectrometry. PK parameters were calculated using Phoenix 8.1.
RESULTS
Overall, 14 male patients hospitalized for severe Mpox with ongoing tecovirimat treatment were enrolled in this study. Six of the 14 patients were living with human immunodeficiency virus (HIV), all of whom were on antiretroviral therapy (ART) and virologically suppressed at the time of hospitalization. Significant differences in tecovirimat PK were observed in subjects without HIV compared with subjects with HIV. In subjects with HIV, the maximum tecovirimat plasma concentration (39%, P≤0.0001), minimum tecovirimat plasma concentration (42%, P=0.0079) and area under the curve from zero to the last measured time-point (40%, P≤0.0001) were significantly lower compared with subjects without HIV, but all concentrations remained above the in-vitro calculated 90% inhibitory concentration. No significant associations were found between demographic/clinical data and tecovirimat PK. All patients recovered completely within 14 (range 6-36) days of treatment initiation.
CONCLUSIONS
This study found a significant decrease in plasma exposure of tecovirimat in Mpox patients with HIV on effective ART compared with those without HIV, with no evident impact on clinical outcomes. Although these results need to be confirmed in larger studies, they may provide useful information on the PK of tecovirimat.
Topics: Humans; Male; Prospective Studies; Mpox (monkeypox); HIV Infections; HIV
PubMed: 38141836
DOI: 10.1016/j.ijantimicag.2023.107068 -
Science (New York, N.Y.) Nov 2023Historically, mpox has been characterized as an endemic zoonotic disease that transmits through contact with the reservoir rodent host in West and Central Africa....
Historically, mpox has been characterized as an endemic zoonotic disease that transmits through contact with the reservoir rodent host in West and Central Africa. However, in May 2022, human cases of mpox were detected spreading internationally beyond countries with known endemic reservoirs. When the first cases from 2022 were sequenced, they shared 42 nucleotide differences from the closest mpox virus (MPXV) previously sampled. Nearly all these mutations are characteristic of the action of APOBEC3 deaminases, host enzymes with antiviral function. Assuming APOBEC3 editing is characteristic of human MPXV infection, we developed a dual-process phylogenetic molecular clock that-inferring a rate of ~6 APOBEC3 mutations per year-estimates that MPXV has been circulating in humans since 2016. These observations of sustained MPXV transmission present a fundamental shift to the perceived paradigm of MPXV epidemiology as a zoonosis and highlight the need for revising public health messaging around MPXV as well as outbreak management and control.
Topics: Animals; Humans; Africa, Central; Africa, Western; APOBEC Deaminases; Disease Outbreaks; Mpox (monkeypox); Monkeypox virus; Mutation; Phylogeny; Viral Zoonoses; RNA Editing
PubMed: 37917680
DOI: 10.1126/science.adg8116 -
Journal of Infection and Public Health Sep 2023The first human monkeypox (MPX) case was identified in the Democratic Republic of Congo (DRC) in 1970 with an outbreak in 2010 and the first human MPX case in the UK in... (Review)
Review
BACKGROUND
The first human monkeypox (MPX) case was identified in the Democratic Republic of Congo (DRC) in 1970 with an outbreak in 2010 and the first human MPX case in the UK in 2022. In this study, we conducted a bibliometric analysis of the literature on monkeypox based on the Web of Science Core Collection (WOSCC) of the Institute for Scientific Information (ISI) to identify relevant topics and trends in monkeypox research.
METHODS
We searched the Web of Science from 1964 until July 14, 2022, for all publications using the keywords "Monkeypox" and "Monkeypox virus." Results were compared using numerous bibliometric methodologies and stratified by journal, author, year, institution, and country-specific metrics.
RESULTS
Out of 1170 publications initially selected, 1163 entered our analysis, with 65.26 % (n = 759) being original research articles and 9.37 % (n = 109) being review articles. Most MPX publications were in 2010, with 6.02 % (n = 70), followed by 2009 and 2022 at 5.67 % (n = 66) each. The USA was the country with the highest number of publications, with n = 662 (56.92 %) of total publications, followed by Germany with n = 82 (7.05 %), the UK with n = 74 (6.36 %), and Congo with n = 65 (5.59 %). Journal of Virology published the highest number of MPX publications, followed by Virology Journal and Emerging Infectious Diseases with n = 52 (9.25 %), n = 43 (7.65 %), and n = 32 (5.69 %) publications, respectively. The top contributing institutions were the Centers for Disease Control and Prevention (CDC), the US Army Medical Research Institute of Infectious Diseases, and the National Institutes of Health (NIH)National Institute of Allergy and Infectious Diseases (NIAID).
CONCLUSION
Our analysis provides an objective and robust overview of the current literature on MPX and its global trends; this information could serve as a reference guide for those aiming to conduct further MPX-related research and as a source for those seeking information about MPX.
Topics: Humans; Bibliometrics; Disease Outbreaks; Germany; Mpox (monkeypox); Monkeypox virus
PubMed: 37429097
DOI: 10.1016/j.jiph.2023.05.035 -
International Journal of Infectious... Sep 2023
Topics: Humans; Mpox (monkeypox); Antibodies, Viral; Smallpox
PubMed: 37451393
DOI: 10.1016/j.ijid.2023.07.005 -
Globalization and Health Aug 2023Outbreaks of monkeypox have been ongoing in non-endemic countries since May 2022. A thorough assessment of its global zoonotic niche and potential transmission risk is... (Observational Study)
Observational Study
BACKGROUND
Outbreaks of monkeypox have been ongoing in non-endemic countries since May 2022. A thorough assessment of its global zoonotic niche and potential transmission risk is lacking.
METHODS
We established an integrated database on global monkeypox virus (MPXV) occurrence during 1958 - 2022. Phylogenetic analysis was performed to examine the evolution of MPXV and effective reproductive number (R) was estimated over time to examine the dynamic of MPXV transmissibility. The potential ecological drivers of zoonotic transmission and inter-regional transmission risks of MPXV were examined.
RESULTS
As of 24 July 2022, a total of 49 432 human patients with MPXV infections have been reported in 78 countries. Based on 525 whole genome sequences, two main clades of MPXV were formed, of which Congo Basin clade has a higher transmissibility than West African clade before the 2022-monkeypox, estimated by the overall R (0.81 vs. 0.56), and the latter significantly increased in the recent decade. R of 2022-monkeypox varied from 1.14 to 4.24 among the 15 continuously epidemic countries outside Africa, with the top three as Peru (4.24, 95% CI: 2.89-6.71), Brazil (3.45, 95% CI: 1.62-7.00) and the United States (2.44, 95% CI: 1.62-3.60). The zoonotic niche of MPXV was associated with the distributions of Graphiurus lorraineus and Graphiurus crassicaudatus, the richness of Rodentia, and four ecoclimatic indicators. Besides endemic areas in Africa, more areas of South America, the Caribbean States, and Southeast and South Asia are ecologically suitable for the occurrence of MPXV once the virus has invaded. Most of Western Europe has a high-imported risk of monkeypox from Western Africa, whereas France and the United Kingdom have a potential imported risk of Congo Basin clade MPXV from Central Africa. Eleven of the top 15 countries with a high risk of MPXV importation from the main countries of 2022-monkeypox outbreaks are located at Europe with the highest risk in Italy, Ireland and Poland.
CONCLUSIONS
The suitable ecological niche for MPXV is not limited to Africa, and the transmissibility of MPXV was significantly increased during the 2022-monkeypox outbreaks. The imported risk is higher in Europe, both from endemic areas and currently epidemic countries. Future surveillance and targeted intervention programs are needed in its high-risk areas informed by updated prediction.
Topics: Humans; Mpox (monkeypox); Phylogeny; Disease Outbreaks; Retrospective Studies; Brazil
PubMed: 37592305
DOI: 10.1186/s12992-023-00959-0