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Journal of the American Academy of... Jul 2024
Topics: Humans; Mpox (monkeypox)
PubMed: 38490371
DOI: 10.1016/j.jaad.2024.02.048 -
Advances in Experimental Medicine and... 2024Smallpox was a significant cause of mortality for over three thousand years, amounting to 10% of deaths yearly. Edward Jenner discovered smallpox vaccination in 1796,... (Review)
Review
Smallpox was a significant cause of mortality for over three thousand years, amounting to 10% of deaths yearly. Edward Jenner discovered smallpox vaccination in 1796, which rapidly became a smallpox infection preventive practice throughout the world and eradicated smallpox infection by 1980. After smallpox eradication, monkeypox vaccines have been used primarily in research and in outbreaks in Africa, where the disease is endemic. In the present, the vaccines are being used for people who work with animals or in high-risk areas, as well as for healthcare workers treating patients with monkeypox. Among all orthopoxviruses (OPXV), monkeypox viral (MPXV) infection occurs mainly in cynomolgus monkeys, natural reservoirs, and occasionally causes severe multi-organ infection in humans, who were the incidental hosts. The first case of the present epidemic of MXPV was identified on May 7, 2022, and rapidly increased the number of cases. In this regard, the WHO declared the outbreak, an international public health emergency on July 23, 2022. The first monkeypox vaccine was developed in the 1960s by the US Army and was based on the vaccinia virus, which is also used in smallpox vaccines. In recent years, newer monkeypox vaccines have been developed based on other viruses such as Modified Vaccinia Ankara (MVA). These newer vaccines are safer and can provide longer-lasting immunity with fewer side effects. For the future, there is ongoing research to improve the current vaccines and to develop new ones. One notable advance has been the development of a recombinant vaccine that uses a genetically modified vaccinia virus to express monkeypox antigens. This vaccine has shown promising results in pre-clinical trials and is currently undergoing further testing in clinical trials. Another recent development has been the use of a DNA vaccine, which delivers genetic material encoding monkeypox antigens directly into cells. This type of vaccine has shown effectiveness in animal studies and is also undergoing clinical testing in humans. Overall, these recent advances in monkeypox vaccine development hold promise for protecting individuals against this potentially serious disease.
Topics: Humans; Animals; Smallpox Vaccine; Smallpox; History, 21st Century; History, 20th Century; Mpox (monkeypox); Poxviridae Infections; Poxviridae; Monkeypox virus; Vaccination; Viral Vaccines; Vaccine Development
PubMed: 38801584
DOI: 10.1007/978-3-031-57165-7_17 -
The American Journal of Medicine Mar 2023Monkeypox, a neglected disease previously confined to Africa, is causing a worldwide outbreak affecting predominantly males who have sex with males, especially those who... (Review)
Review
Monkeypox, a neglected disease previously confined to Africa, is causing a worldwide outbreak affecting predominantly males who have sex with males, especially those who are infected with HIV. The clinical presentation during the current outbreak differs from endemic cases. Treatment with tecovirimat and other antivirals is available. Immunization may be used as preexposure and postexposure prophylaxis.
Topics: Male; Humans; Female; Mpox (monkeypox); Homosexuality, Male; Sexual and Gender Minorities; Antiviral Agents; Benzamides
PubMed: 36495937
DOI: 10.1016/j.amjmed.2022.10.023 -
Journal of Medicinal Chemistry Apr 2023The current monkeypox outbreaks during the COVID-19 pandemic have reignited interest in orthopoxvirus antivirals. Monkeypox belongs to the genus of the Poxviridae... (Review)
Review
The current monkeypox outbreaks during the COVID-19 pandemic have reignited interest in orthopoxvirus antivirals. Monkeypox belongs to the genus of the Poxviridae family, which also includes the variola virus, vaccinia virus, and cowpox virus. Two orally bioavailable drugs, tecovirimat and brincidofovir, have been approved for treating smallpox infections. Given their human safety profiles and in vivo antiviral efficacy in animal models, both drugs have also been recommended to treat monkeypox infection. To facilitate the development of additional orthopoxvirus antivirals, we summarize the antiviral activity, mechanism of action, and mechanism of resistance of orthopoxvirus antivirals. This perspective covers both direct-acting and host-targeting antivirals with an emphasis on drug candidates showing in vivo antiviral efficacy in animal models. We hope to speed the orthopoxvirus antiviral drug discovery by providing medicinal chemists with insights into prioritizing proper drug targets and hits for further development.
Topics: Animals; Humans; Orthopoxvirus; Monkeypox virus; Antiviral Agents; Mpox (monkeypox); Pandemics; COVID-19; Variola virus
PubMed: 36961984
DOI: 10.1021/acs.jmedchem.3c00069 -
American Journal of Health-system... Jan 2023The objective of this clinical review is to provide an overview of antiviral therapies for monkeypox treatment and summarize the role of vaccines in monkeypox prevention. (Review)
Review
PURPOSE
The objective of this clinical review is to provide an overview of antiviral therapies for monkeypox treatment and summarize the role of vaccines in monkeypox prevention.
SUMMARY
The human monkeypox virus is a double-stranded DNA virus of the Orthopoxvirus genus of the Poxviridae family. The estimated case fatality rate for monkeypox ranges between 0% and 11%. The first human monkeypox infection was reportedly due to an unidentified animal reservoir. Per the Centers for Disease Control and Prevention, isolation and infection control procedures should be followed in the care of those infected with monkeypox virus. Monkeypox virus infection symptoms include rash, fever, chills, headache, muscle aches, backache, and fatigue that may progress to exhaustion. Severe complications such as encephalitis, pneumonia, and retropharyngeal abscess could appear in immunocompromised or critically ill patients. There are currently no specific Food and Drug Administration (FDA)-approved therapies for monkeypox. As with most viral infections, supportive care is the backbone of monkeypox clinical management. However, therapies effective for smallpox, such as cidofovir, brincidofovir, and tecovirimat, have previously been reported to be effective in the management of monkeypox. Pre- and postexposure prophylaxis to prevent monkeypox transmission are recommended in the US for those at high risk for disease transmission.
CONCLUSION
There are no FDA-approved treatments for monkeypox infection. Surveillance and detection of monkeypox among high-risk populations should be implemented to help understand the epidemiology of this disease.
Topics: Animals; Humans; Mpox (monkeypox); Monkeypox virus; Disease Outbreaks; Cidofovir; Exanthema
PubMed: 36259674
DOI: 10.1093/ajhp/zxac300 -
Frontiers in Immunology 2023On 23rd July 2022, the World Health Organization (WHO) recognized the ongoing monkeypox outbreak as a public medical crisis. Monkeypox virus (MPV), the etiological agent... (Review)
Review
On 23rd July 2022, the World Health Organization (WHO) recognized the ongoing monkeypox outbreak as a public medical crisis. Monkeypox virus (MPV), the etiological agent of monkeypox, is a zoonotic, linear, double-stranded DNA virus. In 1970, the Democratic Republic of the Congo reported the first case of MPV infection. Human-to-human transmission can happen through sexual contact, inhaled droplets, or skin-to-skin contact. Once inoculated, the viruses multiply rapidly and spread into the bloodstream to cause viremia, which then affect multiple organs, including the skin, gastrointestinal tract, genitals, lungs, and liver. By September 9, 2022, more than 57,000 cases had been reported in 103 locations, especially in Europe and the United States. Infected patients are characterized by physical symptoms such as red rash, fatigue, backache, muscle aches, headache, and fever. A variety of medical strategies are available for orthopoxviruses, including monkeypox. Monkeypox prevention following the smallpox vaccine has shown up to 85% efficacy, and several antiviral drugs, such as Cidofovir and Brincidofovir, may slow the viral spread. In this article, we review the origin, pathophysiology, global epidemiology, clinical manifestation, and possible treatments of MPV to prevent the propagation of the virus and provide cues to generate specific drugs.
Topics: Humans; Antigens, Viral; Antiviral Agents; Cidofovir; Mpox (monkeypox); Prevalence
PubMed: 37026012
DOI: 10.3389/fimmu.2023.1132250 -
The Medical Journal of Australia Aug 2022
Topics: Australia; Humans; Mpox (monkeypox)
PubMed: 35842889
DOI: 10.5694/mja2.51647 -
JAMA Neurology Nov 2022Orthopox viruses include smallpox virus, a once feared but now eradicated virus, as well as monkeypox virus. Monkeypox is an emerging virus initially isolated in 1958,... (Review)
Review
IMPORTANCE
Orthopox viruses include smallpox virus, a once feared but now eradicated virus, as well as monkeypox virus. Monkeypox is an emerging virus initially isolated in 1958, previously unrecognized outside sub-Saharan Africa until a worldwide outbreak in May 2022. It is important to review known neurologic consequences of both these viruses, as complications of smallpox may be relevant to monkeypox, though complications of monkeypox may be rarer and perhaps less severe.
OBSERVATIONS
This was a literature review of the known neurologic complications of smallpox, which include encephalitis, transverse myelitis, and acute disseminated encephalomyelitis among others; historical complications of smallpox vaccination, including postvaccinal encephalomyelitis; and the known neurologic complications of monkeypox, which include headaches and mood disturbances, as well as rare presentations of encephalitis, transverse myelitis, and seizures. Of concern is the possibility of viral persistence and systemic complications in immunocompromised individuals. Also provided were considerations for diagnosis, current treatment, and prevention of monkeypox.
CONCLUSIONS AND RELEVANCE
Monkeypox should be considered in high-risk populations who present with neurologic syndromes. Diagnosis may require serology and polymerase chain reaction testing of blood and spinal fluid. Antiviral therapy should be initiated early in the course of the illness.
Topics: Humans; Mpox (monkeypox); Smallpox; Variola virus; Myelitis, Transverse; Nervous System Diseases; Encephalitis
PubMed: 36125794
DOI: 10.1001/jamaneurol.2022.3491 -
Journal of Perinatology : Official... Apr 2023Monkeypox has emerged as a significant human pathogen, posing severe risks in vulnerable populations. At present, there is not enough data available as to whether... (Review)
Review
Monkeypox has emerged as a significant human pathogen, posing severe risks in vulnerable populations. At present, there is not enough data available as to whether pregnant women are more vulnerable to monkeypox infection, or they suffer more severe symptoms, and studies on this issue as well as to the possible adverse effects on the developing fetus are limited. The aim of this review, was to bring together what is known so far about monkeypox virus transmission, the clinical course of the disease, and associated maternal-fetal outcomes. Furthermore, to summarize the current available recommendations on the prevention and management of monkeypox infection during pregnancy, in order to help obstetricians and neonatologists navigate through this new challenging area and provide the best available care to their patients.
Topics: Pregnancy; Humans; Female; Mpox (monkeypox); Prenatal Care
PubMed: 36725987
DOI: 10.1038/s41372-023-01629-0 -
Viruses Feb 2022Although variola virus (VARV) has been eradicated through widespread vaccination, other pathogenic for humans circulate in nature. Recently, new , including some able...
Although variola virus (VARV) has been eradicated through widespread vaccination, other pathogenic for humans circulate in nature. Recently, new , including some able to infect humans, have been found and their complete genomes have been sequenced. Questions about the mutation rate and the emergence of new threats to humankind as a result of the evolution of circulating remain open. Based on contemporary data on ancient VARV DNA and DNA of new species, an analysis of the molecular evolution of was carried out and the timescale of their emergence was estimated. It was calculated that the of the Old and New Worlds separated approximately 40,000 years ago; the recently discovered Akhmeta virus and Alaskapox virus separated from other approximately 10,000-20,000 years ago; the rest of modern orthopoxvirus species originated from 1700 to 6000 years ago, with the exception of VARV, which emerged in approximately 300 AD. Later, there was a separation of genetic variants of some species, so the monkeypox virus West African subtype originated approximately 600 years ago, and the VARV minor alastrim subtype emerged approximately 300 years ago.
Topics: Animals; Databases, Genetic; Evolution, Molecular; Mutation Rate; Orthopoxvirus; Phylogeny; Poxviridae Infections
PubMed: 35215981
DOI: 10.3390/v14020388