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International Journal of Infectious... Feb 2023Human monkeypox virus (MPXV) infection is a recently declared public health emergency of international concern by the World Health Organization. Besides, there is scant...
OBJECTIVES
Human monkeypox virus (MPXV) infection is a recently declared public health emergency of international concern by the World Health Organization. Besides, there is scant literature available on the use of antivirals in MPXV infection. This systematic review compiles all evidence of various antivirals used on their efficacy and safety and summarizes their mechanisms of action.
METHODS
A review was done of all original studies mentioning individual patient data on the use of antivirals in patients with MPXV infection.
RESULTS
Of the total 487 non-duplicate studies, 18 studies with 71 individuals were included. Tecovirimat was used in 61 individuals, followed by cidofovir in seven and brincidofovir (BCV) in three individuals. Topical trifluridine was used in four ophthalmic cases in addition to tecovirimat. Of the total, 59 (83.1%) were reported to have complete resolution of symptoms; one was experiencing waxing and waning of symptoms, only one (1.8%) had died, and the others were having a resolution of symptoms. The death was thought unrelated to tecovirimat. Elevated hepatic panels were reported among all individuals treated with BCV (leading to treatment discontinuation) and five treated with tecovirimat.
CONCLUSION
Tecovirimat is the most used and has proven beneficial in several aggravating cases. No major safety concerns were detected upon its use. Topical trifluridine was used as an adjuvant treatment option along with tecovirimat. BCV and cidofovir were seldom used, with the latter often being used due to the unavailability of tecovirimat. BCV was associated with treatment discontinuation due to adverse events.
Topics: Humans; Antiviral Agents; Benzamides; Cidofovir; Disease Outbreaks; Isoindoles; Mpox (monkeypox); Monkeypox virus; Trifluridine
PubMed: 36470502
DOI: 10.1016/j.ijid.2022.11.040 -
Frontiers in Public Health 2023Monkeypox (mpox), a zoonotic viral infection, poses a global threat that is being acknowledged at the national and international levels. This systematic review aims to...
BACKGROUND
Monkeypox (mpox), a zoonotic viral infection, poses a global threat that is being acknowledged at the national and international levels. This systematic review aims to identify and characterize interventional clinical trials for mpox.
METHOD
All interventional clinical trials registered at ClinicalTrials.gov for mpox were searched up to January 6, 2023. We described the characteristics of interventional clinical trials, and drug interventions (including drugs and vaccines).
RESULTS
As of January 6, 2023, there were 10 clinical trials in the ClinicalTrials.gov registry that met our criteria. Most of the interventional clinical trials were focused on the treatment ( = 4, 40%) and prevention ( = 4, 40%) of mpox. From the 10 trials, 50% used random treatment allocation, and six (60%) chose the parallel assignment intervention model. All 10 studies were blinded, and six were open-label blinded. The largest proportion of the clinical trials ( = 4, 40%) were registered in Europe, followed by America ( = 3, 30%) and Africa and others ( = 3, 30%). The JYNNEOS vaccine (40%), followed by Tecovirimat (30%) were the most frequently studied drugs used against mpox.
CONCLUSION
A limited number of clinical trials have been registered on ClinicalTrials.gov since the first case of mpox was reported. Therefore, there is an urgent need to conduct large-scale randomized clinical trials to assess the safety and efficacy of the drugs and vaccines being used against the mpox virus.
Topics: Humans; Mpox (monkeypox); Africa; Benzamides; Databases, Factual; Europe
PubMed: 36969617
DOI: 10.3389/fpubh.2023.1144325 -
Planta Medica Oct 2020Viruses have a high mutation rate, and, thus, there is a continual emergence of new antiviral-resistant strains. Therefore, it becomes imperative to explore and develop...
Viruses have a high mutation rate, and, thus, there is a continual emergence of new antiviral-resistant strains. Therefore, it becomes imperative to explore and develop new antiviral compounds continually. The search for pharmacological substances of plant origin that are effective against animal viruses, which have a high mortality rate or cause large economic losses, has garnered interest in the last few decades. This systematic review compiles 130 plant species that exhibit antiviral activity on 37 different virus species causing serious diseases in animals. The kind of extract, fraction, or compound exhibiting the antiviral activity and the design of the trial were particularly considered for review. The literature revealed details regarding plant species exhibiting antiviral activities against pathogenic animal virus species of the following families-, and that cause infections, among others, in poultry, cattle, pigs, horses, shrimps, and fish. Overall, 30 plant species exhibited activity against various influenza viruses, most of them causing avian influenza. Furthermore, 30 plant species were noted to be active against Newcastle disease virus. In addition, regarding the pathogens most frequently investigated, this review provides a compilation of 20 plant species active against bovine herpesvirus, 16 against fowlpox virus, 12 against white spot syndrome virus in marine shrimps, and 10 against suide herpesvirus. Nevertheless, some plant extracts, particularly their compounds, are promising candidates for the development of new antiviral remedies, which are urgently required.
Topics: Animal Diseases; Animals; Antiviral Agents; Cattle; Horses; Orthomyxoviridae; Plant Extracts; Plants, Medicinal; Swine; Veterinary Medicine
PubMed: 32777833
DOI: 10.1055/a-1224-6115 -
Revista Espanola de Quimioterapia :... Jun 2015Discussions on the need for smallpox virus preservation in 1999 focused attention on an eradicated disease 20 years ago. Smallpox was replaced as a potential candidate... (Review)
Review
INTRODUCTION
Discussions on the need for smallpox virus preservation in 1999 focused attention on an eradicated disease 20 years ago. Smallpox was replaced as a potential candidate to be used as a bioterrorist weapon because of the international alarm scenario produced after the 11/9 events in USA. The reactivation of a vaccine which remained forgotten was the direct consequence. The initial target groups were the security forces of America. Spain was also among the countries that were interested in acquiring the smallpox vaccine. The aim of this study is to analyze the considerable media coverage of smallpox obtained in our country.
METHODS
Systematic review of published news in the four largest national daily newspapers (ABC, El Mundo, El País and La Vanguardia) for the period 1999-2004 of the Dow Jones Factiva document database. "Smallpox" were used as a key word. From the obtained data, a qualitative and quantitative analysis was done.
RESULTS
416 reviews were analyzed; the newspaper El Mundo was the most interested in these news (158 citations, 37.98%). Most of the news were published in 2003 (152, 36.5%) The year with more news about smallpox (2003) coincides with the purchase of vaccines in Spain. The type of messages in the news was highly changeable over this six-year period. Those related to "politics and diplomacy", "epidemiological risk", "bioterrorism" and "vaccine" were predominant.
CONCLUSIONS
The alarm raised around the smallpox vaccination was a media phenomenon due to political strategy issues rather than a real public health problem.
Topics: Bibliometrics; Bioterrorism; Disease Eradication; Dissent and Disputes; Humans; Mass Media; Newspapers as Topic; Politics; Public Health; Public Opinion; Smallpox; Smallpox Vaccine; Spain; Vaccination
PubMed: 26032996
DOI: No ID Found -
BMC Public Health Jan 2024Mpox is a zoonotic viral disease that emerged in May 2022 and has since shown a high prevalence in non-mpox-endemic areas, resulting in an outbreak that caused more than... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Mpox is a zoonotic viral disease that emerged in May 2022 and has since shown a high prevalence in non-mpox-endemic areas, resulting in an outbreak that caused more than 84,000 cases in 110 countries around the globe. Several vaccines are available to prevent the disease, and multiple studies have been conducted to assess the attitudes of different populations toward receiving the mpox vaccine. This study systematically reviews all the studies conducted on mpox vaccine acceptance/hesitancy among healthcare workers.
METHODS
A systematic literature search was conducted through four electronic databases, including PubMed, Scopus, Web of Science, and Google Scholar, up to March 2023. Studies that described mpox vaccine acceptance/hesitancy among healthcare workers were included, and the data were extracted using a uniform extraction sheet. Following the extraction, the meta-analysis included ten studies with 7322 healthcare workers. Three researchers independently assessed the risk of bias in the included study using the Newcastle-Ottawa Scale (NOS).
RESULTS
Ten studies were included in the review. This review indicates that the prevalence of mpox vaccine acceptance was 58.5%, and the prevalence of mpox vaccine hesitancy was 41.5%. There was a higher prevalence of acceptance in countries located in Asian and African areas compared to those in North America and Europe, estimated at 68% and 44.3%, respectively. Among the studies conducted solely among physicians, there was a high prevalence of mpox vaccine acceptance, at 77.1%, compared to 49% in studies that included all healthcare workers.
CONCLUSION
There is a significant variation in the prevalence of mpox vaccine acceptance among different populations. Further research is needed to identify the factors that contribute to this variation and to develop interventions to increase vaccine acceptance. In addition, it is important to promote research on mpox vaccine acceptance and hesitancy among healthcare workers in countries where data is limited. This research will help policymakers develop effective policies to increase acceptance and reduce the disease burden.
Topics: Humans; Health Personnel; Mpox (monkeypox); Physicians; Smallpox Vaccine; Zoonoses
PubMed: 38166685
DOI: 10.1186/s12889-023-17186-2 -
BMC Public Health Dec 2020Previous initiatives have aimed to document the history and legacy of the Smallpox Eradication Program (SEP) and the Global Polio Eradication Initiative (GPEI). In this...
A multi-pronged scoping review approach to understanding the evolving implementation of the Smallpox and Polio eradication programs: what can other Global Health initiatives learn?
BACKGROUND
Previous initiatives have aimed to document the history and legacy of the Smallpox Eradication Program (SEP) and the Global Polio Eradication Initiative (GPEI). In this multi-pronged scoping review, we explored the evolution and learning from SEP and GPEI implementation over time at global and country levels to inform other global health programs.
METHODS
Three related reviews of literature were conducted; we searched for documents on 1) the SEP and 2) GPEI via online database searches and also conducted global and national-level grey literature searches for documents related to the GPEI in seven purposively selected countries under the Synthesis and Translation of Research and Innovations from Polio Eradication (STRIPE) project. We included documents relevant to GPEI implementation. We conducted full text data analysis and captured data on Expert Recommendations for Implementing Change (ERIC) implementation strategies and principles, tools, outcomes, target audiences, and relevance to global health knowledge areas.
RESULTS
200 articles were included in the SEP scoping review, 1885 articles in the GPEI scoping review, and 963 documents in the grey literature review. M&E and engagement strategies were consistently translated from the SEP to GPEI; these evolved into newer approaches under the GPEI. Management strategies including setting up robust record systems also carried forward from SEP to GPEI; however, lessons around the need for operational flexibility in applying these strategies at national and sub-national levels did not. Similarly, strategies and lessons around conducting health systems readiness assessments prior to implementation were not carried forward from SEP to GPEI. Differences in the planning and communication strategies between the two programs included fidelity to implementation blueprints appeared to be higher under SEP, and independent monitoring boards and communication and media strategies were more prominent under GPEI.
CONCLUSIONS
Linear learning did not always occur between SEP and GPEI; several lessons were lost and had to be re-learned. Implementation and adaptation of strategies in global health programs should be well codified, including information on the contextual, time and stakeholders' issues that elicit adaptations. Such description can improve the systematic translation of knowledge, and gains in efficiency and effectiveness of future global health programs.
Topics: Communication; Disease Eradication; Global Health; Health Education; Humans; Immunization Programs; Poliomyelitis; Smallpox
PubMed: 33339517
DOI: 10.1186/s12889-020-09439-1 -
Frontiers in Cellular and Infection... 2023Human monkeypox (mpox) disease is a multicountry outbreak driven by human-human transmission which has resulted in an international public health emergency. However,... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Human monkeypox (mpox) disease is a multicountry outbreak driven by human-human transmission which has resulted in an international public health emergency. However, there is limited evidence on the positivity rate of skin lesions for mpox viral DNA. We aim to fill this gap by estimating the pooled positivity rate of skin samples with mpox viral DNA from mpox patients globally.
METHODS
In this systematic review and meta-analysis, seven databases and several preprint servers have been extensively searched until 17 January 2023 according to a prospectively registered protocol (PROSPERO: CRD42023392505). Articles including the positivity rate of skin samples with mpox viral DNA in mpox-confirmed patients were considered eligible. After a quality assessment, a random-effect meta-analysis was used for pooled prevalence. To explore and resolve heterogeneity, we used statistical methods for outlier detection, influence analysis, and sensitivity analysis.
FINDINGS
Among the 331 articles retrieved after deduplication, 14 studies were finally included. The pooled positivity rate of the skin samples was 98.77% (95% CI: 94.74%-99.72%). After the removal of an influential outlier, for heterogeneity dropped from 92.5% to 10.8%. Meta-regression did not reveal any significant moderator.
CONCLUSION/INTERPRETATION
The present findings reinforce that skin lesions act as a reservoir of mpox viral DNA and contribute to a high infectivity risk. This may be a prevailing basis of prompt transmission during the current multicountry outbreak and also needs further investigation. The present imperative outcome may benefit in producing valuable preventive and management procedures in an appropriate health strategy.
Topics: Humans; DNA, Viral; Mpox (monkeypox); Prevalence; Databases, Factual; Disease Outbreaks
PubMed: 37457957
DOI: 10.3389/fcimb.2023.1179885 -
BMC Cardiovascular Disorders Jun 2023Monkeypox is a zoonotic viral infection first reported in May 2022. Monkeypox cases present with prodromal symptoms, rash, and/or systemic complications. This study...
BACKGROUND
Monkeypox is a zoonotic viral infection first reported in May 2022. Monkeypox cases present with prodromal symptoms, rash, and/or systemic complications. This study systematically reviews the monkeypox cases presented with any cardiac complications.
METHODS
A systematic literature search was done to locate papers that discuss any cardiac complications associated with monkeypox; then, data were analyzed qualitatively.
RESULTS
Nine articles, including the 13 cases that reported cardiac complications of the disease, were included in the review. Five cases previously had sex with men, and two cases had unprotected intercourse, which reveals the importance of the sexual route in disease transmission. All cases have a wide spectrum of cardiac complications, such as acute myocarditis, pericarditis, pericardial effusion, and myopericarditis.
CONCLUSION
This study clarifies the potential for cardiac complications in monkeypox cases and provides avenues for future research to determine the underlying mechanism. Also, we found that the cases with pericarditis were treated with colchicine, and those with myocarditis were treated with supportive care or cardioprotective treatment (Bisoprolol and Ramipril). Furthermore, Tecovirimat is used as an antiviral drug for 14 days.
Topics: Male; Humans; Myocarditis; Mpox (monkeypox); Heart; Pericarditis; Pericardial Effusion
PubMed: 37380955
DOI: 10.1186/s12872-023-03351-3 -
PloS One 2013Vaccinia-associated myo/pericarditis was observed during the US smallpox vaccination (DryVax) campaign initiated in 2002. A highly-attenuated vaccinia strain, modified...
BACKGROUND
Vaccinia-associated myo/pericarditis was observed during the US smallpox vaccination (DryVax) campaign initiated in 2002. A highly-attenuated vaccinia strain, modified vaccinia Ankara (MVA) has been evaluated in clinical trials as a safer alternative to DryVax and as a vector for recombinant vaccines. Due to the lack of prospectively collected cardiac safety data, the US Food and Drug Administration required cardiac screening and surveillance in all clinical trials of MVA since 2004. Here, we report cardiac safety surveillance from 6 phase I trials of MVA vaccines.
METHODS
Four clinical research organizations contributed cardiac safety data using common surveillance methods in trials administering MVA or recombinant MVA vaccines to healthy participants. 'Routine cardiac investigations' (ECGs and cardiac enzymes obtained 2 weeks after injections of MVA or MVA-HIV recombinants, or placebo-controls), and 'Symptom-driven cardiac investigations' are reported. The outcome measure is the number of participants who met the CDC-case definition for vaccinia-related myo/pericarditis or who experienced cardiac adverse events from an MVA vaccine.
RESULTS
Four hundred twenty-five study participants had post-vaccination safety data analyzed, 382 received at least one MVA-containing vaccine and 43 received placebo; 717 routine ECGs and 930 cardiac troponin assays were performed. Forty-five MVA recipients (12%) had additional cardiac testing performed; 22 for cardiac symptoms, 19 for ECG/laboratory changes, and 4 for cardiac symptoms with an ECG/laboratory change. No participant had evidence of symptomatic or asymptomatic myo/pericarditis meeting the CDC-case definition and judged to be related to an MVA vaccine.
CONCLUSIONS
Prospective surveillance of MVA recipients for myo/pericarditis did not detect cardiac adverse reactions in 382 study participants.
TRIAL REGISTRATION
ClinicalTrials.gov NCT00082446 NCT003766090 NCT00252148 NCT00083603 NCT00301184 NCT00428337.
Topics: Clinical Trials, Phase I as Topic; Epidemiological Monitoring; Heart Failure; Humans; Prospective Studies; Smallpox; Smallpox Vaccine; United States; United States Food and Drug Administration; Vaccination; Vaccines, Attenuated; Vaccinia; Vaccinia virus
PubMed: 23349878
DOI: 10.1371/journal.pone.0054407