RESUMO
Monkeypox is an emerging zoonotic viral disease caused by the Monkeypox virus, traditionally confined to central and west Africa, which has recently spread to other regions worldwide, making it a global health concern...
Assuntos
Mpox , Humanos , Mpox/epidemiologia , Animais , Urologia , Doenças Urológicas/terapia , Doenças Transmissíveis Emergentes/epidemiologiaRESUMO
OBJECTIVE: Monkeypox is a viral zoonotic disease endemic to West and Central Africa; it has been reported in more countries during the last decade than in the previous 40 years. In 2022 a multinational outbreak occurred. This change in the epidemiology of the virus may represent an evolutionary adaptation. The purpose of this study is to analyze the molecular aspects of Monkeypox virus (MPXV) disease that may explain the latter's change in epidemiology during the 2022 outbreak. METHODS: From July 2022 through December 2022, the period of the outbreak, a narrative review was conducted on the available literature, with a total of 271 articles published in the MEDLINE/PubMed and LILACS databases being examined. The chosen articles were organized using the search and reference manager Mendeley Desktop 1.19.4. Duplicates and articles that did not meet the study's objective were eliminated, resulting in the selection of 49 articles for the present review. DISCUSSION: MPXV resurgence poses challenges due to waning immunity and changing epidemiological patterns. Recent outbreaks show different transmission routes, affecting new demographics. Genomic evolution, vaccination history, and potential new animal reservoirs complicate containment efforts. Continued surveillance and vaccination are crucial for control. CONCLUSIONS: It seems possible that MPXV has (re-)emerged to occupy the ecological niche left by the smallpox virus. Mutations of the apolipoprotein B mRNA editing enzyme, catalytic subunit 3G motif, in MPXV clade IIb since 2017 may explain the epidemiological change that has occurred in recent years. This pattern could be due to sustained transmission in a new host or a new route of infection.
Assuntos
Surtos de Doenças , Monkeypox virus , Mpox , Mpox/epidemiologia , Mpox/virologia , Humanos , Monkeypox virus/genética , Animais , Zoonoses/epidemiologia , Zoonoses/virologiaRESUMO
BACKGROUND: Mpox, is a zoonosis that is known to be endemic in several Central and West African countries. Recently, in 2022, it has emerged in Europe and United States, what raised the alarm to be declared in late June 2024 as a public health event of international concern. This study aimed to give insight about the recent spread of mpox in Sudan, and documents the epidemiologic situation. METHODS: Through a cross-sectional design, Sudan mpox data was extracted from the disease surveillance line-list at the national level at Sudan Federal Ministry of Health. the data was customized and then analyzed using Epi Info7 software. Analysis was done using frequencies and percentages and the results presented in tables and figures. Permission and ethical approval were obtained from the Health Emergency and Epidemic Control Directorate at the Federal Ministry of Health. RESULTS: The outbreak of mpox was confirmed after testing of initial specimens outside Sudan with positivity rate of 72%. Later the cases continued to be reported based on the clinical diagnosis and standard case definition. Out of 375 reported cases, 54.4% were males, while 45.6% were females. The age of cases ranged from one month to 78 years with majority (41.1%) of the cases were children under 5 years of age. Regarding the reported symptoms, all cases had the characteristic skin rash and 74.1% of them had fever. Other symptoms included, headache (31.5%), sore throat (30.9%) and lymphadenopathy (26.1%). For occupation, 35.7% were preschool and 10.4% were school children, 9% of cases were prisoners. Around 22 (5.8%) reported contact history with a confirmed case, while (5.6%) of the cases were imported cases. Cases were reported from 17 states with 42 affected localities (districts) with an overall attack rate of 2.36/ 100,000. The highest number of cases was reported from Gadaref (45.3%), West Darfur (25.9%), Khartoum (13.3%) and north Darfur (3.5%). In Gadaref, 146 (85.8%) of the cases were from a refugees' camp. Started in epi week 19, the outbreak peaked in week 38 and last in week 42. CONCLUSION: Mpox was confirmed in the new Sudan for the first time with cases reported in most of states. Although importation of the virus is hypothesized, internal hidden circulation is possible and more in-depth investigation is highly recommended. The higher rate of infection among preschool, school children and refugees, highlights the need to strengthen the prevention and control measures in schools and camps. More focus on the data completeness is required for better understanding of the disease and can be ensured by the surveillance directorate through training of staff and updating of reporting forms. Strengthening the lab capacity inside the country is a necessity to ensure testing of all the clinically diagnosed cases.
Assuntos
Mpox , Humanos , Sudão/epidemiologia , Feminino , Masculino , Criança , Adulto , Adolescente , Pré-Escolar , Lactente , Pessoa de Meia-Idade , Adulto Jovem , Estudos Transversais , Idoso , Mpox/epidemiologia , Pandemias , Vigilância da População/métodosAssuntos
COVID-19 , Surtos de Doenças , Mpox , Vacinas Virais , Humanos , África/epidemiologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19/economia , Vacinas contra COVID-19/provisão & distribuição , Surtos de Doenças/prevenção & controle , Surtos de Doenças/estatística & dados numéricos , Mpox/epidemiologia , Mpox/prevenção & controle , Mpox/virologia , Vacinas Virais/economia , Vacinas Virais/provisão & distribuição , AprendizagemRESUMO
Between January and August 2024, mpox cases have been reported in nearly all provinces of the Democratic Republic of the Congo (DRC). Monkeypox virus genome sequences were obtained from 11 mpox cases' samples, collected in July-August 2024 in several health zones of Kinshasa. Characterisation of the sequences showed subclades Ia and Ib co-circulating in the Limete health zone, while phylogenetic analyses suggested multiple introductions of the two subclades in Kinshasa. This illustrates the growing complexity of Clade I mpox outbreaks in DRC.
Assuntos
Surtos de Doenças , Monkeypox virus , Mpox , Filogenia , República Democrática do Congo/epidemiologia , Mpox/epidemiologia , Mpox/virologia , Humanos , Monkeypox virus/genética , Monkeypox virus/isolamento & purificação , Genoma Viral , RNA Viral/genética , Masculino , Análise de Sequência de DNARESUMO
BACKGROUND: Since May 7 2022, mpox has been endemic in many countries which has attracted the attention of health authorities in various countries and made control decisions, in which vaccination is the mainstream strategy. However, the shortage of vaccine doses and the reduction of protective efficacy have led to unresolved issues such as vaccine allocation decisions and evaluation of transmission scale. METHODS: We developed an epidemiological model to describe the prevalence of the mpox virus in New York City and calibrated the model to match surveillance data from May 19 to November 3, 2022. Finally, we adjusted the model to simulate and compare several scenarios of non-vaccination and pre-pandemic vaccination. RESULTS: Relative to the status quo, if vaccination is not carried out, the number of new infections increases to about 385%, and the transmission time will be extended to about 350%, while if vaccinated before the epidemic, the number of new infections decreases to 94.2-96%. CONCLUSIONS: The mpox outbreak in New York City may be linked to the Pride event. However, with current vaccine coverage, there will be no more large-scale outbreaks of mpox, even if there is another similar activity. For areas with limited vaccines, priority is given to high-risk groups in the age group [34-45] years as soon as possible.
Assuntos
Surtos de Doenças , Humanos , Cidade de Nova Iorque/epidemiologia , Surtos de Doenças/prevenção & controle , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Adolescente , Criança , Idoso , Vacinação/estatística & dados numéricos , Pré-Escolar , Mpox/epidemiologia , Mpox/prevenção & controle , Lactente , Masculino , Feminino , Modelos Epidemiológicos , Idoso de 80 Anos ou mais , Vacinas contra Influenza/administração & dosagem , Recém-Nascido , Fatores Etários , PrevalênciaRESUMO
Mpox, caused by the Monkeypox virus (MPXV), has emerged as a significant global public health concern, particularly affecting vulnerable populations. The recent outbreak in the Democratic Republic of the Congo (DRC) is the largest recorded, driven by the highly virulent clade 1 strain. Transmission has shifted from animal contact to primarily sexual contact among Key Populations (KPs) such as Sex Workers (SW) and Men who have Sex with Men (MSM). In Zanzibar, where HIV prevalence is significantly higher among Key Populations, People Living with Human Immunodeficiency Virus (PLHIV) are at increased risk of Mpox infection due to socioeconomic challenges and immunosuppression. Despite no reported cases in Zanzibar, the spread of Mpox in non-endemic areas highlights the need for proactive measures. Leveraging Zanzibar's strengthened public health infrastructure, key strategies include tailored awareness campaigns, improved vaccine access through existing COVID-19 vaccination models, healthcare infrastructure enhancement, and mental health support. These targeted actions aim to protect Zanzibar's most vulnerable populations and bolster preparedness against Mpox, emphasizing the importance of resource-appropriate interventions to mitigate potential outbreaks.
Assuntos
Infecções por HIV , Mpox , Saúde Pública , Populações Vulneráveis , Feminino , Humanos , Masculino , Infecções por HIV/epidemiologia , Infecções por HIV/tratamento farmacológico , Infecções por HIV/transmissão , Homossexualidade Masculina , Monkeypox virus , Mpox/epidemiologia , Mpox/prevenção & controle , Profissionais do Sexo , Tanzânia/epidemiologiaRESUMO
OBJECTIVE: The World Health Organization declared the current monkeypox outbreak a public health emergency of international concern (PHEIC) on July 23, 2022, as it has posed a great threat to human health. This bibliometric analysis aimed to explore the current research hotspots focused on monkeypox. METHODS: A systematic search of the Web of Science Core Collection database was conducted for published articles on monkeypox from database inception to February 23, 2023. VOSviewer software was used for analysis and visualization of research results. RESULTS: A total of 1646 publications on monkeypox virus were included for bibliometric analysis. Results showed that (1) the number of publications about monkeypox virus increased significantly in 2022, (2) smallpox and monkeypox virus were popular research keywords, (3) the United States has made the most significant contribution to the study of monkeypox virus, (4) Journal of Virology was the most active journal in publishing articles about monkeypox, and (5) research themes mainly included the body's reaction after monkeypox infection, epidemiology, diagnosis, and pathological mechanisms. CONCLUSIONS: Future research should focus on early sensitive diagnostic measures of monkeypox and the development of vaccines based on the characteristics of the virus. Study findings also provided key areas for public health experts to focus on and collaborate with policymakers.
Assuntos
Bibliometria , Monkeypox virus , Mpox , Humanos , Monkeypox virus/patogenicidade , Mpox/epidemiologia , Surtos de Doenças/estatística & dados numéricos , Publicações/estatística & dados numéricos , Publicações/tendênciasAssuntos
Ciência da Implementação , Mpox , Humanos , África , Mpox/epidemiologia , Mpox/prevenção & controleAssuntos
Mpox , Humanos , Criança , Mpox/diagnóstico , Mpox/epidemiologia , Antivirais/uso terapêuticoRESUMO
We used published data from outbreak investigations of monkeypox virus clade I in the Democratic Republic of the Congo to estimate the distributions of critical epidemiological parameters. We estimated a mean incubation period of 9.9 days (95% credible interval [CrI] 8.5-11.5 days) and a mean generation time of 17.2 days (95% CrI 14.1-20.9 days) or 11.3 days (95% CrI 9.4-14.0 days), depending on the considered dataset. Presymptomatic transmission was limited. Those estimates suggest generally slower transmission dynamics in clade I than in clade IIb. The time-varying reproduction number for clade I in the Democratic Republic of the Congo was estimated to be below the epidemic threshold in the first half of 2024. However, in the South Kivu Province, where the newly identified subclade Ib has been associated with sustained human-to-human transmission, we estimated an effective reproduction number above the epidemic threshold (95% CrI 0.96-1.27).
Assuntos
Surtos de Doenças , Monkeypox virus , Mpox , Humanos , República Democrática do Congo/epidemiologia , Monkeypox virus/genética , Monkeypox virus/classificação , Mpox/epidemiologia , Mpox/virologia , Mpox/transmissão , Filogenia , História do Século XXIRESUMO
BACKGROUND: Of the 43 mpox cases reported by the WHO in South East Asia between January 2022 and March 2023, 24 (56%) were from India. OBJECTIVES: We describe the clinical and epidemiological profile of cases identified through India's hospital case-based surveillance. MATERIALS AND METHODS: We identified mpox cases as a positive result for mpox virus polymerase-chain-reaction assay, reported through surveillance from July 1, 2022 to January 7, 2023. Cases and clinicians were interviewed, and data were abstracted from the medical records. We conducted contact tracing among family, close social networks, and healthcare personnel staff for the first 17 cases. We collected the data on sociodemographics, clinical findings, and behavior, and described data using summary statistics. RESULTS: We identified 24 laboratory-confirmed cases (42% females, median age 30 years, range 22-38), including one death (case fatality rate 4.2%). We collected clinical and behavioural data from 21 of 24 cases. All had rashes with vesicles and genital lesions; 7 (33%) reported genital lesions as the first symptom; and 3 (13%) reported complications. Among the 21 cases, all were sexually active, none self-identified as men having sex with men (MSM), and 6 (29%) reported multiple sex partners. We identified 51 contacts of the first 17 reported cases, none reported symptoms suggestive of mpox. CONCLUSION: The clinical and behavioral characteristics of mpox cases in India are consistent with the global 2022 outbreak, with the exception that no cases in India reported MSM. Most were sexually active young adult economic migrants and developed genital lesions.
Assuntos
Busca de Comunicante , Mpox , Adulto , Feminino , Humanos , Masculino , Adulto Jovem , Índia/epidemiologia , Mpox/diagnóstico , Mpox/epidemiologiaRESUMO
Monkeypox virus (MPXV) is the zoonotic agent responsible for mpox, an often-self-limiting pox-like disease. Since May 2022, an outbreak characterized by increased human-to-human transmission was detected outside the endemic regions. Whole genome sequencing (WGS) has been successfully used to keep track of viral evolution during outbreaks or for surveillance of multiple pathogens of public health significance. Current WGS protocols for MPXV are either based on metagenomic sequencing or tiled-PCR amplification. The latter allows multiplexing due to the efficient enrichment of the viral DNA, however, mutations or the presence of different clades can negatively influence genome coverage yield. Here, we present the establishment of a novel isothermal WGS method for MPXV based on Phi29 DNA polymerase-based multiple displacement amplification (MDA) properties making use of only 6 primers. This approach yielded from 88% up to 100% genome coverage using either alkaline denatured extracted DNA or clinical material as starting material, with the highest coverage generated by clinical material. We demonstrate that this novel isothermal WGS protocol is suitable for monitoring viral evolution during MPXV outbreaks and surveillance in any conventional laboratory setting.
Assuntos
Genoma Viral , Monkeypox virus , Sequenciamento Completo do Genoma , Sequenciamento Completo do Genoma/métodos , Humanos , Monkeypox virus/genética , Mpox/virologia , Mpox/epidemiologia , DNA Viral/genética , Técnicas de Amplificação de Ácido Nucleico/métodos , Surtos de Doenças , AnimaisRESUMO
On August 14, 2024, the Director General of the World Health Organization (WHO) declared that the increasing outbreaks of mpox (formerly monkeypox) should be regarded as an international public health emergency due to the growing number of cases in endemic and non-endemic geographical areas, and increasing disease severity. The latest update from the WHO and the alerts given regarding the status of mpox follows an upsurge in the incidence and severity of mpox in the Democratic Republic of the Congo (DRC) and an increasing number of African countries, with spread to other continents and countries This Editorial aims to provide an update on the current status of mpox and includes reasons for the increasing global concerns for the spread of the mpox virus (MPXV).
Assuntos
Surtos de Doenças , Saúde Global , Mpox , Organização Mundial da Saúde , Humanos , Mpox/epidemiologia , Mpox/transmissão , Monkeypox virus/patogenicidade , Saúde Pública , África/epidemiologia , Incidência , República Democrática do Congo/epidemiologiaRESUMO
Monkeypox virus (MPXV) can spread among humans through direct contact with lesions, scabs, or saliva; via respiratory secretions; and indirectly from fomites; via percutaneous injuries; and by crossing the placenta to the fetus during pregnancy. Since 2022, most patients with mpox in the United States have experienced painful skin lesions, and some have had severe illness. During 2021-2022, CDC initiated aircraft contact investigations after receiving reports of travelers on commercial flights with probable or confirmed mpox during their infectious period. Data were collected 1) during 2021, when two isolated clade II mpox cases not linked to an outbreak were imported into the United States by international travelers and 2) for flights arriving in or traveling within the United States during April 30-August 2, 2022, after a global clade II mpox outbreak was detected in May 2022. A total of 113 persons (100 passengers and 13 crew members) traveled on 221 flights while they were infectious with mpox. CDC developed definitions for aircraft contacts based on proximity to mpox cases and flight duration, sent information about these contacts to U.S. health departments, and received outcome information for 1,046 (68%) of 1,538 contacts. No traveler was found to have acquired mpox via a U.S. flight exposure. For persons with mpox and their contacts who had departed from the United States, CDC forwarded contact information as well as details about the exposure event to destination countries to facilitate their own public health investigations. Findings from these aircraft contact investigations suggest that traveling on a flight with a person with mpox does not appear to constitute an exposure risk or warrant routine contact tracing activities. Nonetheless, CDC recommends that persons with mpox isolate and delay travel until they are no longer infectious.