Clinical manifestations of human Mpox infection: A systematic review and meta‐analysis

Yon, Hyunju; Shin, Hyoin; Smıth, Lee; Shin, Jung U; Shin, Youn Ho; Lee, Jin-Seok; Rhee, Sang Youl; Koyanagi, Ai; Jacob, Louis; Lee, Seungwon; Rahmati, Masoud; Ahmad, Suhana; Cho, Wonyoung; Yon, Dong Keon

doi:10.1002/rmv.2446

Cited by 29 publications

(14 citation statements)

References 58 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, further research is required to determine whether the smallpox vaccine can reduce the risk of MPXV infection, and government should provide support for the development of a new vaccine. Immunisation is recommended as pre‐exposure prophylaxis for high‐risk groups and healthcare workers with occupational risk 13,46,50 …”

Section: Discussionmentioning

confidence: 99%

“…49 However, further healthcare workers with occupational risk. 13,46,50 Because previous analyses mainly included case reports and studies with small sample sizes and limited countries, one of the strengths of this study was its global and extensive meta-analysis on a large scale. The clinical manifestations were divided into 17 categories, and the four anatomical sites of rash occurrence were classified into clades to predict the severity and infection route.…”

Section: Clinical Manifestations Of the Human Mpoxv Infectionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical characteristics and outcomes of patients with mpox during the 2022 mpox outbreak compared with those before the outbreak: A systematic review and meta‐analysis

Cho,

Park,

Kim

et al. 2024

Reviews in Medical Virology

Self Cite

View full text Add to dashboard Cite

On 23 July 2022, the World Health Organization declared the global mpox outbreak as a public health emergency of international significance. The mpox virus (MPXV) that caused the outbreak was classified as clade IIb, which belongs to the West African clade. However, the relationship between MPXV clades and symptoms, as well as the severity of mpox outcomes, is not fully understood. Thus, we aimed to investigate the global mpox prevalence and the differences in clinical manifestations and outcomes among patients with mpox between pre‐outbreak (2003–2021) and the current mpox outbreak. In this systematic review and meta‐analysis, PubMed/MEDLINE, Web of Science, Embase, Cumulative Index to Nursing and Allied Health Literature, and Google Scholar were searched using the keyword “monkeypox” and “mpox” up to 13 October 2022. A random effects model was used to obtain the pooled prevalence and 95% confidence intervals. This study included 27 articles, and 5698 patients with mpox with 19 distinctive features from 19 countries across five continents were assessed. Patients with mpox during the 2022 mpox outbreak showed mild clinical manifestations and outcomes compared with those before the 2022 mpox outbreak: mild rash (relative ratio [RR]: 5.09, 95% confidence interval [CI]: 1.52–17.08), fever (0.68, 0.49–0.94), pruritus (0.25, 0.19–0.32), myalgia (0.50, 0.31–0.81), headache (0.56, 0.35–0.88), skin ulcer (0.32, 0.17–0.59), abdominal symptom (0.29, 0.20–0.42), pharyngitis (0.32, 0.18–0.58), nausea or vomiting (0.15, 0.02–0.93), conjunctivitis (0.11, 0.03–0.38), concomitant infection with HIV (1.70, 0.95–3 0.04), and death (0.02, 0.001–0.31). MPXV clade IIb exhibited higher infectivity but may cause mild disease symptoms and low mortality rate. It is important to consider MPXV infection in patients with mpox‐related features and/or a history of sexual transmission to prevent the spread of the disease and recognise the current pandemic threat.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Clinical Manifestations Of the Human Mpoxv Infectionmentioning

confidence: 99%

Clinical characteristics and outcomes of patients with mpox during the 2022 mpox outbreak compared with those before the outbreak: A systematic review and meta‐analysis

Cho,

Park,

Kim

et al. 2024

Reviews in Medical Virology

Self Cite

View full text Add to dashboard Cite

show abstract

“…Following a second viraemia which enables further virus dissemination, the characteristic lesions appear on the skin 3,4 . Typical symptoms of Mpox include, amongst others, the characteristic skin lesions, fever, headache, lethargy or exhaustion as well as more systemic respiratory and gastrointestinal symptoms 5 . While Mpox is typically self‐limiting, some patients experience complications such as encephalitis and require hospitalization 6 .…”

Section: Introductionmentioning

confidence: 99%

“…3,4 Typical symptoms of Mpox include, amongst others, the characteristic skin lesions, fever, headache, lethargy or exhaustion as well as more systemic respiratory and gastrointestinal symptoms. 5 While Mpox is typically self-limiting, some patients experience complications such as encephalitis and require hospitalization. 6 Whilst the case fatality rate during global outbreaks has remained relatively low (about 0.03%), in previously endemic areas in Central and Western Africa, reported case fatality rates ranged from 3% to 6% 7 which, combined with other factors, resulted in MPXV being classified as a risk group 3 biological agent.…”

mentioning

confidence: 99%

Serological methods for the detection of antibodies against monkeypox virus applicable for laboratories with different biosafety levels

Grossegesse,

Stern,

Hofmann

et al. 2023

Journal of Medical Virology

View full text Add to dashboard Cite

The monkeypox virus (MPXV) outbreak in 2022 has renewed interest in the detection of antibodies against orthopox viruses (OPXV) and MPXV, as serological methods can aid diagnostics and are key to epidemiological studies. Here three complementary serological methods are described with different strengths to aid the development and evaluation of in‐house assays: An immunofluorescence assay (IFA) for specific detection of IgG and IgM, an enzyme‐linked immunosorbent assay for higher sample throughput to aid epidemiological studies and a neutralization test to detect virus neutralizing antibodies. As implementation of MPXV‐specific diagnostics is often hampered by the requirement for a dedicated biosafety level 3 laboratory (BSL‐3), the focus of this study is on biosafety aspects to facilitate safe testing also under BSL‐2 conditions. To this aim, it was analyzed whether OPXV, which can be handled under BSL‐2 conditions, could be used as less virulent alternatives to MPXV. Furthermore, an inactivation method was established to remove up to five log‐steps of infectious virus particles from viraemic sera without compromising antibody detection. The results show that immunological cross‐reactivity between OPXV provides an opportunity for the interchangeable usage of different OPXV species in serological assays, enabling MPXV serology outside of BSL‐3 facilities.

show abstract

“…Following a second viraemia which enables further virus dissemination, the characteristic lesions appear on the skin [3,4]. Typical symptoms of Mpox include, amongst others, the characteristic skin lesions, fever, headache, lethargy or exhaustion as well as more systemic respiratory and gastrointestinal symptoms [5]. While Mpox is typically self-limiting, some patients experience complications such as encephalitis and require hospitalization [6].…”

Section: Introductionmentioning

confidence: 99%

Serological methods for the detection of antibodies against Monkeypox virus applicable for laboratories with different biosafety levels

Grossegesse

Stern

Hofmann

et al. 2023

Preprint

View full text Add to dashboard Cite

The monkeypox virus (MPXV) outbreak in 2022 has renewed interest in the detection of antibodies against orthopox viruses (OPXV) and MPXV, as serological methods can aid diagnostics and are key to epidemiological studies. Here three complementary serological methods are described with different strengths to aid the development and evaluation of in-house assays: An immunofluorescence assay (IFA) for specific detection of IgG and IgM, an enzyme-linked immunosorbent assay (ELISA) for higher sample throughput to aid epidemiological studies and a neutralization test (NT) to detect virus neutralising antibodies. As implementation of MPXV-specific diagnostics is often hampered by the requirement for a dedicated biosafety level 3 laboratory (BSL-3), the focus is on biosafety aspects to facilitate safe testing also under BSL-2 conditions. To this aim, IFA and NT titres of sera are compared after MPXV or cowpox virus infection or vaccinia virus immunization by using both homologous and heterologous antigens. Because of a large degree of cross-reactivity, vaccinia virus could be used as a less virulent alternative to MPXV, as VACV can be handled under BSL-2 conditions. Furthermore, an inactivation method to remove potentially infectious virus particles from viraemic sera without compromising antibody detection was developed. Although the existing immunological cross-reactivity between OPXV prevents species differentiation by general serological methods, it also provides an opportunity for the interchangeable usage of different OPXV species in serological assays, enabling MPXV serology outside of BSL-3 facilities.

show abstract

Clinical manifestations of human Mpox infection: A systematic review and meta‐analysis

Cited by 29 publications

References 58 publications

Clinical characteristics and outcomes of patients with mpox during the 2022 mpox outbreak compared with those before the outbreak: A systematic review and meta‐analysis

Clinical characteristics and outcomes of patients with mpox during the 2022 mpox outbreak compared with those before the outbreak: A systematic review and meta‐analysis

Serological methods for the detection of antibodies against monkeypox virus applicable for laboratories with different biosafety levels

Serological methods for the detection of antibodies against Monkeypox virus applicable for laboratories with different biosafety levels

Contact Info

Product

Resources

About