Correction for Hutson et al., “Pharmacokinetics and Efficacy of a Potential Smallpox Therapeutic, Brincidofovir, in a Lethal Monkeypox Virus Animal Model”

Hutson, Christina L.; Kondas, Ashley V.; Mauldin, Matthew R.; Doty, Jeffrey B.; Grossi, Irma M.; Morgan, Clint N.; Ostergaard, Sharon Dietz; Hughes, Christine M.; Nakazawa, Yoshinori; Kling, C.; Martin, Brock E.; Ellison, James A.; Carroll, Darin S.; Gallardo-Romero, Nadia; Olson, Victoria A.

doi:10.1128/msphere.00126-21

Cited by 22 publications

(7 citation statements)

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“…In the recent case series in the United Kingdom of imported illness from 2018 to 2021, transaminitis was reported in association with antiviral treatment in three patients using brincidofovir. Antiviral therapy is another gap in available information regarding its use and apparent efficacy and safety as a treatment for monkeypox [ 46 , 82 ]. Multiple aspects of monkeypox were not addressed before the 2003 United States outbreak [ 83 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical features, hospitalisation and deaths associated with monkeypox: a systematic review and meta-analysis

Benítes-Zapata

Ulloque-Badaracco

Alarcón-Braga

et al. 2022

Ann Clin Microbiol Antimicrob

111

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Introduction A multicountry monkeypox disease (MPX) outbreak began in May 2022 in Europe, leading to the assessment as a potential Public Health Emergency of International Concern (PHEIC) on June 23, 2022. Some observational studies have partially characterised clinical features, hospitalisations, and deaths. However, no systematic reviews of this MPX outbreak have been published. Methods We performed a systematic review with meta-analysis, using five databases to assess clinical features, hospitalisations, complications and deaths of MPX confirmed or probable cases. Observational studies, case reports and case series, were included. We performed a random-effects model meta-analysis to calculate the pooled prevalence and 95% confidence interval (95% CI). In addition, we carried out a subgroup analysis according to the continents and a sensitivity analysis excluding studies classified as having a high risk of bias. Results A total of 19 articles were included, using only 12 articles in the quantitative synthesis (meta-analysis). For 1958 patients, rash (93%, 95% CI 80–100%), fever (72%, 95% CI 30–99%), pruritus (65%, 95% CI 47–81%), and lymphadenopathy (62%, 47–76%), were the most prevalent manifestations. Among the patients, 35% (95% CI 14–59%) were hospitalised. Some 4% (95% CI 1–9%) of hospitalised patients had fatal outcomes (case fatality rate, CFR). Conclusion MPX is spreading rapidly, with a third of hospitalised patients, but less than 5% with fatal outcomes. As this zoonotic virus spreads globally, countries must urgently prepare human resources, infrastructure and facilities to treat patients according to the emerging guidelines and the most reliable clinical information.

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Section: Discussionmentioning

confidence: 99%

Clinical features, hospitalisation and deaths associated with monkeypox: a systematic review and meta-analysis

Benítes-Zapata

Ulloque-Badaracco

Alarcón-Braga

et al. 2022

Ann Clin Microbiol Antimicrob

111

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“…No data are available on the efficacy of cidofovir and brincidofovir in the treatment of human cases of MPVX. However, both have demonstrated activity against poxviruses in in vitro and animal studies [ 91 , 92 ].…”

Section: Are There Drugs Effective Against Mpvx In Humans?mentioning

confidence: 99%

Monkeypox in humans: a new outbreak

Martín-Delgado¹,

Sánchez²,

Martínez-Sellés³

et al. 2022

Rev Esp Quimioter

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Infection caused by Monkeypox Virus (MPVX) has small rodents as its natural reservoir and both monkeys and humans are occasional hosts. The causative agent is an Orthopoxvirus (MPVX) that was isolated in monkeys in 1958 and proved capable of passing to humans in 1970. It remained contained in Africa, causing isolated episodes of infection, until 2003 when an outbreak occurred in the United States following importation of animals from that continent. Since then, anecdotal cases have continued to be reported outside Africa, usually very clearly linked to travelers to those countries, but in May 2022, a broad outbreak of this disease has begun, now affecting several continents, with the emergence of human cases of MPVX (H-MPVX) infection mainly among Men that have Sex with Men (MSM). The disease has an incubation time ranging from 5 to 15 days and is characterized by the presence of pustules, fever, malaise and headache. The presence of significant regional lymphadenopathy is a differential feature with episodes of classical smallpox. Proctitis and pharyngitis, with minimal skin lesions, may be another form of presentation. Diagnosis can be confirmed by PCR testing of lesions or by demonstration of MPVX in other body fluids or tissues, although in the appropriate epidemiologic setting the clinical picture is highly suggestive of the disease. Effective drug treatment has been developed as part of programs to protect against potential bioterrorist agents and smallpox vaccinees are known to have high protection against monkeypox. New vaccines are available, but neither the drugs nor the vaccines are yet freely available on the market. The prognosis of the disease appears, at least in adults in developed countries, to be good, with very low mortality figures and much less aggressive behavior than that described in classical smallpox. Isolation measures, essential for the control of the outbreak, have been published by the health authorities.

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“…Under the FDA Animal Rule, brincidofovir’s effectiveness and safety in the treatment of orthopoxviruses was assessed. The efficacy of brincidofovir has been investigated in mice, rabbits and prairie dogs infected with ectromelia virus, rabbitpox virus and Mpox virus respectively [64–66]. Bowel disturbances, hepatotoxicity, increase in the liver enzymes ALT and AST, and elevations of total bilirubin are among the significant minor side effects of brincidofovir.…”

Section: Managementmentioning

confidence: 99%

Insights into the challenging multi-country outbreak of Mpox: a comprehensive review

Bhat,

Saha,

Garg

et al. 2023

Journal of Medical Microbiology

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Human monkeypox virus (hMpoxV) is of zoonotic origin and is closely related to the once-dreaded smallpox virus. It is largely endemic to the African continent but has moved out of the endemic regions as sporadic clusters in the past 20 years, raising concerns worldwide. Human Mpox is characterized by a mild to severe, self-limiting infection, with mortality ranging from less than 1% to up to 10% during different outbreaks caused by different clades of MpoxV. Bushmeat hunting is one of the primary reasons for its transmission from animals to humans. Various international and national health regulatory bodies are closely monitoring the disease and have laid down guidelines to manage and prevent hMpox cases. Emergency Use Status has been granted to Tecovirimat and Brincidofovir to treat severe cases and vaccination with the smallpox vaccine is recommended for high-risk group individuals. Strategies to repurpose and discover novel therapeutics and vaccines to control the outbreak are being researched. The current Mpox outbreak that has mainly affected men as approximately 96% of all cases are reported in men, is probably the result of a complex intersection of various factors. This necessitates a strong One Health response coordination involving human, animal and environmental health institutions. This review is an attempt to provide an all-inclusive overview of the biology, history, epidemiology, pathophysiology, diagnosis and management of hMpox in context to the recent 2022–2023 multi-country outbreak which is termed by WHO a ‘Public Health Emergency of International Concern (PHEIC)’.

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Correction for Hutson et al., “Pharmacokinetics and Efficacy of a Potential Smallpox Therapeutic, Brincidofovir, in a Lethal Monkeypox Virus Animal Model”

Cited by 22 publications

References 0 publications

Clinical features, hospitalisation and deaths associated with monkeypox: a systematic review and meta-analysis

Clinical features, hospitalisation and deaths associated with monkeypox: a systematic review and meta-analysis

Monkeypox in humans: a new outbreak

Insights into the challenging multi-country outbreak of Mpox: a comprehensive review

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