Emergence and dissemination of monkeypox, an intimidating global public health problem

Ejaz, Hasan; Junaid, Kashaf; Younas, Sonia; Abdalla, Abualgasim Elgaili; Bukhari, Syed Nasir Abbas; Abosalif, Khalid Omer Abdalla; Ahmad, Naveed; Ahmed, Zeeshan; Hamza, Manhal Ahmed; Anwar, Naeem

doi:10.1016/j.jiph.2022.09.008

Cited by 37 publications

(36 citation statements)

References 42 publications

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“…45 The combined case fatality rate of the West African and Congo Basin MPXV clades is around 8.7% worldwide. 46,47 The demographic characteristics of reported cases distinguished from the previous outbreak were 99% male with a median age of 37 years, and 44% were HIV-positive. 48 Furthermore, 99% of reported cases were gay, bisexual, and having men-to-men sex, 48 indicating sexual transmission as a new mode of transmission.…”

Section: The Ongoing 2022 Mpox Outbreakmentioning

confidence: 99%

Monkeypox (mpox) in immunosuppressed patients

et al. 2023

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The World Health Assembly declared that smallpox had been completely eradicated from the human population in 1980. Monkeypox, a zoonosis native to damp forested regions in West and Central Africa, is the illness that is most comparable to smallpox clinically and immunologically. Both illnesses could be prevented by the smallpox vaccine. Although the monkeypox virus is a less effective human disease than the smallpox virus, it could now spread among human populations if smallpox had not been eradicated and population-wide immunity had not been developed. A health warning on severe monkeypox in people who are immunocompromised due to Human Immunodeficiency virus (HIV) and other illnesses was released by the U.S. Centers for Disease Control and Prevention (CDC) on September 29, 2022. The advise does not specifically include primary immunodeficiency, but it does define other immunocompromising disorders as “having autoimmune disease with immunodeficiency as a clinical component”. The documented severe signs of monkeypox include widespread rashes with secondary fungal or bacterial skin infections or tissue death (necrosis), intestine obstruction, and difficulties with the heart, lungs, urinary system, and nervous system. Both those with healthy immune systems and those with weakened immune systems, such as those who are immunosuppressed, older people, children, etc., have encountered serious health issues, but the latter group is more likely to do so. According to the advisory, “of the people with severe monkeypox manifestations for whom CDC has been consulted, the majority have had HIV with CD4 counts 200 cells/ml, indicating substantial immunosuppression”. The current article goes into great detail about monkeypox disease occurring in immunocompromised patients and preventive guidelines.

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Section: The Ongoing 2022 Mpox Outbreakmentioning

confidence: 99%

Monkeypox (mpox) in immunosuppressed patients

et al. 2023

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“…The WHO counts nearly 30 Ebola virus disease outbreaks since 1976 that involved major or massive cases [ 97 ]. In 2022 and 2023, despite all the supposed COVID-19 lessons, the same mistakes and deficiencies observed with Ebola virus disease (EVD) and COVID-19 [ 98 ] are being repeated with mpox [ 99 , 100 , 101 ].…”

Section: A New Global Approach To Vaccine Research Development and Ma...mentioning

confidence: 99%

The Future of Epidemic and Pandemic Vaccines to Serve Global Public Health Needs

et al. 2023

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This Review initiates a wide-ranging discussion over 2023 by selecting and exploring core themes to be investigated more deeply in papers submitted to the Vaccines Special Issue on the “Future of Epidemic and Pandemic Vaccines to Serve Global Public Health Needs”. To tackle the SARS-CoV-2 pandemic, an acceleration of vaccine development across different technology platforms resulted in the emergency use authorization of multiple vaccines in less than a year. Despite this record speed, many limitations surfaced including unequal access to products and technologies, regulatory hurdles, restrictions on the flow of intellectual property needed to develop and manufacture vaccines, clinical trials challenges, development of vaccines that did not curtail or prevent transmission, unsustainable strategies for dealing with variants, and the distorted allocation of funding to favour dominant companies in affluent countries. Key to future epidemic and pandemic responses will be sustainable, global-public-health-driven vaccine development and manufacturing based on equitable access to platform technologies, decentralised and localised innovation, and multiple developers and manufacturers, especially in low- and middle-income countries (LMICs). There is talk of flexible, modular pandemic preparedness, of technology access pools based on non-exclusive global licensing agreements in exchange for fair compensation, of WHO-supported vaccine technology transfer hubs and spokes, and of the creation of vaccine prototypes ready for phase I/II trials, etc. However, all these concepts face extraordinary challenges shaped by current commercial incentives, the unwillingness of pharmaceutical companies and governments to share intellectual property and know-how, the precariousness of building capacity based solely on COVID-19 vaccines, the focus on large-scale manufacturing capacity rather than small-scale rapid-response innovation to stop outbreaks when and where they occur, and the inability of many resource-limited countries to afford next-generation vaccines for their national vaccine programmes. Once the current high subsidies are gone and interest has waned, sustaining vaccine innovation and manufacturing capability in interpandemic periods will require equitable access to vaccine innovation and manufacturing capabilities in all regions of the world based on many vaccines, not just “pandemic vaccines”. Public and philanthropic investments will need to leverage enforceable commitments to share vaccines and critical technology so that countries everywhere can establish and scale up vaccine development and manufacturing capability. This will only happen if we question all prior assumptions and learn the lessons offered by the current pandemic. We invite submissions to the special issue, which we hope will help guide the world towards a global vaccine research, development, and manufacturing ecosystem that better balances and integrates scientific, clinical trial, regulatory, and commercial interests and puts global public health needs first.

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“…In general, specific antivirals for MPXV infection are lacking; the only option available is that previously approved and used in smallpox. 30,31 Tecovirimat is the only drug approved by the European Medicines Agency (EMA) for the treatment of smallpox, MPX, cowpox, and vaccinia complications. 32 Also, cidofovir is a Food and Drug Administration (FDA)-approved drug for use in different DNA virus infections, especially in patients with HIV who progress to acquired immunodeficiency syndrome (AIDS).…”

Section: How About Antivirals In Treating Patients With Iei In Case O...mentioning

confidence: 99%