Human Monkeypox – After 40 Years, an Unintended Consequence of Smallpox Eradication

Simpson, Karl; Heyman, David; Bland, Stewart; Brown, Colin; Edmunds, W. John; Elsgaard, Jesper; Fine, Paul E. M.; Hochrein, Hubertus; Hoff, Nicole A.; Green, Andrew; Ihekweazu, Chikwe; Jones, Terry C.; Lule, Swaib A.; Maclennan, Jane; McCollum, Andrea M.; Mühlemann, Barbara; Nightingale, Emily; Ogoina, Dimie; Yinka-Ogunleye, Adesola; Petersen, Brett W.; Powell, Jacqueline D; Quantick, Ollie; Rimoin, Anne W.; Ulaeato, David; Wapling, Andy

doi:10.2139/ssrn.3534215

Cited by 22 publications

(33 citation statements)

References 32 publications

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“…However, during the recent outbreaks in Nigeria and Democratic republic of Congo (DRC), increased person-to-person transmission was observed along with associated imported cases in UK, US, Israel and Singapore [83,89]. Additionally, in the US Midwest outbreak, the virus showed the ability to infect intermediate hosts (prairie dogs) from natural reservoirs and subsequently infect humans [90]. Infection with a Orthopoxvirus or smallpox vaccination provided protection against monkeypox virus and thus smallpox eradication and cessation of vaccination has resulted in decreasing number of vaccinated individuals [90].…”

Section: Monkeypox Virusmentioning

confidence: 99%

“…Additionally, in the US Midwest outbreak, the virus showed the ability to infect intermediate hosts (prairie dogs) from natural reservoirs and subsequently infect humans [90]. Infection with a Orthopoxvirus or smallpox vaccination provided protection against monkeypox virus and thus smallpox eradication and cessation of vaccination has resulted in decreasing number of vaccinated individuals [90]. Currently the monkeypox virus is in stage-3 of pathogen evolution to cause disease and phase-3 of WHO pandemic security alert level.…”

Section: Monkeypox Virusmentioning

confidence: 99%

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Which Plagues are Coming Next?

Izurieta¹,

Campos²,

Parikh³

et al. 2021

Contemporary Developments and Perspectives in International Health Security - Volume 2

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Plagues and pandemics are no longer distant thoughts of the past. Previously referred as moments in history, infectious diseases have re-emerged as potential existential threats to mankind. International Health Security researchers have repeatedly warned society about impending pandemics and in 2020, the world experienced its first major pandemic in over a century. The SARS-CoV-2/COVID-19 pandemic came fast and hit hard, impacting the entire world within months of discovery. Although SARS-CoV-2 was a completely novel virus, there are an assortment of novel and timeworn pathogens fostering the potential to become the next pandemic. This chapter focuses on pathogens ranging from yeast to virus, capable of transmission through food, water, air, or animal, that could emerge as the next International Health Security threat.

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Section: Monkeypox Virusmentioning

confidence: 99%

Section: Monkeypox Virusmentioning

confidence: 99%

Which Plagues are Coming Next?

Izurieta¹,

Campos²,

Parikh³

et al. 2021

Contemporary Developments and Perspectives in International Health Security - Volume 2

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show abstract

“…Most are usually found near tropical rainforests, where there are animals carrying the virus, but there have been emergencies in other remote countries such as the US and the United Kingdom. Importantly, there is currently no specific treatment for monkeypox (16), although vaccination against smallpox has been shown to be approximately 85% effective in preventing monkeypox (17,18).…”

Section: Introductionmentioning

confidence: 99%

Vaccinia virus attenuation by codon deoptimization of the A24R gene for vaccine development

Lorenzo

Nogales

Chiem

et al. 2022

Preprint

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Poxviruses have large DNA genomes and they are able to infect multiple vertebrate and invertebrate animals, including humans. Despite the eradication of smallpox, poxvirus infections still remain a significant public health concern. Vaccinia virus (VV) is the prototypic member in the poxviridae family and it has been used extensively for different therapeutic applications, including the generation of vaccines against multiple infectious diseases and/or for oncolytic treatment. Many attempts have been pursued to develop novel attenuated forms of VV with improved safety profiles for their implementation as vaccines and/or vaccines vectors. We and others have previously demonstrated how RNA viruses encoding codon-deoptimized viral genes are attenuated, immunogenic and able to protect, upon a single administration, against challenge with parental viruses. In this study, we employed the same experimental approach based on the use of misrepresented codons for the generation of a recombinant (r)VV encoding a codon-deoptimized A24R gene, which is a key component of the viral RNA polymerase. Similar to our previous studies with RNA viruses, the A24R codon-deoptimized rVV (v-A24cd) was highly attenuated in vivo but able to protect, after a single intranasal dose administration, against an otherwise lethal challenge with parental VV. These results indicate that poxviruses can be effectively attenuated by synonymous codon deoptimization and open the possibility of using this methodology alone or in combination with other experimental approaches for the development of attenuated vaccines for the treatment of poxvirus infection, or to generate improved VV-based vectors. Moreover, this approach could be applied to other DNA viruses.

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“…Transmission from animal to human may occur by bite or scratch, bush meat preparation, direct contact with body fluids or lesion material, or indirect contact with lesion material, such as through contaminated bedding. 6 Human-to-human transmission is potential regarding large monkeypox outbreak that occurred in Nigeria in 2017-2018. 7 A study in the Democratic Republic of Congo (formerly Zaire) showed that among 730 patients diagnosed as cases of chickenpox, 3.3% had monkeypox by diagnostic testing.…”

Section: Introductionmentioning

confidence: 99%

“…8 The first human case of monkeypox was recorded in 1970 in the Democratic Republic of the Congo during a period of intensified effort to eliminate smallpox. 6 Since 2010, monkeypox has expanded to cause outbreaks among humans in seven additional African countries: Cameroon, Central African Republic, Republic of the Congo, Liberia, Nigeria, Sierra Leone, and South Sudan. Complications of monkeypox included secondary bacterial infections, respiratory distress, bronchopneumonia, gastrointestinal involvement, dehydration, sepsis, encephalitis, and corneal infection with ensuing loss of vision.…”

Section: Introductionmentioning

confidence: 99%

Chickenpox Mimicking Monkeypox in Adult with Diabetes Mellitus and Acute Kidney Injury: Diagnosis and Management

Wardiana¹,

Rahmadewi²,

Murtiastutik³

et al. 2021

BIKK

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Background: Chickenpox caused by the varicella-zoster virus (VZV) in diabetes mellitus patients might exhibit similar clinical features with monkeypox, caused by monkeypox virus (MPXV). In May 2019, Singapore notified World Health Organization (WHO) of one laboratory-confirmed case of monkeypox. Considering Singapore is located near Indonesia, awareness about the possibility of an outbreak in Indonesia should be raised. Purpose: To report a case of chickenpox mimicking monkeypox in an adult with diabetes mellitus and acute kidney injury. Case: A 51-year-old male with poorly controlled diabetes mellitus was suspected to have a chickenpox differential diagnosis with monkeypox. His chief complaint was multiple blisters on his body and vomiting. There was a history of feeding a monkey. From dermatological status on facial, trunk, and extremities there were multiple pleomorphic vesicles. Laboratory results showed elevated renal function. Polymerase chain reaction (PCR) examination using VZV as primer revealed a positive result in the range of 810 bp. He was treated with intravenous acyclovir for 3 days and oral acyclovir for 7 days then discharged with improvement in skin lesions and normal renal function. Discussion: Chickenpox in adult and diabetes mellitus patients can give severe clinical manifestation mimicking monkeypox. PCR has a significant role especially when diagnosis could not be established from the physical examination. Acyclovir can be given as the therapy. Conclusion: Adult and poorly controlled diabetes mellitus are important risk factors associated with the severity and complication of chickenpox. A careful diagnostic approach and management are needed.

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Human Monkeypox – After 40 Years, an Unintended Consequence of Smallpox Eradication

Cited by 22 publications

References 32 publications

Which Plagues are Coming Next?

Which Plagues are Coming Next?

Vaccinia virus attenuation by codon deoptimization of the A24R gene for vaccine development

Chickenpox Mimicking Monkeypox in Adult with Diabetes Mellitus and Acute Kidney Injury: Diagnosis and Management

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