Mpox respiratory transmission: the state of the evidence

Beeson, Amy; Styczynski, Ashley; Hutson, Christina L.; Whitehill, Florence; Angelo, Kristina M.; Minhaj, Faisal S.; Morgan, Clint N.; Ciampaglio, Kaitlyn; Reynolds, Mary G.; McCollum, Andrea M.; Guagliardo, Sarah Anne J.

doi:10.1016/s2666-5247(23)00034-4

Cited by 53 publications

(39 citation statements)

References 59 publications

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“…Transmission of mpox virus has been occurring since 1960s in the nonhuman primates. Evidence of animal‐to‐animal transmission both in the natural environment and laboratory is well documented 4,57–60 . The natural history of mpox virus is yet to be understood well.…”

Section: Resultsmentioning

confidence: 99%

“…Monkeypox virus variants from clade IIb were involved in the majority of the cases and responsible for distinct epidemiological features from pre‐2022 outbreaks. As more human‐to‐human transmission occur the changes in the genome accelerated 4,53–57 . Lineage I and IIa were confined to the majority of the cases in Central Africa and West Africa, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…72 Drugs used in the treatment of T A B L E 4 Identified risk factors of transmission of mpox outbreak. 4,34,50,[57][58][59][60][64][65][66][67][68][69]…”

Section: Treatment and Prevention Of Mpox Virus Infected Peoplementioning

confidence: 99%

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Molecular epidemiology, transmission and clinical features of 2022‐mpox outbreak: A systematic review

Sharif,

Alzahrani

et al. 2023

Health Science Reports

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Background and AimsThe 2022‐mpox outbreak has spread worldwide in a short time. Integrated knowledge of the epidemiology, clinical characteristics, and transmission of mpox are limited. This systematic review of peer‐reviewed articles and gray literature was conducted to shed light on the epidemiology, clinical features, and transmission of 2022‐mpox outbreak.MethodsWe identified 45 peer‐reviewed manuscripts for data analysis. The standards of the Preferred Reporting Items for Systematic Review and Meta‐Analysis (PRISMA) Statement and Cochrane Collaboration were followed for conducting the study.ResultsThe case number of mpox has increased about 100 times worldwide. About 99% of the cases in 2022 outbreak was from non‐endemic regions. Men (70%–98% cases) were mostly infected with homosexual and bisexual behavior (30%–60%). The ages of the infected people ranged between 30 and 40 years. The presence of HIV and sexually transmitted infections among 30%–60% of cases were reported. Human‐to‐human transmission via direct contact and different body fluids were involved in the majority of the cases (90%–100%). Lesions in genitals, perianal, and anogenital areas were more prevalent. Unusually, pharyngitis (15%–40%) and proctitis (20%–40%) were more common during 2022 outbreak than pre‐2022 outbreaks. Brincidofovir is approved for the treatment of smallpox by FDA (USA). Two vaccines, including JYNNEOSTM and ACAM2000®, are approved and used for pre‐ and post‐prophylaxis in cases. About 100% of the cases in non‐endemic regions were associated with isolates of IIb clade with a divergence of 0.0018–0.0035. Isolates from B.1 lineage were the most predominant followed by B.1.2 and B.1.10.ConclusionThis study will add integrated knowledge of the epidemiology, clinical features, and transmission of mpox.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Molecular epidemiology, transmission and clinical features of 2022‐mpox outbreak: A systematic review

Sharif,

Alzahrani

et al. 2023

Health Science Reports

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“…The first aspect pertains the epidemiological features of mpox, which are complex. The disease has three phases (incubation, prodromal, and eruptive), and various modes of transmission (contact with fluids, mucous membranes, or inhalation of infectious particles,) [4] . These epidemiological characteristics of the disease introduce the possibility of differences in transmission rates, or in the proportions of the population that are in quarantine, exposed, or recovered at each stage, thus becoming important from a modeling perspective.…”

Section: Discussionmentioning

confidence: 99%

“…Mpox is a disease caused by the double-stranded DNA virus monkeypox from the Poxviridae family, that is transmitted to humans by contact with the biologic fluids or lesions of an infected animal, which is thought to be a rodent in most cases [15] . Human-to-human transmission occurs via contact with biological fluids, skin lesions, mucous membranes, or inhalation of contaminated particles from infected individuals [4] . In humans, the disease has three phases: an incubation period, that on average, lasts 13 days; a prodromal phase, which lasts between 1 to 4 days and is characterized by fever, fatigue, and lymph node swelling; and an eruptive stage, which lasts between 14 to 28 days, and that is characterized by the appearance of skin lesions which concentrate mostly in the face and extremities [29] , [15] .…”

Section: Introductionmentioning

confidence: 99%

Mathematical modeling of mpox: A scoping review

et al. 2023

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Mpox Clinical Presentation, Diagnostic Approaches, and Treatment Strategies

Titanji,

Hazra,

Zucker

2024

JAMA

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ImportanceA global outbreak of clade IIb Monkeypox virus (MPXV) infections spread rapidly across at least 118 countries resulting in a Public Health Emergency of International Concern (PHEIC) from July 2022 to May 2023. This outbreak affected more than 99 000 persons worldwide and caused more than 33 000 infections and 60 deaths in the US. In 2024, there have been approximately 200 new infections per month in the US. On August 14, 2024, the World Health Organization declared mpox a PHEIC for a second time due to a rapid increase in infections with clade I MPXV in Central Africa.ObservationsMpox is primarily acquired through direct skin to skin contact with MPXV. With clade IIb MPXV, infections are most commonly associated with sexual activity among individuals who are gay, bisexual, and other men who have sex with men. After a median incubation period of 7 to 10 days, prodromal symptoms include fever (62%-72%), lymphadenopathy (56%-86%), myalgias (31%-55%), malaise (23%-57%), and headache (25%-55%). Skin lesions progress through 4 well-defined stages (macules, papules, vesicles, and pustules) over 2 to 4 weeks. Clade IIb MPXV is typically a self-limited illness with a low mortality rate (&lt;0.2% in the US); however, severe illness and death may occur in immunocompromised individuals, especially those with advanced HIV (CD4 count &lt;200 cells/μL). Mpox should be suspected in patients with potential exposure to MPXV who have skin lesions, and the diagnosis is confirmed with polymerase chain reaction testing of lesions. Management is supportive and focuses on skin care and symptom relief with analgesics. While no antiviral treatments are currently approved for mpox by the US Food and Drug Administration, several therapeutics, such as tecovirimat, brincidofovir, and vaccinia immune globulin intravenous, are available through expanded access programs or clinical trials. Vaccination with the 2-dose Modified Vaccinia Ankara-Bavarian Nordic vaccine is recommended for high-incidence populations and has an efficacy of 66% to 86%.Conclusions and RelevanceMpox is a viral infection transmitted primarily through close skin to skin contact that typically causes a self-resolving illness but can result in severe illness and death in immunocompromised individuals. First-line therapy is supportive care, although patients with severe mpox infection may be treated with advanced therapeutics. Mpox vaccination is effective and, if available, should be offered to individuals at risk of exposure to mpox.

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Mpox respiratory transmission: the state of the evidence

Cited by 53 publications

References 59 publications

Molecular epidemiology, transmission and clinical features of 2022‐mpox outbreak: A systematic review

Molecular epidemiology, transmission and clinical features of 2022‐mpox outbreak: A systematic review

Mathematical modeling of mpox: A scoping review

Mpox Clinical Presentation, Diagnostic Approaches, and Treatment Strategies

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