Update on the Monkeypox Outbreak

Rı́o, Carlos del; Malani, Preeti N.

doi:10.1001/jama.2022.14857

Cited by 38 publications

(46 citation statements)

References 7 publications

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“…335 According to the latest report, it is currently underway or planned to conduct several clinical experiments to evaluate tecovirimat's safety and effectiveness in treating monkeypox patients (PALM-007, PLATINUM, WHO/ARNS, and ACTG5418). 336,337 Cidofovir Since 1996, Cidofovir (CDV, also known as Vistide) has been approved for clinical use to treat cytomegalovirus (CMV) retinitis in persons with acquired immunodeficiency syndrome (AIDS). [338][339][340][341] CDV is a prodrug, and it must be phosphorylated by enzymes of the cytoplasm after enter the host cells, and into CDV diphosphate (CDV-pp), which has a prolonged half-life.…”

Section: Treatmentmentioning

confidence: 99%

Monkeypox: epidemiology, pathogenesis, treatment and prevention

Huang

Wang

2022

Sig Transduct Target Ther

165

120

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Monkeypox is a zoonotic disease that was once endemic in west and central Africa caused by monkeypox virus. However, cases recently have been confirmed in many nonendemic countries outside of Africa. WHO declared the ongoing monkeypox outbreak to be a public health emergency of international concern on July 23, 2022, in the context of the COVID-19 pandemic. The rapidly increasing number of confirmed cases could pose a threat to the international community. Here, we review the epidemiology of monkeypox, monkeypox virus reservoirs, novel transmission patterns, mutations and mechanisms of viral infection, clinical characteristics, laboratory diagnosis and treatment measures. In addition, strategies for the prevention, such as vaccination of smallpox vaccine, is also included. Current epidemiological data indicate that high frequency of human-to-human transmission could lead to further outbreaks, especially among men who have sex with men. The development of antiviral drugs and vaccines against monkeypox virus is urgently needed, despite some therapeutic effects of currently used drugs in the clinic. We provide useful information to improve the understanding of monkeypox virus and give guidance for the government and relative agency to prevent and control the further spread of monkeypox virus.

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Section: Treatmentmentioning

confidence: 99%

Monkeypox: epidemiology, pathogenesis, treatment and prevention

Huang

Wang

2022

Sig Transduct Target Ther

165

120

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“…The United States CDC has reported in its Sep. 28, 2022 update, that among 32 U.S. jurisdictions, MPXVi among people who were recommended to receive a vaccine was 14 times higher among unvaccinated people compared with the vaccinated, suggesting potentially higher vaccine effectiveness than demonstrated in our study. However, this reported data did not control for possible differences in baseline characteristics such as age, underlying conditions, or other differences between the two groups (9).…”

Section: Discussionmentioning

confidence: 90%

Usefulness of Single Dose of Subcutaneous Modified Vaccinia Ankara for Human Monkeypox

Arbel

Wolff-Sagy

Zucker

et al. 2022

Preprint

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The recent global outbreak of the human monkeypox virus was declared a public health emergency by the WHO. Modified Vaccinia Ankara (MVA), provided in a two-dose regimen, is currently the only FDA-approved vaccine against monkeypox virus infection (MPXVi). Nevertheless, many have implemented a single-dose strategy to maximize vaccine supply because of a vaccine shortage. The emergency approval of MVA use for MPXVi was based only on efficacy data from non-human primates. Evidence for the real-life effectiveness of MVA in reducing MPXVi is still warranted. This observational, retrospective cohort study included all members of Clalit Health Services (CHS), eligible for the MVA vaccine on Jul. 31, 2022, when the CHS vaccination campaign was initiated. The rate of MPXVi in participants who received one dose of MVA was compared with that for participants who were not vaccinated. A Cox proportional-hazards regression model with time-dependent covariates was used to estimate the association between vaccination and MPXVi while adjusting for sociodemographic and clinical risk factors. A total of 2,092 subjects met vaccine eligibility criteria. Of those, 1,068 (51%) were vaccinated during the 105 days study period and completed at least 25 days of follow-up. During the study period, 5 infections were confirmed in the vaccinated and 16 infections were confirmed in the unvaccinated participants. The adjusted vaccine effectiveness was estimated at 87% (95% CI: 60%-95%). Our results suggest that a single dose of subcutaneous MVA is associated with a significantly lower risk for MPXVi in high-risk individuals and may contribute to the containment of the current outbreak.

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“…The RT-PCR test is the "silver-bullet" test as it is the preferred method due to its accuracy, sensitivity and turn-around time. Of note, blood tests are not used to determine the presence of the monkeypox virus as they are deemed to have results that are inconclusive and lack accuracy [63][64][65][66][67][68][69][70][71][72][73][74][75][76].…”

Section: Detection and Diagnosismentioning

confidence: 99%

“…round-to-oval with sausage shaped virions measuring 200 to 300 um within the keratinocyte cytoplasm at various stages of assembly [67,69].…”

Section: Electron Microscopy (Em) -Electron Microscopy Revealsmentioning

confidence: 99%

Monkeypox: Is it our Fault?

Roomi¹

2022

J Otolaryngol Res & Rep

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The shock and awe of Covid-19 is still very much with us - the world has experienced first-hand the devastating effects of an out-of-control viral pandemic. Just as we are getting our arms around COVID-19, we find ourselves in the midst of a new threat - the monkey poxvirus. Monkey pox is a known quantity to the scientific community and has been for more than 60 years. Mostly relegated to the tropical rainforests of Central and West Africa; this zoonotic disease has largely been ignored in Europe and the Americas until just recently. Cases of the monkey pox infection first appeared sporadically among gay and bisexual men. Europe first reported cases in mid-2022. Shortly thereafter, the United States saw its first cases in large metropolitan areas such as New York, Chicago, San Francisco and Los Angeles. Monkey pox infections are transmitted through close personal contact with infected individuals. The World Health Organization has declared monkey pox a “Public health emergency of international concern”. Monkey pox is genetically similar to smallpox. Although no treatment for the monkey poxvirus exists, antivirals and vaccines developed for smallpox have proven effective against monkey pox. Because of its similarity to smallpox, individuals infected with monkey pox demonstrate attenuated symptoms (i.e. fever, chills, muscle aches, sore throat and cough) as compared to those infected with smallpox. After a 3-week incubation period, monkey pox goes away on its own in approximately 2-5 weeks. Diagnostic testing and disease confirmation is performed via RT-PCR testing of genetic material from the infected areas and through the presence of lymphadenopathy (i.e. enlarged lymph nodes). This overview serves as a point of discussion of the aforementioned areas and provides commentary on understanding methods of prevention and containment of the disease. In summary, the power of viral spread causing global pandemics is not to be ignored or neglected - and much more research is to be conducted

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Update on the Monkeypox Outbreak

Abstract: This Viewpoint updates information about the current monkeypox outbreak, including confirmed cases, primary modes of transmission, clinical characteristics, diagnosis, treatment, and prevention.

Cited by 38 publications

References 7 publications

Monkeypox: epidemiology, pathogenesis, treatment and prevention

Monkeypox: epidemiology, pathogenesis, treatment and prevention

Usefulness of Single Dose of Subcutaneous Modified Vaccinia Ankara for Human Monkeypox

Monkeypox: Is it our Fault?

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