Use of JYNNEOS (Smallpox and Monkeypox Vaccine, Live, Nonreplicating) for Preexposure Vaccination of Persons at Risk for Occupational Exposure to Orthopoxviruses: Recommendations of the Advisory Committee on Immunization Practices — United States, 2022

When a Neglected Tropical Disease Goes Global: Knowledge, Attitudes and Practices of Italian Physicians towards Monkeypox, Preliminary Results

“…In fact, when dealing with MPX, clinical expertise and high suspicion index are instrumental in guaranteeing ad appropriate and timely diagnosis, as laboratory exams other than PCR may be somehow misleading. Orthopoxviruses share several common antigenic features, with a substantial cross-reactivity of elicited antibodies [ 11 , 19 , 42 , 55 , 56 ] that, in fact, represented the cornerstone of VARV vaccination [ 11 , 29 , 48 , 52 , 55 ], but still impair the reliability of most of serological exams. In settings characterized by the low suspicion index that is suggested by the very low RPS we were able to characterize, it is quite reasonable that a large share of patients may receive a proper diagnosis only in later stages of their disease, when the skin lesions have either acquired more specific features, or because of their extent and profusion [ 17 , 33 , 35 , 36 , 45 ] Interestingly enough, Adler et al recently stressed that cases associated with the current out-of-Africa outbreak may be characterized by even more unspecific skin lesions [ 16 ], as initially reported from the USA outbreak of 2003 [ 10 ], representing a further defy for front-line professionals.…”

“…Questionnaire items were specifically designed for this study through an extensive literature review [ 1 , 2 , 3 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 21 , 22 , 23 , 30 , 31 , 33 , 36 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ], and designed as if self-reported, and not externally validated questions. Their test–retest reliability was preventively assessed through a survey on 15 HCWs completing the questionnaire at two different points in time (i.e., 20 and 24 May 2020).…”

Monkeypox transmission following exposure in healthcare facilities in nonendemic settings: Low risk but limited literature

“…These findings may inform the provision of pre-exposure prophylaxis (PrEP), which has been recommended not only for laboratory personnel working with or performing diagnostic testing for orthopoxviruses and HCP who administer ACAM2000 (Smallpox [Vaccinia] Vaccine, Live) but also for HCP designated by public health authorities as response team members and for HCP who care for patients infected with orthopoxviruses. 7 The literature, however, is limited both in scale and in the details required to effectively categorize risk. Evaluations of nosocomial exposures during the current outbreak may provide additional information regarding the risk of exposure in healthcare facilities, which would in turn provide information on both PrEP and PEP strategies, though comparisons across care settings will likely be hindered by inconsistent exposure definitions and risk classification.…”

Monkeypox: A Contemporary Review for Healthcare Professionals

“…Unlike chickenpox, skin lesions due to monkeypox tend to be similar in size and typically present at the same stage. The number of lesions can range from 10 to 150 and can persist for up to 4 weeks [ 72 ]. Patients are infectious from the time symptoms start (presumed to include prodromal symptoms before the appearance of the rash) until the lesions scab and fall off, with a new layer of skin being formed [ 8 ].…”

“…In the current outbreak happening in nonendemic countries, vaccination administered as post-exposure prophylaxis (PEP) for close contacts with high-risk exposures and exposed healthcare workers is underway in several European Union countries the UK, the United States, and Canada and being considered in others [ 72 , 121 , 122 ]. Exposure risk can be classified into three categories: high, intermediate, and low/uncertain [ 19 ].…”