The International Health Regulations(IHR)of the republic of South Africa confirmed 20 human monkeypox(mpox)cases including the death of 3 individuals to the World Health Organization(WHO)between 8 May and 2 July 2024....The International Health Regulations(IHR)of the republic of South Africa confirmed 20 human monkeypox(mpox)cases including the death of 3 individuals to the World Health Organization(WHO)between 8 May and 2 July 2024.All the cases were men aged between 17 and 43 years and 11 were men who have sex with men.Out of these cases,15 cases were living with un-managed or recently diagnosed HIV infection.All these cases were symptomatic with extensive skin lesions and required hospitalization.This sudden incidence of mpox cases without any prior history of international travel,high prevalence of HIV and high case fatality ratio,suggests that the community transmission is still prevalent.Rise of mpox cases in vulnerable groups in South Africa has the potential for increased health impact in people living in neighboring countries and has the risk of cross border and international spread.Due to this reason,national health authorities in South Africa have initiated various response measures with the support from the WHO to control this infection[1].展开更多
Since May 2022,a severe global Mpox epidemic has underscored the urgent need for a preventative vaccine.On September 16,2022,the mainland of China reported its first case of imported Mpox,which was subsequently follow...Since May 2022,a severe global Mpox epidemic has underscored the urgent need for a preventative vaccine.On September 16,2022,the mainland of China reported its first case of imported Mpox,which was subsequently followed by a significant rise in domestic infections commencing from June 2023.This alarming trend has escalated the likelihood of localized outbreaks and covert transmission,posing a heightened risk to public health.Notably,the United States,many European countries,and Japan have approved the use of smallpox vaccines for Mpox prevention and emergency vaccination post-exposure,based on their cross-protection efficacy.In recent years,virology research has broadened its scope to include investigations into various novel vaccine approaches,such as nucleic acid-based vaccines,protein subunit vaccines,and epitope peptide vaccines,and other related methodologies.This review offers a thorough examination of the current global landscape of Mpox prevalence,delves into the advancements in Mpox vaccine development,and highlights the progress achieved in Mpox vaccine research,serving as a valuable resource and providing technical insights essential for the effective prevention and control of Mpox.展开更多
Background and objectives:The ongoing mpox outbreaks have garnered significant attention due to their public health implications,particularly the potential mental health impacts.Despite the growing concern,there has b...Background and objectives:The ongoing mpox outbreaks have garnered significant attention due to their public health implications,particularly the potential mental health impacts.Despite the growing concern,there has been limited exploration of the intersection between mpox and mental health within the research literature.This study aims to conduct a comprehensive bibliometric analysis to examine global research trends,regional distribution,and thematic focus areas related to mpox's psychological and psychiatric implications.Methods:We conducted a bibliometric analysis using Scopus and the Web of Science database.The analysis was carried out using the R-bibliometrics package and involved identifying literature on mpox and mental health,focusing on global research trends,regional distribution,and thematic areas of study.The analysis included 416 documents obtained from 295 sources from January 1,2014 to August 27,2024.Results:Our analysis revealed a growing but unevenly distributed literature on mpox and mental health.Most studies concentrated on the relationship between mpox and conditions such as depression and anxiety,while other psychiatric outcomes remain underexplored.The geographic distribution of research was also uneven,with regions like Europe and the Americas receiving more focus than others.Conclusions:The study highlights the need for more targeted research on the mental health sequelae of mpox,particularly for vulnerable populations and regions that are currently underrepresented in the literature.Future research should include longitudinal studies to assess the long-term effects of mpox on mental health and the development of robust methodologies to establish causality.Integrating mental health considerations into public health responses to mpox outbreaks is crucial,with significant implications for research,policy,and clinical practice.展开更多
The risk of new pathogen emergence is constantly increasing due to several factors,including the expansion and exploration of previously uninhabited regions,increased global trade,tourism,climate change and others.Rec...The risk of new pathogen emergence is constantly increasing due to several factors,including the expansion and exploration of previously uninhabited regions,increased global trade,tourism,climate change and others.Recently,monkeypox(mpox)cases have been increasing,causing alarm as the cases are reported from countries where the disease is not endemic.Mpox virus is an emerging pathogen responsible for human mpox.展开更多
Background:Vaccinia virus(VACV)and mpox virus(MPXV)belong to the orthopoxvirus genus and share high genetic similarity,making VACV widely used in the mpox pandemic.CAST/EiJ mice have been widely used for studying orth...Background:Vaccinia virus(VACV)and mpox virus(MPXV)belong to the orthopoxvirus genus and share high genetic similarity,making VACV widely used in the mpox pandemic.CAST/EiJ mice have been widely used for studying orthopoxvirus infection.However,the histopathological features of CAST/EiJ mice with mpox virus(MPXV)and vaccinia virus(VACV)infections have not been fully elucidated.Methods:Four group of CAST/EiJ mice were challenged with low-dose VACV(103 PFU,VACV-L),high-dose VACV(106 PFU,VACV-H),MPXV(106 PFU)or PBS via intraperitoneal route,and the disease signs and body weight were monitored daily.Subsequently,viral loads and titers in the blood and spleen of CAST/EiJ mice were analyzed via qPCR and TCID 50 assay.Finally,the spleen samples were analyzed for histopathological,immunohistochemical and RNA-seq.Results:Herein,we found that VACV-L and MPXV caused splenomegaly via the intraperitoneal route,whereas VACV-H caused rapid lethality with limited splenomegaly.Transcriptome analysis from spleen revealed significant differences in gene expression between VACV-L and VACV-H groups,but the differentially expressed genes induced by splenomegaly between VACV-L and MPXV groups were highly similar.Furthermore,pathway enrichment analysis demonstrated that the VACV-L,VACV-H,and MPXV groups were all associated with the calcium,MAPK,and PI3K-Akt signaling pathway.Compared to the lethal infection observed in VACV-H group,the splenomegaly in the VACV-L and MPXV groups was characterized by extramedullary hematopoiesis and increased macrophages infiltration in the red pulp.Transcriptome analysis of the spleen demonstrated that the Wnt,tumor necrosis factor(TNF),and transforming growth factorβ(TGF-β)signaling pathways may promote splenomegaly by modulating granulocyte infiltration and inflammatory responses.Compared to VACV-L group,the limited splenomegaly but lethality in VACV-H-infected mice might be associated with extensive splenic necrosis,diffuse congestion,and hemorrhage in the red pulp,as well as changes in the cGMP-PKG,Ras signaling,and Fc gamma Rmediated phagocytosis pathways.Conclusions:Our findings systematically compared the pathogenicity of VACV and MPXV in CAST/EiJ mice,incorporating splenic transcriptome analysis to provide insights into the potential molecular mechanism behind orthopoxvirus-induced splenomegaly in CAST/EiJ mice.展开更多
Objectives: This research aims to focus on the differences in mpox outbreaks that occurred in 2003 and 2022 in the United States. Methods: We searched the following databases Medline, Google Scholar, Gayle Power Searc...Objectives: This research aims to focus on the differences in mpox outbreaks that occurred in 2003 and 2022 in the United States. Methods: We searched the following databases Medline, Google Scholar, Gayle Power Search, PubMed, and Springerlink using the following search terms “mpox virus”, “MPX”, “mpox in the US”, “US mpox virus 2003”, “US mpox virus 2022”, “US mpox outbreak 2003” and US mpox outbreak 2022”. The only articles selected were those written between 2003 and 2022. Results: Findings showed more Mpox research was conducted during the first US Mpox outbreak in 2003 compared to the US Mpox outbreak in 2022. Findings also indicated that the mpox outbreak of 2003 consisted of more animal-to-human transmissions acquired from sick prairie dogs compared to more human-to-human from an infected international traveler from Nigeria to the US. Conclusion: Major differences in the mpox outbreaks in the US include the number, location of lesions, and transmission type. We recommend further research to increase awareness of the human-to-human transmission of mpox via sexual contact to assist healthcare professionals and public health leaders in providing prevention and wellness in US communities.展开更多
Mpox is an infectious and contagious zoonotic disease caused by the mpox virus(MPXV),which belongs to the genus Orthopoxvirus.Since 2022,MPXV has posed a significant threat to global public health.The emergence of thou...Mpox is an infectious and contagious zoonotic disease caused by the mpox virus(MPXV),which belongs to the genus Orthopoxvirus.Since 2022,MPXV has posed a significant threat to global public health.The emergence of thousands of cases across the Western Hemisphere prompted the World Health Organization to declare an emergency.The extensive coevolutionary history of poxviruses with humans has enabled these viruses to develop sophisticated mechanisms to counter the human immune system.Specifically,MPXV employs unique immune evasion strategies against a wide range of immunological elements,presenting a considerable challenge for treatment,especially following the discontinuation of routine smallpox vaccination among the general population.In this review,we start by discussing the entry of the mpox virus and the onset of early infection,followed by an introduction to the mechanisms by which the mpox virus can evade the innate and adaptive immune responses.Two caspase-1 inhibitory proteins and a PKR escape-related protein have been identified as phylogenomic hubs involved in modulating the immune environment during the MPXV infection.With respect to adaptive immunity,mpox viruses exhibit unique and exceptional T-cell inhibition capabilities,thereby comprehensively remodeling the host immune environment.The viral envelope also poses challenges for the neutralizing effects of antibodies and the complement system.The unique immune evasion mechanisms employed by MPXV make novel multi-epitope and nucleic acid-based vaccines highly promising research directions worth investigating.Finally,we briefly discuss the impact of MPXV infection on immunosuppressed patients and the current status of MPXV vaccine development.This review may provide valuable information for the development of new immunological treatments for mpox.展开更多
Mpox,formerly known as monkeypox,is a viral zoonotic disease endemic to Central and West Africa that has posed significant public health challenges since its identification in 1970.Despite decades of experience in man...Mpox,formerly known as monkeypox,is a viral zoonotic disease endemic to Central and West Africa that has posed significant public health challenges since its identification in 1970.Despite decades of experience in managing outbreaks,the 2022-2024 Mpox outbreaks exposed substantial gaps in global preparedness and response,leading the World Health Organization(WHO)to declare a Public Health Emergency of International Concern(PHEIC)in 2022.The resurgence of cases in Europe in 2022 and the more recent emergence of the virulent clade Ib in the Democratic Republic of the Congo(DRC)in 2024 have highlighted a critical need for improved proactive and response strategies to curb the epidemic.This narrative review examines the historical and recent epidemiology of Mpox in Africa and explores the factors that have limited effective management.These include objective influences such as viral mutations,zoonotic transmission patterns,and environmental changes like deforestation,as well as subjective factors,including delayed responses,limited vaccine availability,cessation of smallpox vaccinations,and inequitable access to healthcare.In particular,the review emphasizes the ongoing disparities in global health equity,as wealthier nations have been able to secure vaccines and therapeutics quickly,while endemic regions in Africa continue to struggle with limited resources.The review also discusses how socio-economic and cultural factors,combined with weak public health infrastructure and inadequate surveillance systems,perpetuate cycles of outbreak in vulnerable populations.Furthermore,the emergence of clade Ib in 2024,with its higher virulence and mortality rates among children,particularly in rural areas,underscores the urgency of addressing the evolving epidemiological landscape of Mpox.In response to these challenges,this review recommends strengthening healthcare infrastructure,enhancing surveillance systems,ensuring equitable access to vaccines and treatments,and integrating environmental management into public health strategies.Global collaboration remains essential to provide African countries with the resources and support needed to manage and prevent future outbreaks effectively.Without these measures,the world risks a prolonged public health crisis with far-reaching consequences for both Africa and the global community.展开更多
The recently re-emerged mpox(monkeypox)virus that causes mpox disease is a member of genus Orthopoxvirus and has unprecedentedly spread worldwide.Numerous studies have contributed to our understanding of its evolution...The recently re-emerged mpox(monkeypox)virus that causes mpox disease is a member of genus Orthopoxvirus and has unprecedentedly spread worldwide.Numerous studies have contributed to our understanding of its evolution,pathophysiology,and clinical manifestations.The current outbreak of the mpox virus depicts its novel route of transmission as a new variant.However,the exact reason for its transition from an epidemic to a pandemic remains unclear.Furthermore,other poxviruses such as vaccinia virus,variola virus,and cowpox virus,also belong to the same genus,Orthopoxvirus.In the present review,our objective was to summarize the evidence on evolution,pathophysiology,and clinical manifestations of mpox virus and its related poxviruses.The present review would aid in a better understanding of the current circulating mpox virus and its differences from other poxviruses.In addition,the shared genetic factors contributing to virulence in these Orthopoxvirus highlight their evolutionary connections and genetic similarities.While they exhibit differences in virulence,studying these genetic relationships is crucial for understanding their biology,pathogenicity,and the development of effective vaccines and antiviral therapeutics to curb mpox disease.展开更多
Mpox disease is caused by a double-stranded DNA virus, genus Orthopoxvirus of the family Poxviridae. The incubation period is usually 6 to 13 days but can range from 5 to 21 days while symptoms and signs may persist f...Mpox disease is caused by a double-stranded DNA virus, genus Orthopoxvirus of the family Poxviridae. The incubation period is usually 6 to 13 days but can range from 5 to 21 days while symptoms and signs may persist for 2 to 5 weeks. Although, the clinical features are usually less severe when compared to the deadly smallpox, the disease can be fatal with case fatality rate between 1% and 10%. In Imo State, Nigeria, there has been a changing epidemiology of the disease in the last 6 years and the frequency and geographic distribution of cases have progressively increased. This study aims to conduct a review of the disease epidemiology between 2017 and 2023 and implications for surveillance in Imo State. Surveillance data from the Surveillance Outbreak Response and Management System (SORMAS) was extracted between January 2017 and December 2023 across the 27 Local Government Areas (LGAs) of Imo State. A line list of 231 suspected cases was downloaded into an excel template and analyzed using SPSS<sup>®</sup> version 20 software. Analysis was done using descriptive statistics and associations were tested using Fischer’s exact at 0.05 level of significance. Of the 231 suspected cases, 57.1% (132) were males, 42.9% (99) were females and the modal age group was between the ages of 0 - 4 (32.5%). Eight (8) LGAs (districts) accounted for 71% (n = 164) of all the suspected cases. 21.2% (49) were confirmed positive, 27 males (55.1%) and 22 females (44.9%) (p > 0.05). Modal age group was 20 - 24 (22.4%, n = 11), 18% (9) were children under 14 years, p > 0.05. Case fatality rate was 8% (n = 4). There was no significant association between mortality and age group. Five (5) LGAs accounted for about 60% (29) of all confirmed cases. These LGAs contribute only 20% to the total population in the State. Only 5.6% and 4% of suspected and confirmed cases, respectively, had knowledge of contact with an infectious source. The study described the epidemiology of Mpox outbreaks between 2017 and 2023 and the findings have significant implications on detection and outbreak response activities.展开更多
As the global community continues to recover from the COVID-19 pandemic,the World Health Organization has issued a warning of another viral infection,mpox(monkeypox),that can pose a significant threat to public health...As the global community continues to recover from the COVID-19 pandemic,the World Health Organization has issued a warning of another viral infection,mpox(monkeypox),that can pose a significant threat to public health.Mpox was once endemic in Africa but has spread globally,prompting the World Health Organization to declare it a public health emergency.In response,healthcare personnel must initiate timely,decisive,and robust action before the infection escalates.Moreover,accurate diagnosis is crucial,given the similarity between mpox and other rash-causing infections.This article provides a comprehensive overview of the symptoms,differentiating it from similar diseases,risk assessment,and treatment strategies.In addition,it aims to educate healthcare personnel with the necessary knowledge to educate others and take preventative measures when handling cases,thereby avoiding the spread of infection.展开更多
Objective:To identify the knowledge and awareness level of human mpox viral infection among healthcare workers in southwestern Nigeria.Methods:A cross-sectional study was conducted in Ekiti State,southwest Nigeria amo...Objective:To identify the knowledge and awareness level of human mpox viral infection among healthcare workers in southwestern Nigeria.Methods:A cross-sectional study was conducted in Ekiti State,southwest Nigeria among 316 healthcare workers that were selected through a systematic random sampling.Data were collected with the aid of a semi-structured,self-administered questionnaire.The Chi-square test and binary logistic regression were used to find the association between the independent and dependent variables.The significance level was set at P-value<0.05.Results:Two hundred and twenty-two(70.3%)of the respondents were aged≤40 years,mean age(36±9)years,189(59.8%)were female,306(96.8%)were Christians,and 203(64.2%)were married.Three hundred and fourteen(99.4%)of the respondents were aware of mpox infection.Main sources of information about mpox were medical education(44.0%),radio/television(32.0%)and newspaper(21.0%).However,among those aware of the disease,209(67.0%)demonstrated poor knowledge levels.Longer than 5 years’experience of medical practice was the only significant predictor of higher knowledge level of the disease(OR 1.76,95%CI 1.01-3.06;P=0.046).Conclusions:Despite the high awareness level of mpox infection among healthcare workers,there still exists a huge knowledge gap.It is recommended that targeted intervention could be directed towards continuous medical education and simulation exercises on re-emerging infectious diseases like mpox to improve the knowledge of the healthcare workers.展开更多
Objective:This study aimed to analyze the epidemiological characteristics and clinical symptoms of mpox cases with and without human immunodeficiency virus(HIV)reported in China in 2023,providing evidence for coordina...Objective:This study aimed to analyze the epidemiological characteristics and clinical symptoms of mpox cases with and without human immunodeficiency virus(HIV)reported in China in 2023,providing evidence for coordinated prevention and control strategies for both infections.Method:All confirmed mpox cases reported in 2023 were extracted from China’s Information System for Disease Control and Prevention.Data were collected from the surveillance system and epidemiological investigations.Statistical analyses were performed using SPSS 24.0,with group comparisons conducted using t-tests and chi-square tests.Results:Among 1,712 confirmed mpox cases in China during 2023,802(46.8%)were people with human immunodeficiency virus(PWH).Of the 1,702 male cases,97.3%of PWH and 91.1%of those without HIV self-identified as men who have sex with men(MSM).Age distribution showed 79.4%of PWH and 87.6%of those without HIV were under 40 years old,while 64.2%of PWH and 71.3%of those without HIV were reported from eastern regions.Cardinal symptoms at diagnosis occurred at similar rates between those with and without HIV,including rash(90.9%vs.93.4%),fever(52.5%vs.53.8%),and lymphadenopathy(23.8%vs.25.4%).Among coinfected cases,individuals diagnosed with HIV after mpox or within one year before mpox demonstrated higher rates of immunodeficiency and lower rates of HIV viral suppression.Conclusion:Male mpox cases with HIV was more likely to be MSM,older,and reported from central and western regions compared to those without HIV.No significant differences were observed in cardinal symptom occurrence between groups.These findings emphasize the importance of implementing integrated prevention strategies targeting both HIV and mpox,particularly among key populations.展开更多
In recent years,mpox virus Clade Ib has emerged as a significant global public health threat due to its rapid transmission and potential for severe disease outcomes.This strain was first identified in the Democratic R...In recent years,mpox virus Clade Ib has emerged as a significant global public health threat due to its rapid transmission and potential for severe disease outcomes.This strain was first identified in the Democratic Republic of the Congo(DRC)in September 2023 and began spreading to neighboring African countries by July 2024.It was subsequently imported through international travel to 12 non-African countries across Asia,Europe,and the Americas.Clade Ib exhibits increased transmissibility,and current data suggest that infections may lead to more severe symptoms,with higher risks of severe illness and mortality,particularly among vulnerable populations such as children,pregnant individuals,and immunocompromised groups(e.g.,people living with HIV/AIDS).Epidemiologically,Clade Ib primarily spreads through sexual contact,close household contact,and healthcare-related exposure.This review aims to provide an overview of the current understanding of mpox virus Clade Ib,including its genetic characteristics,epidemiological patterns,and prevention and control strategies.Additionally,it discusses the strategies and interventions needed to address this emerging threat.展开更多
On Aug 14,2024,the World Health Organization(WHO)declared the second public health emergency of international concern(PHEIC)on mpox spread,considering the upsurge of mpox in the Democratic Republic of the Congo and a ...On Aug 14,2024,the World Health Organization(WHO)declared the second public health emergency of international concern(PHEIC)on mpox spread,considering the upsurge of mpox in the Democratic Republic of the Congo and a growing number of countries in Africa[1].Mpox has been mainly confinedwithin Africa since its first isolation in Denmark inmonkeys kept for research in 1958 and the first reported human mpox case of an infant boy in the Democratic Republic of the Congo in 1970[2].The spillover spread outside of Africa to America in 2003 caused approximately 70 infections[3].Fortunately,the endemic caused no deaths but alerted society to the potential threat of mpox.In Jul 2022,WHO once declared the first PHEIC on mpox since quickly reported mpox-infected cases in Europe,America,and Asia.The rapid increase of mpox in 2024 calls for urgent collaborative efforts to address the disease’s evolving epidemiology and transmission dynamics[4],emphasizing the potential threat from mpox and the need for caution and preparedness.展开更多
In 2022,a global outbreak of mpox was anticipated,with several cases reported in non-endemic countries in early May.Given the challenge of distinguishing the mpox virus(MPXV)from other pathogens based solely on sympto...In 2022,a global outbreak of mpox was anticipated,with several cases reported in non-endemic countries in early May.Given the challenge of distinguishing the mpox virus(MPXV)from other pathogens based solely on symptoms,there is an urgent need for prompt and reliable MPXV detection methods.In this study,we developed assays using recombinase-aided amplification(RAA)to identify MPXV and evaluated their applicability with clinical samples.The assays were designed to detect theN4R gene of MPXV.All assays demonstrated detection limits of 1 copy/μL within the reaction system and exhibited no cross-reactivity with ectromelia or the TianTan strain of vaccinia virus,confirming their high specificity.Our established assay provides results in less than 50 min.Furthermore,we evaluated our assay using clinical samples from laboratory-confirmed mpox patients and demonstrated that the RAA-based assay is valuable for diagnosing MPXV infections in field and clinic settings,especially in areas with limited laboratory resources.Overall,three RAA-based nucleic acid assays for MPXV were established,providing a powerful tool for efficient,rapid,and specific detection of MPXV infection.展开更多
Mpox is a zoonotic infectious disease caused by the mpox virus(MPXV).Historically,the majority of mpox cases have been documented in Central Africa.However,since May 2022,there has been a notable rise in reported case...Mpox is a zoonotic infectious disease caused by the mpox virus(MPXV).Historically,the majority of mpox cases have been documented in Central Africa.However,since May 2022,there has been a notable rise in reported cases from regions beyond Africa.Currently,over 110 countries spanning Europe,North America,South America,Asia,and other territories have reported mpox infections.This report details a case involving a patient who identifies as a man who has sex with men(MSM)and is concurrently infected with MPXV,human immunodeficiency virus type 1(HIV-1),Pneumocystis jiroveci,as well as extensively drug-resistant tuberculosis(XDR-TB).This patient had also received a vaccination for smallpox in the past.Additionally,we provide photographic documentation charting the progression of dermatological manifestations associated with mpox.This case highlights the significance of sexual intercourse as a crucial mode of transmission for mpox.The rapid and widespread dissemination of the MPXV across various regions,especially among MSM communities,underscores the importance of enhancing preventive education efforts targeted at high-risk populations.展开更多
Background The 2022-2023 mpox(monkeypox)outbreak has spread rapidly across multiple countries in the non-endemic region,mainly among men who have sex with men(MSM).In this study,we aimed to evaluate mpox's importa...Background The 2022-2023 mpox(monkeypox)outbreak has spread rapidly across multiple countries in the non-endemic region,mainly among men who have sex with men(MSM).In this study,we aimed to evaluate mpox's importation risk,border screening effectiveness and the risk of local outbreak in Chinese mainland.Methods We estimated the risk of mpox importation in Chinese mainland from April 14 to September 11,2022 using the number of reported mpox cases during this multi-country outbreak from Global.health and the international air-travel data from Official Aviation Guide.We constructed a probabilistic model to simulate the effectiveness of a border screening scenario during the mpox outbreak and a hypothetical scenario with less stringent quarantine requirement.And we further evaluated the mpox outbreak potential given that undetected mpox infections were introduced into men who have sex with men,considering different transmissibility,population immunity and population activity.Results We found that the reduced international air-travel volume and stringent border entry policy decreased about 94% and 69% mpox importations respectively.Under the quarantine policy,15-19% of imported infections would remain undetected.Once a case of mpox is introduced into active MSM population with almost no population immunity,the risk of triggering local transmission is estimated at 42%,and would rise to>95% with over six cases.Conclusions Our study demonstrates that the reduced international air-travel volume and stringent border entry policy during the COvID-19 pandemic reduced mpox importations prominently.However,the risk could be sub-stantially higher with the recovery of air-travel volume to pre-pandemic level.Mpox could emerge as a public health threat for Chinese mainland given its large MSM community.展开更多
Introduction:The transmission dynamics of the recent mpox outbreak highlights the lack of infrastructure available to rapidly respond to novel STI outbreaks,of which Asia and Oceania remains particularly susceptible.H...Introduction:The transmission dynamics of the recent mpox outbreak highlights the lack of infrastructure available to rapidly respond to novel STI outbreaks,of which Asia and Oceania remains particularly susceptible.Here,we simulate outbreaks in this setting and propose the use of pre-emptive vaccination within the men who have sex with men(MSM)community before the arrival and establishment of the virus.Materials and methods Using data driven heterogeneous sexual contact networks,we simulated outbreaks of mpox in Singapore,Hong Kong,and Sydney.An individual based SEIR compartmental model was used to simulate epidemic trajectories and the impact of different vaccination uptakes was assessed in their ability to avert or suppress outbreaks upon the arrival of mpox within the MSM populations.Results:The highly dense sexual networks of Singapore and Sydney experience rapid outbreaks,with infection peaks occurring at day 41 and 23 respectively,compared to Hong Kong which occurs at day 77.Across the simulations with no vaccination,68.2%–89.7%of the MSM community will become infected with mpox across the different cities,over a simulation period of 1 year.By implementing vaccination strategies,the infection rate across the cities can be reduced to as low as 3.1%of the population(range:3.1%–82.2%)depending on the implementation and uptake of the vaccine.Vaccination is also extremely effective in slowing the start of the epidemic,delaying the epidemic peak by 36–50 days in Hong Kong,or even preventing the outbreak of mpox.Discussion:With extremely dense and well-connected sexual contact networks,where 65.2%–83.2%of the population are connected to a super-spreader in the different contact networks,pre-emptive or immediate vaccination upon identification of the first case is strongly recommended to help better manage the outbreak of mpox and prevent potential straining of healthcare systems.展开更多
The ongoing transmission of mpox in specific countries and regions necessitates urgent action.It is essential to implement targeted containment strategies that concentrate on high-risk populations and critical locatio...The ongoing transmission of mpox in specific countries and regions necessitates urgent action.It is essential to implement targeted containment strategies that concentrate on high-risk populations and critical locations,such as college campuses,to effectively curb the spread of mpox.This study is dedicated to evaluating the performance of various vaccination and quarantine strategies in curbing the spread of mpox and estimating the outbreak risk.To accomplish this,we constructed a stochastic,agent-based,discrete-time susceptible-latent-infectious-recovered(SLIR)model,to examine mpox transmission on a simulated college campus.Our findings reveal that relying solely on PEP is insufficient in containing mpox effectively.To bolster the population immunity and protect the vulnerable,pre-exposure vaccination among high-risk populations prior to an outbreak is imperative.Our study demonstrates that a pre-exposure vaccination rate of 50%in high-risk populations can led to a remarkable 74.2%reduction of infections.This translated to a mere 1.0%cumulative infection incidence in the overall population.In cases where the desired vaccination coverage is not attainable,enhancing case detection and isolation measures can serve as an effective emergency response to contain mpox outbreaks.For pre-exposure vaccination coverage of 20%or lower,a 40%isolation ratio is necessary to keep the cumulative number of infections in check.However,when the coverage exceeds 30%,a reduced isolation ratio of 20%becomes sufficient to manage the outbreak effectively.These insights underscore the importance of strategic pre-exposure vaccination in conjunction with robust surveillance and isolation protocols to safeguard public health and prevent the escalation of mpox outbreaks.展开更多
文摘The International Health Regulations(IHR)of the republic of South Africa confirmed 20 human monkeypox(mpox)cases including the death of 3 individuals to the World Health Organization(WHO)between 8 May and 2 July 2024.All the cases were men aged between 17 and 43 years and 11 were men who have sex with men.Out of these cases,15 cases were living with un-managed or recently diagnosed HIV infection.All these cases were symptomatic with extensive skin lesions and required hospitalization.This sudden incidence of mpox cases without any prior history of international travel,high prevalence of HIV and high case fatality ratio,suggests that the community transmission is still prevalent.Rise of mpox cases in vulnerable groups in South Africa has the potential for increased health impact in people living in neighboring countries and has the risk of cross border and international spread.Due to this reason,national health authorities in South Africa have initiated various response measures with the support from the WHO to control this infection[1].
文摘Since May 2022,a severe global Mpox epidemic has underscored the urgent need for a preventative vaccine.On September 16,2022,the mainland of China reported its first case of imported Mpox,which was subsequently followed by a significant rise in domestic infections commencing from June 2023.This alarming trend has escalated the likelihood of localized outbreaks and covert transmission,posing a heightened risk to public health.Notably,the United States,many European countries,and Japan have approved the use of smallpox vaccines for Mpox prevention and emergency vaccination post-exposure,based on their cross-protection efficacy.In recent years,virology research has broadened its scope to include investigations into various novel vaccine approaches,such as nucleic acid-based vaccines,protein subunit vaccines,and epitope peptide vaccines,and other related methodologies.This review offers a thorough examination of the current global landscape of Mpox prevalence,delves into the advancements in Mpox vaccine development,and highlights the progress achieved in Mpox vaccine research,serving as a valuable resource and providing technical insights essential for the effective prevention and control of Mpox.
文摘Background and objectives:The ongoing mpox outbreaks have garnered significant attention due to their public health implications,particularly the potential mental health impacts.Despite the growing concern,there has been limited exploration of the intersection between mpox and mental health within the research literature.This study aims to conduct a comprehensive bibliometric analysis to examine global research trends,regional distribution,and thematic focus areas related to mpox's psychological and psychiatric implications.Methods:We conducted a bibliometric analysis using Scopus and the Web of Science database.The analysis was carried out using the R-bibliometrics package and involved identifying literature on mpox and mental health,focusing on global research trends,regional distribution,and thematic areas of study.The analysis included 416 documents obtained from 295 sources from January 1,2014 to August 27,2024.Results:Our analysis revealed a growing but unevenly distributed literature on mpox and mental health.Most studies concentrated on the relationship between mpox and conditions such as depression and anxiety,while other psychiatric outcomes remain underexplored.The geographic distribution of research was also uneven,with regions like Europe and the Americas receiving more focus than others.Conclusions:The study highlights the need for more targeted research on the mental health sequelae of mpox,particularly for vulnerable populations and regions that are currently underrepresented in the literature.Future research should include longitudinal studies to assess the long-term effects of mpox on mental health and the development of robust methodologies to establish causality.Integrating mental health considerations into public health responses to mpox outbreaks is crucial,with significant implications for research,policy,and clinical practice.
文摘The risk of new pathogen emergence is constantly increasing due to several factors,including the expansion and exploration of previously uninhabited regions,increased global trade,tourism,climate change and others.Recently,monkeypox(mpox)cases have been increasing,causing alarm as the cases are reported from countries where the disease is not endemic.Mpox virus is an emerging pathogen responsible for human mpox.
基金Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences,Grant/Award Number:2023-I2M-2-001National Key Research and Development Project of China,Grant/Award Number:2022YFC2304100 and 2023YFC2309000+1 种基金National Natural Science Foundation of China,Grant/Award Number:82241068 and 82222041Beijing Natural Science Foundation,Grant/Award Number:Z220018。
文摘Background:Vaccinia virus(VACV)and mpox virus(MPXV)belong to the orthopoxvirus genus and share high genetic similarity,making VACV widely used in the mpox pandemic.CAST/EiJ mice have been widely used for studying orthopoxvirus infection.However,the histopathological features of CAST/EiJ mice with mpox virus(MPXV)and vaccinia virus(VACV)infections have not been fully elucidated.Methods:Four group of CAST/EiJ mice were challenged with low-dose VACV(103 PFU,VACV-L),high-dose VACV(106 PFU,VACV-H),MPXV(106 PFU)or PBS via intraperitoneal route,and the disease signs and body weight were monitored daily.Subsequently,viral loads and titers in the blood and spleen of CAST/EiJ mice were analyzed via qPCR and TCID 50 assay.Finally,the spleen samples were analyzed for histopathological,immunohistochemical and RNA-seq.Results:Herein,we found that VACV-L and MPXV caused splenomegaly via the intraperitoneal route,whereas VACV-H caused rapid lethality with limited splenomegaly.Transcriptome analysis from spleen revealed significant differences in gene expression between VACV-L and VACV-H groups,but the differentially expressed genes induced by splenomegaly between VACV-L and MPXV groups were highly similar.Furthermore,pathway enrichment analysis demonstrated that the VACV-L,VACV-H,and MPXV groups were all associated with the calcium,MAPK,and PI3K-Akt signaling pathway.Compared to the lethal infection observed in VACV-H group,the splenomegaly in the VACV-L and MPXV groups was characterized by extramedullary hematopoiesis and increased macrophages infiltration in the red pulp.Transcriptome analysis of the spleen demonstrated that the Wnt,tumor necrosis factor(TNF),and transforming growth factorβ(TGF-β)signaling pathways may promote splenomegaly by modulating granulocyte infiltration and inflammatory responses.Compared to VACV-L group,the limited splenomegaly but lethality in VACV-H-infected mice might be associated with extensive splenic necrosis,diffuse congestion,and hemorrhage in the red pulp,as well as changes in the cGMP-PKG,Ras signaling,and Fc gamma Rmediated phagocytosis pathways.Conclusions:Our findings systematically compared the pathogenicity of VACV and MPXV in CAST/EiJ mice,incorporating splenic transcriptome analysis to provide insights into the potential molecular mechanism behind orthopoxvirus-induced splenomegaly in CAST/EiJ mice.
文摘Objectives: This research aims to focus on the differences in mpox outbreaks that occurred in 2003 and 2022 in the United States. Methods: We searched the following databases Medline, Google Scholar, Gayle Power Search, PubMed, and Springerlink using the following search terms “mpox virus”, “MPX”, “mpox in the US”, “US mpox virus 2003”, “US mpox virus 2022”, “US mpox outbreak 2003” and US mpox outbreak 2022”. The only articles selected were those written between 2003 and 2022. Results: Findings showed more Mpox research was conducted during the first US Mpox outbreak in 2003 compared to the US Mpox outbreak in 2022. Findings also indicated that the mpox outbreak of 2003 consisted of more animal-to-human transmissions acquired from sick prairie dogs compared to more human-to-human from an infected international traveler from Nigeria to the US. Conclusion: Major differences in the mpox outbreaks in the US include the number, location of lesions, and transmission type. We recommend further research to increase awareness of the human-to-human transmission of mpox via sexual contact to assist healthcare professionals and public health leaders in providing prevention and wellness in US communities.
基金supported by the High-Level Public Health Specialized Talents Project of Beijing Municipal Health Commission(2022-2-018 to B.S.)Beijing Key Laboratory for HIV/AIDS Research(BZ0089).The funders had no role in study design,data collection and analysis,decision to publish,or preparation of the manuscript.
文摘Mpox is an infectious and contagious zoonotic disease caused by the mpox virus(MPXV),which belongs to the genus Orthopoxvirus.Since 2022,MPXV has posed a significant threat to global public health.The emergence of thousands of cases across the Western Hemisphere prompted the World Health Organization to declare an emergency.The extensive coevolutionary history of poxviruses with humans has enabled these viruses to develop sophisticated mechanisms to counter the human immune system.Specifically,MPXV employs unique immune evasion strategies against a wide range of immunological elements,presenting a considerable challenge for treatment,especially following the discontinuation of routine smallpox vaccination among the general population.In this review,we start by discussing the entry of the mpox virus and the onset of early infection,followed by an introduction to the mechanisms by which the mpox virus can evade the innate and adaptive immune responses.Two caspase-1 inhibitory proteins and a PKR escape-related protein have been identified as phylogenomic hubs involved in modulating the immune environment during the MPXV infection.With respect to adaptive immunity,mpox viruses exhibit unique and exceptional T-cell inhibition capabilities,thereby comprehensively remodeling the host immune environment.The viral envelope also poses challenges for the neutralizing effects of antibodies and the complement system.The unique immune evasion mechanisms employed by MPXV make novel multi-epitope and nucleic acid-based vaccines highly promising research directions worth investigating.Finally,we briefly discuss the impact of MPXV infection on immunosuppressed patients and the current status of MPXV vaccine development.This review may provide valuable information for the development of new immunological treatments for mpox.
文摘Mpox,formerly known as monkeypox,is a viral zoonotic disease endemic to Central and West Africa that has posed significant public health challenges since its identification in 1970.Despite decades of experience in managing outbreaks,the 2022-2024 Mpox outbreaks exposed substantial gaps in global preparedness and response,leading the World Health Organization(WHO)to declare a Public Health Emergency of International Concern(PHEIC)in 2022.The resurgence of cases in Europe in 2022 and the more recent emergence of the virulent clade Ib in the Democratic Republic of the Congo(DRC)in 2024 have highlighted a critical need for improved proactive and response strategies to curb the epidemic.This narrative review examines the historical and recent epidemiology of Mpox in Africa and explores the factors that have limited effective management.These include objective influences such as viral mutations,zoonotic transmission patterns,and environmental changes like deforestation,as well as subjective factors,including delayed responses,limited vaccine availability,cessation of smallpox vaccinations,and inequitable access to healthcare.In particular,the review emphasizes the ongoing disparities in global health equity,as wealthier nations have been able to secure vaccines and therapeutics quickly,while endemic regions in Africa continue to struggle with limited resources.The review also discusses how socio-economic and cultural factors,combined with weak public health infrastructure and inadequate surveillance systems,perpetuate cycles of outbreak in vulnerable populations.Furthermore,the emergence of clade Ib in 2024,with its higher virulence and mortality rates among children,particularly in rural areas,underscores the urgency of addressing the evolving epidemiological landscape of Mpox.In response to these challenges,this review recommends strengthening healthcare infrastructure,enhancing surveillance systems,ensuring equitable access to vaccines and treatments,and integrating environmental management into public health strategies.Global collaboration remains essential to provide African countries with the resources and support needed to manage and prevent future outbreaks effectively.Without these measures,the world risks a prolonged public health crisis with far-reaching consequences for both Africa and the global community.
文摘The recently re-emerged mpox(monkeypox)virus that causes mpox disease is a member of genus Orthopoxvirus and has unprecedentedly spread worldwide.Numerous studies have contributed to our understanding of its evolution,pathophysiology,and clinical manifestations.The current outbreak of the mpox virus depicts its novel route of transmission as a new variant.However,the exact reason for its transition from an epidemic to a pandemic remains unclear.Furthermore,other poxviruses such as vaccinia virus,variola virus,and cowpox virus,also belong to the same genus,Orthopoxvirus.In the present review,our objective was to summarize the evidence on evolution,pathophysiology,and clinical manifestations of mpox virus and its related poxviruses.The present review would aid in a better understanding of the current circulating mpox virus and its differences from other poxviruses.In addition,the shared genetic factors contributing to virulence in these Orthopoxvirus highlight their evolutionary connections and genetic similarities.While they exhibit differences in virulence,studying these genetic relationships is crucial for understanding their biology,pathogenicity,and the development of effective vaccines and antiviral therapeutics to curb mpox disease.
文摘Mpox disease is caused by a double-stranded DNA virus, genus Orthopoxvirus of the family Poxviridae. The incubation period is usually 6 to 13 days but can range from 5 to 21 days while symptoms and signs may persist for 2 to 5 weeks. Although, the clinical features are usually less severe when compared to the deadly smallpox, the disease can be fatal with case fatality rate between 1% and 10%. In Imo State, Nigeria, there has been a changing epidemiology of the disease in the last 6 years and the frequency and geographic distribution of cases have progressively increased. This study aims to conduct a review of the disease epidemiology between 2017 and 2023 and implications for surveillance in Imo State. Surveillance data from the Surveillance Outbreak Response and Management System (SORMAS) was extracted between January 2017 and December 2023 across the 27 Local Government Areas (LGAs) of Imo State. A line list of 231 suspected cases was downloaded into an excel template and analyzed using SPSS<sup>®</sup> version 20 software. Analysis was done using descriptive statistics and associations were tested using Fischer’s exact at 0.05 level of significance. Of the 231 suspected cases, 57.1% (132) were males, 42.9% (99) were females and the modal age group was between the ages of 0 - 4 (32.5%). Eight (8) LGAs (districts) accounted for 71% (n = 164) of all the suspected cases. 21.2% (49) were confirmed positive, 27 males (55.1%) and 22 females (44.9%) (p > 0.05). Modal age group was 20 - 24 (22.4%, n = 11), 18% (9) were children under 14 years, p > 0.05. Case fatality rate was 8% (n = 4). There was no significant association between mortality and age group. Five (5) LGAs accounted for about 60% (29) of all confirmed cases. These LGAs contribute only 20% to the total population in the State. Only 5.6% and 4% of suspected and confirmed cases, respectively, had knowledge of contact with an infectious source. The study described the epidemiology of Mpox outbreaks between 2017 and 2023 and the findings have significant implications on detection and outbreak response activities.
文摘As the global community continues to recover from the COVID-19 pandemic,the World Health Organization has issued a warning of another viral infection,mpox(monkeypox),that can pose a significant threat to public health.Mpox was once endemic in Africa but has spread globally,prompting the World Health Organization to declare it a public health emergency.In response,healthcare personnel must initiate timely,decisive,and robust action before the infection escalates.Moreover,accurate diagnosis is crucial,given the similarity between mpox and other rash-causing infections.This article provides a comprehensive overview of the symptoms,differentiating it from similar diseases,risk assessment,and treatment strategies.In addition,it aims to educate healthcare personnel with the necessary knowledge to educate others and take preventative measures when handling cases,thereby avoiding the spread of infection.
文摘Objective:To identify the knowledge and awareness level of human mpox viral infection among healthcare workers in southwestern Nigeria.Methods:A cross-sectional study was conducted in Ekiti State,southwest Nigeria among 316 healthcare workers that were selected through a systematic random sampling.Data were collected with the aid of a semi-structured,self-administered questionnaire.The Chi-square test and binary logistic regression were used to find the association between the independent and dependent variables.The significance level was set at P-value<0.05.Results:Two hundred and twenty-two(70.3%)of the respondents were aged≤40 years,mean age(36±9)years,189(59.8%)were female,306(96.8%)were Christians,and 203(64.2%)were married.Three hundred and fourteen(99.4%)of the respondents were aware of mpox infection.Main sources of information about mpox were medical education(44.0%),radio/television(32.0%)and newspaper(21.0%).However,among those aware of the disease,209(67.0%)demonstrated poor knowledge levels.Longer than 5 years’experience of medical practice was the only significant predictor of higher knowledge level of the disease(OR 1.76,95%CI 1.01-3.06;P=0.046).Conclusions:Despite the high awareness level of mpox infection among healthcare workers,there still exists a huge knowledge gap.It is recommended that targeted intervention could be directed towards continuous medical education and simulation exercises on re-emerging infectious diseases like mpox to improve the knowledge of the healthcare workers.
基金National Key Research and Development Program of China(2024YFC2309501).
文摘Objective:This study aimed to analyze the epidemiological characteristics and clinical symptoms of mpox cases with and without human immunodeficiency virus(HIV)reported in China in 2023,providing evidence for coordinated prevention and control strategies for both infections.Method:All confirmed mpox cases reported in 2023 were extracted from China’s Information System for Disease Control and Prevention.Data were collected from the surveillance system and epidemiological investigations.Statistical analyses were performed using SPSS 24.0,with group comparisons conducted using t-tests and chi-square tests.Results:Among 1,712 confirmed mpox cases in China during 2023,802(46.8%)were people with human immunodeficiency virus(PWH).Of the 1,702 male cases,97.3%of PWH and 91.1%of those without HIV self-identified as men who have sex with men(MSM).Age distribution showed 79.4%of PWH and 87.6%of those without HIV were under 40 years old,while 64.2%of PWH and 71.3%of those without HIV were reported from eastern regions.Cardinal symptoms at diagnosis occurred at similar rates between those with and without HIV,including rash(90.9%vs.93.4%),fever(52.5%vs.53.8%),and lymphadenopathy(23.8%vs.25.4%).Among coinfected cases,individuals diagnosed with HIV after mpox or within one year before mpox demonstrated higher rates of immunodeficiency and lower rates of HIV viral suppression.Conclusion:Male mpox cases with HIV was more likely to be MSM,older,and reported from central and western regions compared to those without HIV.No significant differences were observed in cardinal symptom occurrence between groups.These findings emphasize the importance of implementing integrated prevention strategies targeting both HIV and mpox,particularly among key populations.
基金Supported by Research on Genetic Evolution Characteristics and Key Techniques for Tracing of Highly Pathogenic Viruses(2023YFC2605602)the key research project of Three-Year Initiative Plan for Strengthening Public Health System Construction in Shanghai(2023-2025)(GWVI-3)+3 种基金Three-Year Initiative Plan for Strengthening Public Health System Construction in Shanghai(2023-2025)Key Discipline Project(GWVI-11.1-12)Key Discipline-Infectious Diseases of Threeyear Action Program of Shanghai Municipality for Strengthening the Construction of Public Health System(2023-2025)(GWVI-11.1-01)the Key Discipline Program on Public Health System Construction of Shanghai(GWVI-11.1-15)Shanghai Municipal Science and Technology Major Project(ZD2021CY001).
文摘In recent years,mpox virus Clade Ib has emerged as a significant global public health threat due to its rapid transmission and potential for severe disease outcomes.This strain was first identified in the Democratic Republic of the Congo(DRC)in September 2023 and began spreading to neighboring African countries by July 2024.It was subsequently imported through international travel to 12 non-African countries across Asia,Europe,and the Americas.Clade Ib exhibits increased transmissibility,and current data suggest that infections may lead to more severe symptoms,with higher risks of severe illness and mortality,particularly among vulnerable populations such as children,pregnant individuals,and immunocompromised groups(e.g.,people living with HIV/AIDS).Epidemiologically,Clade Ib primarily spreads through sexual contact,close household contact,and healthcare-related exposure.This review aims to provide an overview of the current understanding of mpox virus Clade Ib,including its genetic characteristics,epidemiological patterns,and prevention and control strategies.Additionally,it discusses the strategies and interventions needed to address this emerging threat.
基金approved by the Institutional Animal Ethics Committee of Guangzhou Eighth People’s Hospital,Guangzhou Medical University(IACUC-LF-2024-05).
文摘On Aug 14,2024,the World Health Organization(WHO)declared the second public health emergency of international concern(PHEIC)on mpox spread,considering the upsurge of mpox in the Democratic Republic of the Congo and a growing number of countries in Africa[1].Mpox has been mainly confinedwithin Africa since its first isolation in Denmark inmonkeys kept for research in 1958 and the first reported human mpox case of an infant boy in the Democratic Republic of the Congo in 1970[2].The spillover spread outside of Africa to America in 2003 caused approximately 70 infections[3].Fortunately,the endemic caused no deaths but alerted society to the potential threat of mpox.In Jul 2022,WHO once declared the first PHEIC on mpox since quickly reported mpox-infected cases in Europe,America,and Asia.The rapid increase of mpox in 2024 calls for urgent collaborative efforts to address the disease’s evolving epidemiology and transmission dynamics[4],emphasizing the potential threat from mpox and the need for caution and preparedness.
基金supported by the Beijing Natural Science Foundation(7254390)the Youth Science Foundation of the Chinese Center for Disease Control and Prevention(2024A103)the National Key R&D Program of China(2022YFC2303400).
文摘In 2022,a global outbreak of mpox was anticipated,with several cases reported in non-endemic countries in early May.Given the challenge of distinguishing the mpox virus(MPXV)from other pathogens based solely on symptoms,there is an urgent need for prompt and reliable MPXV detection methods.In this study,we developed assays using recombinase-aided amplification(RAA)to identify MPXV and evaluated their applicability with clinical samples.The assays were designed to detect theN4R gene of MPXV.All assays demonstrated detection limits of 1 copy/μL within the reaction system and exhibited no cross-reactivity with ectromelia or the TianTan strain of vaccinia virus,confirming their high specificity.Our established assay provides results in less than 50 min.Furthermore,we evaluated our assay using clinical samples from laboratory-confirmed mpox patients and demonstrated that the RAA-based assay is valuable for diagnosing MPXV infections in field and clinic settings,especially in areas with limited laboratory resources.Overall,three RAA-based nucleic acid assays for MPXV were established,providing a powerful tool for efficient,rapid,and specific detection of MPXV infection.
基金the National Natural Science Foundation of China(Nos.82241068 and 82241072).
文摘Mpox is a zoonotic infectious disease caused by the mpox virus(MPXV).Historically,the majority of mpox cases have been documented in Central Africa.However,since May 2022,there has been a notable rise in reported cases from regions beyond Africa.Currently,over 110 countries spanning Europe,North America,South America,Asia,and other territories have reported mpox infections.This report details a case involving a patient who identifies as a man who has sex with men(MSM)and is concurrently infected with MPXV,human immunodeficiency virus type 1(HIV-1),Pneumocystis jiroveci,as well as extensively drug-resistant tuberculosis(XDR-TB).This patient had also received a vaccination for smallpox in the past.Additionally,we provide photographic documentation charting the progression of dermatological manifestations associated with mpox.This case highlights the significance of sexual intercourse as a crucial mode of transmission for mpox.The rapid and widespread dissemination of the MPXV across various regions,especially among MSM communities,underscores the importance of enhancing preventive education efforts targeted at high-risk populations.
基金This study was supported by grants from Key Program of the National Natural Science Foundation of China(82130093).
文摘Background The 2022-2023 mpox(monkeypox)outbreak has spread rapidly across multiple countries in the non-endemic region,mainly among men who have sex with men(MSM).In this study,we aimed to evaluate mpox's importation risk,border screening effectiveness and the risk of local outbreak in Chinese mainland.Methods We estimated the risk of mpox importation in Chinese mainland from April 14 to September 11,2022 using the number of reported mpox cases during this multi-country outbreak from Global.health and the international air-travel data from Official Aviation Guide.We constructed a probabilistic model to simulate the effectiveness of a border screening scenario during the mpox outbreak and a hypothetical scenario with less stringent quarantine requirement.And we further evaluated the mpox outbreak potential given that undetected mpox infections were introduced into men who have sex with men,considering different transmissibility,population immunity and population activity.Results We found that the reduced international air-travel volume and stringent border entry policy decreased about 94% and 69% mpox importations respectively.Under the quarantine policy,15-19% of imported infections would remain undetected.Once a case of mpox is introduced into active MSM population with almost no population immunity,the risk of triggering local transmission is estimated at 42%,and would rise to>95% with over six cases.Conclusions Our study demonstrates that the reduced international air-travel volume and stringent border entry policy during the COvID-19 pandemic reduced mpox importations prominently.However,the risk could be sub-stantially higher with the recovery of air-travel volume to pre-pandemic level.Mpox could emerge as a public health threat for Chinese mainland given its large MSM community.
基金supported by the NUS Saw Swee Hock School of Public Health's Start Up Fund[22-5118-A0001]the Singapore Ministry of Health’s National Medical Research Council under its National Epidemic Preparedness and Response R&D Funding Initiative(MOH-001041)Programme for Research in Epidemic Preparedness And REsponse(PREPARE).
文摘Introduction:The transmission dynamics of the recent mpox outbreak highlights the lack of infrastructure available to rapidly respond to novel STI outbreaks,of which Asia and Oceania remains particularly susceptible.Here,we simulate outbreaks in this setting and propose the use of pre-emptive vaccination within the men who have sex with men(MSM)community before the arrival and establishment of the virus.Materials and methods Using data driven heterogeneous sexual contact networks,we simulated outbreaks of mpox in Singapore,Hong Kong,and Sydney.An individual based SEIR compartmental model was used to simulate epidemic trajectories and the impact of different vaccination uptakes was assessed in their ability to avert or suppress outbreaks upon the arrival of mpox within the MSM populations.Results:The highly dense sexual networks of Singapore and Sydney experience rapid outbreaks,with infection peaks occurring at day 41 and 23 respectively,compared to Hong Kong which occurs at day 77.Across the simulations with no vaccination,68.2%–89.7%of the MSM community will become infected with mpox across the different cities,over a simulation period of 1 year.By implementing vaccination strategies,the infection rate across the cities can be reduced to as low as 3.1%of the population(range:3.1%–82.2%)depending on the implementation and uptake of the vaccine.Vaccination is also extremely effective in slowing the start of the epidemic,delaying the epidemic peak by 36–50 days in Hong Kong,or even preventing the outbreak of mpox.Discussion:With extremely dense and well-connected sexual contact networks,where 65.2%–83.2%of the population are connected to a super-spreader in the different contact networks,pre-emptive or immediate vaccination upon identification of the first case is strongly recommended to help better manage the outbreak of mpox and prevent potential straining of healthcare systems.
基金This study was supported by grants from the Chinese Academy of Medical Sciences(CAMS)Innovation Fund for Medical Sciences(2021-I2M-1–044).
文摘The ongoing transmission of mpox in specific countries and regions necessitates urgent action.It is essential to implement targeted containment strategies that concentrate on high-risk populations and critical locations,such as college campuses,to effectively curb the spread of mpox.This study is dedicated to evaluating the performance of various vaccination and quarantine strategies in curbing the spread of mpox and estimating the outbreak risk.To accomplish this,we constructed a stochastic,agent-based,discrete-time susceptible-latent-infectious-recovered(SLIR)model,to examine mpox transmission on a simulated college campus.Our findings reveal that relying solely on PEP is insufficient in containing mpox effectively.To bolster the population immunity and protect the vulnerable,pre-exposure vaccination among high-risk populations prior to an outbreak is imperative.Our study demonstrates that a pre-exposure vaccination rate of 50%in high-risk populations can led to a remarkable 74.2%reduction of infections.This translated to a mere 1.0%cumulative infection incidence in the overall population.In cases where the desired vaccination coverage is not attainable,enhancing case detection and isolation measures can serve as an effective emergency response to contain mpox outbreaks.For pre-exposure vaccination coverage of 20%or lower,a 40%isolation ratio is necessary to keep the cumulative number of infections in check.However,when the coverage exceeds 30%,a reduced isolation ratio of 20%becomes sufficient to manage the outbreak effectively.These insights underscore the importance of strategic pre-exposure vaccination in conjunction with robust surveillance and isolation protocols to safeguard public health and prevent the escalation of mpox outbreaks.
