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
BACKGROUND Monkeypox(Mpox),is a disease of global public health concern,as it does not affect only countries in western and central Africa.AIM To assess Burundi healthcare workers(HCWs)s’level of knowledge and confid...BACKGROUND Monkeypox(Mpox),is a disease of global public health concern,as it does not affect only countries in western and central Africa.AIM To assess Burundi healthcare workers(HCWs)s’level of knowledge and confidence in the diagnosis and management of Mpox.METHODS We conducted a cross-sectional study via an online survey designed mainly from the World Health Organization course distributed among Burundi HCWs from June-July 2023.The questionnaire comprises 8 socioprofessional-related questions,22 questions about Mpox disease knowledge,and 3 questions to assess confidence in Mpox diagnosis and management.The data were analyzed via SPSS software version 25.0.A P value<0.05 was considered to indicate statistical significance.RESULTS The study sample comprised 471 HCWs who were mainly medical doctors(63.9%)and nurses(30.1%).None of the 22 questions concerning Mpox knowledge had at least 50%correct responses.A very low number of HCWs(17.4%)knew that Mpox has a vaccine.The confidence level to diagnose(21.20%),treat(18.00%)or prevent(23.30%)Mpox was low among HCWs.The confidence level in the diagnosis of Mpox was associated with the HCWs’age(P value=0.009),sex(P value<0.001),work experience(P value=0.002),and residence(P value<0.001).The confidence level to treat Mpox was significantly associated with the HCWs’age(P value=0.050),sex(P value<0.001),education(P value=0.033)and occupation(P value=0.005).The confidence level to prevent Mpox was associated with the HCWs’education(P value<0.001),work experience(P value=0.002),residence(P value<0.001)and type of work institution(P value=0.003).CONCLUSION This study revealed that HCWs have the lowest level of knowledge regarding Mpox and a lack of confidence in the ability to diagnose,treat or prevent it.There is an urgent need to organize continuing medical education programs on Mpox epidemiology and preparedness for Burundi HCWs.We encourage future researchers to assess potential hesitancy toward Mpox vaccination and its associated factors.展开更多
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
Monkeypox(Mpox),a zoonotic infection caused by the Mpox virus,has reemerged as a global public health concern,with unique implications for neonatal health.Although rare in newborns,cases of neonatal Mpox pose signific...Monkeypox(Mpox),a zoonotic infection caused by the Mpox virus,has reemerged as a global public health concern,with unique implications for neonatal health.Although rare in newborns,cases of neonatal Mpox pose significant diagnostic and therapeutic challenges due to limited clinical data and the vulnerability of this population.This narrative review explores the pathophysiology,clinical presentation,diagnostic barriers,and therapeutic strategies associated with Mpox in neonates.Vertical and perinatal transmission have been identified,with some cases presenting with vesicular rashes,fever,lymphadenopathy,and systemic involvement such as respiratory or neurological complications.Diagnosis often relies on polymerase chain reaction testing,yet resource limitations and symptom overlap with other neonatal infections can hinder accurate identification.Antiviral treatments like tecovirimat and cidofovir are considered in severe cases,but dosing in neonates remains uncertain due to a lack of robust safety data.Supportive care,including hydration,fever management,and prevention of secondary infections,is critical.Breastfeeding decisions require individualized assessment due to the unknown risk of viral transmission through breast milk.Preventive strategies emphasize early isolation,surveillance,and infection control measures in neonatal care settings.The review highlights significant research gaps in understanding neonatal Mpox,especially concerning long-term outcomes and optimal treatment protocols.A coordinated global effort is essential to improve diagnostics,develop safe therapeutic options,and establish evidence-based guidelines tailored to neonates.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
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
Rapid and precise diagnostic tools for Monkeypox(Mpox)lesions are crucial for effective treatment because their symptoms are similar to those of other pox-related illnesses,like smallpox and chickenpox.The morphologic...Rapid and precise diagnostic tools for Monkeypox(Mpox)lesions are crucial for effective treatment because their symptoms are similar to those of other pox-related illnesses,like smallpox and chickenpox.The morphological similarities between smallpox,chickenpox,and monkeypox,particularly in how they appear as rashes and skin lesions,which can sometimes make diagnosis challenging.Chickenpox lesions appear in many simultaneous phases and are more diffuse,often beginning on the trunk.In contrast,monkeypox lesions emerge progressively and are typically centralized on the face,palms,and soles.To provide accessible diagnostics,this study introduces a novel method for automated monkeypox lesion classification using the HMTNet(Hybrid Mobile Transformer Network).The convolutional layers and Vision Transformers(ViT)are combined to enhance the spatial features.In addition,we replace the classical MHSA(Multi-head self-attention)with the WMHSA(Window-based Multi-Head Self-Attention)to effectively capture long-range dependencies within image patches and depth-wise separable convolutions for local feature extraction.We trained and validated HMTNet on the two datasets for binary and multiclass classification.The model achieved 98.38% accuracy for multiclass classification using cross-validation and 99.25% accuracy for binary classification.These findings show that the model has the potential to be a useful diagnostic tool for monkeypox,especially in environments with limited resources.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
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
The Department of Economic and Social Affairs of the United Nations has released seventeen goals for sustainable development and SDG No.3 is“Good Health and Well-being”,which mainly emphasizes the strategies to be a...The Department of Economic and Social Affairs of the United Nations has released seventeen goals for sustainable development and SDG No.3 is“Good Health and Well-being”,which mainly emphasizes the strategies to be adopted for maintaining a healthy life.The Monkeypox Virus disease was first reported in 1970.Since then,various health initiatives have been taken,including by the WHO.In the present work,we attempt a fractional model of Monkeypox virus disease,which we feel is crucial for a better understanding of this disease.We use the recently introduced ABC fractional derivative to closely examine the Monkeypox virus disease model.The evaluation of this model determines the existence of two equilibrium states.These two stable points exist within the model and include a disease-free equilibrium and endemic equilibrium.The disease-free equilibrium has undergone proof to demonstrate its stability properties.The system remains stable locally and globally whenever the effective reproduction number remains below one.The effective reproduction number becoming greater than unity makes the endemic equilibrium more stable both globally and locally than unity.To comprehensively study the model’s solutions,we employ the Picard-Lindelof approach to investigate their existence and uniqueness.We investigate the Ulam-Hyers and UlamHyers Rassias stability of the fractional order nonlinear framework for the Monkeypox virus disease model.Furthermore,the approximate solutions of the ABC fractional order Monkeypox virus disease model are obtained with the help of a numerical technique combining the Lagrange polynomial interpolation and fundamental theorem of fractional calculus with the ABC fractional derivative.展开更多
Human monkeypox(MPX)is a rare zoonotic infection characterized by smallpox-like signs and symptoms.It is caused by monkeypox virus(MPXV),a double stranded DNA virus belonging to the genus Orthopoxvirus.MPX was first i...Human monkeypox(MPX)is a rare zoonotic infection characterized by smallpox-like signs and symptoms.It is caused by monkeypox virus(MPXV),a double stranded DNA virus belonging to the genus Orthopoxvirus.MPX was first identified in 1970 and mostly prevailed in the rural rainforests of Central and West Africa in the past.Outside Africa,MPX was reported in the United Kingdom,the USA,Israel,and Singapore.In 2022,the resurgence of MPX in Europe and elsewhere posed a potential threat to humans.MPXV was transmitted by the animals-human or human-human pathway,and the symptoms of MPXV infection are similar to that of smallpox,but in a milder form and with lower mortality(1%–10%).Although the smallpox vaccination has been shown to provide 85%protection against MPXV infection,and two anti-smallpox virus drugs have been approved to treat MPXV,there are still no specific vaccines and drugs against MPXV infection.Therefore it is urgent to take active measures including the adoption of novel anti-MPXV strategies to control the spread of MPXV and prevent MPX epidemic.In this review,we summarize the biological features,epidemiology,pathogenicity,laboratory diagnosis,and prevention and treatment strategies on MPXV.This review provides the basic knowledge for prevention and control of future outbreaks of this emerging infection.展开更多
Presently, an ongoing outbreak of the monkeypox virus infection that began in Bayelsa State of Nigeria has now spread to other parts of the country including mostly States in the South-South with the Nigerian Ministry...Presently, an ongoing outbreak of the monkeypox virus infection that began in Bayelsa State of Nigeria has now spread to other parts of the country including mostly States in the South-South with the Nigerian Ministry of Health confirming 4 samples out of the 43 sent for testing at WHO Regional Laboratory in Dakar, Senegal. This reminds us that apart from the eradicated smallpox, there are other poxviruses that pose potential threat to people in West and Central Africa. In this paper, we developed a mathematical model for the dynamics of the transmission of monkeypox virus infection with control strategies of combined vaccine and treatment interventions. Using standard approaches, we established two equilibria for the model namely: disease-free and endemic. The disease-free equilibrium was proved to be both locally and globally asymptotically stable if R0 < 1 using the next-generation matrix and the comparison theorem. While the endemic equilibrium point existed only when R0 > 1, was proved to be locally asymptotically stable if R0 > 1 using the linearization plus row-reduction method. The basic reproduction numbers for the humans and the non-human primates of the model are computed using parameter values to be R0,h = 9.1304 x 10-6 and R0,n = 3.375 x 10-3 respectively. Numerical simulations carried out on the model revealed that the infectious individuals in the human and non-human primates’ populations will die out in the course of the proposed interventions in this paper during the time of the study. Sensitivity analysis carried out on the model parameters shows that the basic reproduction numbers of the model which served as a threshold for measuring new infections in the host populations decrease with increase in the control parameters of vaccination and treatment.展开更多
Objective To analyze the 2022 multiple-country monkeypox outbreak and assess its importation risk into China.Methods Data was from United States Centers for Disease Control and Prevention.We described the global epide...Objective To analyze the 2022 multiple-country monkeypox outbreak and assess its importation risk into China.Methods Data was from United States Centers for Disease Control and Prevention.We described the global epidemic and calculated concentration index to measure economic-related inequality.Importation risk into China was evaluated and ranked by using risk matrix method and Borda count method,respectively.Results As of July 29,2022,of 79 countries or territories,39(49.37%,39/79),17(21.52%,17/79),6(7.59%,6/79),12(15.19%,12/79),and 5(6.33%,5/79)country or territories identified cases<10,10-,51-,101-,and>1,000.There were economic-related health disparities exist in the distribution of cases(the concentration index=0.42,P=0.027),and the inequality disadvantageous to the rich(pro-poor).There were 12(15.38%,12/78),15(19.23%,15/78),6(7.69%,6/78),and 45(57.69%,45/78)countries or territories with extremely high,high,moderate,and low importation risk.United States and France ranked first with the highest Borda points of 156,and counts of zero.Conclusion Of 78 countries or territories,the key attention need be paid to the United States and France,relatively.As the epidemic progresses,preparing prevention and control measures to further reduce importation risk was crucial.展开更多
Transformation-associated recombination(TAR)has been widely used to assemble large DNA constructs.One of the significant obstacles hindering assembly efficiency is the presence of error-prone DNA repair pathways in ye...Transformation-associated recombination(TAR)has been widely used to assemble large DNA constructs.One of the significant obstacles hindering assembly efficiency is the presence of error-prone DNA repair pathways in yeast,which results in vector backbone recircularization or illegitimate recombination products.To increase TAR assembly efficiency,we prepared a dual-selective TAR vector,pGFCS,by adding a PADH1-URA3 cassette to a previously described yeast-bacteria shuttle vector,p GF,harboring a PHIS3–HIS3 cassette as a positive selection marker.This new cassette works as a negative selection marker to ensure that yeast harboring a recircularized vector cannot propagate in the presence of 5-fluoroorotic acid.To prevent pGFCS bearing ura3 from recombining with endogenous ura3-52 in the yeast genome,a highly transformable Saccharomyces cerevisiae strain,VL6-48B,was prepared by chromosomal substitution of ura3-52 with a transgene conferring resistance to blasticidin.A55-kb genomic fragment of monkeypox virus encompassing primary detection targets for quantitative PCR was assembled by TAR using pGFCS in VL6-48B.The pGFCS-mediated TAR assembly showed a zero rate of vector recircularization and an average correct assembly yield of 79%indicating that the dual-selection strategy provides an efficient approach to optimizing TAR assembly.展开更多
The monkeypox virus(MPXV)has triggered a current outbreak globally.Genome sequencing of MPXV and rapid tracing of genetic variants will benefit disease diagnosis and control.It is a significant challenge but necessary...The monkeypox virus(MPXV)has triggered a current outbreak globally.Genome sequencing of MPXV and rapid tracing of genetic variants will benefit disease diagnosis and control.It is a significant challenge but necessary to optimize the strategy and application of rapid full-length genome identification and to track variations of MPXV in clinical specimens with low viral loads,as it is one of the DNA viruses with the largest genome and the most AT-biased,and has a significant number of tandem repeats.Here we evaluated the performance of metagenomic and amplicon sequencing techniques,and three sequencing platforms in MPXV genome sequencing based on multiple clinical specimens of five mpox cases in Chinese mainland.We rapidly identified the full-length genome of MPXV with the assembly of accurate tandem repeats in multiple clinical specimens.Amplicon sequencing enables cost-effective and rapid sequencing of clinical specimens to obtain high-quality MPXV genomes.Third-generation sequencing facilitates the assembly of the terminal tandem repeat regions in the monkeypox virus genome and corrects a common misassembly in published sequences.Besides,several intra-host single nucleotide variations were identified in the first imported mpox case.This study offers an evaluation of various strategies aimed at identifying the complete genome of MPXV in clinical specimens.The findings of this study will significantly enhance the surveillance of MPXV.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
Monkeypox(mpox)has been a public health emergency of international concern that emerged in mid-2022 and has spread to 110 countries.The clinical findings of the disease vary according to the seriousness of the cases.A...Monkeypox(mpox)has been a public health emergency of international concern that emerged in mid-2022 and has spread to 110 countries.The clinical findings of the disease vary according to the seriousness of the cases.Although its case fatality risk has not been high,a significant percentage of patients require hospitalization.In this context,local initiatives were taken to extend the limited supply of vaccines against the disease;however,such measures have not been sufficient to contain the spread of cases and ensure an equitable distribution of health resources.As a result,endemic regions of low-income countries continue to have insufficient access to mpox vaccination.Despite this and considering the global scope of the disease,there is still little discussion in the literature about the difficulties in achieving adequate vaccination coverage rates for the target population of interest.In this article,we briefly discussed general aspects of the disease,including its surveillance,the current global context of challenges for mpox vaccination,and issues on global allocation of health resources as well as proposed related recommendations.展开更多
The monkeypox,a viral zoonotic disease usually found in forest areas of Central and Western Africa,has spread worldwide through new modes of transmission little understood.The WHO on 23 July 2022,declared the virus a ...The monkeypox,a viral zoonotic disease usually found in forest areas of Central and Western Africa,has spread worldwide through new modes of transmission little understood.The WHO on 23 July 2022,declared the virus a Public Health Emergency of International Concern(PHEIC).The declaration has stirred criticism from leading scientists that the criteria for PHEIC as defined by International Health Regulation have not been met and it is non-transparent and contradictory.This paper reviews the criteria of PHEIC and weighs the rationales behind the declaration to increase the clarity of the WHO's decision,justifications,and legitimacy in the ongoing outbreak.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
The World Health Organization(WHO) called the recent monkeypox(MPX)outbreak a Public Health Emergency of International Concern on July 23,2022.The United States of America(US) alarmed the recent MPX outbreak as the US...The World Health Organization(WHO) called the recent monkeypox(MPX)outbreak a Public Health Emergency of International Concern on July 23,2022.The United States of America(US) alarmed the recent MPX outbreak as the US public health emergency on August 4,2022.Since early May 2022,more than 35000 MPX cases and 12 deaths had been reported to WHO from 92 countries and territories by August 17,2022,and MPX cases continue rising rapidly with improved surveillance,access to diagnosis,and continuous virus spreading globally.Approximately 99% MPX cases are men,of which 95% cases are men who have sex with man.No evidence of MPX being sexually transmitted infections(STIs) is found;however,a high percentage(25%) of concurrent STIs and frequent anogenital symptoms suggest transmission through local inoculation during close intimate contact or sexual activity.Many approaches including a comprehensive international vaccination strategy and adequate supplies are mandatory to prevent MPX pandemic.Education,vaccination,MPX scrutiny and careful monitoring,and crossborder collaborations with international sectors are practical strategy to contain MPX outbreaks.People are educated to reduce the risk of exposure and to reduce the number of sexual partners especially new ones,to avoid contacting travelers from epidemic regions or animals that may carry MPX virus,and avoid traveling to endemic areas.展开更多
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BACKGROUND Monkeypox(Mpox),is a disease of global public health concern,as it does not affect only countries in western and central Africa.AIM To assess Burundi healthcare workers(HCWs)s’level of knowledge and confidence in the diagnosis and management of Mpox.METHODS We conducted a cross-sectional study via an online survey designed mainly from the World Health Organization course distributed among Burundi HCWs from June-July 2023.The questionnaire comprises 8 socioprofessional-related questions,22 questions about Mpox disease knowledge,and 3 questions to assess confidence in Mpox diagnosis and management.The data were analyzed via SPSS software version 25.0.A P value<0.05 was considered to indicate statistical significance.RESULTS The study sample comprised 471 HCWs who were mainly medical doctors(63.9%)and nurses(30.1%).None of the 22 questions concerning Mpox knowledge had at least 50%correct responses.A very low number of HCWs(17.4%)knew that Mpox has a vaccine.The confidence level to diagnose(21.20%),treat(18.00%)or prevent(23.30%)Mpox was low among HCWs.The confidence level in the diagnosis of Mpox was associated with the HCWs’age(P value=0.009),sex(P value<0.001),work experience(P value=0.002),and residence(P value<0.001).The confidence level to treat Mpox was significantly associated with the HCWs’age(P value=0.050),sex(P value<0.001),education(P value=0.033)and occupation(P value=0.005).The confidence level to prevent Mpox was associated with the HCWs’education(P value<0.001),work experience(P value=0.002),residence(P value<0.001)and type of work institution(P value=0.003).CONCLUSION This study revealed that HCWs have the lowest level of knowledge regarding Mpox and a lack of confidence in the ability to diagnose,treat or prevent it.There is an urgent need to organize continuing medical education programs on Mpox epidemiology and preparedness for Burundi HCWs.We encourage future researchers to assess potential hesitancy toward Mpox vaccination and its associated factors.
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Monkeypox(Mpox),a zoonotic infection caused by the Mpox virus,has reemerged as a global public health concern,with unique implications for neonatal health.Although rare in newborns,cases of neonatal Mpox pose significant diagnostic and therapeutic challenges due to limited clinical data and the vulnerability of this population.This narrative review explores the pathophysiology,clinical presentation,diagnostic barriers,and therapeutic strategies associated with Mpox in neonates.Vertical and perinatal transmission have been identified,with some cases presenting with vesicular rashes,fever,lymphadenopathy,and systemic involvement such as respiratory or neurological complications.Diagnosis often relies on polymerase chain reaction testing,yet resource limitations and symptom overlap with other neonatal infections can hinder accurate identification.Antiviral treatments like tecovirimat and cidofovir are considered in severe cases,but dosing in neonates remains uncertain due to a lack of robust safety data.Supportive care,including hydration,fever management,and prevention of secondary infections,is critical.Breastfeeding decisions require individualized assessment due to the unknown risk of viral transmission through breast milk.Preventive strategies emphasize early isolation,surveillance,and infection control measures in neonatal care settings.The review highlights significant research gaps in understanding neonatal Mpox,especially concerning long-term outcomes and optimal treatment protocols.A coordinated global effort is essential to improve diagnostics,develop safe therapeutic options,and establish evidence-based guidelines tailored to neonates.
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.
基金supported by Princess Nourah bint Abdulrahman University Researchers Supporting Project number(PNURSP2025R432),Princess Nourah bint Abdulrahman University,Riyadh,Saudi Arabia。
文摘Rapid and precise diagnostic tools for Monkeypox(Mpox)lesions are crucial for effective treatment because their symptoms are similar to those of other pox-related illnesses,like smallpox and chickenpox.The morphological similarities between smallpox,chickenpox,and monkeypox,particularly in how they appear as rashes and skin lesions,which can sometimes make diagnosis challenging.Chickenpox lesions appear in many simultaneous phases and are more diffuse,often beginning on the trunk.In contrast,monkeypox lesions emerge progressively and are typically centralized on the face,palms,and soles.To provide accessible diagnostics,this study introduces a novel method for automated monkeypox lesion classification using the HMTNet(Hybrid Mobile Transformer Network).The convolutional layers and Vision Transformers(ViT)are combined to enhance the spatial features.In addition,we replace the classical MHSA(Multi-head self-attention)with the WMHSA(Window-based Multi-Head Self-Attention)to effectively capture long-range dependencies within image patches and depth-wise separable convolutions for local feature extraction.We trained and validated HMTNet on the two datasets for binary and multiclass classification.The model achieved 98.38% accuracy for multiclass classification using cross-validation and 99.25% accuracy for binary classification.These findings show that the model has the potential to be a useful diagnostic tool for monkeypox,especially in environments with limited resources.
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sponsored by Prince Sattam Bin Abulaziz University(PSAU)as part of funding for its SDG Roadmap Research Funding Programme Project Number PSAU-2023-SDG-107.
文摘The Department of Economic and Social Affairs of the United Nations has released seventeen goals for sustainable development and SDG No.3 is“Good Health and Well-being”,which mainly emphasizes the strategies to be adopted for maintaining a healthy life.The Monkeypox Virus disease was first reported in 1970.Since then,various health initiatives have been taken,including by the WHO.In the present work,we attempt a fractional model of Monkeypox virus disease,which we feel is crucial for a better understanding of this disease.We use the recently introduced ABC fractional derivative to closely examine the Monkeypox virus disease model.The evaluation of this model determines the existence of two equilibrium states.These two stable points exist within the model and include a disease-free equilibrium and endemic equilibrium.The disease-free equilibrium has undergone proof to demonstrate its stability properties.The system remains stable locally and globally whenever the effective reproduction number remains below one.The effective reproduction number becoming greater than unity makes the endemic equilibrium more stable both globally and locally than unity.To comprehensively study the model’s solutions,we employ the Picard-Lindelof approach to investigate their existence and uniqueness.We investigate the Ulam-Hyers and UlamHyers Rassias stability of the fractional order nonlinear framework for the Monkeypox virus disease model.Furthermore,the approximate solutions of the ABC fractional order Monkeypox virus disease model are obtained with the help of a numerical technique combining the Lagrange polynomial interpolation and fundamental theorem of fractional calculus with the ABC fractional derivative.
基金the Natural Science Foundation of Hebei Province,China(no.H2020206352)the National Natural Science Foundation of China(no.81902026)+1 种基金Science and Technology Project of Hebei Education Department(no.BJ2020018)Project for the Introduction overseas students of Hebei Provincial Department of Human Resources and Social Security(no.C20200344)。
文摘Human monkeypox(MPX)is a rare zoonotic infection characterized by smallpox-like signs and symptoms.It is caused by monkeypox virus(MPXV),a double stranded DNA virus belonging to the genus Orthopoxvirus.MPX was first identified in 1970 and mostly prevailed in the rural rainforests of Central and West Africa in the past.Outside Africa,MPX was reported in the United Kingdom,the USA,Israel,and Singapore.In 2022,the resurgence of MPX in Europe and elsewhere posed a potential threat to humans.MPXV was transmitted by the animals-human or human-human pathway,and the symptoms of MPXV infection are similar to that of smallpox,but in a milder form and with lower mortality(1%–10%).Although the smallpox vaccination has been shown to provide 85%protection against MPXV infection,and two anti-smallpox virus drugs have been approved to treat MPXV,there are still no specific vaccines and drugs against MPXV infection.Therefore it is urgent to take active measures including the adoption of novel anti-MPXV strategies to control the spread of MPXV and prevent MPX epidemic.In this review,we summarize the biological features,epidemiology,pathogenicity,laboratory diagnosis,and prevention and treatment strategies on MPXV.This review provides the basic knowledge for prevention and control of future outbreaks of this emerging infection.
文摘Presently, an ongoing outbreak of the monkeypox virus infection that began in Bayelsa State of Nigeria has now spread to other parts of the country including mostly States in the South-South with the Nigerian Ministry of Health confirming 4 samples out of the 43 sent for testing at WHO Regional Laboratory in Dakar, Senegal. This reminds us that apart from the eradicated smallpox, there are other poxviruses that pose potential threat to people in West and Central Africa. In this paper, we developed a mathematical model for the dynamics of the transmission of monkeypox virus infection with control strategies of combined vaccine and treatment interventions. Using standard approaches, we established two equilibria for the model namely: disease-free and endemic. The disease-free equilibrium was proved to be both locally and globally asymptotically stable if R0 < 1 using the next-generation matrix and the comparison theorem. While the endemic equilibrium point existed only when R0 > 1, was proved to be locally asymptotically stable if R0 > 1 using the linearization plus row-reduction method. The basic reproduction numbers for the humans and the non-human primates of the model are computed using parameter values to be R0,h = 9.1304 x 10-6 and R0,n = 3.375 x 10-3 respectively. Numerical simulations carried out on the model revealed that the infectious individuals in the human and non-human primates’ populations will die out in the course of the proposed interventions in this paper during the time of the study. Sensitivity analysis carried out on the model parameters shows that the basic reproduction numbers of the model which served as a threshold for measuring new infections in the host populations decrease with increase in the control parameters of vaccination and treatment.
基金partly supported by the National Natural Science Foundation of China[grant numbers 72122001,71934002]the National Key Research and Development Project of China[grant number 2021ZD0114101,2021ZD0114104,2021ZD0114105]+2 种基金National Statistical Science Research Project[grant numbers 2021LY038]the Fundamental Research Funds for the Central Universities supported by Global Center for Infectious Disease and Policy Research&Global Health and Infectious Diseases Group,of Peking University[grant number 202204]National Science and Technology Project on Development Assistance for Technology,Developing China-ASEAN Public Health Research and Development Collaborating Center[grant number KY202101004]
文摘Objective To analyze the 2022 multiple-country monkeypox outbreak and assess its importation risk into China.Methods Data was from United States Centers for Disease Control and Prevention.We described the global epidemic and calculated concentration index to measure economic-related inequality.Importation risk into China was evaluated and ranked by using risk matrix method and Borda count method,respectively.Results As of July 29,2022,of 79 countries or territories,39(49.37%,39/79),17(21.52%,17/79),6(7.59%,6/79),12(15.19%,12/79),and 5(6.33%,5/79)country or territories identified cases<10,10-,51-,101-,and>1,000.There were economic-related health disparities exist in the distribution of cases(the concentration index=0.42,P=0.027),and the inequality disadvantageous to the rich(pro-poor).There were 12(15.38%,12/78),15(19.23%,15/78),6(7.69%,6/78),and 45(57.69%,45/78)countries or territories with extremely high,high,moderate,and low importation risk.United States and France ranked first with the highest Borda points of 156,and counts of zero.Conclusion Of 78 countries or territories,the key attention need be paid to the United States and France,relatively.As the epidemic progresses,preparing prevention and control measures to further reduce importation risk was crucial.
基金supported by the National Science and Technology Major Project of China(2018ZX10711001-006)the Key Research Program of the Chinese Academy of Sciences(KJZD-SW-L06-02)。
文摘Transformation-associated recombination(TAR)has been widely used to assemble large DNA constructs.One of the significant obstacles hindering assembly efficiency is the presence of error-prone DNA repair pathways in yeast,which results in vector backbone recircularization or illegitimate recombination products.To increase TAR assembly efficiency,we prepared a dual-selective TAR vector,pGFCS,by adding a PADH1-URA3 cassette to a previously described yeast-bacteria shuttle vector,p GF,harboring a PHIS3–HIS3 cassette as a positive selection marker.This new cassette works as a negative selection marker to ensure that yeast harboring a recircularized vector cannot propagate in the presence of 5-fluoroorotic acid.To prevent pGFCS bearing ura3 from recombining with endogenous ura3-52 in the yeast genome,a highly transformable Saccharomyces cerevisiae strain,VL6-48B,was prepared by chromosomal substitution of ura3-52 with a transgene conferring resistance to blasticidin.A55-kb genomic fragment of monkeypox virus encompassing primary detection targets for quantitative PCR was assembled by TAR using pGFCS in VL6-48B.The pGFCS-mediated TAR assembly showed a zero rate of vector recircularization and an average correct assembly yield of 79%indicating that the dual-selection strategy provides an efficient approach to optimizing TAR assembly.
基金supported by the National Key Research and Development Program of China(2022YFC2303401,2022YFC2304100,2016YFD0500301,2021YFC0863300)the Beijing Science and Technology Plan(Z211100002521017)the National Natural Science Foundation of China(82241080)。
文摘The monkeypox virus(MPXV)has triggered a current outbreak globally.Genome sequencing of MPXV and rapid tracing of genetic variants will benefit disease diagnosis and control.It is a significant challenge but necessary to optimize the strategy and application of rapid full-length genome identification and to track variations of MPXV in clinical specimens with low viral loads,as it is one of the DNA viruses with the largest genome and the most AT-biased,and has a significant number of tandem repeats.Here we evaluated the performance of metagenomic and amplicon sequencing techniques,and three sequencing platforms in MPXV genome sequencing based on multiple clinical specimens of five mpox cases in Chinese mainland.We rapidly identified the full-length genome of MPXV with the assembly of accurate tandem repeats in multiple clinical specimens.Amplicon sequencing enables cost-effective and rapid sequencing of clinical specimens to obtain high-quality MPXV genomes.Third-generation sequencing facilitates the assembly of the terminal tandem repeat regions in the monkeypox virus genome and corrects a common misassembly in published sequences.Besides,several intra-host single nucleotide variations were identified in the first imported mpox case.This study offers an evaluation of various strategies aimed at identifying the complete genome of MPXV in clinical specimens.The findings of this study will significantly enhance the surveillance of MPXV.
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the Italian Ministry of Health-Ricerca Corrente 2023Saveetha Institute of Medical and Technical Sciences for supporting this study。
文摘Monkeypox(mpox)has been a public health emergency of international concern that emerged in mid-2022 and has spread to 110 countries.The clinical findings of the disease vary according to the seriousness of the cases.Although its case fatality risk has not been high,a significant percentage of patients require hospitalization.In this context,local initiatives were taken to extend the limited supply of vaccines against the disease;however,such measures have not been sufficient to contain the spread of cases and ensure an equitable distribution of health resources.As a result,endemic regions of low-income countries continue to have insufficient access to mpox vaccination.Despite this and considering the global scope of the disease,there is still little discussion in the literature about the difficulties in achieving adequate vaccination coverage rates for the target population of interest.In this article,we briefly discussed general aspects of the disease,including its surveillance,the current global context of challenges for mpox vaccination,and issues on global allocation of health resources as well as proposed related recommendations.
文摘The monkeypox,a viral zoonotic disease usually found in forest areas of Central and Western Africa,has spread worldwide through new modes of transmission little understood.The WHO on 23 July 2022,declared the virus a Public Health Emergency of International Concern(PHEIC).The declaration has stirred criticism from leading scientists that the criteria for PHEIC as defined by International Health Regulation have not been met and it is non-transparent and contradictory.This paper reviews the criteria of PHEIC and weighs the rationales behind the declaration to increase the clarity of the WHO's decision,justifications,and legitimacy in the ongoing outbreak.
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The World Health Organization(WHO) called the recent monkeypox(MPX)outbreak a Public Health Emergency of International Concern on July 23,2022.The United States of America(US) alarmed the recent MPX outbreak as the US public health emergency on August 4,2022.Since early May 2022,more than 35000 MPX cases and 12 deaths had been reported to WHO from 92 countries and territories by August 17,2022,and MPX cases continue rising rapidly with improved surveillance,access to diagnosis,and continuous virus spreading globally.Approximately 99% MPX cases are men,of which 95% cases are men who have sex with man.No evidence of MPX being sexually transmitted infections(STIs) is found;however,a high percentage(25%) of concurrent STIs and frequent anogenital symptoms suggest transmission through local inoculation during close intimate contact or sexual activity.Many approaches including a comprehensive international vaccination strategy and adequate supplies are mandatory to prevent MPX pandemic.Education,vaccination,MPX scrutiny and careful monitoring,and crossborder collaborations with international sectors are practical strategy to contain MPX outbreaks.People are educated to reduce the risk of exposure and to reduce the number of sexual partners especially new ones,to avoid contacting travelers from epidemic regions or animals that may carry MPX virus,and avoid traveling to endemic areas.
