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 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
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
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
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
The monkeypox virus(MPXV)outbreak,declared a Public Health Emergency of International Concern(PHEIC)by the World Health Organization(WHO)in 2022,continues to pose a significant threat due to the absence of vaccines or...The monkeypox virus(MPXV)outbreak,declared a Public Health Emergency of International Concern(PHEIC)by the World Health Organization(WHO)in 2022,continues to pose a significant threat due to the absence of vaccines or drugs for MPXV infection.In this study,we developed an mRNA vaccine that expressing the A29L antigen,a specific protein of the intracellular mature virus.Our vaccine utilizes a thermostable ionizable lipid nanoparticle(iLNP)platform and has been administered to mice.Our find-ings demonstrate that the MPXV A29L mRNA vaccine candidate induces robust cross-neutralizing immune responses against both vaccinia virus(VACV)and MPXV live virus.Furthermore,immunization with the vaccine candidate provided protection against the VACV challenge in mice.These findings underscore the potential of mRNA-LNP vaccines as safe and effective candidates against monkeypox epidemics.Given the current absence of specific interventions for MPXV infection,our study represents a significant step forward in developing a viable solution to combat this ongoing public health threat.展开更多
The efficient immobilization of capture antibodies is crucial for timely pathogen detection during global pandemic outbreaks.Therefore,we proposed a silica-binding protein featuring core functional domains(cSP).It com...The efficient immobilization of capture antibodies is crucial for timely pathogen detection during global pandemic outbreaks.Therefore,we proposed a silica-binding protein featuring core functional domains(cSP).It comprises a peptide with a silica-binding tag designed to adhere to silica surfaces and tandem protein G fragments(2C2)for effective antibody capture.This innovation facilitates precise site-directed immobilization of antibodies onto silica surfaces.We applied cSP to silica-coated optical fibers,creating a fiber-optic biolayer interferometer(FO-BLI)biosensor capable of monitoring the monkeypox virus(MPXV)protein A29L in spiked clinical samples to rapidly detect the MPXV.The cSP-based FO-BLI biosensor for MPXV demonstrated a limit of detection(LOD)of 0.62 ng/mL in buffer,comparable to the 0.52 ng/mL LOD achieved using a conventional streptavidin(SA)-based FO-BLI biosensor.Furthermore,it achieved LODs of 0.77 ng/mL in spiked serum and 0.80 ng/mL in spiked saliva,exhibiting no cross-reactivity with other viral antigens.The MPXV detection process was completed within 14 min.We further proposed a cSP-based multi-virus biosensor strategy capable of detecting various pandemic strains,such as MPXV,the latest coronavirus disease(COVID)variants,and influenza A protein,to extend its versatility.The proposed cSP-modified FO-BLI biosensor has a high potential for rapidly and accurately detecting MPXV antigens,making valuable contributions to epidemiological studies.展开更多
Background:In the 2022-2023 global outbreak,the United States and state of Texas recorded a total of 31,277 and 3,085 confirmed monkeypox(Mpox)cases respectively as of November 2023.This study aims to investigate the ...Background:In the 2022-2023 global outbreak,the United States and state of Texas recorded a total of 31,277 and 3,085 confirmed monkeypox(Mpox)cases respectively as of November 2023.This study aims to investigate the demographic characteristics and risk factors of Mpox outbreak in Houston and document the epidemiologic control measures implemented with their outcomes.Methods:Houston Health Department received reports of suspected Mpox cases via electronic case reports and laboratory reports from healthcare providers within Houston.These were then investigated and reclassified as either positive or negative using DNA polymerase chain reaction tests.All the reported cases received between May 2022 and January 2023 were included in this study using convenient sampling methods.Descriptive statistics using frequency distribution was used to analyze the sociodemographic,clinical features and travel history of the cases.A two-sided Chi-squared test was used to determine association between Mpox test results and risk factors with significant level set at P<0.05.Other infection control measures such as community engagement,health education,tracking and contact tracing,vaccination,referrals and laboratory sample logistics support were implemented by the health department.Results:Out of the total of 1,625 suspected persons investigated for Mpox,724(44.6%)tested positive.Among the 724 confirmed cases,male was 700(96.7%),females 20(2.8%),transgender male 1(0.1%),transgender female 3(0.4%).Age groups 30-39 years constituted 43.6%,18-29 years 27.4%,40-49 years 18.2%,50-59 years was 8%.Race distribution of positive cases was Whites 43.4%,African American 38.7%,Asian 1.4%.Risk factors with P<0.05 included male gender,age groups 30-39 years and 40-49 years,travel history to Mpox endemic areas,recent sexual contact with known or suspected Mpox cases,human immunodeficiency virus seropositivity.Identifying as gay and bisexual were also statistically significant risk factors for Mpox infection.Conclusion:The timely implementation of primary and secondary prevention measures targeted at the most at-risk populations was very effective at curtailing the spread of Mpox infection within the city of Houston.展开更多
The Centers for Disease Control and Prevention(CDC)is monitoring an epidemic of monkeypox infection in the United States.The outbreak is now global and more than 6900 cases have already been reported.There are 83 conf...The Centers for Disease Control and Prevention(CDC)is monitoring an epidemic of monkeypox infection in the United States.The outbreak is now global and more than 6900 cases have already been reported.There are 83 confirmed cases among children and adolescents,as shown in the report published on November 3,2022,in the USA.However,monkeypox in pediatric patients is still infrequent(<0.3%of total cases).Among cases in the United States,16 cases were in children<5 years,12 in the age group 5-12 years,and 55 cases in adolescents 13-17 years old.In the adolescent age group,89%were male.For children<12 years of age,close physical contact with an adult household with monkeypox was the primary exposure,but for adolescents,male-to-male sexual contact was found more frequently.The CDC advised United States healthcare providers to remain vigilant for patients with a rash resembling monkeypox,even if there is no history of travel to a country with high risk.This article summarizes the history and epidemiology of monkeypox with a specific emphasis on clinical features and management in pediatric patients.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 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
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
Infectious diseases have posed a global threat recently, progressing from endemic to pandemic. Early detection and finding a better cure are methods for curbing the disease and its transmission. Machine learning (ML) ...Infectious diseases have posed a global threat recently, progressing from endemic to pandemic. Early detection and finding a better cure are methods for curbing the disease and its transmission. Machine learning (ML) has demonstrated to be an ideal approach for early disease diagnosis. This review highlights the use of ML algorithms for monkeypox (MP). Various models, such as CNN, DL, NLP, Naïve Bayes, GRA-TLA, HMD, ARIMA, SEL, Regression analysis, and Twitter posts were built to extract useful information from the dataset. These findings show that detection, classification, forecasting, and sentiment analysis are primarily analyzed. Furthermore, this review will assist researchers in understanding the latest implementations of ML in MP and further progress in the field to discover potent therapeutics.展开更多
Dear Editor,Monkeypox is a zoonosis caused by monkeypox virus (MPXV)infection first reported in Central and West Africa[1]. The first outbreak of monkeypox outside of Africa was reported in2003[2].Afterthat,Israel,the...Dear Editor,Monkeypox is a zoonosis caused by monkeypox virus (MPXV)infection first reported in Central and West Africa[1]. The first outbreak of monkeypox outside of Africa was reported in2003[2].Afterthat,Israel,theUnitedKingdom(UK),Singapore, and other countries have reported monkeypox cases among travelers back from Nigeria since 2018[3].展开更多
Dear Editor,Monkeypox is an infectious disease that is endemic in a dozen of African countries.Some imported cases have been also reported outside of Africa in the past[1].Since early May 2022,monkeypox infections inc...Dear Editor,Monkeypox is an infectious disease that is endemic in a dozen of African countries.Some imported cases have been also reported outside of Africa in the past[1].Since early May 2022,monkeypox infections including human-to-human transmission,were reported in a multi-country outbreak in non-endemic countries and declared Public Health Emergency of International Concern(PHEIC)by the World Health Organization(WHO)in July 2022[2].As of 20 September 2022,a total of at least 62,798 human cases of monkeypox with 20 deaths have been confirmed in 115 countries in five WHO regions[3].展开更多
Objective:To evaluate the awareness,knowledge,and attitude on monkeypox viral infection among preclinical and clinical dental students in Malaysia.Methods:A cross-sectional study was conducted among 229 preclinical an...Objective:To evaluate the awareness,knowledge,and attitude on monkeypox viral infection among preclinical and clinical dental students in Malaysia.Methods:A cross-sectional study was conducted among 229 preclinical and clinical dental students via an online self-reported questionnaire.The questionnaire included 3 items on awareness,15 items on knowledge,9 items on attitude and 2 open-ended questions.Data were presented as frequencies and percentages.Chi-square test was used to compare knowledge and awareness scores between preclinical and clinical dental students and content analysis was performed for open-ended responses.Results:Preclinical and clinical dental students were aware of the existence of monkeypox(89.5%and 94.4%,respectively),that the disease emerged in non-endemic countries(81.0%and 87.1%,respectively)and that it was declared a public health emergency of international concern by the World Health Organization(73.3%and 79.0%,respectively).Clinical dental students’overall knowledge level was significantly higher than preclinical dental students(P=0.014).Both preclinical(95.2%)and clinical(96.8%)dental students demonstrated positive attitudes toward monkeypox with no significant difference(P=0.736)noted between them.Three themes emerged from the open-ended questions:(1)reimplementation of nationwide lockdown,(2)impact on the economy and health,and(3)disruption to the educational system.Students also anticipated their face-to-face learning to be reduced should there be a new outbreak.Conclusions:Both preclinical and clinical dental students showed comparable awareness and attitudes,while the latter demonstrated greater satisfactory knowledge toward the re-emergence of monkeypox during the COVID-19 pandemic.Nonetheless,efforts to improve dental students’understanding of this alarming outbreak are required,to safeguard their health and minimise transmission.展开更多
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 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.
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.
基金supported by National Key Research&Development Program of China(Nos.2021YFA1201000,2021YFC2302400)Beijing Institute of Technology Research Fund Program for Young Scholars(No.XSQD-6120220072)+1 种基金National Natural Science Foundation of China(No.82371846)China Postdoctoral Science Foundation(No.2022M720438).
文摘The monkeypox virus(MPXV)outbreak,declared a Public Health Emergency of International Concern(PHEIC)by the World Health Organization(WHO)in 2022,continues to pose a significant threat due to the absence of vaccines or drugs for MPXV infection.In this study,we developed an mRNA vaccine that expressing the A29L antigen,a specific protein of the intracellular mature virus.Our vaccine utilizes a thermostable ionizable lipid nanoparticle(iLNP)platform and has been administered to mice.Our find-ings demonstrate that the MPXV A29L mRNA vaccine candidate induces robust cross-neutralizing immune responses against both vaccinia virus(VACV)and MPXV live virus.Furthermore,immunization with the vaccine candidate provided protection against the VACV challenge in mice.These findings underscore the potential of mRNA-LNP vaccines as safe and effective candidates against monkeypox epidemics.Given the current absence of specific interventions for MPXV infection,our study represents a significant step forward in developing a viable solution to combat this ongoing public health threat.
基金This research was supported by Westlake University,China(Startup funds)the Research Center for Industries of the Future of Westlake University,China(Grant No.:WU2022C040)the National Natural Science Foundation of China(Grant No.:82104122).
文摘The efficient immobilization of capture antibodies is crucial for timely pathogen detection during global pandemic outbreaks.Therefore,we proposed a silica-binding protein featuring core functional domains(cSP).It comprises a peptide with a silica-binding tag designed to adhere to silica surfaces and tandem protein G fragments(2C2)for effective antibody capture.This innovation facilitates precise site-directed immobilization of antibodies onto silica surfaces.We applied cSP to silica-coated optical fibers,creating a fiber-optic biolayer interferometer(FO-BLI)biosensor capable of monitoring the monkeypox virus(MPXV)protein A29L in spiked clinical samples to rapidly detect the MPXV.The cSP-based FO-BLI biosensor for MPXV demonstrated a limit of detection(LOD)of 0.62 ng/mL in buffer,comparable to the 0.52 ng/mL LOD achieved using a conventional streptavidin(SA)-based FO-BLI biosensor.Furthermore,it achieved LODs of 0.77 ng/mL in spiked serum and 0.80 ng/mL in spiked saliva,exhibiting no cross-reactivity with other viral antigens.The MPXV detection process was completed within 14 min.We further proposed a cSP-based multi-virus biosensor strategy capable of detecting various pandemic strains,such as MPXV,the latest coronavirus disease(COVID)variants,and influenza A protein,to extend its versatility.The proposed cSP-modified FO-BLI biosensor has a high potential for rapidly and accurately detecting MPXV antigens,making valuable contributions to epidemiological studies.
基金supported by U.S.Centers for Disease Control and Prevention Public Health Crisis Response Funding titled CDC-RFA-TP22-2201:Public Health Crisis Response Cooperative Agreement.
文摘Background:In the 2022-2023 global outbreak,the United States and state of Texas recorded a total of 31,277 and 3,085 confirmed monkeypox(Mpox)cases respectively as of November 2023.This study aims to investigate the demographic characteristics and risk factors of Mpox outbreak in Houston and document the epidemiologic control measures implemented with their outcomes.Methods:Houston Health Department received reports of suspected Mpox cases via electronic case reports and laboratory reports from healthcare providers within Houston.These were then investigated and reclassified as either positive or negative using DNA polymerase chain reaction tests.All the reported cases received between May 2022 and January 2023 were included in this study using convenient sampling methods.Descriptive statistics using frequency distribution was used to analyze the sociodemographic,clinical features and travel history of the cases.A two-sided Chi-squared test was used to determine association between Mpox test results and risk factors with significant level set at P<0.05.Other infection control measures such as community engagement,health education,tracking and contact tracing,vaccination,referrals and laboratory sample logistics support were implemented by the health department.Results:Out of the total of 1,625 suspected persons investigated for Mpox,724(44.6%)tested positive.Among the 724 confirmed cases,male was 700(96.7%),females 20(2.8%),transgender male 1(0.1%),transgender female 3(0.4%).Age groups 30-39 years constituted 43.6%,18-29 years 27.4%,40-49 years 18.2%,50-59 years was 8%.Race distribution of positive cases was Whites 43.4%,African American 38.7%,Asian 1.4%.Risk factors with P<0.05 included male gender,age groups 30-39 years and 40-49 years,travel history to Mpox endemic areas,recent sexual contact with known or suspected Mpox cases,human immunodeficiency virus seropositivity.Identifying as gay and bisexual were also statistically significant risk factors for Mpox infection.Conclusion:The timely implementation of primary and secondary prevention measures targeted at the most at-risk populations was very effective at curtailing the spread of Mpox infection within the city of Houston.
文摘The Centers for Disease Control and Prevention(CDC)is monitoring an epidemic of monkeypox infection in the United States.The outbreak is now global and more than 6900 cases have already been reported.There are 83 confirmed cases among children and adolescents,as shown in the report published on November 3,2022,in the USA.However,monkeypox in pediatric patients is still infrequent(<0.3%of total cases).Among cases in the United States,16 cases were in children<5 years,12 in the age group 5-12 years,and 55 cases in adolescents 13-17 years old.In the adolescent age group,89%were male.For children<12 years of age,close physical contact with an adult household with monkeypox was the primary exposure,but for adolescents,male-to-male sexual contact was found more frequently.The CDC advised United States healthcare providers to remain vigilant for patients with a rash resembling monkeypox,even if there is no history of travel to a country with high risk.This article summarizes the history and epidemiology of monkeypox with a specific emphasis on clinical features and management in pediatric patients.
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.
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.
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.
文摘Infectious diseases have posed a global threat recently, progressing from endemic to pandemic. Early detection and finding a better cure are methods for curbing the disease and its transmission. Machine learning (ML) has demonstrated to be an ideal approach for early disease diagnosis. This review highlights the use of ML algorithms for monkeypox (MP). Various models, such as CNN, DL, NLP, Naïve Bayes, GRA-TLA, HMD, ARIMA, SEL, Regression analysis, and Twitter posts were built to extract useful information from the dataset. These findings show that detection, classification, forecasting, and sentiment analysis are primarily analyzed. Furthermore, this review will assist researchers in understanding the latest implementations of ML in MP and further progress in the field to discover potent therapeutics.
文摘Dear Editor,Monkeypox is a zoonosis caused by monkeypox virus (MPXV)infection first reported in Central and West Africa[1]. The first outbreak of monkeypox outside of Africa was reported in2003[2].Afterthat,Israel,theUnitedKingdom(UK),Singapore, and other countries have reported monkeypox cases among travelers back from Nigeria since 2018[3].
基金supported by the Benin Ministry of Health and the Institut Pasteur de Dakar Internal Funds for Research.·。
文摘Dear Editor,Monkeypox is an infectious disease that is endemic in a dozen of African countries.Some imported cases have been also reported outside of Africa in the past[1].Since early May 2022,monkeypox infections including human-to-human transmission,were reported in a multi-country outbreak in non-endemic countries and declared Public Health Emergency of International Concern(PHEIC)by the World Health Organization(WHO)in July 2022[2].As of 20 September 2022,a total of at least 62,798 human cases of monkeypox with 20 deaths have been confirmed in 115 countries in five WHO regions[3].
文摘Objective:To evaluate the awareness,knowledge,and attitude on monkeypox viral infection among preclinical and clinical dental students in Malaysia.Methods:A cross-sectional study was conducted among 229 preclinical and clinical dental students via an online self-reported questionnaire.The questionnaire included 3 items on awareness,15 items on knowledge,9 items on attitude and 2 open-ended questions.Data were presented as frequencies and percentages.Chi-square test was used to compare knowledge and awareness scores between preclinical and clinical dental students and content analysis was performed for open-ended responses.Results:Preclinical and clinical dental students were aware of the existence of monkeypox(89.5%and 94.4%,respectively),that the disease emerged in non-endemic countries(81.0%and 87.1%,respectively)and that it was declared a public health emergency of international concern by the World Health Organization(73.3%and 79.0%,respectively).Clinical dental students’overall knowledge level was significantly higher than preclinical dental students(P=0.014).Both preclinical(95.2%)and clinical(96.8%)dental students demonstrated positive attitudes toward monkeypox with no significant difference(P=0.736)noted between them.Three themes emerged from the open-ended questions:(1)reimplementation of nationwide lockdown,(2)impact on the economy and health,and(3)disruption to the educational system.Students also anticipated their face-to-face learning to be reduced should there be a new outbreak.Conclusions:Both preclinical and clinical dental students showed comparable awareness and attitudes,while the latter demonstrated greater satisfactory knowledge toward the re-emergence of monkeypox during the COVID-19 pandemic.Nonetheless,efforts to improve dental students’understanding of this alarming outbreak are required,to safeguard their health and minimise transmission.