RESUMO
Monkeypox (Mpox) is a zoonotic disease caused by the monkeypox virus (MPXV). MPXV can be transmitted by close contact with lesions, body fluids, respiratory droplets, and contaminated materials. A new pattern of spread among sexual networks has been recently described. The present work aimed to report the epidemiological and genomic characterization of the 2022 MPXV outbreak in central Argentina. A total of 113 scabs and/or lesion swab specimens were studied. MPXV infection was confirmed in 46.0% of the studied patients, all of whom were men. Varicella-zoster virus infection was the most frequent differential diagnosis. Eight complete viral genomes were obtained by next-generation sequencing. The Argentinian sequences were grouped intermingled with other sequences from the 2022 MPXV outbreak, related to samples from the USA, Europe, and Peru. Taken together, our study provided an initial assessment of the genetic and epidemiological characteristics of the 2022 MPXV outbreak in Córdoba, Argentina.
Assuntos
Surtos de Doenças , Genoma Viral , Monkeypox virus , Mpox , Argentina/epidemiologia , Humanos , Masculino , Mpox/epidemiologia , Mpox/virologia , Monkeypox virus/genética , Feminino , Adulto , Pessoa de Meia-Idade , Sequenciamento Completo do Genoma , Animais , Adulto Jovem , Idoso , AdolescenteRESUMO
The monkeypox virus (MPXV) outbreak, primarily endemic to Africa, has spread globally, with Brazil reporting the second-highest number of cases. The emergence of MPXV in non-endemic areas has raised concerns, particularly due to the co-circulation of other exanthematous viruses such as varicella-zoster virus (VZV) and molluscum contagiosum virus (MOCV). To perform an accurate differential diagnosis of MPXV during the ongoing outbreak in Minas Gerais, Brazil, a 5PLEX qPCR assay targeting orthopoxviruses (OPV), VZV, and MOCV was used to retrospectively analyze all clinical samples that tested negative for MPXV in the initial screening conducted at Funed. In summary, our study analyzed 1,175 clinical samples received from patients suspected of MPXV infection and found a positivity rate of 33.8% (397 samples) for MPXV using the non-variola qPCR assay. Testing the 778 MPXV-negative clinical samples using the 5PLEX qPCR assay revealed that 174 clinical samples (22.36%) tested positive for VZV. MOCV DNA was detected in 13 and other OPV in 3 clinical samples. The sequencing of randomly selected amplified clinical samples confirmed the initial molecular diagnosis. Analysis of patient profiles revealed a significant difference in the median age between groups testing positive for MPXV and VZV and a male predominance in MPXV cases. The geographic distribution of positive cases was concentrated in the most populous mesoregions of Minas Gerais state. This study highlights the challenges posed by emerging infectious diseases. It emphasizes the importance of epidemiological surveillance and accurate diagnosis in enabling timely responses for public health policies and appropriate medical care. IMPORTANCE: Brazil ranks second in the number of cases during the global monkeypox epidemic. The study, conducted in Minas Gerais, the second most populous state in Brazil with over 20 million inhabitants, utilized differential diagnostics, revealing a significant number of positive cases for other exanthematous viruses and emphasizing the need for accurate diagnoses. During the study, we were able to assess the co-circulation of other viruses alongside monkeypox, including varicella-zoster virus, molluscum contagiosum virus, and other orthopoxviruses. The significance of the research is underscored by the concentration of positive cases in populous areas, highlighting the challenges posed by emerging infectious diseases. This demographic context further amplifies the importance of the research in guiding public health policies and medical interventions, given the substantial population at risk. The study not only addresses a global concern but also holds critical implications for a state with such a large population and geographic expanse within Brazil. Overall, the study emphasizes the pivotal role of surveillance and precise diagnosis in guiding effective public health responses and ensuring appropriate medical interventions.
Assuntos
Surtos de Doenças , Humanos , Brasil/epidemiologia , Estudos Retrospectivos , Masculino , Feminino , Adulto , Diagnóstico Diferencial , Criança , Adolescente , Mpox/diagnóstico , Mpox/epidemiologia , Mpox/virologia , Adulto Jovem , Pré-Escolar , Pessoa de Meia-Idade , Monkeypox virus/genética , Monkeypox virus/isolamento & purificação , Herpesvirus Humano 3/genética , Herpesvirus Humano 3/isolamento & purificação , Lactente , Idoso , Exantema/virologia , Exantema/epidemiologia , Reação em Cadeia da Polimerase em Tempo RealRESUMO
BACKGROUND: Monkeypox (Mpox) virus infection is a topic of growing interest today because of its potential public health impact and concern about possible outbreaks. Reliable and up-to-date sources of information that provide accurate data on its transmission, symptoms, prevention, and treatment are essential for understanding and effectively addressing this disease. Therefore, the aim of the present study is to determine the prevalence of sources of information on Mpox virus infection. METHODS: An exhaustive systematic review and meta-analysis was carried out using the information available in the PubMed, Scopus, Web of Science, Embase, and ScienceDirect databases up to August 3, 2023. The data were analyzed using R software version 4.2.3. The quality of the cross-sectional studies that formed part of this review was assessed using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) tool. In addition, a subgroup analysis was performed based on the study populations. RESULTS: Through electronic searches of five databases, a total of 1833 studies were identified. Twenty-four cross-sectional articles were included, with a total sample of 35,959 participants from 34 countries. The pooled prevalence of each of the included information sources was: social networks reached 59% (95% CI: 50-68%; 29,146 participants; 22 studies; I2 = 100%; p < 0.01); the Internet was 61% (95% CI: 44-77%; 14,002 participants; 5 studies; I2 = 100%; p < 0.01), radio reached 10% (95% CI: 07-13%; 8917 participants; 4 studies; I2 = 93%; p < 0.01), television accounted for 24% (95% CI: 09-43%; 14,896 participants; 8 studies; I2 = 100%; p < 0.01), and the combination of radio and television accounted for 45% (95% CI: 31-60%; 4207 participants; 7 studies; I2 = 99%; p < 0.01); for newspapers, it was 15% (95% CI: 05-27%; 2841 participants; 6 studies; I2 = 99%; p < 0.01), friends and relatives accounted for 19% (95% CI: 12-28%; 28,470 participants; 19 studies; I2 = 100%; p < 0.01), the World Health Organization (WHO) accounted for 17% (95% CI: 07-29%; 1656 participants; 3 studies; I2 = 97%; p < 0.01), the Centers for Disease Control and Prevention (CDC) accounted for 10% (95% CI: 03-21%; 2378 participants; 3 studies; I2 = 98%; p < 0.01), and the combination of WHO and CDC websites accounted for 60% (95% CI: 48-72%; 1828 participants; 4 studies; I2 = 96%; p < 0.01), and finally, scientific articles and journals accounted for 24% (95% CI: 16-33%; 16,775 participants; 13 studies; I2 = 99%; p < 0.01). CONCLUSION: The study suggests that people access a variety of information sources to gain knowledge about Mpox virus infection, with a strong emphasis on online sources such as social networks and the Internet. However, it is important to note that the quality and accuracy of information available from these sources can vary, underscoring the need to promote access to reliable and up-to-date information about this disease to ensure public health.
Assuntos
Monkeypox virus , Mpox , Estados Unidos , Humanos , Estudos Transversais , Academias e Institutos , Fonte de InformaçãoRESUMO
Human monkeypox is a zoonosis caused by an orthopoxvirus and the clinical presentation resembles that of smallpox and chickenpox. The disease may start with a prodrome that includes lymphadenopathy, headache, fatigue, and fever, followed by a vesiculo-pustular rash. Ocular manifestations such as conjunctivitis and edema are present in approximately 20% of affected people, with a greater incidence among unvaccinated patients. Corneal involvement has also been reported and can result in corneal scarring and severe forms of keratitis. The natural course of the disease is most often benign and self-limiting, however, in some individuals, especially immunocompromised patients, there is a risk of complications such as bronchopneumonia, encephalitis, and vision loss. Herein, we present a case of a patient with monkeypox which caused conjunctival vesicles and anterior uveitis.
Assuntos
Mpox , Uveíte Anterior , Animais , Humanos , Monkeypox virus , Zoonoses , Uveíte Anterior/diagnóstico , OlhoRESUMO
This retrospective case series aims to describe the ophthalmic manifestations of the Monkeypox virus infection in seven patients evaluated in two countries of South America (Colombia and Brazil). Two had skin lesions in the eyelid, and five had conjunctivitis. None had intraocular involvement. Three of seven patients had a history of Human Immunodeficiency Virus infection, and all patients had lesions in the genital region, suggesting sexual-contact transmission. In 6 of 7 cases, conjunctival RT-PCR was positive for the Monkeypox virus, including one case without conjunctival vesicles. In all cases, lesions resolved without complications, and just two required antiviral treatment. All patients demonstrated improvement without complications. RT-PCR positivity in conjunctiva demonstrated the presence of the Monkeypox virus, suggesting that ocular-mediated transmission could be plausible. Ophthalmologists should be aware of this ophthalmic manifestation.
Assuntos
Monkeypox virus , Mpox , Humanos , Estudos Retrospectivos , Túnica Conjuntiva , PálpebrasRESUMO
Monkeypox virus (MPXV) infection was classified as a public health emergency of international concern by the World Health Organization (WHO) in 2022, being transmitted between humans by large respiratory droplets, in contact with skin lesions, fomites, and sexually. Currently, there are no available accessible and simple-to-use diagnostic tests that accurately detect MPXV antigens for decentralized and frequent testing. Here, we report an electrochemical biosensor to detect MPXV antigens in saliva and plasma samples within 15 min using accessible materials. The electrochemical system was manufactured onto a paper substrate engraved by a CO2 laser machine, modified with gold nanostructures (AuNS) and a monoclonal antibody, enabling sensitive detection of A29 viral protein. The diagnostic test is based on the use of electrochemical impedance spectroscopy (EIS) and can be run by a miniaturized potentiostat connected to a smartphone. The impedimetric biosensing method presented excellent analytical parameters, enabling the detection of A29 glycoprotein in the concentration ranging from 1 × 10-14 to 1 × 10-7 g mL-1, with a limit of detection (LOD) of 3.0 × 10-16 g mL-1. Furthermore, it enabled the detection of MPXV antigens in the concentration ranging from 1 × 10-1 to 1 × 104 PFU mL-1, with an LOD of 7.8 × 10-3 PFU mL-1. Importantly, no cross-reactivity was observed when our device was tested in the presence of other poxvirus and nonpoxvirus strains, indicating the adequate selectivity of our nanobiosensor for MPXV detection. Collectively, the nanobiosensor presents high greenness metrics associated with the use of a reproducible and large-scale fabrication method, an accessible and sustainable paper substrate, and a low volume of sample (2.5 µL), which could facilitate frequent testing of MPXV at point-of-care (POC).
Assuntos
Monkeypox virus , Mpox , Humanos , Limite de Detecção , Proteínas Virais , Antígenos ViraisRESUMO
The recent global outbreak of mpox, caused by monkeypox virus (MPV) emerged in Europe in 2022 and rapidly spread to over 40 countries. The Americas are currently facing the highest impact, reporting over 50,000 cases by early 2023. In this study, we analyzed 880 MPV isolates worldwide to gain insights into the evolutionary patterns and initial introduction events of the virus in Mexico. We found that MPV entered Mexico on multiple occasions, from the United Kingdom, Portugal, and Canada, and subsequently spread locally in different regions of Mexico. Additionally, we show that MPV has an open pangenome, highlighting the role of gene turnover in shaping its genomic diversity, rather than single-nucleotide polymorphisms (SNPs), which do not contribute significantly to genome diversity. Although the genome contains multiple SNPs in coding regions, these remain under purifying selection, suggesting their evolutionary conservation. One notable exception is amino acid position 63 of the protein encoded by the Cop-A4L gene, which is intricately related to viral maturity, which we found to be under strong positive selection. Ancestral state reconstruction indicated that the ancestral state at position 63 corresponds to the amino acid valine, which is present only in isolates of clade I. However, the isolates from the current outbreak contained threonine at position 63. Our findings contribute new information about the evolution of monkeypox virus.
Assuntos
Mpox , Humanos , Monkeypox virus/genética , México/epidemiologia , Filogenia , Aminoácidos/genética , Surtos de DoençasRESUMO
Monkeypox virus (MPXV), belonging to the Poxviridae family and Orthopoxvirus genus, is closely related to the smallpox virus. Initial prodromal symptoms typically include headache, fever, and lymphadenopathy. This review aims to detail various ocular manifestations and immune evasion associated with the monkeypox viral infection and its complications, making it appropriate as a narrative review. Common external ocular manifestations of MPXV typically involve a generalized pustular rash, keratitis, discharges, and dried secretions related to conjunctival pustules, photophobia, and lacrimation. Orthopoxviruses can evade host immune responses by secreting proteins that antagonize the functions of host IFNγ, CC and CXC chemokines, IL-1ß, and the complement system. One of the most important transcription factors downstream of pattern recognition receptors binding is IRF3, which controls the expression of the crucial antiviral molecules IFNα and IFNß. We strongly recommend that ophthalmologists include MPXV as part of their differential diagnosis when they encounter similar cases presenting with ophthalmic manifestations such as conjunctivitis, blepharitis, or corneal lesions. Furthermore, because non-vaccinated individuals are more likely to exhibit these symptoms, it is recommended that healthcare administrators prioritize smallpox vaccination for at-risk groups, including very young children, pregnant women, older adults, and immunocompromised individuals, especially those in close contact with MPXV cases.
Assuntos
Doenças da Córnea , Monkeypox virus , Criança , Humanos , Feminino , Gravidez , Pré-Escolar , Idoso , Evasão da Resposta Imune , Vacinação , PálpebrasRESUMO
Monkeypox virus is a member of the family Poxviridae, as are variola virus and vaccinia virus. It has a linear double-strand DNA genome approximately 197 kb long, containing ~190 non-overlapping ORFs. Comparison of members of the Central and West African clades shows the presence of unique genes that are associated with different disease presentations, depending on the strain. The last smallpox vaccination efforts ended in the mid-1980s, and there is concern about the recent spread of human monkeypox disease around the world. Almost 87,000 human monkeypox cases have been diagnosed in the world, of which more than 10,900 were in Brazil. The aim of this study was to evaluate the epidemiology and molecular evolution of hMpxV. From computational biology analysis of 640 hMpxV genomes from 1962 to 2022, synteny breaks and gene conservation were observed between Central and West clade genomes, and strains belonged with the 2022 outbreak assigned to the West African clade. Evidence was found for diversifying selective pressure at specific sites within protein coding sequences, acting on immunomodulatory processes. The existence of different sites under diversifying and purifying selection in paralog genes indicates adaptive mechanisms underlying the host-pathogen interaction of monkeypox virus in humans.