Search

There is growing evidence to support new modes of transmission for human monkeypox infection. As these methods are being explored, this report delineates the day-to-day clinical sequelae following the initial exposure in an HIV-positive man who had sexual intercourse with another man days preceding his infection. We describe atypical cutaneous manifestations involving widespread erythematous pustules with preceding anogenital ulcerations and concomitant bilateral inguinal lymphadenopathy. Clinicopathologic correlation is used to assist in the workup and establishing the diagnosis. Our case supports others reported in the literature that suggest sexual contact as a means of transmission. More research is needed that investigates the presence of infection in both men and women, including those who could act as carriers, to elucidate other pathways in this evolving yet evasive viral disease.

Identifying distinct noncanonical structures in pathogenic genomes is crucial for developing new diagnostic tools. This study uncovers stable G-quadruplex (GQ) structures in conserved DNA sequences unique to the monkeypox virus (MPV). Furthermore, we developed a method for the detection of target GQ using a fluorogenic probe. [ABSTRACT FROM AUTHOR]

Monkeypox virus clade I is endemic in several central African countries and characterised by an increase in disease severity and mortality. Since October, 2023, a large-scale mpox outbreak has emerged in DR Congo, and in March, 2024, the first individuals with mpox were reported outside the endemic areas in Republic of the Congo. We aimed to provide insight into the epidemic by sequencing samples obtained from individuals with mpox in Republic of the Congo. In this cross-sectional, descriptive study, samples were collected from individuals with suspected mpox between Jan 15 and April 8, 2024, in Brazzaville, Pointe-Noire, Likouala, Cuvette-Centrale, and Plateaux (Republic of the Congo). Blood samples, skin or oropharyngeal swabs, or skin crusts were obtained for molecular diagnosis via real-time PCR. Monkeypox virus sequences were obtained and analysed using newly established nanopore sequencing methodology and bioinformatic pipeline. The sequences obtained were aligned and used to construct a maximum likelihood phylogenetic tree using IG-TREE. 61 samples were collected from individuals with suspected mpox, 31 of which were positive for monkeypox virus and were included in our analysis (four positive samples were excluded due to unavailability of epidemiological data or insufficient biological material). Individuals who tested positive for monkeypox virus were from Cuvette-Centrale (19 [61%] of 31), Likouala (eight [26%]), and Pointe-Noire (four [13%]). 20 (65%) were male and 11 (35%) were female. Phylogenetic analysis of sequences showed two major clusters within clade Ia. One cluster was made up of four sequences from this study clustering with two monkeypox virus sequences from the current DR Congo outbreak, three older sequences from Central African Republic sequenced between 2017 and 2018, and seven sequences from DR Congo sequenced in 2006–07 and 2022. The second cluster was made up of 16 sequences from this study clustering with sequences from the current DR Congo outbreak. In addition, sequences from Republic of the Congo show multiple phylogenetic positioning suggesting the occurrence of multiple co-circulating strains in the human population. Our findings suggest that multiple monkeypox virus strains are co-circulating in the human population, highlighting the need for implementation of expanded mpox surveillance, especially in countries bordering DR Congo and Republic of the Congo, in combination with control measures focused on containing the current outbreaks in these countries to prevent escalation into a larger-scale epidemic. Intramural Research Program of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health. [ABSTRACT FROM AUTHOR]

This study explored the pathogenesis of human immunodeficiency virus (HIV) and monkeypox co-infection, identifying candidate hub genes and potential drugs using bioinformatics and machine learning. Datasets for HIV (GSE 37250) and monkeypox (GSE 24125) were obtained from the GEO database. Common differentially expressed genes (DEGs) in co-infection were identified by intersecting DEGs from monkeypox datasets with genes from key HIV modules screened using Weighted Gene Co-Expression Network Analysis (WGCNA). After gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis and construction of protein-protein interaction (PPI) network, candidate hub genes were further screened based on machine learning algorithms. Transcriptional factors (TFs) and miRNA-candidate hub gene networks were constructed to understand regulatory mechanisms and protein-drug interactions to identify potential therapeutic drugs. Seven candidate hub genes—MX2, ADAR, POLR2H, RPL5, IFI16, IFIT2, and RPS5—were identified. TFs and miRNAs associated with these hub genes, playing a key role in regulating viral infection and inflammation due to the activation of antiviral innate immunity, were also identified through network analysis. Potential therapeutic drugs were screened based on these hub genes: AZT, a nucleotide reverse transcriptase inhibitor, suppressed viral replication in HIV and monkeypox co-infection, while mefloquine inhibited inflammation due to the activation of antiviral innate immunity. In conclusion, the study identified candidate hub genes, their transcriptional regulation, signaling pathways, and small-molecule drugs in HIV and monkeypox co-infection, contributing to understanding the pathogenesis of HIV and monkeypox co-infection and informing precise therapeutic strategies. [ABSTRACT FROM AUTHOR]

The World Health Organization declared a state of emergency in 2022 because of monkeypox. This disease has raised international concern as it has spread beyond Africa, where it is endemic. The global community has shown attention and solidarity in combating this disease as its daily increase becomes evident. Various skin symptoms appear in people infected with this disease, which can spread easily, especially in a polluted environment. It is difficult to diagnose monkeypox in its early stages because of its similarity with the symptoms of other diseases such as chicken pox and measles. Recently, computer-aided classification methods such as deep learning and machine learning within artificial intelligence have been employed to detect various diseases, including COVID-19, tumor cells, and Monkeypox, in a short period and with high accuracy. In this study, we propose the CanDark model, an end-to-end deep-learning model that incorporates cancelable biometrics for diagnosing Monkeypox. CanDark stands for cancelable DarkNet-53, which means that DarkNet-53 CNN is utilized for extracting deep features from Monkeypox skin images. Then a cancelable method is applied to these features to protect patient information. Various cancelable techniques have been evaluated, such as bio-hashing, multilayer perceptron (MLP) hashing, index-of-maximum Gaussian random projection-based hashing (IoM-GRP), and index-of-maximum uniformly random permutation-based hashing (IoM-URP). The proposed approach's performance is evaluated using various assessment issues such as accuracy, specificity, precision, recall, and fscore. Using the IoM-URP, the CanDark model is superior to other state-of-the-art Monkeypox diagnostic techniques. The proposed framework achieved an accuracy of 98.81%, a specificity of 98.73%, a precision of 98.9%, a recall of 97.02%, and fscore of 97.95%. [ABSTRACT FROM AUTHOR]

As the world still vividly recalls the previous monkeypox (mpox) outbreak that impacted over 120 countries worldwide with more than 99,000 cases in 2022, we are now facing a second wave of infections from the monkeypox virus (MPXV), characterized by an exponential increase in cases. The current 2024 outbreak has already recorded more than 20,000 cases in Africa, marking a dramatic escalation compared to previous outbreaks. The predominance of the newly identified clade Ib variant, first detected in the Democratic Republic of the Congo (DRC) and now identified across multiple African nations and beyond, underscores its enhanced transmissibility and potential for international spread, evidenced by cases in Sweden and Thailand. The World Health Organization (WHO) declared on August 14, 2024, the current mpox outbreak a Public Health Emergency of International Concern (PHEIC), calling for heightened global public health measures. The ongoing pattern of unusual, frequent, and extensive outbreaks of mpox with potential global implications poses significant questions. This review addresses, in the format of 50 questions and answers, the 2024 mpox outbreak, detailing its characteristics, epidemiological data, and impact compared to previous outbreaks. It comprehensively explores critical questions related to MPXV virological characteristics, immunological response, clinical manifestations, epidemiology, diagnostics, and available treatments. The review also documents the significant and evolving challenges posed by the current mpox outbreak, highlighting its scale, spread, and public health response. [ABSTRACT FROM AUTHOR]

Objectives: The risk for mpox virus (MPXV) transmission in most workplaces has not been thoroughly assessed in the context of the 2022 global mpox outbreak. Our objectives were to describe mpox case patients who worked while infectious and the subsequent workplace contact tracing efforts, risk assessments, and outcomes. Methods: The Centers for Disease Control and Prevention requested information from health departments in the United States in September 2022 to identify people with confirmed or probable mpox who worked outside the home while infectious, either before or after diagnosis, from June 1 through August 31, 2022. We collected and summarized data on demographic, clinical, and workplace characteristics of case patients and workplace contact investigations. We stratified data by industry and occupation categories. Results: In total, 102 case patients were reported by 6 jurisdictions. The most common industries were accommodation and food services (19.8%) and professional business, management, and technical services (17.0%). Contact investigations identified 178 total contacts; 54 cases (52.9%) had no contacts identified. Of 178 contacts, 54 (30.3%) were recommended to receive postexposure prophylaxis (PEP) and 18 (10.1%) received PEP. None of the contacts developed a rash or were tested for orthopox or mpox, and none were reported to have confirmed or probable mpox. Conclusion: Data from 6 jurisdictions suggest that the risk of MPXV transmission from workers to others in workplace settings in many industries is low. These findings might support future updates to exposure risk classifications and work activity recommendations for patients. These findings also demonstrate the importance of collecting and analyzing occupation and industry data in case reports to better understand risks in workplaces. [ABSTRACT FROM AUTHOR]

We studied a community cluster of 25 mpox cases in Vietnam caused by emerging monkeypox virus sublineage C.1 and imported into Vietnam through 2 independent events; 1 major cluster carried a novel APOBEC3-like mutation. Three patients died; all had advanced HIV coinfection. Viral evolution and its potential consequences should be closely monitored. [ABSTRACT FROM AUTHOR]

We used cross-sectional data from 226 patients with monkeypox virus to investigate the association between anatomic exposure site and lesion development. Penile, anorectal, and oral exposures predicted lesion presence at correlating anatomic sites. Exposure site also predicted the first lesion site of the penis and anus. [ABSTRACT FROM AUTHOR]

The sudden spread of the monkeypox virus has been accompanied by an increase in the scientific interest in the virus. More than 1,400 PubMed-indexed documents have been authored by about 5,800 unique authors, averaging around 120 publications per month. This sheer rise in the number led us to explore the content published in the literature. We discovered more than 30% of the documents are Quantitative Productivity (QP) i.e., papers that illustrate the emerging trends of parachute concerns, modified salami tactics, cyclic recycling, and excellence in redundancy. In addition, we found few common hyper-prolific authors previously identified in the COVID-19 literature. Further, we share our experience in publishing monkeypox literature and highlight the growing readership and citation interest in editorials, commentaries, and correspondences that were thought to be uncitable in the medical literature. As long as the scientific community and public demand, the supply of such papers will continue, with no responsibility on the authors, journals, or the reader. Since overhauling the current system is an arduous task, we propose the optimization of existing retrieval services that would selectively filter documents based on article type (requires standardization of definitions) to dilute the crowding out effects of quantitative productivity. [ABSTRACT FROM AUTHOR]

Introduction: During the mpox outbreak in 2022, the highest number of cases in Germany were registered in Berlin, almost all of them in men who have sex with men (MSM). However, the frequency of clinically undiagnosed infections is unknown. Methods: A cross-sectional study was conducted among MSM in Berlin, Germany. Participants were recruited from private practices and community-based checkpoints specialised in HIV and STI care for MSM. They were asked to complete an online questionnaire on socio-demographic data, mpox diagnosis, vaccination history and sexual behaviour, and to provide a blood sample for serological analysis. The samples were tested for antibodies against a range of antigens to distinguish between antibodies induced by mpox infection and MVA vaccination, with pre-immune sera from childhood smallpox vaccination as a confounding factor. Associations of behavioural variables with reported and suspected mpox diagnosis as the outcome were tested using univariable and multivariable logistic regression models. Results: Between the 11th April and 1st July 2023, 1,119 participants were recruited in eight private practices and two community-based checkpoints in Berlin. All participants provided a blood sample for serological testing. Information for the online questionnaire was provided by 728 participants; core data on age and mpox history for participants who did not provide questionnaire data were provided by the practices for an additional 218 participants. A previous diagnosis of mpox was reported for/by 70 participants (7.4%). Using a conservative and strict case definition, we serologically identified an additional 91 individuals with suspected undiagnosed mpox infection. Individuals with reported or suspected mpox infections reported more condomless anal sex partners in the past 3 months (OR = 5.93; 95% CI 2.10-18.35 for 5–10 partners; OR = 9.53; 95% CI 2.72–37.54 for > 10 partners) and were more likely to report sexual contact with partners diagnosed with mpox (OR = 2.87; 95% CI 1.39–5.84). Conclusion: A substantial proportion of mpox infections were clinically undiagnosed. The number of condomless anal sex partners was strongly associated with both confirmed and suspected undiagnosed mpox infection. Therefore, mpox control measures based on clinical diagnosis of mpox are likely to have limited effectiveness in preventing mpox transmission in outbreak situations because many infections remain unrecognised and undiagnosed. [ABSTRACT FROM AUTHOR]

The Mpox virus (or Monkeypox virus, MPXV) uses its own encoded proteins to form a replication machine that replicates the viral genome in the host cell cytoplasm, making this machinery a key target for antiviral drug design. The D5 (also known as the OPG117 or E5) protein, a bi‐functional helicase–primase enzyme, is crucial in the MPXV replication machinery and genome uncoating process. Recently, cryo‐electron microscopy (cryo‐EM) structures of D5 in multiple states have been determined. These structures have elucidated the full trajectory of the MPXV D5 helicase–primase as it moves along single‐stranded DNA, providing unprecedented advancements in the molecular dynamics and unwinding mechanism. This structural snapshot describes the structural features of the D5 protein and dissects the broader implications of its pivotal role in MPXV replication. [ABSTRACT FROM AUTHOR]

Monkeypox (mpox) is a zoonotic illness caused by the monkeypox virus (MPXV), with higher health concerns among people who are pregnant, children, and persons who are immunocompromised, including people with untreated and advanced HIV disease. Significant progress has been made in developing vaccines against mpox, yet critical challenges and limitations persist in ensuring their effectiveness, safety, and accessibility. The pertinence of this review is highlighted by the World Health Organization's declaration of a global health emergency on August 14, 2024, due to the recent mpox outbreak, underscoring the critical necessity for effective vaccine solutions in the face of a rapidly evolving virus. Here, we comprehensively analyze various vaccine platforms utilized in mpox prevention, including attenuated and nonreplicating virus vaccines, viral vector-based vaccines, recombinant protein vaccines, and DNA and mRNA vaccines. We evaluate the advantages and limitations of each platform, highlighting the urgent need for ongoing research and innovation to enhance vaccine efficacy and safety. Recent advancements, such as incorporating immunostimulatory sequences, improved delivery systems, and developing polyvalent vaccines, are explored for their potential to offer broader protection against diverse orthopoxvirus strains. This work underscores the need to optimize currently available vaccines and investigate novel vaccination strategies to address future public health emergencies effectively. By focusing on these advanced methodologies, we aim to contribute to the development of robust and adaptable vaccine solutions for mpox and other related viral threats. [ABSTRACT FROM AUTHOR]

RNA N6 -methyladenosine (m6A) demethylase AlkB homolog 5 (ALKBH5) plays a crucial role in regulating innate immunity. Lysine acylation, a widespread protein modification, influences protein function, but its impact on ALKBH5 during viral infections has not been well characterized. This study investigates the presence and regulatory mechanisms of a previously unidentified lysine acylation in ALKBH5 and its role in mediating m6A modifications to activate antiviral innate immune responses. We demonstrate that ALKBH5 undergoes lactylation, which is essential for an effective innate immune response against DNA herpesviruses, including herpes simplex virus type 1 (HSV-1), Kaposi’s sarcoma–associated herpesvirus (KSHV), and mpox virus (MPXV). This lactylation attenuates viral replication. Mechanistically, viral infections enhance ALKBH5 lactylation by increasing its interaction with acetyltransferase ESCO2 and decreasing its interaction with deacetyltransferase SIRT6. Lactylated ALKBH5 binds interferon-beta (IFN-β) messenger RNA (mRNA), leading to demethylation of its m6A modifications and promoting IFN-β mRNA biogenesis. Overexpression of ESCO2 or depletion of SIRT6 further enhances ALKBH5 lactylation to strengthen IFN-β mRNA biogenesis. Our results identify a posttranslational modification of ALKBH5 and its role in regulating antiviral innate immune responses through m6A modification. The finding provides an understanding of innate immunity and offers a potential therapeutic target for HSV-1, KSHV, and MPXV infections. [ABSTRACT FROM AUTHOR]

The outbreak of emerging infectious diseases poses significant challenges to global public health. Accurate early forecasting is crucial for effective resource allocation and emergency response planning. This study aims to develop a comprehensive predictive model for emerging infectious diseases, integrating the blending framework, transfer learning, incremental learning, and the biological feature Rt to increase prediction accuracy and practicality. By transferring features from a COVID-19 dataset to a monkeypox dataset and introducing dynamically updated incremental learning techniques, the model's predictive capability in data-scarce scenarios was significantly improved. The research findings demonstrate that the blending framework performs exceptionally well in short-term (7-day) predictions. Furthermore, the combination of transfer learning and incremental learning techniques significantly enhanced the adaptability and precision, with a 91.41% improvement in the RMSE and an 89.13% improvement in the MAE. In particular, the inclusion of the Rt feature enabled the model to more accurately reflect the dynamics of disease spread, further improving the RMSE by 1.91% and the MAE by 2.17%. This study underscores the significant application potential of multimodel fusion and real-time data updates in infectious disease prediction, offering new theoretical perspectives and technical support. This research not only enriches the theoretical foundation of infectious disease prediction models but also provides reliable technical support for public health emergency responses. Future research should continue to explore integrating data from multiple sources and enhancing model generalization capabilities to further enhance the practicality and reliability of predictive tools. [ABSTRACT FROM AUTHOR]

Lumpy skin disease virus (LSDV) is an extremely infectious, viral, and chronic skin disease that is caused by the Capripox virus. This viral disease is predominantly found in cows. Mosquitoes and ticks are the primary transmitters for the spread of this virus. Recently, LSDV has been rapidly spreading all over the world, especially in several areas of Pakistan, India, and Iran. Thousands of cows have died due to this infectious virus in Pakistan and early detection of LSDV is needed to avoid further loss. The prediction and classification of LSDV are hindered by the lack of publicly available datasets. Despite a few studies using LSDV datasets, such datasets are often small, which may lead to model overfitting. In this regard, we collect the dataset from several online sources, as well as, collecting images from veterinary farms in different areas of Pakistan. Deep learning has been widely used in the medical field for disease detection and classification. Therefore, this study leverages DenseNet deep learning models for LSDV detection and classification. Experiments are performed using VGG-16, ResNet-50, MobileNet-V2, custom-designed convolutional neural network, and Inception-V3. The DenseNet architecture presents a Convolutional Block Attention Module (CBAM) and Spatial Attention (SA) for the prediction and classification of LSD. Results demonstrate that a 99.11% accuracy can be obtained on the augmented dataset while a 94.23% accuracy can be achieved with the original dataset for chicken pox, monkey pox, and LSDV. Comparison with state-of-the-art studies corroborates the superior performance of the proposed model. [ABSTRACT FROM AUTHOR]

During the 2022 mpox outbreak, our study conducted 30 interviews with a recruited sample of Chicago gay men (age 18+) during June-September to investigate their experiences of mpox, HIV/AIDS, and COVID-19. Participants were interviewed with a semi-structured guide about gay sexual identity and social experiences; HIV/AIDS, ART, and PrEP; and COVID-19 behaviors and vaccination. All 30 interview respondents had been fully vaccinated for COVID-19 and expressed minimal COVID-19 vaccine hesitancy. All the men living with HIV in our study were on ART with HIV well controlled. A majority of HIV- participants (70%) were on PrEP, with participants universally aware of PrEP benefits. Additionally, most participants had already received at least one shot of the Jynneos mpox vaccine, with many interviewees enduring long lines, sometimes at multiple locations, before vaccination in primarily gay social spaces. These Chicago gay men demonstrated widespread enthusiasm for mpox vaccination as a disease prevention strategy and most of them had already been vaccinated despite significant barriers. The enthusiasm of the participants in our study emerged within a medical landscape shaped by both COVID-19 vaccination and HIV/AIDS-related health interventions including ART and PrEP, which may have helped instill increased medical trust among this population. Our study suggests that out urban gay men may comprise a distinctive minority population with increased medical trust due to specific social, sexual, and historical experiences. [ABSTRACT FROM AUTHOR]

Four fundamental models that describe the spread of Monkeypox disease are analyzed: the SIR-SIR, SEIR-SIR, SIR-SEIR, and SEIR-SEIR models. They form the basis of most Monkeypox diseases models that are currently discussed in the literature. It is shown that the way the model subpopulations are organized in disease outbreaks and evolve relative to each other is determined by the relevant unstable system eigenvectors, also called order parameters. For all models, analytical expressions of the order parameters are derived. Under appropriate conditions these order parameters describe the initial outbreak phases of exponential increase in good approximation. It is shown that all four models exhibit maximally two order parameters and maximally one human–animal order parameter. The human–animal order parameter firmly connects the outbreak dynamics in the animal system with the dynamics in the human system. For the special case of the SIR-SIR model, it is found that the two possible order parameters completely describe the dynamics of infected humans and animals during entire infection waves. Finally, a simulation of a Monkeypox infection wave illustrates that in line with the aforementioned analytical results the leading order parameter explains most of the variance in the infection dynamics. [ABSTRACT FROM AUTHOR]

Mpox, caused by the Mpox virus (MPXV), emerged globally in 2022 with the Clade IIb strain, presenting a critical public health challenge. While MPXV is primarily characterized by fever and rash, gastrointestinal (GI) complications, such as diarrhea and proctitis, have also been observed. This study is a reanalysis of GSE219036 without own data and focuses on the impact of MPXV infection on the colon, using human-induced pluripotent stem cell-derived colon organoids as a model. We applied a tailored statistical framework for RNA-seq data, Generalized Linear Models with Quasi-Likelihood F-tests and Relaxed Magnitude–Altitude Scoring (GLMQL-RMAS), to identify differentially expressed genes (DEGs) across MPXV clades: MPXV I (Zr-599 Congo Basin), MPXV IIa (Liberia), and MPXV IIb (2022 MPXV). Through a novel methodology called Cross-RMAS, we ranked genes by integrating statistical significance and biological relevance across all clades. Machine learning analysis using the genes identified by Cross-RMAS, demonstrated 100% accuracy in differentiating between the different MPXV strains and mock samples. Furthermore, our findings reveal that MPXV Clade I induces the most extensive alterations in gene expression, with significant upregulation of stress response genes, such as HSPA6 and FOS, and downregulation of genes involved in cytoskeletal organization and vesicular trafficking, such as PSAP and CFL1. In contrast, Clade IIb shows the least impact on gene expression. Through Gene Ontology (GO) analysis, we identified pathways involved in protein folding, immune response, and epithelial integrity that are disrupted in infected cells, suggesting mechanisms by which MPXV may contribute to GI symptoms. [ABSTRACT FROM AUTHOR]

Dual‐mode readout platforms with colorimetric and electrochemiluminescence (ECL) signal enhancement are proposed for the ultrasensitive and flexible detection of the monkeypox virus (MPXV) in different scenes. A new nanotag, Ru@U6‐Ru/Pt NPs is constructed for dual‐mode platforms by integrating double‐layered ECL luminophores and the nanozyme using Zr‐MOF (UiO‐66‐NH2) as the carrier, which not only generates enhanced ECL and colorimetric signals but also provide greater stability than that of commonly used nanotags. Dual‐mode platforms are used within 15 min from the "sample in" to the "result out" steps, without nucleic acid amplification. The colorimetric mode allows the screening of MPXV with the visual limit of detection (vLOD) of 0.1 pM (6 × 108 copies µL−1) and the ECL mode supports quantitative detection of MPXV with an LOD as low as 10 aM (6 copies·µL−1), resulting in a broad sensing range of 60 to 3 × 1011 copies·µL−1 (10 orders of magnitude). Validation is conducted using 50 clinical samples, which is 100% concordant to those of quantitative polymerase chain reaction (qPCR), indicating that Ru@U6‐Ru/Pt NPs‐based dual‐mode sensing platforms showed great promise as rapid, sensitive, and accurate tools for diagnosis of the nucleic acid of MPXV and other infectious pathogens. [ABSTRACT FROM AUTHOR]

The threat of the emergence of potential pandemics in the future has been looming ever since the world witnessed the worst-ever public health catastrophe following the coronavirus disease 2019 (COVID-19) pandemic caused by the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The COVID-19 pandemic affected billions of people killing millions of people throughout the world. Now, we have been noticing an alarming rise in the cases of mpox disease caused by Mpox virus (MPXV). Although discovered in 1958, mpox was largely confined to monkeys before causing the first human infection in 1970. The MPXV is demonstrating a complex transmission behavior as noted by its discovery first in Denmark in monkeys imported from Singapore (Asia) and later spreading to humans causing repeated re-emergence. The virus was confined to the African nations including the Democratic Republic of Congo (DRC) before reemerging in the United States of America in 2003 affecting several people who had a history of contact with animals. Following scattered reports from endemic regions, the virus appears to have remerged after approximately two decades in 2022 involving the United States of America (USA) and European countries. The virus has been spreading across the globe as evidenced by its discovery in 60 countries in 2022 to more than 120 countries in the current year. It is therefore essential to improve the understanding of the MPXV, its epidemiology, pathogenicity and virulence, clinical features, and control and preventive measures and increase preparedness to efficiently tackle any future public health emergency. [ABSTRACT FROM AUTHOR]

ABSTRACT A thiophosphoric triamide (SPT) ligand P(S)[NH‐2Py]3 was synthesized and utilized as a ligand to make novel binuclear and mononuclear Co2+ and Cd2+ complexes. The compounds are the first examples of discrete chelate SPT complexes with a [N]3P(S)‐based backbone in which the SPT acts as a flexible tridentate N,N,N‐donor or N,N,O‐donor ligand. The metal cation features a hexacoordinate environment M(N)3(Cl)3/M(N)4(O)2 adopting a distorted octahedral geometry. Hirshfeld surface analysis affirms that the pyridinyl nitrogen is a more dominant H‐bond acceptor than the thiophosphoryl sulfur atom. The inhibitory activity against the MDA‐MB‐231 cancer cell line in vitro indicated a good inhibitory effect for all compounds. The mononuclear Co2+ complex showed a stronger inhibitory activity against cancer cells than other studied compounds with an IC50 of 62 ± 1.4 nM. Antioxidant and antihemolytic activity of the compounds showed appreciable performance with the highest activities for the Cd2+ complex. A computational DNA binding study by molecular docking indicated a good affinity of the compounds with the DNA receptor by a mixed mode of interactions. Docking was also performed on SARS‐CoV‐2 and monkeypox (Mpox), resulting in binding energies (−5.5 to −8.9 kcal/mol) that are competitive with current effective drugs. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has significantly impacted the mental health of human beings since 2020, especially the young people and the pre-existing marginalized groups such as men who have sex with men (MSM). During the COVID-19 pandemic, the multi-country outbreak of mpox in 2022 additionally posed a significant stress on the most-affected communities (i.e., MSM). This study investigated the level of depressive symptoms and its multifaceted associated factors among Chinese young men who have sex with men (YMSM) in this unique period. In September 2022, a large-scale cross-sectional survey was conducted among YMSM aged 18–29 years across six representative provinces in China. Hierarchical regression analysis was performed to test the various types of associated factors of depressive symptoms. Among the 2493 participants, 65.6 % (n = 1638) reported mild to severe depressive symptoms. The hierarchical regression analysis identified that depressive symptoms was significantly positively associated with unemployment, having substance use in the past 6 months, a higher level of MSM self-stigma, incompletion of COVID-19 vaccination, greater mpox risk perception, and presence of mpox related-like symptoms. This study used the facility-based sampling method to recruit the participants, which may lead to selection bias. Chinese YMSM faced significant mental health challenges during the concurrent epidemics of COVID-19 and mpox, which was associated with their socio-economic status, risk behaviors, stigma, and multiple diseases-related variables. Proactive measures may hold promise as effective strategies for mitigating mental distress among marginalized groups during public health crises. • YMSM experienced severe depressive symptoms in dual-threat context in China. • Identifies key influencing factors across demographic and psychosocial realms. • Urges tailored mental health support for YMSM during health emergencies. • Recommends proactive mental health measures like campaigns and counseling. [ABSTRACT FROM AUTHOR]

Monkeypox is a zoonotic disease caused by monkeypox virus infection. It is easily transmitted among people and poses a major threat to human health, making it of great significance in public health. Therefore, this paper proposes MSMP-Net, a multi-scale neural network for end-to-end monkeypox virus skin lesion classification ConvNeXt is used as the backbone network, and designs such as inverse bottleneck layers and large convolution kernels are used to enhance the network's feature extraction capabilities. In order to effectively utilize the multi-level feature maps generated by the backbone network, a multi-scale feature fusion structure was designed. By fusing the deepest feature maps of multi-scale features, the model's ability to represent monkeypox image features is enhanced. Experimental results show that the accuracy, precision, recall, and F1-score of this method on the MSLD v2.0 dataset are 87.03 ± 3.43%, 87.59 ± 3.37%, 87.03 ± 3.43%, and 86.58 ± 3.66%, respectively. [ABSTRACT FROM AUTHOR]

AbstractThis study investigated the Mpox outbreak that occurred in a health cluster of three hospitals in Riyadh, Saudi Arabia, involving 97 patients diagnosed between May and December 2023. Among them, 48% were Saudi nationals, 94% were men, and 73% were under 35 years old. While sexual activity was a potential transmission mode, only 38% of patients reported it. All patients were presented with skin lesions and common symptoms like fever, headaches, and itching, with two being HIV positive. Genotyping revealed all samples were from subclade IIb (West Africa clade). Unlike previous outbreaks, rashes and systemic symptoms emerged simultaneously without a prodromal phase. Stringent infection control measures kept healthcare workers safe, although underreporting of sexual behavior may limit the study’s findings. This highlights the need for Mpox consideration in young individuals with skin lesions. [ABSTRACT FROM AUTHOR]

The article from the New England Journal of Medicine discusses the risks, vertical transmission, prevention, and treatment of Mpox in pregnancy. Mpox is caused by the monkeypox virus (MPXV) and can be transmitted from mother to fetus, potentially leading to adverse outcomes. The article highlights the urgent need for data to enhance understanding and mitigate risks associated with MPXV infection during pregnancy. Research efforts are focused on investigating transmission patterns, vertical transmission mechanisms, clinical outcomes, vaccine effectiveness, antiviral treatment evaluation, and community engagement to prevent and treat Mpox in pregnant and breastfeeding women. [Extracted from the article]

The article discusses the importance of addressing the handling and consumption of bushmeat to prevent the spread of mpox, a public health emergency. It emphasizes the need for a collaborative One Health approach that considers social, economic, and environmental factors. The article suggests applying lessons from food safety efforts in informal markets and highlights the importance of capacity-building, motivation and incentives, and enabling policies and regulations. It also emphasizes the role of the One Health approach in reducing transmission at the animal-human-environmental interface. The article concludes by proposing a pilot intervention using the "three-legged stool" approach and One Health collaboration. [Extracted from the article]

In the midst of the continuing difficulties presented by the COVID-19 pandemic, the possible emergence of illnesses such as monkeypox places an additional and significant load on public health services that are already under pressure. Conventional diagnostic methods for monkeypox, reliant on polymerase chain reaction tests and biochemical assays on lesion swabs suffer from drawbacks such as patient discomfort and resource limitations, particularly in economically distressed areas of Western and Central Africa. This work investigates the application of deep learning techniques, specifically transfer learning using three trained CNN frameworks (ResNet50V2, MobileNetV2, and Xception), to accurately identify monkeypox. Utilizing the "Monkeypox Skin Lesion Dataset," images of patients' skin lesions are augmented and incorporated into the training and validation of the models. Additional layers for classifying monkeypox and non-monkeypox images are introduced. Evaluation metrics, with a focus on accuracy and F1-score, showcase the superior performance of the ResNet50V2-based model (0.9874 accuracy, F1-score of 0.99), followed by Xception (0.9546 accuracy, F1-score of 0.95), and MobileNetV2 (0.9452 accuracy, F1-score of 0.94). Comparative analysis with previous works in the field underscores the improved results achieved in this research. The proposed models offer a promising avenue for early monkeypox detection, contributing to effective preventive measures against its spread. Looking ahead, we aim to deploy the developed MobileNetV2-based model as a web application, leveraging its lightweight architecture and notable accuracy. This initiative is intended to provide people in rural areas with a cost-effective and easily accessible solution for the early detection of monkeypox, contributing to improved healthcare in resource-constrained settings. [ABSTRACT FROM AUTHOR]

Background: In light of the ongoing monkeypox (MPOX) epidemic, healthcare workers (HCWs) have been in contact with various diseases. Therefore, they should take appropriate preventive and control measures to maintain their health. This study assessed Egyptian HCWs' intentions to take MPOX vaccines. Methods: A cross-sectional survey was conducted using social media platforms between September 27 and November 4, 2022. An anonymous online survey using the 5C scale was conducted using convenience and snowball sampling methods to assess the five psychological antecedents of vaccination (i.e., confidence, constraints, complacency, calculation, and collective responsibility). Results: A total of 399 HCWs with a mean age of 32.6 ± 5.7 participated in this study. Of them, 89.7% were female. The five C psychological antecedents of vaccination were as follows: 55.9% were confident about vaccination, 50.6% were complacent, 56.6% experienced constraints, 60.7% calculated the risk and benefit, and 58.4% had collective responsibility. Multivariate analysis showed that high income level and having information about MPOX were significant predictors of confidence in the MPOX vaccines (adjusted odds ratio ((AOR) = 4.19, 95% CI (1.12– 15.59), P = 0.032). Participants aged 31–45 years and 19–30 years showed significant association (AOR = 2.46, 95% CI (0.85–7.15), P = 0.096) and (AOR = 4.19, 95% CI (1.39–12.64), P = 0.011), respectively. Having an idea about the MPOX vaccines significantly predicted the complacency domain (AOR = 3.77, 95%CI (1.47–9.65, P = 0.006). Moreover, precollege/undergraduate education and having an idea about MPOX vaccination were significant predictors of the constraint domain (AOR = 1.81.95% CI (1.09–2.99, P = 0.020), (AOR = 2.70, 95% CI (1.05–6.95, P = 0.038), respectively). Female sex, having a diploma, postgraduate studies, and having an idea about MPOX vaccine significantly predicted calculation domain (AOR = 2.06, 95% CI (1.05–4.04, P = 0.035), (AOR = 3.98,95% CI (1.33–11.87, P = 0.013), (AOR = 2.02, 95% CI (1.25–3.26, P = 0.004) & (AOR = 2.75. 95% CI (1.05–7.18, P = 0.039), respectively. The only significant predictor of collective responsibility was having a diploma and postgraduate studies (AOR = 3.44, 95% CI (1.21–9.78, P = 0.020), (AOR = 1.90,95% CI (1.17–3.09, P = 0.009). Conclusions: Efforts to control MPOX should focus on promoting protective measures such as the vaccination of HCWs as well as raising their awareness about the updated information regarding the virus and the approved vaccines. [ABSTRACT FROM AUTHOR]

Background: Preprints are scientific articles that have not undergone the peer-review process. They allow the latest evidence to be rapidly shared, however it is unclear whether they can be confidently used for decision-making during a public health emergency. This study aimed to compare the data and quality of preprints released during the first four months of the 2022 mpox outbreak to their published versions. Methods: Eligible preprints (n = 76) posted between May to August 2022 were identified through an established mpox literature database and followed to July 2024 for changes in publication status. Quality of preprints and published studies was assessed by two independent reviewers to evaluate changes in quality, using validated tools that were available for the study design (n = 33). Tools included the Newcastle-Ottawa Scale; Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2); and JBI Critical Appraisal Checklists. The questions in each tool led to an overall quality assessment of high quality (no concerns with study design, conduct, and/or analysis), moderate quality (minor concerns) or low quality (several concerns). Changes in data (e.g. methods, outcomes, results) for preprint-published pairs (n = 60) were assessed by one reviewer and verified by a second. Results: Preprints and published versions that could be evaluated for quality (n = 25 pairs) were mostly assessed as low quality. Minimal to no change in quality from preprint to published was identified: all observational studies (10/10), most case series (6/7) and all surveillance data analyses (3/3) had no change in overall quality, while some diagnostic test accuracy studies (3/5) improved or worsened their quality assessment scores. Among all pairs (n = 60), outcomes were often added in the published version (58%) and less commonly removed (18%). Numerical results changed from preprint to published in 53% of studies, however most of these studies (22/32) had changes that were minor and did not impact main conclusions of the study. Conclusions: This study suggests the minimal changes in quality, results and main conclusions from preprint to published versions supports the use of preprints, and the use of the same critical evaluation tools on preprints as applied to published studies, in decision-making during a public health emergency. [ABSTRACT FROM AUTHOR]

The 2022 monkeypox virus (MPXV) outbreaks spurred global public health concern. In response, we undertook a living systematic review of its zoonotic characteristics, including potential reservoirs and susceptible species, transmissibility, and clinical presentation in nonhuman species. Electronic database searches yielded 148 eligible records published between 2000 and 2022. Primary reservoirs remain unidentified, with natural isolation identified in 2 species, the sooty mangabey monkey and rope squirrel. Transmission primarily occurs from animals to humans, but evidence of reverse zoonosis has emerged. Data on clinical infection and manifestations are sparse, with evidence of potentially susceptible species drawn primarily from experimental studies. Only 10% of articles were appropriate for quality assessment and most of these were rated as critically low. Overall, while evidence regarding MPXV exists, the quality of data are extremely poor, resulting in significant uncertainty regarding MPXV's zoonotic traits. High-quality empirical research to understand the impact of MPXV on animal and human populations is warranted. [ABSTRACT FROM AUTHOR]

The 2022 mpox epidemic predominantly affected gay, bisexual, and other men who have sex with men (GBM). Led by a provincial community program and co-galvanized by clinician-researchers, GBM community leaders in Ontario coordinated a robust response, representing a reproducible strategy for community engagement and mobilization during future epidemics. [ABSTRACT FROM AUTHOR]

Human monkeypox (Mpox) is a zoonotic infection caused by Mpox virus (MPXV) that was first identified in a smallpox suspect in 1970, and presents with smallpox-like symptoms but with less severe manifestations. The infection is initiated through rapid replication at the inoculation site, with early symptoms including fever, chills, and exhaustion. The advent of smallpox vaccines has significantly contributed to its prevention. Due to its zoonotic nature, individuals who consume or handle animals susceptible to the virus are at increased risk and should take appropriate precautions. Both vaccines and non-pharmacological interventions have proven potent in limiting the spread of the infection. This narrative review examines the emergence and spread of Mpox in humans, delving into the epidemiology, clinical manifestations and preventive strategies for Mpox, as well as the transmission dynamics of the two MPXV clades. It also highlights the increase in cases outside Africa, with a particular focus on a UK outbreak linked to travel from Nigeria. The importance of vaccination, especially smallpox vaccines, is underscored, noting recent advancements in vaccine development such as the Vaccinia Ankara vaccine. The review emphasizes the need for robust surveillance, diagnostics, and strategies to control and manage epidemics, drawing lessons from past experiences. It concludes by stressing the clinical similarities between Mpox and smallpox and the growing public health concern posed by Mpox, especially in areas with high human-wildlife interactions. [ABSTRACT FROM AUTHOR]

In May 2022, a global outbreak of mpox (formerly monkeypox virus) affected thousands of mainly gay and bisexual men. Mpox is usually a time-limited illness that can involve fever, pain, and skin lesions, but may require hospitalisation. There is scant research into the firsthand experiences of people affected by mpox, including experiences of symptoms, healthcare, and recovery. This study considers the different illness narratives of people who experienced mpox in Australia in 2022. In-depth interviews and 6-month follow-up interviews were conducted with 16 people, including 13 people diagnosed with mpox and three close contacts. All participants were cisgender gay or bisexual men living in Australia. Participants' accounts described minor to severe periods of sickness, negative and stigmatising experiences engaging with healthcare, and some participants experienced long-term effects on their sexual well-being and complications from mpox. The emergency outbreak context meant that mpox was highly distressing, making it difficult to manage and producing varying forms of disruption to everyday life. Mpox was narrated as disruptive in different ways: as a minor interruption to holiday plans, a prolonged period of poor health, or a biographically disruptive event prompting a re-evaluation of sexual values and health. This analysis demonstrates that an unfamiliar emergent disease outbreak related to sexual practices and sociality can reconfigure personal life and sexual well-being, suggesting a need to focus on providing quality patient care in outbreaks of mpox and other infectious diseases. [ABSTRACT FROM AUTHOR]

This article presents an overview of an mpox epidemiological situation in the most affected regions—Africa, Americas, and Europe—tailoring fractal interpolation for pre-processing the mpox cases. This keen analysis has highlighted the irregular and fractal patterns in the trend of mpox transmission. During the current scenario of public health emergency of international concern due to an mpox outbreak, an additional significance of this article is the interpretation of mpox spread in light of multifractality. The self-similar measure, namely, the multifractal measure, is utilized to explore the heterogeneity in the mpox cases. Moreover, a bidirectional long-short term memory neural network has been employed to forecast the future mpox spread to alert the outbreak as it seems to be a silent symptom for global epidemic. [ABSTRACT FROM AUTHOR]

Since COVID-19, mpox was the first emerging pathogen to have spread globally in 2022. Wastewater-based surveillance (WBS) has proven to be an efficient early warning system for detecting potential resurgences. This report aims to provide insight into the development and implementation of WBS of mpox in Slovenia and to incorporate the surveillance results into the development of public health interventions. WBS of mpox was conducted during the period from 1 June 2023 to 30 September 2023 at the wastewater treatment plant (WWTP) Ljubljana and WWTP Koper. The selected detection method of the monkeypox virus (MPXV) in the wastewater sample was based on PCR analysis. The implemented laboratory method showed that the sample preparation and concentration method enables a stable procedure for MPXV detection in wastewater samples. The laboratory analysis of wastewater samples from the selected WWTPs did not detect the MPXV during the monitoring period. In the event of MPXV detection in a wastewater sample, targeted public health interventions would be implemented, focusing on increasing awareness among the groups of men who have sex with other men and searching for positive mpox cases. We recommend that the developed system be retained in the case of an emergency epidemiological situation. [ABSTRACT FROM AUTHOR]

According to the WHO, more than 90,000 cases of mpox have been reported since the 2022 worldwide outbreak, which resulted in 167 deaths, while a new outbreak in Africa since 2023 has resulted in over 18,000 cases and 617 deaths. Mpox is a zoonosis caused by the monkeypox virus, a double-stranded DNA virus belonging to the Orthopoxvirus genus, which causes smallpox-like illness. Until 2022, cases were predominately located in West and Central Africa, with only sporadic cases and outbreaks reported in other parts of the world. During the 2022 outbreak, the primary mode of transmission was sexual contact among men who have sex with men. The changing epidemiology of mpox resulted in new disease phenotypes and populations at risk, disproportionally affecting people who live with HIV. Commonly presenting as a mild, self-limiting illness, mpox can cause severe and protracted disease in people with HIV with a CD4 count < 200 cell/mm3. The global emergence of mpox that followed and intersected with COVID-19 mobilized the scientific community and healthcare stakeholders to provide accurate diagnostics, preventive vaccines and treatment to those most affected. Despite existing gaps, this rapid response helped to contain the outbreak, but challenges remain as new variants emerge. Preparedness and readiness to respond to the next outbreak is crucial in order to minimize the impact to the most vulnerable. [ABSTRACT FROM AUTHOR]

The Africa Centers for Disease Control and Prevention declared mpox a Public Health Emergency of Continental Security (PHECS) in Africa. African public health systems have moved to mobilize a response against a backdrop of inherent significant challenges. With this commentary, we discuss how lessons from past public health emergencies, particularly COVID-19 and Ebola outbreaks, have prepared the region for improved disease surveillance, rapid response strategies, and effective public health communication and how these lessons can be applied to the mpox response, emphasizing the importance of strong healthcare infrastructure, effective data sharing, community engagement, targeted interventions, and robust contact tracing. Additionally, addressing misinformation and building public trust are crucial for controlling the spread of any disease. By leveraging these strategies, African countries can enhance their response to mpox. This includes improving diagnostic capabilities, strengthening cross-border collaborations, and prioritizing vaccination campaigns where needed. Ultimately, by applying the hard-earned lessons from the COVID-19 pandemic and Ebola outbreak, the East Africa region can better address the challenges posed by mpox and safeguard public health. [ABSTRACT FROM AUTHOR]

Recently, concern has been raised about the spread of human mpox virus, and the demand for rapid detection reagents for mpox virus has increased. This study aims to establish a time‐resolved fluorescence immunochromatography (TRFICO) method for qualitative/quantitative detection of mpox virus. A double‐antibody sandwich TRFICO method was optimized and established using mpox recombinant fusion antigen and its paired monoclonal antibody. The test performance of the method was evaluated using mpox fusion antigen and control serum, including sensitivity, linearity range, specificity, precision, and reference interval. We successfully established a TRFICO method for qualitative/quantitative detection of mpox antigen, its linearity range 0–100 ng/mL, analytical sensitivity 0.017 ng/mL, and reference intervals greater than 0.045 ng/mL. No cross‐reaction was detected with various poxvirus and clinical negative controls, with good specificity. All average recoveries of the intra‐ and inter‐batch ranged from 81.33% to 97.83%, and all CVs were below 10%. Additionally, the TRFICO strips can be stably stored at 37°C for 7 days without significant changes in the fluorescence intensity. This TRFICO method, with high sensitivity, linearity range, specificity, precision, and stability with 16‐min detection time, provides a new option for qualitative/quantitative and convenient testing of mpox virus. [ABSTRACT FROM AUTHOR]

Background Objectives Methods Results Conclusion Monkeypox (MPOX) caused a public health emergency of international concern (PHEIC) outbreak between 2022 and 2023, with a recent rise in cases that prompted the World Health Organization (WHO) to declare the disease a PHEIC once again. There is little information on its long‐term scarring sequelae.The objective of this study was to assess the risk and characteristics of scarring in patients with MPOX in a tertiary hospital.This is a prospective cohort study including patients diagnosed using polymerase chain reaction (PCR) tests. Clinical data were collected and followed up at 12–15 months to assess scarring and its impact on quality of life.Of the 40 patients, 19 (47.5%) developed scars, which were more common in those with initial cutaneous manifestations. Scars significantly affected the quality of life, especially in the genital and mucosal areas. The limited sample and loss to follow‐up may affect the validity of the results.Scarring is a frequent and disfiguring sequela of MPOX, particularly in patients with early skin symptoms. Prevention and close follow‐up are crucial in mitigating these complications. [ABSTRACT FROM AUTHOR]

We linked 4 mpox cases in South Ubangi, Democratic Republic of the Congo, to transboundary transmission from Central African Republic. Viral genome sequencing demonstrated that the monkeypox virus sequences belonged to distinct clusters of subclade Ia. This finding demonstrates the borderless nature of mpox and highlights the need for vigilant regional surveillance. [ABSTRACT FROM AUTHOR]

We used published data from outbreak investigations of monkeypox virus clade I in the Democratic Republic of the Congo to estimate the distributions of critical epidemiological parameters. We estimated a mean incubation period of 9.9 days (95% credible interval [CrI] 8.5–11.5 days) and a mean generation time of 17.2 days (95% CrI 14.1–20.9 days) or 11.3 days (95% CrI 9.4–14.0 days), depending on the considered dataset. Presymptomatic transmission was limited. Those estimates suggest generally slower transmission dynamics in clade I than in clade IIb. The time-varying reproduction number for clade I in the Democratic Republic of the Congo was estimated to be below the epidemic threshold in the first half of 2024. However, in the South Kivu Province, where the newly identified subclade Ib has been associated with sustained human-to-human transmission, we estimated an effective reproduction number above the epidemic threshold (95% CrI 0.96–1.27). [ABSTRACT FROM AUTHOR]

Monkeypox virus (MPXV) is zoonotic and capable of infecting many mammal species. However, whether common companion animals are susceptible to MPXV infection is unclear. During July 2022–March 2023, we collected animal and environmental swab samples within homes of confirmed human mpox case-patients and tested for MPXV and human DNA by PCR. We also used ELISA for orthopoxvirus antibody detection. Overall, 12% (22/191) of animal and 25% (14/56) of environmental swab samples from 4 households, including samples from 4 dogs and 1 cat, were positive for MPXV DNA, but we did not detect viable MPXV or orthopoxvirus antibodies. Among MPXV PCR-positive swab samples, 82% from animals and 93% from the environment amplified human DNA with a statistically significant correlation in observed cycle threshold values. Our findings demonstrate likely DNA contamination from the human mpox cases. Despite the high likelihood for exposure, we found no indications that companion animals were infected with MPXV. [ABSTRACT FROM AUTHOR]

Reported mpox cases in England continued at a low but steady frequency during 2023. Of 137 cases reported in 2023, approximately half were acquired overseas and half were in vaccinated persons. Estimated effectiveness of 2-dose vaccine was 80%, and no vaccinated mpox patient was hospitalized. [ABSTRACT FROM AUTHOR]