Monkeypox in humans:Transmission,pathophysiology,diagnosis,treatment,prevention,and all recent updates

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.

Burden of onchocerciasis-associated epilepsy:first estimates and research priorities

Background:Since the 1990s,evidence has accumulated of an increased prevalence of epilepsy in onchocerciasisendemic areas in Africa as compared to onchocerciasis-free areas.Although the causal relationship between onchocerciasis and epilepsy has yet to be proven,there is likely an association.Here we discuss the need for disease burden estimates of onchocerciasis-associated epilepsy(OAE),provide them,detail how such estimates should be refined,and discuss the socioeconomic impact of OAE,including a cost-estimate for anti-epileptic drugs.Main body:Providing OAE burden estimates may aid prevention of epilepsy in onchocerciasis-endemic areas by inciting and informing collaboration between onchocerciasis control programmes and mental health services.Epilepsy not only massively impacts the health of those affected,but it also carries a high socioeconomic burden for the households and communities involved.We used previously published geospatial estimates of onchocerciasis in Africa and a separately published logistic regression model quantifying the association between onchocerciasis and epilepsy to estimate the number of OAE cases.We then applied disability weights for epilepsy to quantify the burden in terms of years of life lived with disability(YLD)and estimate the cost of treatment.We estimate that in 2015 roughly 117000 people were affected by OAE across onchocerciasis-endemic areas previously under the African Programme for Onchocerciases control(APOC)mandate where OAE has ever been reported or suspected,and another 264000 persons in onchocerciasis-endemic areas where OAE has never been investigated before.The total number of YLDs due to OAE was 39300 and 88700 in these areas respectively,based on a weighted mean disability weight of 0.336.The burden of OAE is approximately 13%of the total YLDs attributable to onchocerciasis and 10%of total YLDs attributable to epilepsy.We estimated that by 2015 the total costs of treatment with antiepileptic drug for OAE cases would have been a minimum of 12.4 million US$.Conclusions:These estimates suggest a considerable health,social and economic burden of OAE in Africa.The treatment and care for people with epilepsy,especially in hyperendemic onchocerciasis areas with high epilepsy prevalence thus requires more financial and human resources.