Mpox and related poxviruses:A literature review of evolution,pathophysiology,and clinical manifestations

The recently re-emerged mpox(monkeypox)virus that causes mpox disease is a member of genus Orthopoxvirus and has unprecedentedly spread worldwide.Numerous studies have contributed to our understanding of its evolution,pathophysiology,and clinical manifestations.The current outbreak of the mpox virus depicts its novel route of transmission as a new variant.However,the exact reason for its transition from an epidemic to a pandemic remains unclear.Furthermore,other poxviruses such as vaccinia virus,variola virus,and cowpox virus,also belong to the same genus,Orthopoxvirus.In the present review,our objective was to summarize the evidence on evolution,pathophysiology,and clinical manifestations of mpox virus and its related poxviruses.The present review would aid in a better understanding of the current circulating mpox virus and its differences from other poxviruses.In addition,the shared genetic factors contributing to virulence in these Orthopoxvirus highlight their evolutionary connections and genetic similarities.While they exhibit differences in virulence,studying these genetic relationships is crucial for understanding their biology,pathogenicity,and the development of effective vaccines and antiviral therapeutics to curb mpox disease.

Review of the prevalence,diagnostics,and containment measures of the current mpox outbreak

Monkeypox(mpox),is a disease from the Poxviridae family that can cause several serious medical issues.This mini-review sought to analyze the existing literature regarding the current mpox outbreak with a focus on the prevalence,diagnostics,and containment measures.Mpox cases have been reported to World Health Organization(WHO)from 85 Member States in all six WHO regions during the period of January 1,2022,through August 3,2022.Standardized or optimized guidelines for the clinical care of patients with mpox are limited,particularly in low-resource settings.In an effort to achieve guidance and meet standards,special attention should be paid to this outbreak in order to eradicate such a rare infectious disease by analyzing prevention and control measures.Patient outcomes may also be poor,and their illnesses may last for a long time.The spectrum of clinical symptoms,including complications and sequelae,as well as aspects of the illness may be indicators of sickness severity and complications;therefore,its clinical presentation must be better understood to improve containment measures.In addition,it is important to create and evaluate a standard of care that takes a variety of parameters into account,including antiviral,immune therapies,and clinical metrics that are particular to mpox.The global emergence of mpox has presented new challenges for public health and has called for further investigation into its epidemiological profile across international contexts.

Monkeypox:An emerging zoonotic pathogen

Monkeypox virus(MPXV),which belongs to the orthopoxvirus genus,causes zoonotic viral disease.This review discusses the biology,epidemiology,and evolution of MPXV infection,particularly cellular,human,and viral factors,virus transmission dynamics,infection,and persistence in nature.This review also describes the role of recombination,gene loss,and gene gain in MPXV evolvement and the role of signal transduction in MPXV infection and provides an overview of the current access to therapeutic options for the treatment and prevention of MPXV.Finally,this review highlighted gaps in knowledge and proposed future research endeavors to address the unresolved questions.

Brazilian vaccinia virus strains show a classical orthopoxvirus infection course and cross-protection

Objectives:The purpose of this work was to study the infection course and cross-protection in mice after intradermal injection of Vaccinia virus(VACV) strain Western Reserve and three Brazilian VACV strains: Aracatuba,Muriae and BeAn58058 isolated from cow,human and rodent,respectively.Methods:Balb/c mice were inoculated by footpad and back scarification and daily monitored regarding lesion development and weight loss.To check cross protection after intradermal VACV inoculation,mice were subsequendy infected with different VACV strains and monitored to check lesion development.Serum neutralization assays were performed to check for the presence of antibodies against Orthopoxvirus.Results:After VACV intradermal inoculation the lesion development pattern was similar in mice infected with the different virus strains.By using the footpad scarification model,cross-protection among VACV strains was observed.Moreover,neutralizing antibodies against Orthopoxvirus were detected in sera from mice infected with all VACV strains.Conclusion:Although it was not possible to observe virulence differences among VACV strains isolated from cow,rodent and human using the murine model,this inoculation route showed to be an appropriated model to study lesions development since it mimics natural infections by VACV in nature.

Monkeypox virus:past and present

Background The objective of this paper is to analyze the current status of monkeypox worldwide.In the face of this public health threat,our purpose is to elucidate the clinical characteristics and epidemiology of monkeypox,the developmental progress of monkeypox-related drugs and the vaccines available.Data sources The literature review was performed in databases including PubMed,Science Direct and Google Scholar up to July 2022.Results Since May 2022,the World Health Organization has reported more than 45,000 confirmed cases from 92 nonendemic countries,including nine deaths.Although some women and children have been infected so far,most cases have occurred among men who have sex with other men,especially those with multiple sexual partners or anonymous sex.Conclusions Pediatric monkeypox infection has been associated with a higher likelihood of severe illness and mortality than in adults.Severe monkeypox illness in pediatrics often requires adjunctive antiviral therapy.It is crucial for all countries to establish sound monitoring and testing systems and be prepared with emergency preparedness.

Monkeypox:A comprehensive review of a multifaceted virus

In May 2022,the world witnessed the re-emergence of the zoonotic disease monkeypox.While this was not the first epidemic of this disease,what differentiated the outbreak was the rapid global spread and increase of cases,which led the WHO to declare monkeypox a global health emergency.Although the disease spreads mainly through inadequately cooked meat of various rodent species,this virus also shows droplet,respiratory,sexual,and even vertical transmission.Monkeypox further multiplies in lymphoproliferative organs and presents with a classical smallpox-like rash,fever,headache,and muscle aches.Diagnosis is confirmed with a polymerase-chain-reaction test and is managed largely supportively with possible usage of some antivirals and immunoglobulins.Moreover,some pre-exposure and postexposure prophylactic vaccines have been developed.This paper aims to conduct an in-depth review of the historical epidemics,transmission,pathophysiology,clinical presentation,and management of the monkeypox disease.

Evaluation of the diagnostic performance of a commercial molecular assay for the screening of suspected monkeypox cases in Sri Lanka

Background:The main objective of the present study was to compare the diagnostic performance of the commercial LightMix Modular Monkeypox Virus(MPXV)qPCR(TIB Molbiol,Germany)assay with the in-house non-variola orthopox/monkeypox generic real-time PCR assay(ICMR-NIV,Pune)for the screening of(MPXV)cases at Medical Research Institute(MRI)in Sri Lanka.Furthermore,clinical and sociodemographic data of suspected/confirmed cases received at MRI for the MPXV screening were also analyzed.Methods:The diagnostic performance of the commercial LightMix Modular MPXV qPCR assay with the in-house nonvariola orthopox/monkeypox generic real-time PCR assay for the screening of suspected MXPV cases was evaluated using standard methods with minor modifications.Socio-demographic and clinical profiles of suspected and confirmed MPXV cases were also analyzed.Results:The commercial LightMix Modular MPXV assay was able to detect MPXV with 100%sensitivity and specificity with non-variola orthopox/monkeypox generic rtPCR assay.During the period of study,from the total of 25 samples tested,only 2 were MPXV-positive(males).The most common symptoms of suspected MPXV cases were lesions or rashes(92%).Conclusions:With the continually increasing number of cases,access to MPXV testing should be made more widely available.The commercial LightMix Modular MPXV(TIB Molbiol)qPCR assay offers comparable performance to the non-variola orthopox/monkeypox generic real time PCR assay for MPXV detection during the present outbreak.

Monkeypox virus:a re-emergent threat to humans

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.