Epidemiological Aspects and Basic Directions of the Protective Medications against Monkeypox Development
https://doi.org/10.31631/2073-3046-2024-23-2-4-14
Abstract
Relevance. After smallpox eradication, in conditions of population immunity to orthopoxviruses absence, Monkeypox virus became most significant orthopoxvirus, pathogenic for humans. Therefore the generalization of data on the areas of infection outbreaks, human diseases and methods of prevention and treatment of monkey pox is important task. Aim. To characterize the problem of monkeypox in the world based on an analysis of foreign scientific publications over the past 20 years. Materials and methods. The work used publications presented in the main international medical information databases PubMed, Web of Science, Embase, etc. To analyze the publications, the analytical epidemiological method was used. Results and discussion. Monkeypox virus, obtained and identified in 1958, by genetic and phenotypic differences divides on two clades: West-African with lethality 3.6% and Central-African (Congo Basin) with lethality 10%. Monkeypox virus transmission to men happens in two ways, either from animal-to-human or human-to-human. Monkey pox is endemic only on African continent, but In 2003 year the first outbreak, numbering 47 confirmed cases, was occurred in non-endemic country – USA and the largest monkeypox outbreak began in Nigeria in September 2017 year and continue to the present. Comparison of the genome sequences of strains, isolated from patients in non-endemic countries, showed, that it genetically close to West-african strains, belong to II clades and were descended from a common ancestor. Many cases of disease in humans in the current outbreak have been traced to sexual transmission especially among men, who identify ourselves as gay or bisexual. The basis method for identification of agent in present time is PCR-RT targeting on the tumor necrosis factor (TNF) receptor gene. Usually monkeypox of human is mild, self-limiting disease. The symptoms of monkeypox are varied and non-specific. One of the most frequently observed clinical symptoms is lymphadenopathy. Most patients recover during some weeks. However, specific antiviral treatment – tecovirimat (S-246) and brincidofovir (CMX-001) – may be used for seriously ill or immunocompromised individuals. For prophylactic disease in present time are use vaccines JYNNEOSTM, ACAM2000R and Aventis Pasteur (APSV). Conclusion. General vaccination against monkeypox don't develop accordingly to modern recommendations WHO. Ring vaccination is recommended to conduct for suppression of spread virus in nidus of infection among population. Timely international coordination is needed to prevent the global spread of a disease with epidemic potential.
About the Authors
L. F. StovbaRussian Federation
Ludmila F. Stovba – Cand. Sci. (Biol.), Senior Researcher of the Department, FSBE «48 Central Scientific Research Institute» of the Ministry of Defense of the Russian Federation.
SergievPosad-6
Tel. +7 (496) 552-12-06
A. A. Petrov
Russian Federation
Alexander A. Petrov – Dr. Sci. (Med.), Chief of the Directorate, FSBE «48 Central Scientific Research Institute» of the Ministry of Defense of the Russian Federation.
SergievPosad-6
Tel. +7 (496) 552-12-06
N. K. Cherniкova
Russian Federation
Natalia K. Chernikova – Cand. Sci. (Biol.), Senior Researcher of the Department, FSBE «48 Central Scientific Research Institute» of the Ministry of Defense of the Russian Federation.
SergievPosad-6
Tel. +7 (496) 552-12-06
A. L. Khmelev
Russian Federation
Alexey L. Khmelev – Cand. Sci. (Med.), Researcher of the Department, FSBE «48 Central Scientific Research Institute» of the Ministry of Defense of the Russian Federation.
SergievPosad-6
Tel. +7 (496) 552-12-06
S. L. Kuznetsov
Russian Federation
Sergey L. Kuznecov – Dr. Sci. (Med.), Chief of the Department, Department of the Head of the Nuclear, Chemical, and Biological Protection Troops of the Russian Armed Forces.
Moscow
Tel. +7 (496) 552-12-06
S. V. Borisevich
Russian Federation
Sergey V. Borisevich – Dr. Sci. (Biol.), Professor, Academician of RAS, Chief of the Institute, FSBE «48 Central Scientific Research Institute» of the Ministry of Defense of the Russian Federation.
11, Octyabrskaya Street, SergievPosad-6, Moscow region, 141306
Tel. +7 (496) 552-12-06
References
1. Сostello V, Sowash M, Gaur A, et al. Imported monkeypox from International Traveler, Maryland. USA. 2021. Emerg. Infect. Dis. 2022;28(5):1002–1005. doi: 10.3201/eid2805.220292
2. Gubser C, Hue S, Kellam P, Smith GL, et al. Poxvirus genomes: A phylogenetic analysis. J. Gen. Virol. 2004;85:105–117. doi: 10.1099/vir.0.19565-0
3. Haller SL, Peng C, McFadden G, et al. Poxviruses and the evolution of host range and virulence. Infect. Genet. Evol. 2014;10:15–40. doi:10.1016/j.meegid.2013.10.014
4. Von Magnus P, Andersen EK, Petersen KB, et al. A pox-like disease in cynomolgus monkeys. Acta Pathol. Microbiol. Scand. 2009;46(2):156–176. doi:10.1111/j.1699-0463.1959.tb00328.x
5. Khodakevich L, Jezek Z, Kinzanzka K. Isolation of monkeypox virus from wild squirrel infected in nature. Lancet. 1986;1(8472) 98–99. doi: 10.1016/s0140-6736(86)90748-8
6. Radonic A, Metzger S, Dabrovski PW, et al. Fatal monkeypox in wild-living sooty mangabey, Cote d’Ivoire, 2012. Emerg. Infect. Dis. 2014;20(6):1009–1011. doi: 10.3201/eid2006.13-1329
7. Theves C, Biagini P, Crubezy E. The rediscovery of smallpox. Clin. Microbiol. Infect. 2014;20(3):210–218. doi: 10.1111/1469-0691.12536
8. Likos AM, Sammons SA, Olson VA, et al. A tale of two clades: monkeypox viruses. J. Gen. Virol. 2005; 86(Pt 10): 2661–2672. doi: 10.1099/vir.0.81215-0
9. Mahy BWJ. An overview on the use of a viral pathogen as a bioterrorism agent: why smallpox? Antiviral Res. 2003;57(1-2):1–5. doi: 10.1016/s0166-3542(02)00194-8
10. Ladnyj ID, Ziegler P, Kima E. A human infection caused by monkeypox virus in Basankusu Territory, Democratic Republic of the Congo. Bull. World Health Organ. 1972;46(5):593–597. PMCID: PMC2480792
11. Hraib M, Jouni S, Albitar M, et. al. The outbreak of monkeypox 2022: An overviev. Ann. Med. Surg. (Lond). 2022;79:104069. doi:10.1016/j.amsu.2022.104069
12. Reed KD, Melski JW, Graham MB, et al. The detection of monkeypox in human Western Hemisphere. N. Engl. J. Med. 2004;350(4):342–350. doi: 10.1056/NEJMoa032299
13. Bunge EM, Hoet B, Chen L, et al. The changing epidemiology of human monkeypox – A potential threat? A systematic review. PLoS Negl. Trop. Dis. 2022;16(2): e0010141. doi:10.1371/journal.pntd.0010141
14. Доступно на:/ Available at: https://www.cdc.gov/poxvirus/monkeypox/response/2022/world-map.html. Accessed: 12 July 2022.
15. Доступно на:/ Available at: https://www.ourworlddindata.org/monkeypox Accessed: 21 October 2022.
16. Доступно на:/ Available at: https://www.ncbi.nlm.nih.gov/nuccore. Accessed: 21 October 2022.
17. Mauldin MR, McCollum AM, Nakazava YJ, et al. Exportation of Monkeypox Virus From the African Continent. J. Infect. Dis. 2022;225(8):1367–1376. doi:10./10.1093/infdis/jiaa559
18. Velavan TP, Meyer CG. Monkeypox 2022 outbreak: An update. Trop. Med. Int. Health. 2022; 27(7):604–605. doi:10.1111/tmi
19. Kozlov M. Monkeypox goes global: why scientists are on alert. Nature. 2022;606(7912):15–16. doi: 10.1038/d41586-022-01421-8
20. Mahase E. Seven monkeypox cases are confirmed in England. BMJ. 2022;377:o1239. doi:10.1136/bmjo1239
21. Monkeypox virus infections in the united states and other non-endemic countries 2022. Доступно на:/ Available at: https://www.emergency.Cdc.gov/han/2022han00466.asp. AccessedMay 25 2022.
22. Dye С, Kraemer MUG. Investigating the monkeypox outbreak. BMJ. 2022;377:ol314. doi:10.l136/bmi.o1314
23. Nalca A, Rimoin AW, Bavari S, et al. Reemergence of monkeypox: prevalence, diagnostics, and countermeasures. Clin. Infect. Dis. 2005;41(12):1765–1771. doi:10.1086/498155
24. Antinori A, Mazzotta V, Vita S, et al. Epidemiological, clinical аnd virological characteristics of four cases of monkeypox support transmission throught sexual contact, Italy, May 2022 separator commenting unaviable. Euro Surveill. 2022;27(22):2200421. doi:10.2807/1560-7917.ES.2022.27.22.2200421
25. Moore M, Rathish B, Zahra F. Mpox (Monkeypox). In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan. 2022 Nov 30. PMID: 34662033. Bookshelf ID: NBK574519.
26. McCollum AM, Damon IK. Human monkeypox. Clin. Infect. Dis. 2014;58(2):260–267. doi:10./10.1093/cid/cit703
27. Rizk JG, Lippi G, Henry BM, et al. Prevention and Treatment of Monkeypox. Drugs. 2022;82(9):957–963. doi: 10.1007/s40265-022-01742-y
28. Hammarlund E, Lewis MW, Carter SV, et al. Multiple diagnostic techniques identify previously vaccinated individuals with protective immunity against monkeypox. Nat. Med. 2005;11(9):1005–1011. doi:10.1038/nm1273
29. JYNNEOS [Package Insert]. Kvistgard, Denmark: Bavarian Nordic A/S:2019. Available at: https:/www.fda.gov/media/131078/download. Accessed: 25 May 2022.
30. Volz A, Sutter G. Modified Vaccinia virus Ankara: History, Value in Basic Research, and Current Perspectives for Vaccine Development. Adv. Virus. Res. 2017;97:187–243. doi: 10.1016/bs.aivir.2016.07.001
31. Crum-Cianflone NF, Sullivan E. Vaccination for the HIV-Infected Adult: A Revive of the Current Recommendations, Part I. Infect. Dis. Ther. 2017;6(3):303–331. doi: 10.1007/s40121-017-0166-x
32. US Centers For Disease Control and Prevention (CDC). Smallpox vaccines. Updated December 2, 2019. Available at: https://www.cdc.gov/smallpox/clinicians/vaccines.html. Accessed: 25 May 2022.
33. Smallpox/MonkeypoxVaccine (JYNNEOS™): What You Need to Know. Доступно на:/ Available at: https://www.cdc.gov/poxvirus/monkeypox. Accessed: 25 May 2022.
34. Wittek R. Vaccinia immune globulin: current policies, preparedness, and product safety and efficacy. Int. J. Infect. Dis. 2006;10(3):193–201. doi:10.1016/j.ijid.2005.12/001
35. Oliveira SNI, de Oliveira JS, Kroon EG, et al. Here, There, and Everywhere: The Wide Host Range and Geogrаphic Distribution of Zoonotic Orthopoxviruses. Viruses. 2021;13(1):43.doi:10.3390/v13010043
36. Sklenovska N, Van Ranst M. Emergence of Monkeypox as the Most Important Orthopoxvirus Infection in Humans. Front. Pablic. Heal. 2018;6:241. doi: 10.3389/fpubh.2018.00241
37. World Health Organization (WHO). Human monkeypox in Kasai Oriental, Democratic Republic of the Congo (former Zaire): Preliminary report of October, 1997 investigation. Wkly. Epidemiol. Rec. 1997;72(49):369–372. PMID: 9426474
38. Reynolds MG, Emerson GL, Pukuta E, et al. Detection of human monkeypox in the Republic of the Congo following intensive community education. Am. J. Trop. Med. Hyg. 2013;88(5):982–985. doi: 10.4269/ajtmh.12-0758
39. Berthet N, Nakoune E, Whist E, et al. Maculopapular lesions in the Central African Republic. Lancet. 2011;378(9799):1354. doi: 10.1016/S0140-6736(11)61142-2
40. McCollum AM, Nakazava Y, Nlongala GM, et al. Case report: Human monkeypox in the kivus, a conflict region of the Democratic Republic of the Congo. Am. J. Trop. Med. Hyg. 2015;93(4):718–721. doi: 10.4269/ajtmh.15-0095
41. Centers for Disease Control and Prevention (CDC). About Monkeypox. Доступно на:/ Available at: https://www.cdc.gov/poxvirus/monkeypox/about.html. Accessed: 24 September 2020.
42. Kalthan E, Dondo-Fongbia JP, Yambele S, et al. Twelve cases of monkeypox virus outbreak in Bangasou District (Central African Republic) in december 2015. Bull. Soc. Pathol. Exot. 2016;109(5):358–363. doi: 10.1007/s13149-016-0516-z
43. World Health Organization (WHO). Monkeypox in Central African Republic. Доступно на:/ Available at: https://www.who.int/csr/don/13-october-2016-monkeypox-caf/en/ Accessed: 25 September 2020.
44. World Health Organization (WHO). Weekly Bulletin on outbreaks and Other Emergencies, Week 48. 2017. Доступно на:/ Available at: https://www.apps.who.int/iris/bit-stream/handle/10665/259557/OEW482504122017.pdf. Accessed: 25 September 2020.
45. Yinka-Ogunleye A, Aruna O, Dalhat M, et al. Outbreak of human monkeypox in Nigeria in 2017–18: a clinical and epidemiological report. Lancet Infect. Dis. 2019;19:872– 879. doi: 10.1016/S1473-3099(19)30294-4
46. World Health Organization (WHO). Weekly Bulletin on outbreaks and Other Emergencies, Week 22. 2019. Доступно на:/ Available at: https://www.apps.who.int/iris/bit-stream/handle/10665/325086/OEW22-270502062019.pdf. Accessed: 25 September 2020.
47. World Health Organization (WHO). Weekly Bulletin on outbreaks and Other Emergencies, Week 11.2020. Доступно на:/ Available at: https://www.apps.who.int/iris/bit-stream/handle/10665/255579//OEW11-0915032020.pdf. Accessed: 25 September 2020.
48. World Health Organization (WHO). Weekly Bulletin on outbreaks and Other Emergencies, Week 21.2017. Доступно на:/ Available at: https://www.apps.who.int/iris/bit-stream/handle/10665/255579//OEW21-202652017.pdf. Accessed: 25 September 2020.
49. World Health Organization (WHO). Weekly Bulletin on outbreaks and Other Emergencies, Week 08.2018. Доступно на:/ Available at: https://www.apps.who.int/iris/bit-stream/handle/10665/260335//OEW8-1723022018.pdf. Accessed: 26 September 2020.
50. World Health Organization (WHO). Weekly Bulletin on outbreaks and Other Emergencies, Week 39. 2018. Доступно на:/ Available at: https://www.apps.who.int/iris/bitstream/handle/275136/260335//OEW39-2228092018.pdf. Accessed: 25 September 2020.
51. World Health Organization (WHO). Weekly Bulletin on outbreaks and Other Emergencies, Week 01. 2018. Available at: https://www.apps.who.int/iris/bitstream/handle/278952/260335//OEW01-29122018-04012019.pdf. Accessed: 26 September 2020.
52. World Health Organization (WHO). Weekly Bulletin on outbreaks and Other Emergencies, Week 37.2020. Available at: https://www.apps.who.int/iris/bitstream/handle/10665/334303//OEW37-0713092020.pdf. Accessed: 26 September 2020.
53. Доступно на:/ Available at: https://www.ourworldindata.org/monkeypox. Accessed: 26 September 2020.
Review
For citations:
Stovba L.F., Petrov A.A., Cherniкova N.K., Khmelev A.L., Kuznetsov S.L., Borisevich S.V. Epidemiological Aspects and Basic Directions of the Protective Medications against Monkeypox Development. Epidemiology and Vaccinal Prevention. 2024;23(2):4-14. (In Russ.) https://doi.org/10.31631/2073-3046-2024-23-2-4-14