Gene duplication, gene loss, and recombination events with variola virus shaped the complex evolutionary path of historical American horsepox-based smallpox vaccines.

IMPORTANCE: Modern smallpox vaccines, such as those used against mpox, are made from vaccinia viruses, but it is still unknown whether cowpox, horsepox, or vaccinia viruses were used in the early 20th century or earlier. The mystery began to be solved when the genomes of six historical smallpox vaccines used in the United States from 1850 to 1902 were determined. Our work analyzed in detail the genomes of these six historical vaccines, revealing a complex genomic structure. Historical vaccines are highly similar to horsepox in the core of their genomes, but some are closer to the structure of vaccinia virus at the ends of the genome. One of the vaccines is a recombinant virus with parts of variola virus recombined into its genome. Our data add valuable information for understanding the evolutionary path of current smallpox vaccines and the genetic makeup of the potentially extinct group of horsepox viruses.

La viruela símica como enfermedad zoonótica viral y reemergente en el actual contexto sanitario mundial / Mpox as a Viral Zoonotic Disease Reemerging in the Current Global Health Context

Introducción: La viruela símica es una enfermedad zoonótica que también se trasmite de persona a persona por contacto estrecho. En el brote actual hasta el 31 de agosto de 2022 se reportaban 50 496 casos diagnosticados en 101 países, por lo que se consideró una situación preocupante por la Organización Mundial de la Salud. Objetivo: Exponer información actualizada sobre la viruela símica en el contexto sanitario actual. Métodos: Se realizó una búsqueda de literatura científica en las bases de datos ScienceDirect, PubMed/Medline, SciELO y Google Académico, mediante los descriptores o palabras relacionadas con la enfermedad, para encontrar revisiones, comunicados, informes, distintos artículos de revistas, entre otros documentos especializados de producción científica. Se seleccionó un total de 30 citas, actualizadas en su totalidad. Desarrollo: Desde su identificación en humanos se han reportado brotes de viruela símica en varios países; el más preocupante, ha sido el de reciente declaración en 2022, debido a la presencia de casos en países no endémicos, con un alcance geográfico extenso. Las manifestaciones clínicas pueden cursar con síntomas leves, como erupciones en la cara y el resto del cuerpo, fiebre, cefalea, mialgias y fatiga, por lo que no constituye una enfermedad potencialmente mortal; sin embargo, de presentarse comorbilidades la evolución podría ser tórpida. Conclusiones: La presencia de casos de viruela símica en humanos se ha mantenido desde su aparición, sin encontrar un tratamiento específico y vacunas autorizadas para su administración, lo que podría generar un aumento de contagios y fallecidos(AU)

Introduction: Mpox is a zoonotic disease also transmitted from person to person by close contact. The current outbreak, up to August 31, 2022, reported 50 496 diagnosed cases from 101 countries; therefore; it was considered a situation of concern by the World Health Organization. Objective: To present updated information on Mpox in the current health context. Methods: A scientific literature search was carried out in the databases ScienceDirect, PubMed/Medline, SciELO and Google Scholar, using descriptors or words related to the disease, in order to find reviews, communications, reports, different journal articles, among other specialized documents of scientific production. A total of 30 entirely updated citations were selected. Development: Since Mpox was identified in humans, outbreaks of the disease have been reported in several countries; the most worrisome has been reported recently in 2022, due to the presence of cases in nonendemic countries, with an extensive geographical scope. The clinical manifestations may occur with mild symptoms, such as rash on the face or the rest of the body, fever, headache, myalgia and fatigue; therefore, it is not a potentially mortal disease. However, in case of comorbidity, the evolution could be torpid. Conclusions: Mpox cases in humans has been present since its appearance, without any specific treatment or vaccines authorized to be administered, which could generate an increase in contagions and deaths(AU)

Low prevalence of anti-Orthopoxvirus neutralizing antibodies in an urban population of Brazil.

Since 1999, Vaccinia virus (VACV) has been described as a causative agent of bovine vaccinia (BV), a zoonotic disease that occurs mainly in rural areas of Brazil. However, the circulation of VACV in urban environments and its associated burden has been poorly explored. Moreover, the current monkeypox (mpox) outbreak has raised questions regarding the immune status of the worldwide population previous vaccinated against smallpox. Hence, we conducted a cross-sectional study to better understand the prevalence of anti-OPV neutralizing antibodies (NA) and related exposure factors in a susceptible urban population of Brazil. A total of 372 individuals were sampled, yielding an overall seroprevalence of 16.9% (CI95% = 13.4-21.1), and antibodies titers ranging from 100 to 800 neutralizing units/mL. The prevalence of NA among individuals potentially vaccinated against smallpox (≥36 years old [yo]) was 24.9% (IC 95% = 19.5-31.2), and among those unvaccinated (<36yo) was 6.7% (IC 95% = 3.7-11.8). Interestingly, contact with horses was pointed out as an exposure factor for the presence of NA, however, the multivariate logistic regression analysis indicated that age ≥36yo and the presence of vaccine take were independently associated with the presence of anti-OPV NA. Our findings suggest that vulnerable populations could be subclinically exposed to VACV in urban areas, drawing attention to alternative routes of zoonotic VACV exposure. Our data is also important for better strategies to mitigate zoonotic OPV infections mainly among vulnerable populations.

Orthopoxvirus Circulation in an Endemic Area in Brazil: Investigation of Infections in Small Mammals during an Absence of Outbreaks.

Vaccinia virus (VACV) is the causative agent of an emerging viral zoonosis called bovine vaccinia (BV). Several studies have documented characteristics of VACV infections in Brazil; however, the manner in which this virus is maintained in wildlife remains unknown. This work investigated the presence of viral DNA and anti-orthopoxvirus (OPXV) antibodies in samples collected from small mammals in a VACV-endemic area in Minas Gerais, Brazil, in the absence of current outbreaks. Samples did not show amplification of OPXV DNA in molecular tests. However, 5/142 serum samples demonstrated the presence of anti-OPXV neutralizing antibodies in serological tests. These data reinforce the involvement of small mammals in the natural cycle of VACV, highlighting the need for further ecological studies to better understand how this virus is maintained in nature and to develop measures to prevent BV outbreaks.

Orthopoxvirus Seroprevalence and Infection Susceptibility in France, Bolivia, Laos, and Mali.

To determine a demographic overview of orthopoxvirus seroprevalence, we tested blood samples collected during 2003-2019 from France (n = 4,876), Bolivia (n = 601), Laos (n = 657), and Mali (n = 255) for neutralizing antibodies against vaccinia virus. In addition, we tested 4,448 of the 4,876 samples from France for neutralizing antibodies against cowpox virus. We confirmed extensive cross-immunity between the 2 viruses. Seroprevalence of antibodies was <1% in Bolivia, <5% in Laos, and 17.25% in Mali. In France, we found low prevalence of neutralizing antibodies in persons who were unvaccinated and vaccinated for smallpox, suggesting immunosenescence occurred in vaccinated persons, and smallpox vaccination compliance declined before the end of compulsory vaccination. Our results suggest that populations in Europe, Africa, Asia, and South America are susceptible to orthopoxvirus infections, which might have precipitated the emergence of orthopoxvirus infections such as the 2022 spread of monkeypox in Europe.

Nota Técnica N. 2/2022 - SES/ASREA - 18776 - Nota técnica de manejo da Monkeypox em gestantes, puérperas e lactantes / Technical Note N. 2/2022 - SES/ASREA- 18776 - Technical note on the management of Monkeypox in pregnant, postpartum and lactating women

A presente nota técnica tem como objetivo orientar os profissionais de saúde em relação à condução dos casos suspeitos e/ou confirmados de Monkeypox em gestantes, puérperas e lactantes. A Monkeypox (MPX) ou Varíola M é uma doença causada pelo vírus Monkeypox do gênero Orthopoxvirus e família Poxviridae. Trata-se de uma zoonose viral cuja transmissão pode ocorrer por meio do contato desprotegido com lesões ou fluidos corporais (contato sexual, saliva, olhos, cavidade oral) e/ou materiais contaminados (roupa de cama, vestes, utensílios domésticos)

This technical note aims to guide health professionals in relation to the management of suspected and/or confirmed cases of Monkeypox in pregnant, postpartum and lactating women. Monkeypox (MPX) or Smallpox M is a disease caused by the Monkeypox virus of the genus Orthopoxvirus and family Poxviridae. It is a viral zoonosis whose transmission can occur through unprotected contact with injuries or bodily fluids (sexual contact, saliva, eyes, sinus oral) and/or contaminated materials (bedding, clothing, household items)

Guidance on Clinical Suspicion and Differential Diagnosis of Monkeypox. Provisional Technical Note, June 2022

The purpose of this publication is to present guidelines for the clinical diagnosis of monkeypox to assist in the proper management of patients and the application of infection control practices. In addition, given that the appearance and evolution of the typical skin lesions of this viral disease are variable, a selection of photographs of different cases is included that will help in the differential diagnosis.

Viruela símica: zoonosis emergente con impacto global / Monkeypox: emerging zoonosis with unprecedentedglobal impact

El virus de la viruela símica es un orthopoxvirus de características zoonóticas endémico en las regiones de África Central y África Occidental, donde causa brotes desde 1970. En las últimas décadas se registró un aumento exponencial de casos, probablemente asociado a la disminución en la inmunidad conferida por la vacuna antivariólica, discontinuada luego de la erradicación de la viruela. En los últimos años se registraron casos esporádicos fuera del continente africano, siempre relacionados epidemiológicamente a la permanencia en áreas endémicas o contacto con animales infectados. Desde el 13 de mayo de 2022 se encuentra en curso el mayor brote de viruela símica registrado fuera de las áreas endémicas de África, con casos en los cinco continentes. La extensión, el impacto y la duración del brote permanecen aún inciertos.

Monkeypox virus is an orthopoxvirus with zoonotic characteristics endemic in Central and West Africa regions, where it has caused outbreaks since 1970. An exponential increase in cases has been registered in the last decades, probably associated with a decrease in the immunity conferred by the smallpox vaccine, discontinued after smallpox eradication. In recent years, sporadic cases have been reported outside the African continent, always epidemiologically related to permanence in endemic areas or contact with infected animals. Since May 13, 2022, the largest monkeypox outbreak ever reported outside Africa endemic areas, with cases on the five continents, is unfolding. The extent, impact and duration of this outbreak still remain uncertain

Orientaciones sobre la sospecha clínica y el diagnóstico diferencial de la viruela símica. Nota técnica provisional, junio del 2022

El propósito de esta publicación es presentar unas orientaciones para el diagnóstico clínico de la viruela símica a fin de ayudar al adecuado manejo de los pacientes y a la aplicación de las prácticas de control de infecciones. Además, dado que la apariencia y evolución de las lesiones cutáneas típicas de esta enfermedad viral son variables, se incluye una selección de fotografías de distintos casos que servirán de ayuda para el diagnóstico diferencial.

Monkeypox - varíola dos macacos / Monkeypox

Monkeypox ou varíola dos macacos (VM) é uma rara zoonose causada pelo vírus monkeypox que pertence ao gênero Orthopoxvirus na família Poxviridae. Deste gênero, também fazem parte os vírus da varíola humana, bovina e o vaccinia, o qual é usado na produção da vacina contra a varíola em seres humanos. Seus sintomas são semelhantes aos observados no passado em pacientes com varíola, embora clinicamente menos graves (febre, erupções cutâneas, linfonodos inflamados) (CDC, 2022a; WHO, 2022a )

Monkeypox or monkeypox (MV) is a rare zoonosis caused by the monkeypox virus that belongs to the genus Orthopoxvirus in the family Poxviridae. This genus also includes human and cowpox viruses, and vaccinia, which is used in the production of the vaccine. against smallpox in humans. Its symptoms are similar to those seen in the past in smallpox patients, although clinically less severe (fever, rash, swollen lymph nodes) (CDC, 2022a; WHO, 2022a)

Monkeypox - vacinas / Monkeypox - vaccines

Monkeypox é uma rara zoonose causada pelo vírus Monkeypox que pertence ao gênero Orthopoxvirus na família Poxviridae. Deste gênero, também fazem parte os vírus da varíola humana, bovina e o vaccinia, o qual é usado na produção da vacina contra a varíola em seres humanos. Seus sintomas são semelhantes aos observados no passado em pacientes com varíola, embora clinicamente menos graves (febre, erupções cutâneas, linfonodos inflamados) (CDC, 2022a; WHO, 2022a)

Monkeypox is a rare zoonosis caused by the Monkeypox virus that belongs to the genus Orthopoxvirus in the family Poxviridae. This genus also includes human and cowpox viruses and vaccinia, which is used in the production of smallpox vaccine in human beings. humans. Its symptoms are similar to those seen in the past in smallpox patients, although clinically less severe (fever, rash, swollen lymph nodes) (CDC, 2022a; WHO, 2022a)

VIIIe réunion ad hoc du Groupe consultatif technique (GCT) de l'OPS sur les maladies évitables par la vaccination. Briefing technique sur l'épidémie multi-pays de variole du singe, 31 mai 2022 (virtual)

Le virus de la variole du singe est un orthopoxvirus qui provoque une maladie dont les symptômes sont similaires, mais moins graves, à ceux de la variole. Alors que la variole a été éradiquée en 1980, la variole du singe continue d'être présent dans les pays d'Afrique centrale et occidentale. Deux clades distincts sont identifiés : le clade ouest-africain et le clade du bassin du Congo. La variole du singe est une zoonose. Les cas sont souvent observés en proximité des forêts tropicales humides où divers animaux sont porteurs du virus, notamment les écureuils, les rongeurs, les loirs et les singes. La plupart des infections humaines par le virus de la variole du singe dans les pays endémiques résultent d'une transmission primaire de l'animal à l'homme. La transmission interhumaine existe, la plus longue chaîne de transmission documentée étant de six générations. La transmission se fait par contact avec les fluides corporels, les lésions sur la peau ou sur les surfaces muqueuses internes, comme dans la bouche ou la gorge, les gouttelettes respiratoires et les objets contaminés. Il faut éviter tout contact étroit avec des personnes infectées ou des matériaux contaminés. Bien que la transmission d'homme à animal soit rare, elle doit être considérée comme un lien possible dans la chaîne de transmission. La variole du singe est endémique en Afrique centrale et occidentale depuis sa première détection en 1958 en la République Démocratique du Congo. Néanmoins, depuis le 13 mai 2022, cependant, plusieurs pays d'Europe ont signalé l'apparition soudaine et inattendue de la variole du singe. À ce jour, 27 pays non endémiques répartis dans quatre régions de l'OMS ont signalé des cas. Parmi ceux-ci, quatre sont des pays des Amériques. Plusieurs cas suspects dans ces pays et dans d'autres sont en cours d'investigation. Le Groupe consultatif technique (GCT) sur les maladies évitables par la vaccination s'est réuni le 31 mai 2022 afin de discuter des implications de la variole du singe dans la Région des Amériques. Le rapport résume les données épidémiologiques à ce jour, passe en revue les informations disponibles sur les vaccins contre la variole du singe, et fournit des recommandations aux États Membres des Amériques sur les stratégies pour minimiser la transmission virale et aborder les opérations de vaccination.

VIII Reunión ad hoc del Grupo Técnico Asesor (GTA) sobre Enfermedades Prevenibles por Vacunación de la OPS. Informe técnico sobre el brote de viruela símica en varios países, 31 de mayo del 2022 (virtual)

El virus de la viruela símica es un Ortopoxvirus que causa una enfermedad con síntomas similares, pero menos graves, a los de la viruela. Aunque la viruela fue erradicada en 1980, la viruela símica sigue apareciendo en países de África central y occidental. Se han identificado dos clados distintos: el clado de África occidental y el clado de la cuenca del Congo. La viruela símica es una zoonosis. Los casos suelen encontrarse cerca de las selvas tropicales, donde varios animales son portadores del virus, como las ardillas, los roedores, los lirones y los monos. La mayoría de las infecciones humanas por viruela símica en los países endémicos son el resultado de una transmisión primaria de animal a humano. La transmisión de persona a persona se produce, siendo la cadena de transmisión más larga documentada de seis generaciones. La transmisión se produce a través del contacto con fluidos corporales, lesiones en la piel o en superficies mucosas internas, como en la boca o la garganta, gotas respiratorias y objetos contaminados. Debe evitarse el contacto estrecho con personas infectadas o materiales contaminados. Aunque la transmisión de persona a animal es rara, debe considerarse como un posible eslabón en la cadena de transmisión. La viruela símica ha sido endémica en África central y occidental desde su primera detección en 1958 en la República Democrática del Congo. Sin embargo, desde el 13 de mayo de 2022, múltiples países de Europa han notificado la aparición repentina e inesperada de la viruela símica. Hasta la fecha, 27 países no endémicos de cuatro regiones de la OMS han notificado casos. De ellos, cuatro son países de las Américas. Actualmente se están investigando múltiples casos sospechosos en estos y otros países. El Grupo Técnico Asesor (GTA) sobre Enfermedades Prevenibles por Vacunación de la OPS se reunió el 31 de mayo del 2022 para discutir las implicaciones de la viruela símica en la Región de las Américas. El informe los datos epidemiológicos hasta la fecha, revisa la información disponible sobre las vacunas contra la viruela símica y ofrece recomendaciones a los Estados Miembros de las Américas sobre cómo minimizar la transmisión viral y enfocar las operaciones de vacunación.

VIII Reunião Ad Hoc do Grupo Técnico Assessor (GTA) da OPAS sobre Doenças Preveníveis Imunopreveníveis. Informe técnico sobre o surto de varíola dos macacos em vários países, 31 de maio de 2022 (virtual)

O vírus da varíola é um Orthopoxvirus que causa uma doença com sintomas semelhantes à varíola, mas menos graves. Enquanto a varíola foi erradicada em 1980, a varíola dos macacos continua a ocorrer em países da África Central e Ocidental. Dois clados distintos são identificados: o clado da África Ocidental e o clado da Bacia do Congo. A varíola dos macacos é uma zoonose. Muitas vezes são encontrados casos próximos a florestas tropicais onde vários animais transportam o vírus, incluindo esquilos, roedores, dormitórios e macacos. A maioria das infecções por varíola dos macacos em humanos nos países endêmicos resulta de uma transmissão primária de animais para humanos. A transmissão entre humanos ocorre, sendo que a cadeia de transmissão mais longa e documentada é de seis gerações. A transmissão ocorre por contato com fluidos corporais, lesões na pele ou em superfícies internas da mucosa, como na boca ou garganta, gotículas respiratórias e objetos contaminados. O contato próximo com pessoas infectadas ou materiais contaminados deve ser evitado. Embora a transmissão homem-animal seja rara, ela deve ser considerada como um possível elo na cadeia de transmissão. A varíola dos macacos (ou varíola símia) é endêmica na África central e ocidental desde sua primeira detecção em 1958 na República Democrática do Congo. Entretanto, desde 13 de maio de 2022, entretanto, vários países na Europa relataram o aparecimento repentino e inesperado da varíola dos macacos. Até hoje, 27 países não endêmicos em quatro regiões da OMS relataram casos. Destes, quatro são países das Américas. Vários casos suspeitos nestes e em outros países estão atualmente sob investigação. O Grupo Técnico Assessor (GTA) sobre Doenças Preveníveis por Vacinas da OPAS reuniu-se para uma reunião ad hoc em 31 de maio de 2022 para discutir as implicações da varíola macaco na Região das Américas. O relatório resume os dados epidemiológicos até o momento, analisa as informações disponíveis sobre vacinas contra a varíola dos macacos e fornece recomendações aos Estados Membros das Américas sobre como minimizar a transmissão viral e abordar as operações de vacinação.

VIII Ad Hoc Meeting of PAHO’s Technical Advisory Group (TAG) on Vaccine-Preventable Diseases. Technical Briefing on the Multi-Country Monkeypox Outbreak: Recommendations on Monkeypox Vaccines and Vaccination

Monkeypox virus is an orthopoxvirus that causes a disease with symptoms similar, but less severe, to smallpox. While smallpox was eradicated in 1980, monkeypox continues to occur in countries of Central and West Africa. Two distinct clades are identified: the West African clade and the Congo Basin clade. Monkeypox is a zoonosis and cases are often found close to tropical rainforests where various animals carry the virus including squirrels, rodents, dormice, and monkeys. Most human monkeypox infections in endemic countries result from a primary animal-to-human transmission. Human-to-human transmission does occur, with the longest documented chain of transmission being six generations. Transmission occurs through contact with bodily fluids, lesions on the skin or on internal mucosal surfaces, such as in the mouth or throat, respiratory droplets, and contaminated objects. Close contact with infected people or contaminated materials should be avoided. While human-to-animal transmission is rare, it should be considered as a possible link in the transmission chain. Monkeypox has been endemic in central and west Africa since its first detection in 1958 in the Democratic Republic of Congo. However, since 13 May 2022 multiple countries in Europe have reported the sudden and unexpected appearance of monkeypox. To date, 27 non-endemic countries across four WHO regions have reported cases. Of these, four are countries in the Americas. Multiple suspected cases in these and other countries are currently under investigation. PAHO's Technical Advisory Group (TAG) on Vaccine-Preventable Diseases met for an ad hoc meeting on 31 May 2022 to discuss the implications for monkeypox in the Region of the Americas. This executive summary summarizes the contents of the final report generated from this meeting.

VIII Ad Hoc Meeting of PAHO’s Technical Advisory Group (TAG) On Vaccine-Preventable Diseases: Technical Briefing on the Multi-Country Monkeypox Outbreak, 31 May 2022 (virtual)

Monkeypox virus is an orthopoxvirus that causes a disease with symptoms similar, but less severe, to smallpox. While smallpox was eradicated in 1980, monkeypox continues to occur in countries of Central and West Africa. Two distinct clades are identified: the West African clade and the Congo Basin clade. Monkeypox is a zoonosis. Cases are often found close to tropical rainforests where various animals carry the virus including squirrels, rodents, dormice, and monkeys. Most human monkeypox infections in endemic countries result from a primary animal-to-human transmission. Human-to-human transmission does occur, with the longest documented chain of transmission being six generations. Transmission occurs through contact with bodily fluids, lesions on the skin or on internal mucosal surfaces, such as in the mouth or throat, respiratory droplets, and contaminated objects. Close contact with infected people or contaminated materials should be avoided. While human-to-animal transmission is rare, it should be considered as a possible link in the transmission chain. Monkeypox has been endemic in central and west Africa since its first detection in 1958 in the Democratic Republic of the Congo (1). However, since 13 May 2022 multiple countries in Europe have reported the sudden and unexpected appearance of monkeypox. To date, 27 non-endemic countries across four WHO regions have reported cases. Of these, four are countries in the Americas. Multiple suspected cases in these and other countries are currently under investigation. PAHO's Technical Advisory Group (TAG) on Vaccine-Preventable Diseases met for an ad hoc meeting on 31 May 2022 to discuss the implications for monkeypox in the Region of the Americas. The following report summarizes the epidemiological data to date, reviews available information on monkeypox vaccines, and provides recommendations to Member States of the Americas on how to minimize viral transmission and approach vaccination operations.

Rasgos clínicos y epidemiológicos de la viruela símica / Clinical and epidemiological features of monkeypox

La viruela símica (VS) es una enfermedad viral, zoonótica que afecta principalmente a los primates y se transmite a humanos. Dicho virus fue aislado inicialmente de un mono de laboratorio en la República Democrática del Congo en 1970 y a partir de allí, ha circulado en el continente africano, principalmente en República Democrática del Congo, Sudán del Sur, Camerún, República Centroafricana, Liberia, Nigeria, Sierra Leona y República del Congo; durante las últimas cinco décadas. Desde el año 2003 se reportaron casos fuera de África, específicamente en Estados Unidos, Reino Unido, Israel y Singapur; mientras que en mayo de 2022, la OMS; reportó un brote de VS humano en varios países de Europa y América, con más de 38000 casos en 93 países y cinco muertes en África, además de la ausencia de vínculos directos con países endémicos y un cambio en el patrón de transmisión; lo que conllevó al organismo a declarar el brote como emergencia de salud pública de interés internacional. La VS cursa con fiebre, cefalea, mialgias, linfadenopatia y lesiones dérmicas; y aunque la enfermedad no es fácilmente transmisible con tendencia a la curación espontánea; los casos observados actualmente no son típicos, con lesiones similares a las producidas por la viruela humana. La presente revisión tiene el objetivo de actualizar los conocimientos acerca de los rasgos clínicos y epidemiológicos de la VS, para comprender la presentación del brote actual y brindar herramientas que permitan diagnosticar y tratar eficazmente a los pacientes afectados(AU)

Monkeypox (MPX) is a viral, zoonotic disease that mainly affects primates and is transmitted to humans. This virus was initially isolated from a laboratory monkey in the Democratic Republic of the Congo in 1970 and since then has circulated on the African continent, mainly in the Democratic Republic of the Congo, South Sudan, Cameroon, the Central African Republic, Liberia, Nigeria, Sierra Leone, and Republic of the Congo; during the last five decades. Since 2003, cases have been reported outside of Africa, specifically in the United States, the United Kingdom, Israel, and Singapore; while in May 2022, the WHO; reported an outbreak of human MPX in several countries in Europe and America, with more than 38,000 cases in 93 countries and five deaths in Africa, in addition to the absence of direct links with endemic countries and a change in the pattern of transmission; which led the agency to declare the outbreak a public health emergency of international concern. MPX presents with fever, headache, myalgia, lymphadenopathy, and skin lesions; and although the disease is not easily transmissible with a tendency to spontaneous healing; the cases currently observed are not typical, with lesions similar to those produced by smallpox. This review aims to update knowledge about the clinical and epidemiological features of MPX, to understand the presentation of the current outbreak and provide tools that allow effective diagnosis and treatment of affected patients(AU)

Here, There, and Everywhere: The Wide Host Range and Geographic Distribution of Zoonotic Orthopoxviruses.

The global emergence of zoonotic viruses, including poxviruses, poses one of the greatest threats to human and animal health. Forty years after the eradication of smallpox, emerging zoonotic orthopoxviruses, such as monkeypox, cowpox, and vaccinia viruses continue to infect humans as well as wild and domestic animals. Currently, the geographical distribution of poxviruses in a broad range of hosts worldwide raises concerns regarding the possibility of outbreaks or viral dissemination to new geographical regions. Here, we review the global host ranges and current epidemiological understanding of zoonotic orthopoxviruses while focusing on orthopoxviruses with epidemic potential, including monkeypox, cowpox, and vaccinia viruses.

Seroprevalence and Risk Factors Possibly Associated with Emerging Zoonotic Vaccinia Virus in a Farming Community, Colombia.

In 2014, vaccinia virus (VACV) infections were identified among farmworkers in Caquetá Department, Colombia; additional cases were identified in Cundinamarca Department in 2015. VACV, an orthopoxvirus (OPXV) used in the smallpox vaccine, has caused sporadic bovine and human outbreaks in countries such as Brazil and India. In response to the emergence of this disease in Colombia, we surveyed and collected blood from 134 farmworkers and household members from 56 farms in Cundinamarca Department. We tested serum samples for OPXV antibodies and correlated risk factors with seropositivity by using multivariate analyses. Fifty-two percent of farmworkers had OPXV antibodies; this percentage decreased to 31% when we excluded persons who would have been eligible for smallpox vaccination. The major risk factors for seropositivity were municipality, age, smallpox vaccination scar, duration of time working on a farm, and animals having vaccinia-like lesions. This investigation provides evidence for possible emergence of VACV as a zoonosis in South America.