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1.
Obstet Gynecol ; 140(3): 391-397, 2022 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-36356237

RESUMEN

Since May 2022, more than 6,900 cases of monkeypox virus infection have been reported in 52 countries. The World Health Organization is planning to rename the virus and its clades to reduce stigma. As of July 5, 2022, 556 cases have been reported in 33 U.S. states and the District of Columbia. The initial cases were travel-associated; however, person-to-person transmission is now occurring domestically. Close, sustained skin-to-skin contact, including during sexual activity, appears to be the primary mode of transmission. The risk of widespread community transmission remains low; however, rapid identification of monkeypox virus infection and isolation of affected individuals is critical to prevent further transmission. Most but not all cases have occurred in males; some infections have started with anogenital lesions and can be mistaken for common sexually transmitted infections. To facilitate rapid, accurate diagnosis of monkeypox virus infection, obstetrician-gynecologists (ob-gyns) in the United States should ask about recent travel history and new ulcers or lesions and perform a thorough visual inspection of skin and mucosal sites (oral, genital, perianal area) in patients presenting with new rash. Obstetrician-gynecologists should become familiar with the appearance of monkeypox lesions and know whom to call to report a suspected case, how and when to test for monkeypox virus, and how to counsel patients. In the event of a suspected case, ob-gyns should follow infection-control guidelines to prevent transmission and make recommendations to prevent further community spread. This article outlines the diagnosis, prevention, and treatment of monkeypox virus infection, monkeypox virus infection during pregnancy, and implications for practicing ob-gyns in the United States.


Asunto(s)
Virus de la Viruela de los Monos , Viruela del Mono , Embarazo , Masculino , Femenino , Humanos , Estados Unidos , Viaje , Personal de Salud , Conducta Sexual
2.
Viruses ; 14(11)2022 Nov 14.
Artículo en Inglés | MEDLINE | ID: mdl-36423129

RESUMEN

Monkeypox virus (MPXV) has emerged as a threatening zoonosis. Its spread around the world has been growing fast over the last 2 years, particularly in 2022. The reasons for this sudden spread are probably multifactorial. The R0 values of the two MPXV clades are rather low, and a massive pandemic is considered unlikely, although the increase in the number of single-nucleotide polymorphisms found in the 2022 MPXV strain could indicate an accelerated human adaptation. Very little is known about the risks of an infection during pregnancy for both the mother and the fetus. Further observations must be made to create clear, adapted, evidence-based guidelines. This article summarizes the current knowledge about MPXV infections and similar pregnancy virus infections.


Asunto(s)
Viruela del Mono , Humanos , Embarazo , Femenino , Viruela del Mono/epidemiología , Virus de la Viruela de los Monos/genética
3.
Pediatr Infect Dis J ; 41(12): 1020-1031, 2022 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-36322796

RESUMEN

Monkeypox is a zoonotic disease, presenting with fever, lymphadenopathy and vesicular-pustular skin lesions, that historically has rarely been reported outside the endemic regions of Central and West Africa. It was previously thought that human-to-human transmission was too low to sustain spread. During 2022, the number of cases of monkeypox, caused by clade II, rose rapidly globally, predominantly among men who have sex with men. In previous outbreaks with monkeypox clade 1 in endemic areas, children were disproportionately more affected with higher morbidity and mortality. It is unclear whether children are at similarly higher risk from monkeypox clade II. Nonetheless, children and pregnant women are considered high-risk groups and antiviral treatment should be considered for those affected. While smallpox vaccination offers good protection against monkeypox, the duration of protection is unknown, and infection occurs in vaccinated individuals. Should the current outbreak spread to children, authorities should be prepared to rapidly implement vaccination for children. In this review, we summarize epidemiological and clinical features, as well as the pathogenesis, treatment, and prevention options for monkeypox with a focus on considerations for children.


Asunto(s)
Viruela del Mono , Minorías Sexuales y de Género , Niño , Masculino , Animales , Femenino , Humanos , Embarazo , Viruela del Mono/diagnóstico , Viruela del Mono/epidemiología , Viruela del Mono/prevención & control , Homosexualidad Masculina , Zoonosis/epidemiología , Pediatras
4.
Rev Clin Esp (Barc) ; 2022 Oct 29.
Artículo en Inglés | MEDLINE | ID: mdl-36341988

RESUMEN

Viral infections during pregnancy have been one of the leading causes associated with significant perinatal problems, such as congenital defects, fetal neurological syndromes, stillbirths, and adverse pregnancy outcomes. The monkeypox virus infection, caused by an Orthopoxvirus related to the human smallpox virus, was declared a global health emergency by the World Health Organization in July 2022 due to the large number of cases emerging outside the usual endemic area in Africa. There is little information on the impact of monkeypox virus infection during pregnancy, although the limited evidence available shows a high rate of fetal harm. This review addresses the problem of monkeypox virus infection in pregnant women and provides indications for its prevention, diagnosis, and treatment.

5.
Skinmed ; 20(4): 334-335, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36314613

RESUMEN

Between January 1, 2022 and July 4, 2022, the World Health Organization (WHO) received 6,027 reports of laboratory-confirmed patients of monkeypox, predominantly men, that had occurred during a multi-country outbreak of the virus. During this period, 21 women and six children were reportedly infected with the monkeypox virus. Although the infected number of women and children was small, these data are worrisome, because young children and pregnant women are at increased risk of severe outcomes from monkeypox. One infant already has been hospitalized in intensive care in London, England. The WHO data regarding the 2022 monkeypox outbreak also indicate that 25 healthcare workers have been diagnosed with monkeypox, although it is still being investigated whether their infection was due to occupational exposure. Three deaths from monkeypox have been reported to WHO during this monkeypox outbreak. A special focus of this presentation is on the monkeypox infection involving women and children. (SKINmed. 2022;20:334-335).


Asunto(s)
Viruela del Mono , Exposición Profesional , Embarazo , Niño , Lactante , Masculino , Humanos , Femenino , Preescolar , Viruela del Mono/epidemiología , Viruela del Mono/diagnóstico , Virus de la Viruela de los Monos , Brotes de Enfermedades , Laboratorios
6.
Skinmed ; 20(5): 334-335, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36314695

RESUMEN

Between January 1, 2022 and July 4, 2022, the World Health Organization (WHO) received 6,027 reports of laboratory-confirmed patients of monkeypox, predominantly men, that had occurred during a multi-country outbreak of the virus. During this period, 21 women and six children were reportedly infected with the monkeypox virus. Although the infected number of women and children was small, these data are worrisome, because young children and pregnant women are at increased risk of severe outcomes from monkeypox. One infant already has been hospitalized in intensive care in London, England. The WHO data regarding the 2022 monkeypox outbreak also indicate that 25 healthcare workers have been diagnosed with monkeypox, although it is still being investigated whether their infection was due to occupational exposure. Three deaths from monkeypox have been reported to WHO during this monkeypox outbreak. A special focus of this presentation is on the monkeypox infection involving women and children.


Asunto(s)
Viruela del Mono , Exposición Profesional , Embarazo , Niño , Lactante , Masculino , Humanos , Femenino , Preescolar , Viruela del Mono/epidemiología , Viruela del Mono/diagnóstico , Virus de la Viruela de los Monos , Brotes de Enfermedades , Laboratorios
8.
Rev Clin Esp ; 2022 Oct 18.
Artículo en Español | MEDLINE | ID: mdl-36277866

RESUMEN

Viral infections during pregnancy have been one of the leading causes associated with significant perinatal problems, such as congenital defects, fetal neurological syndromes, stillbirths, and adverse pregnancy outcomes. The monkeypox virus infection, caused by an Orthopoxvirus related to the human smallpox virus, was declared a global health emergency by the World Health Organization in July 2022 due to the large number of cases emerging outside the usual endemic area in Africa. There is little information on the impact of monkeypox virus infection during pregnancy, although the limited evidence available shows a high rate of fetal harm. This review addresses the problem of monkeypox virus infection in pregnant women and provides indications for its prevention, diagnosis, and treatment.

9.
Goiânia; SES-GO; 09 set. 2022. 1-4 p. quadro.
No convencional en Portugués | LILACS, Coleciona SUS, CONASS, SES-GO | ID: biblio-1392890

RESUMEN

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)


Asunto(s)
Humanos , Femenino , Embarazo , Lactante , Viruela del Mono/prevención & control , Poxviridae , Orthopoxvirus , Viruela del Mono/transmisión
11.
J Paediatr Child Health ; 58(9): 1532-1538, 2022 09.
Artículo en Inglés | MEDLINE | ID: mdl-35979896

RESUMEN

The global spread of human monkeypox disease, a zoonotic infection related to smallpox and endemic to West and Central Africa, presents serious challenges for health systems. As of July 2022, 14 533 cases have been reported world-wide, leading to designation as a Public Health Emergency of International Concern. Monkeypox disease is spread from animals to humans through infected lesions or fluids; human-human transmission occurs through fomites, droplets or direct contact. Illness is usually self-limiting, but severe disease can occur in specific groups - particularly children, and people who are immunocompromised or pregnant. Clinical presentation may include fever, lymphadenopathy and skin rash, but the rash may occur without other symptoms. Complications can include secondary bacterial infection of skin lesions, vision loss from corneal involvement, pneumonia, sepsis and encephalitis. Diagnosis of monkeypox requires consideration of epidemiological, clinical and laboratory findings, with sensitive history-taking, to elicit close contacts, critical. Supportive management is usually sufficient, but treatment options (where required) include antivirals and vaccinia immune globulin. A paucity of safety data for relevant antivirals may limit their use. There are two types of monkeypox vaccines: a replication-competent vaccinia vaccine, the use of which is logistically and clinically complex, and a replication-deficient modified vaccinia Ankara virus vaccine. Preparedness of health systems for addressing the current outbreak is constrained by historic underfunding for research, and compounded by stigma and discrimination against cases and affected communities. Key challenges in halting transmission include improving vaccine equity and countering discrimination against men who have sex with men to aid diagnosis and treatment.


Asunto(s)
Viruela del Mono , Minorías Sexuales y de Género , Vacuna contra Viruela , Vaccinia , Animales , Antivirales , Niño , Femenino , Homosexualidad Masculina , Humanos , Masculino , Viruela del Mono/diagnóstico , Viruela del Mono/epidemiología , Viruela del Mono/terapia , Pediatras , Embarazo , Vaccinia/prevención & control
13.
Indian J Pediatr ; 89(10): 955-960, 2022 10.
Artículo en Inglés | MEDLINE | ID: mdl-35947269

RESUMEN

Monkeypox is caused by a pox virus closely related to smallpox virus and spreads from animals to humans, and humans to humans following close contact. Prior smallpox vaccination gives partial protection against monkeypox. The steady increase in monkeypox cases in Africa over the past few decades were ignored by the global scientific community till this year, when more than 16,000 cases have been reported from nonendemic countries. Monkeypox has recently been labelled as a public health emergency of international concern by the WHO. While most of the current cases are in men who have sex with men, there is the larger threat of the disease spilling into the general population. The disease is characterized by a short febrile illness with lymphadenopathy followed by a rash which spreads centrifugally and passes through phases of macules, papules, vesicles, and pustules. Recovery occurs in most patients within 2-4 wk. Complications are more likely in children, pregnant women, and the immunocompromised. Specific diagnosis is by detection of viral DNA by PCR. Treatment is largely symptomatic. Tecorivimat is a promising antiviral drug. Vaccination with the currently available smallpox vaccines is recommended for high-risk groups, health care workers, and close contacts. Control of the monkeypox outbreak needs a multipronged effort comprising enhanced surveillance, quick diagnosis, isolation of affected people, ring immunization, and adoption of "one health" approach.


Asunto(s)
Viruela del Mono , Minorías Sexuales y de Género , Vacuna contra Viruela , Viruela , Animales , Antivirales/uso terapéutico , Niño , ADN Viral , Femenino , Homosexualidad Masculina , Humanos , Masculino , Viruela del Mono/diagnóstico , Viruela del Mono/epidemiología , Embarazo , Viruela/diagnóstico , Viruela/epidemiología , Viruela/prevención & control
15.
BMJ Glob Health ; 7(8)2022 08.
Artículo en Inglés | MEDLINE | ID: mdl-35973747

RESUMEN

BACKGROUND: Monkeypox (MPX) is an important human Orthopoxvirus infection. There has been an increase in MPX cases and outbreaks in endemic and non-endemic regions in recent decades. We appraised the availability, scope, quality and inclusivity of clinical management guidelines for MPX globally. METHODS: For this systematic review, we searched six databases from inception until 14 October 2021, augmented by a grey literature search until 17 May 2022. MPX guidelines providing treatment and supportive care recommendations were included, with no exclusions for language. Two reviewers assessed the guidelines. Quality was assessed using the Appraisal of Guidelines for Research and Evaluation II tool. RESULTS: Of 2026 records screened, 14 guidelines were included. Overall, most guidelines were of low-quality with a median score of 2 out of 7 (range: 1-7), lacked detail and covered a narrow range of topics. Most guidelines focused on adults, five (36%) provided some advice for children, three (21%) for pregnant women and three (21%) for people living with HIV. Treatment guidance was mostly limited to advice on antivirals; seven guidelines advised cidofovir (four specified for severe MPX only); 29% (4/14) tecovirimat, and 7% (1/14) brincidofovir. Only one guideline provided recommendations on supportive care and treatment of complications. All guidelines recommended vaccination as post-exposure prophylaxis (PEP). Three guidelines advised on vaccinia immune globulin as PEP for severe cases in people with immunosuppression. CONCLUSION: Our results highlight a lack of evidence-based clinical management guidelines for MPX globally. There is a clear and urgent need for research into treatment and prophylaxis including for different risk populations. The current outbreak provides an opportunity to accelerate this research through coordinated high-quality studies. New evidence should be incorporated into globally accessible guidelines, to benefit patient and epidemic outcomes. A 'living guideline' framework is recommended. PROSPERO REGISTRATION NUMBER: CRD42020167361.


Asunto(s)
Viruela del Mono , Adulto , Antivirales/uso terapéutico , Niño , Bases de Datos Factuales , Brotes de Enfermedades , Femenino , Humanos , Viruela del Mono/epidemiología , Viruela del Mono/terapia , Embarazo
18.
Drugs ; 82(9): 957-963, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-35763248

RESUMEN

Human monkeypox is a zoonotic orthopoxvirus with presentation similar to smallpox. Monkeypox is transmitted incidentally to humans when they encounter infected animals. Reports have shown that the virus can also be transmitted through direct contact (sexual or skin-to-skin), respiratory droplets, and via fomites such as towels and bedding. Multiple medical countermeasures are stockpiled for orthopoxviruses such as monkeypox. Two vaccines are currently available, JYNNEOSTM (live, replication incompetent vaccinia virus) and ACAM2000® (live, replication competent vaccinia virus). While most cases of monkeypox will have mild and self-limited disease, with supportive care being typically sufficient, antivirals (e.g. tecovirimat, brincidofovir, cidofovir) and vaccinia immune globulin intravenous (VIGIV) are available as treatments. Antivirals can be considered in severe disease, immunocompromised patients, pediatrics, pregnant and breastfeeding women, complicated lesions, and when lesions appear near the mouth, eyes, and genitals. The purpose of this short review is to describe each of these countermeasures.


Asunto(s)
Viruela del Mono , Viruela , Animales , Antivirales/farmacología , Antivirales/uso terapéutico , Niño , Cidofovir , Femenino , Humanos , Viruela del Mono/tratamiento farmacológico , Viruela del Mono/prevención & control , Embarazo , Viruela/tratamiento farmacológico , Virus Vaccinia
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