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1.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-48795

RESUMO

Surgimento de casos em vários países da Europa e nos Estados Unidos deixam autoridades de saúde em alerta Publicado em: 20/05/2022


Assuntos
Monkeypox/prevenção & controle , Orthopoxvirus , Infecções por Poxviridae/virologia
2.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-48796

RESUMO

Diante da ocorrência de casos de varíola do macaco em alguns países dentro e fora da Região das Américas, a Organização Pan-Americana da Saúde/Organização Mundial da Saúde (OPAS/OMS) compartilha com seus Estados-Membros uma série de considerações em relação a identificação de casos, isolamento, identificação e acompanhamento de contatos, manejo clínico, e prevenção e controle de infecção relacionada à atenção a saúde. Também oferece orientações sobre tratamentos disponíveis e vacinas


Assuntos
Monkeypox/epidemiologia , Estado de Alerta em Emergências , Monkeypox/prevenção & controle
4.
BMJ ; 377: o1239, 2022 05 17.
Artigo em Inglês | MEDLINE | ID: mdl-35580887
5.
MMWR Morb Mortal Wkly Rep ; 71(14): 509-516, 2022 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-35389974

RESUMO

Monkeypox is a rare, sometimes life-threatening zoonotic infection that occurs in west and central Africa. It is caused by Monkeypox virus, an orthopoxvirus similar to Variola virus (the causative agent of smallpox) and Vaccinia virus (the live virus component of orthopoxvirus vaccines) and can spread to humans. After 39 years without detection of human disease in Nigeria, an outbreak involving 118 confirmed cases was identified during 2017-2018 (1); sporadic cases continue to occur. During September 2018-May 2021, six unrelated persons traveling from Nigeria received diagnoses of monkeypox in non-African countries: four in the United Kingdom and one each in Israel and Singapore. In July 2021, a man who traveled from Lagos, Nigeria, to Dallas, Texas, became the seventh traveler to a non-African country with diagnosed monkeypox. Among 194 monitored contacts, 144 (74%) were flight contacts. The patient received tecovirimat, an antiviral for treatment of orthopoxvirus infections, and his home required large-scale decontamination. Whole genome sequencing showed that the virus was consistent with a strain of Monkeypox virus known to circulate in Nigeria, but the specific source of the patient's infection was not identified. No epidemiologically linked cases were reported in Nigeria; no contact received postexposure prophylaxis (PEP) with the orthopoxvirus vaccine ACAM2000.


Assuntos
Monkeypox , Animais , Humanos , Masculino , Monkeypox/diagnóstico , Monkeypox/epidemiologia , Monkeypox/prevenção & controle , Vírus da Varíola dos Macacos/genética , Nigéria/epidemiologia , Texas/epidemiologia , Zoonoses
7.
Emerg Infect Dis ; 28(5): 1002-1005, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35263559

RESUMO

A case of monkeypox was diagnosed in a returning traveler from Nigeria to Maryland, USA. Prompt infection control measures led to no secondary cases in 40 exposed healthcare workers. Given the global health implications, public health systems should be aware of effective strategies to mitigate the potential spread of monkeypox.


Assuntos
Monkeypox , Animais , Pessoal de Saúde , Humanos , Controle de Infecções , Maryland , Monkeypox/diagnóstico , Monkeypox/epidemiologia , Vírus da Varíola dos Macacos
8.
PLoS Negl Trop Dis ; 16(2): e0010141, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-35148313

RESUMO

Monkeypox, a zoonotic disease caused by an orthopoxvirus, results in a smallpox-like disease in humans. Since monkeypox in humans was initially diagnosed in 1970 in the Democratic Republic of the Congo (DRC), it has spread to other regions of Africa (primarily West and Central), and cases outside Africa have emerged in recent years. We conducted a systematic review of peer-reviewed and grey literature on how monkeypox epidemiology has evolved, with particular emphasis on the number of confirmed, probable, and/or possible cases, age at presentation, mortality, and geographical spread. The review is registered with PROSPERO (CRD42020208269). We identified 48 peer-reviewed articles and 18 grey literature sources for data extraction. The number of human monkeypox cases has been on the rise since the 1970s, with the most dramatic increases occurring in the DRC. The median age at presentation has increased from 4 (1970s) to 21 years (2010-2019). There was an overall case fatality rate of 8.7%, with a significant difference between clades-Central African 10.6% (95% CI: 8.4%- 13.3%) vs. West African 3.6% (95% CI: 1.7%- 6.8%). Since 2003, import- and travel-related spread outside of Africa has occasionally resulted in outbreaks. Interactions/activities with infected animals or individuals are risk behaviors associated with acquiring monkeypox. Our review shows an escalation of monkeypox cases, especially in the highly endemic DRC, a spread to other countries, and a growing median age from young children to young adults. These findings may be related to the cessation of smallpox vaccination, which provided some cross-protection against monkeypox, leading to increased human-to-human transmission. The appearance of outbreaks beyond Africa highlights the global relevance of the disease. Increased surveillance and detection of monkeypox cases are essential tools for understanding the continuously changing epidemiology of this resurging disease.


Assuntos
Vírus da Varíola dos Macacos/fisiologia , Monkeypox/epidemiologia , Adolescente , Adulto , Animais , Criança , Pré-Escolar , República Democrática do Congo , Feminino , História do Século XX , História do Século XXI , Humanos , Masculino , Monkeypox/história , Monkeypox/mortalidade , Monkeypox/virologia , Vírus da Varíola dos Macacos/genética , Doença Relacionada a Viagens , Adulto Jovem , Zoonoses/epidemiologia , Zoonoses/história , Zoonoses/mortalidade , Zoonoses/virologia
9.
J Infect Dis ; 225(8): 1367-1376, 2022 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-32880628

RESUMO

BACKGROUND: The largest West African monkeypox outbreak began September 2017, in Nigeria. Four individuals traveling from Nigeria to the United Kingdom (n = 2), Israel (n = 1), and Singapore (n = 1) became the first human monkeypox cases exported from Africa, and a related nosocomial transmission event in the United Kingdom became the first confirmed human-to-human monkeypox transmission event outside of Africa. METHODS: Epidemiological and molecular data for exported and Nigerian cases were analyzed jointly to better understand the exportations in the temporal and geographic context of the outbreak. RESULTS: Isolates from all travelers and a Bayelsa case shared a most recent common ancestor and traveled to Bayelsa, Delta, or Rivers states. Genetic variation for this cluster was lower than would be expected from a random sampling of genomes from this outbreak, but data did not support direct links between travelers. CONCLUSIONS: Monophyly of exportation cases and the Bayelsa sample, along with the intermediate levels of genetic variation, suggest a small pool of related isolates is the likely source for the exported infections. This may be the result of the level of genetic variation present in monkeypox isolates circulating within the contiguous region of Bayelsa, Delta, and Rivers states, or another more restricted, yet unidentified source pool.


Assuntos
Vírus da Varíola dos Macacos , Monkeypox , Animais , Surtos de Doenças , Humanos , Monkeypox/epidemiologia , Vírus da Varíola dos Macacos/genética , Nigéria/epidemiologia , Reino Unido
10.
Euro Surveill ; 26(32)2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34387184

RESUMO

Most reported cases of human monkeypox occur in Central and West Africa, where the causing virus is endemic. We describe the identification and public health response to an imported case of West African monkeypox from Nigeria to the United Kingdom (UK) in May 2021. Secondary transmission from the index case occurred within the family to another adult and a toddler. Concurrent COVID-19-related control measures upon arrival and at the hospital, facilitated detection and limited the number of potential contacts.


Assuntos
COVID-19 , Monkeypox , Adulto , Animais , Humanos , Monkeypox/diagnóstico , Monkeypox/epidemiologia , Vírus da Varíola dos Macacos , Nigéria , SARS-CoV-2 , Reino Unido/epidemiologia
11.
Sci Rep ; 11(1): 13085, 2021 06 22.
Artigo em Inglês | MEDLINE | ID: mdl-34158533

RESUMO

Monkeypox is an emerging infectious disease, which has a clinical presentation similar to smallpox. In the two past decades, Central Africa has seen an increase in the frequency of cases, with many monkeypox virus (MPXV) isolates detected in the Democratic Republic of Congo (DRC) and the Central African Republic (CAR). To date, no complete MPXV viral genome has been published from the human cases identified in the CAR. The objective of this study was to sequence the full genome of 10 MPXV isolates collected during the CAR epidemics between 2001 and 2018 in order to determine their phylogenetic relationships among MPXV lineages previously described in Central Africa and West Africa. Our phylogenetic results indicate that the 10 CAR isolates belong to three lineages closely related to those found in DRC. The phylogenetic pattern shows that all of them emerged in the rainforest block of the Congo Basin. Since most human index cases in CAR occurred at the northern edge of western and eastern rainforests, transmissions from wild animals living in the rainforest is the most probable hypothesis. In addition, molecular dating estimates suggest that periods of intense political instability resulting in population movements within the country often associated also with increased poverty may have led to more frequent contact with host wild animals. The CAR socio-economic situation, armed conflicts and ecological disturbances will likely incite populations to interact more and more with wild animals and thus increase the risk of zoonotic spillover.


Assuntos
Vírus da Varíola dos Macacos/genética , Monkeypox/genética , Animais , Evolução Biológica , República Centro-Africana/epidemiologia , Evolução Molecular , Genômica , Humanos , Monkeypox/epidemiologia , Vírus da Varíola dos Macacos/isolamento & purificação , Vírus da Varíola dos Macacos/patogenicidade , Filogenia , Zoonoses/genética
13.
Emerg Infect Dis ; 27(4)2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33756100

RESUMO

A monkeypox outbreak in Nigeria during 2017-2020 provides an illustrative case study for emerging zoonoses. We built a statistical model to simulate declining immunity from monkeypox at 2 levels: At the individual level, we used a constant rate of decline in immunity of 1.29% per year as smallpox vaccination rates fell. At the population level, the cohort of vaccinated residents decreased over time because of deaths and births. By 2016, only 10.1% of the total population in Nigeria was vaccinated against smallpox; the serologic immunity level was 25.7% among vaccinated persons and 2.6% in the overall population. The substantial resurgence of monkeypox in Nigeria in 2017 appears to have been driven by a combination of population growth, accumulation of unvaccinated cohorts, and decline in smallpox vaccine immunity. The expanding unvaccinated population means that entire households, not just children, are now more susceptible to monkeypox, increasing risk of human-to-human transmission.


Assuntos
Monkeypox , Vacina Antivariólica , Animais , Criança , Humanos , Vírus da Varíola dos Macacos , Nigéria , Urbanização , Zoonoses
14.
J Infect Dis ; 223(11): 1870-1878, 2021 06 04.
Artigo em Inglês | MEDLINE | ID: mdl-33728469

RESUMO

BACKGROUND: Monkeypox is a poorly described emerging zoonosis endemic to Central and Western Africa. METHODS: Using surveillance data from Tshuapa Province, Democratic Republic of the Congo during 2011-2015, we evaluated differences in incidence, exposures, and clinical presentation of polymerase chain reaction-confirmed cases by sex and age. RESULTS: We report 1057 confirmed cases. The average annual incidence was 14.1 per 100 000 (95% confidence interval, 13.3-15.0). The incidence was higher in male patients (incidence rate ratio comparing males to females, 1.21; 95% confidence interval, 1.07-1.37), except among those 20-29 years old (0.70; .51-.95). Females aged 20-29 years also reported a high frequency of exposures (26.2%) to people with monkeypox-like symptoms.The highest incidence was among 10-19-year-old males, the cohort reporting the highest proportion of animal exposures (37.5%). The incidence was lower among those presumed to have received smallpox vaccination than among those presumed unvaccinated. No differences were observed by age group in lesion count or lesion severity score. CONCLUSIONS: Monkeypox incidence was twice that reported during 1980-1985, an increase possibly linked to declining immunity provided by smallpox vaccination. The high proportion of cases attributed to human exposures suggests changing exposure patterns. Cases were distributed across age and sex, suggesting frequent exposures that follow sociocultural norms.


Assuntos
Monkeypox , Adolescente , Adulto , Animais , Criança , República Democrática do Congo/epidemiologia , Feminino , Humanos , Masculino , Monkeypox/diagnóstico , Monkeypox/epidemiologia , Vírus da Varíola dos Macacos/genética , Vacina Antivariólica , Adulto Jovem , Zoonoses
15.
Am J Trop Med Hyg ; 104(2): 604-611, 2020 12 07.
Artigo em Inglês | MEDLINE | ID: mdl-33289470

RESUMO

Recent enhanced monkeypox (MPX) surveillance in the Democratic Republic of Congo, where MPX is endemic, has uncovered multiple cases of MPX and varicella zoster virus (VZV) coinfections. The purpose of this study was to verify if coinfections occur and to characterize the clinical nature of these cases. Clinical, epidemiological, and laboratory results were used to investigate MPX/VZV coinfections. A coinfection was defined as a patient with at least one Orthopoxvirus/MPX-positive sample and at least one VZV-positive sample within the same disease event. Between September 2009 and April 2014, 134 of the 1,107 (12.1%) suspected MPX cases were confirmed as MPX/VZV coinfections. Coinfections were more likely to report symptoms than VZV-alone cases and less likely than MPX-alone cases. Significantly higher lesion counts were observed for coinfection cases than for VZV-alone but less than MPX-alone cases. Discernible differences in symptom and rash severity were detected for coinfection cases compared with those with MPX or VZV alone. Findings indicate infection with both MPX and VZV could modulate infection severity. Collection of multiple lesion samples allows for the opportunity to detect coinfections. As this program continues, it will be important to continue these procedures to assess variations in the proportion of coinfected cases over time.


Assuntos
Coinfecção/epidemiologia , Coinfecção/virologia , Herpes Zoster/epidemiologia , Herpesvirus Humano 3/genética , Vírus da Varíola dos Macacos/genética , Monkeypox/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , República Democrática do Congo/epidemiologia , Monitoramento Epidemiológico , Feminino , Herpesvirus Humano 3/isolamento & purificação , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Vírus da Varíola dos Macacos/isolamento & purificação , Adulto Jovem
16.
Sci Rep ; 10(1): 19307, 2020 11 09.
Artigo em Inglês | MEDLINE | ID: mdl-33168908

RESUMO

A vaccine for smallpox is no longer administered to the general public, and there is no proven, safe treatment specific to poxvirus infections, leaving people susceptible to infections by smallpox and other zoonotic Orthopoxviruses such as monkeypox. Using vaccinia virus (VACV) as a model organism for other Orthopoxviruses, CRISPR-Cas9 technology was used to target three essential genes that are conserved across the genus, including A17L, E3L, and I2L. Three individual single guide RNAs (sgRNAs) were designed per gene to facilitate redundancy in rendering the genes inactive, thereby reducing the reproduction of the virus. The efficacy of the CRISPR targets was tested by transfecting human embryonic kidney (HEK293) cells with plasmids encoding both SaCas9 and an individual sgRNA. This resulted in a reduction of VACV titer by up to 93.19% per target. Following the verification of CRISPR targets, safe and targeted delivery of the VACV CRISPR antivirals was tested using adeno-associated virus (AAV) as a packaging vector for both SaCas9 and sgRNA. Similarly, AAV delivery of the CRISPR antivirals resulted in a reduction of viral titer by up to 92.97% for an individual target. Overall, we have identified highly specific CRISPR targets that significantly reduce VACV titer as well as an appropriate vector for delivering these CRISPR antiviral components to host cells in vitro.


Assuntos
Sistemas CRISPR-Cas , Dependovirus/genética , Monkeypox/terapia , Orthopoxvirus/metabolismo , RNA Guia/metabolismo , Varíola/terapia , Antivirais , Proteínas de Bactérias/metabolismo , Edição de Genes/métodos , Vetores Genéticos , Proteínas de Fluorescência Verde/metabolismo , Células HEK293 , Humanos , Monkeypox/virologia , Plasmídeos/metabolismo , Varíola/virologia , Transfecção , Vírus Vaccinia
17.
Viruses ; 12(11)2020 11 05.
Artigo em Inglês | MEDLINE | ID: mdl-33167496

RESUMO

Monkeypox is a zoonotic disease caused by monkeypox virus (MPXV), which is a member of orthopoxvirus genus. The reemergence of MPXV in 2017 (at Bayelsa state) after 39 years of no reported case in Nigeria, and the export of travelers' monkeypox (MPX) from Nigeria to other parts of the world, in 2018 and 2019, respectively, have raised concern that MPXV may have emerged to occupy the ecological and immunological niche vacated by smallpox virus. This review X-rays the current state of knowledge pertaining the infection biology, epidemiology, and evolution of MPXV in Nigeria and worldwide, especially with regard to the human, cellular, and viral factors that modulate the virus transmission dynamics, infection, and its maintenance in nature. This paper also elucidates the role of recombination, gene loss and gene gain in MPXV evolution, chronicles the role of signaling in MPXV infection, and reviews the current therapeutic options available for the treatment and prevention of MPX. Additionally, genome-wide phylogenetic analysis was undertaken, and we show that MPXV isolates from recent 2017 outbreak in Nigeria were monophyletic with the isolate exported to Israel from Nigeria but do not share the most recent common ancestor with isolates obtained from earlier outbreaks, in 1971 and 1978, respectively. Finally, the review highlighted gaps in knowledge particularly the non-identification of a definitive reservoir host animal for MPXV and proposed future research endeavors to address the unresolved questions.


Assuntos
Evolução Molecular , Vírus da Varíola dos Macacos/genética , Monkeypox/epidemiologia , Zoonoses Virais/epidemiologia , Animais , DNA Viral/genética , Humanos , Camundongos , Monkeypox/transmissão , Vírus da Varíola dos Macacos/patogenicidade , Nigéria/epidemiologia , Filogenia , Recombinação Genética , Zoonoses Virais/transmissão
19.
Vaccine ; 38(43): 6800-6806, 2020 10 07.
Artigo em Inglês | MEDLINE | ID: mdl-32861468

RESUMO

BACKGROUND: A clinical trial is ongoing to evaluate the safety and efficacy of a monkeypox vaccine among healthcare workers (HCWs). The critical question that needs to be addressed is whether HCWs are willing to accept and purchase this vaccine. The objective of this study was to evaluate the acceptance and willingness to pay (WTP) for the vaccine among HCWs. METHODS: From May to July 2019, a cross-sectional study was conducted among registered general practitioners (GPs) in Indonesia. A contingent valuation method was employed to evaluate the WTP. Besides acceptance and WTP, various explanatory variables were also collected and assessed. A logistic regression and a multivariable linear regression were used to explore the explanatory variables influencing acceptance and WTP, respectively. RESULTS: Among 407 respondents, 391 (96.0%) expressed acceptance of a free vaccination. The mean and median WTP was US$ 37.0(95%CI:US$ 32.76-US$ 41.23) and US$ 17.90(95%CI:US$ 17.90-US$ 17.90), respectively. In an unadjusted analysis, those 30 years old or younger had 2.94 times greater odds of vaccine acceptance compared to those who were older (95%CI: 1.07-8.08). Location of alma mater, type of workplace, length of individual medical experience, and monthly income of GPs were all significantly associated with WTP. CONCLUSION: Although the vast majority of GPs would accept a freely provided vaccine, they were also somewhat price sensitive. This finding indicates that partial subsidy maybe required to achieve high vaccine coverage, particularly among GPs at community health centres or those with a shorter duration of medical practice.


Assuntos
Monkeypox , Vacinas , Adulto , Animais , Estudos Transversais , Humanos , Indonésia , Vírus da Varíola dos Macacos , Aceitação pelo Paciente de Cuidados de Saúde , Inquéritos e Questionários
20.
Viruses ; 12(8)2020 07 23.
Artigo em Inglês | MEDLINE | ID: mdl-32717786

RESUMO

Over the last 15 years, advances in immunofluorescence-imaging based cycling methods, antibody conjugation methods, and automated image processing have facilitated the development of a high-resolution, multiplexed tissue immunofluorescence (MxIF) method with single cell-level quantitation termed Cell DIVETM. Originally developed for fixed oncology samples, here it was evaluated in highly fixed (up to 30 days), archived monkeypox virus-induced inflammatory skin lesions from a retrospective study in 11 rhesus monkeys to determine whether MxIF was comparable to manual H-scoring of chromogenic stains. Six protein markers related to immune and cellular response (CD68, CD3, Hsp70, Hsp90, ERK1/2, ERK1/2 pT202_pY204) were manually quantified (H-scores) by a pathologist from chromogenic IHC double stains on serial sections and compared to MxIF automated single cell quantification of the same markers that were multiplexed on a single tissue section. Overall, there was directional consistency between the H-score and the MxIF results for all markers except phosphorylated ERK1/2 (ERK1/2 pT202_pY204), which showed a decrease in the lesion compared to the adjacent non-lesioned skin by MxIF vs an increase via H-score. Improvements to automated segmentation using machine learning and adding additional cell markers for cell viability are future options for improvement. This method could be useful in infectious disease research as it conserves tissue, provides marker colocalization data on thousands of cells, allowing further cell level data mining as well as a reduction in user bias.


Assuntos
Imunofluorescência/métodos , Imuno-Histoquímica/métodos , Monkeypox/patologia , Pele/virologia , Animais , Biomarcadores/análise , Compostos Cromogênicos , Feminino , Processamento de Imagem Assistida por Computador , Macaca mulatta , Masculino , Vírus da Varíola dos Macacos/patogenicidade , Estudos Retrospectivos , Análise de Célula Única , Pele/patologia , Coloração e Rotulagem
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