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Articles
Published: 2022-08-17

Monkeypox in the COVID-19 era

Department of Functional Sciences, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania

Abstract

Currently, in addition to the COVID-19 waves, the world is confronting an additional threat: the global monkeypox infection outbreak, already regarded as a “public health emergency of international concern” by the World Health Organization. According to the most recently published reports, more than 21000 monkeypox infection cases have been confirmed in 78 countries, with 5 African deaths and more than three deaths outside endemic Africa while the numbers are still increasing. Too little is currently known about the monkeypox virus, although it does not appear as a recently emerged pathogen, being probably as ancient as the smallpox virus. The major fear in regards to the current international monkeypox infection spread has multiple causes: monkeypox's similarity to smallpox, the deadliest pathogen in the history of humanity; lack of knowledge of the virus's natural occurrence, animal reservoir, mechanisms of transmission, pathogenicity, host immune response; lack of effective specific treatment and vaccine; unusually rapid geographic spread and atypical clinical presentation; increase in the mutation rate outside the standard, mathematically anticipated rates; putative complications and sequelae of the infection; potential use as a biological weapon. Actually, with such characteristics, the monkeypox virus has the potential to occupy/replicate the place of the much-feared smallpox virus. In the near future, due to the high registry of viral mutagenesis, limitations in the preventive strategies, and lack of an efficient vaccine, several viruses, including SARS-CoV-2 and monkeypox, could continue their worldwide spread and generate flu-like subsequent infective bursts. Therefore, dedicated research and detailed knowledge of the viral pathogenic mechanisms and transmission routes are required to design efficient therapies and limit/stop future pandemics: until the emergence of a new virus.



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References

  1. World Health Organization (WHO). Multi-country outbreak of monkeypox External Situation Report 2, published July 25 2022. [Cited 2022 July 30]. Available from: https://www.who.int/publications/m/item/multi-country-outbreak-of-monkeypox--external-situation-report--2---25-july-2022.
  2. Spain and Brazil report first monkeypox deaths - BNO News. Published on July 29, 2022, by BNO News. [Cited 2022 July 31]. Available from: https://bnonews.com/index.php/2022/07/spain-and-brazil-report-first-monkeypox-deaths/.
  3. Moore MJ, Rathish B, Zahra F. Monkeypox. [Updated 2022 July 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK574519/.
  4. Alakunle E, Moens U, Nchinda G, Okeke MI. Monkeypox Virus in Nigeria: Infection Biology, Epidemiology, and Evolution. Viruses 2020; 12:1257. doi: 10.3390/v12111257.
  5. Reynolds MG, Doty JB, McCollum AM, Olson VA, Nakazawa Y. Monkeypox re-emrgence in Africa: a call to expand the concept and practice of One Health. Expert Rev Anti Infect Ther 2019; 17(2): 129-139.
  6. Kumar N, Acharya A, Gendelman HE, Byrareddy SN. The 2022 outbreak and the pathobiology of the monkeypox virus. Journal of Autoimmunity 2022; https://doi.org/10.1016/j.jaut.2022.102855.
  7. Adler H, Gould S, Snell LB, Wong W, Houlihan CF, Osborne JC, et al. Clinical features and management of human monkeypox: a retrospective observational study in the UK. Lancet Infect Dis 2022; 22:1153-1162.https://doi.org/10.1016/S1473-3099(22)00228-6.
  8. Bragazzi NL, Kong JD, Wu J. Is monkeypox a new, emerging sexually transmitted disease? A rapid review of the literature. ResearchGate Preprint June 2022. [Cited 2022 July 31]. Available from: https://www.researchgate.net/publication/361372229_Is_monkeypox_a_new_emerging_sexually_transmitted_disease_A_rapid_review_of_the_literature.
  9. Benites-Zapata V, Ulloque-Badarocco JR, Alarcon-Braga EA, Hernandez-Bustamante EA, Mosquera-Rojas MD, Bonilla-Aldana DK, Rodriguez-Morales AJ. Clinical Features, Hospitalization and Deaths associated with Monkeypox: A systematic review and meta-anlysis. ResearchSquare Preprints 2022 (July 05 2022); PREPRINT (Version 1) available at Research Square [https://doi.org/10.21203/rs.3.rs-1789976/v1].
  10. Earl PL, Americo JL, Cotter CA, Moss B. Comparative live bioluminescence imaging of monkeypox virus dissemination in a wild-derived inbred mouse (Mus musculus castaneus) and outbred African dormouse (Graphiurus kelleni). Virology 2015; 475: 150-158.
  11. Sklenovska N, Van Ranst M. Emergence of Monkeypox as the Most Important Orthopoxvirus Infection in Humans. Frontiers in Public Health 2018; 6:241.
  12. McCollum AM, Damon IK. Human monkeypox. Clin Infect Dis 2014; 58 (2): 260-267.
  13. Smithson C, Purdy A, Verster AJ, Upton C. Prediction of Steps in the Evolution of Variola Virus Host Range. PLOS ONE 2014; 9(3): e91520.
  14. Mucker EM, Wollen-Roberts SE, Kimmel A, Shemblin J, Sampey D, Hooper JW. Intranasal monkeypox marmoset model: Prophylactic antibody treatment provides benefit against severe monkeypox virus disease. PLOS Neglected Tropical disease 2018; 12(6): e0006581.
  15. Weaver JR, Isaacs SN. Monkeypox Virus and Insights Into Its Immunomodulatory proteins. Immunol Rev 2008; 225:96-113.
  16. Breman JG. Smallpox. JID 2021; 224 (S 4): S379-S386. https://doi.org/10.1093/infdis/jiaa588.
  17. Song H, Josleyn N, Janoska K, Skinner J, Reeves RK, Cohen M, Jett C, Johnson R, Blaney JE, Bollinger L, Jennings G, Jahrling PB. Monkeypox Virus Infection of Rhesus Macaques Induces Massive Expansion of Natural Killer Cells but Supresses Natural Killer Cell Functions. PLOS ONE 2013; 8(10): e77804.
  18. Petersen E, Abubakar I, Thekweazu C, Heymann D, Ntoumi F, Blumberg L, et al. Monkeypox- Enhancing public health preparedness for an emrging lethal zoonotic epidemic threat in the wake of the smallpox eradication era. International Journal of Infectious Diseases 2019; 78:78-84.
  19. Nigam P, Earl PL, Americo JL, Sharma S, Wyatt LS, Edghill-Spano Y, et al. DNA/MVA HIV-1/AIDS Vaccine Elicits Long-Lived Vaccinia Virus-Specific Immunity and Confers Pretection Against a Lethal Monkeypox Challenge. Virology 2007; 366(1): 73-83.
  20. Douglass NJ, Richardson M, Dumbell KR. Evidence for recent genetic variation in monkeypox viruses. Journal of General Virology 1994; 75: 1303-1309.
  21. Malyarchuk AB, Andreeva TV, Kuznetsova IL, Kunizheva SS, Protasova MS, Uralsky LI, Tyazhelova TV, Gusev FE, Manakhov AD, Rogaev EI. Genomics of Ancient pathogens: First Advances and Prospects. Biokhimiya (Moscow) 2022; 87(3): 242-258.doi: 10.1134/S0006297922030051.
  22. Wahl-Jenssen V, Cann JA, Rubins KH, Huggins JW, Fisher RW, Johnson AJ, de Kok-Mercado F, Larsen T, Raymond JL, Hensley LE Jahrling PB. Progression of Pathogenic Events in Cynomolgus Macaques Infected with Variola Virus. PloS ONE 2011; 6(10): e24832.
  23. Bunge EM, Hoet B, Chen L, Lienert F, Weidenthaler H, Baer LR, Steffen R. The challenging epidemiology of human monkeypox- A potential threat? A systematic review. PloS Negl Trp Dis 2022; 16(2):e0010141. doi: 10.1371/journal.pntd.0010141.
  24. Beer EM, Rao VB. A systematic review of the epidemiology of human monkeypox outbreaks and implications for outbreak strategy. PLoS Negl Trop Dis. 2019;13(10):e0007791. doi: 10.1371/journal.pntd.0007791.
  25. Guarner J, del Rio C, Malani PM. Monkeypox in 2022-What Clinicians Need to Know. JAMA 2022; 328 (2): 139-140.
  26. Petersen BW, Kamamba J, McCollum AM, Lushima RS, Wemakoy EO, Tamfum JJM, et al. Vaccinating against monkeypox in the Democratic Republic of the Congo. Antiviral Res 2019; 162:171-177.
  27. von Magnus P, Andersen EK, Petersen KB, Birch-Andersen A. A pox-like disease in cynomegalus monkeys. Acta Pathologica Microbiologica Scandinavica 1959; 46:156-176. https://doi.org/10.1111/j.1699-0463.1959.tb00328.x.
  28. Bragazzi NL, Kong JD, Mahroum N, Tsigalou C, Khamisy-Farah R, Conerti M, Wu J. Epidemiological trends and clinical features of the ongoing monkeypox epidemic: a preliminary pooled data analysis and literature review. J Med Virol. 2022; 1-8. doi:10.1002/jmv.27931.
  29. Ligon BL. Monkeypox: A Review of the Hostory and Emergence in the Western Hemisphere. Semin Pediatr Infect Dis 2004; 15:280-287.
  30. Harapan H, Setiawan AM, Yufka A, Anwar S, Wahyuni S, Asrizal FW, et al. Knowledge of human monkeypox viral infection among general practioners: a cross-sectional study in Indonesia. Pathogens and Global Health 2020; 114(2): 68-75.
  31. Guagliardo SA, Reynolds MG, Kabamba J, Nguette B, Lushima RS, Wemakoy OE, McCollum AM. Sounding the alarm: Defining thresholds to trigger a public health response to monkeypox. PLOS Neglected Tropical Disease 2018;12(12): e0007034. https://doi.org/10.1371/journal.pntd.0007034.
  32. World Health Organization (WHO). Monkeypox (who.int), 19 May 2022. [Cited 2022 July 31]. Available from: https://www.who.int/news-room/fact-sheets/detail/monkeypox.
  33. Cann JA, Jahrling PB, Hensley LE, Wahl-Jensen V. Comparative Pathology of Smallpox and Monkeypox in Man and Macaques. J Comp Pathol 2013; 148(1):6-21.
  34. Taylor L. Monkeypox: WHO to rename disease to prevent stigma BMJ 2022; 377:o1489 doi:10.1136/bmj.o1489.
  35. Jiang S, Du L, Shi Z. (2020). An emerging coronavirus causing pneumonia outbreak in Wuhan, China: calling for developing therapeutic and prophylactic strategies. Emerging Microbes & Infections 9, 275-277.
  36. Lazar AM. Understanding SARS-CoV-2 features of infectivity, aggressiveness, and transmissibility: an insect-vector theory for SARS-CoV-2 dissemination. Journal of Ideas in Health 2021; 4 (Special 1): 343-347; https://doi.org/10.47108/jidhealth.Vol4.IssSpecial1.109.
  37. South AM, Tomlinson L, Edmonston D, Hiremath S, Sparks MA. (2020). Controversies of renin-angiotensin system inhibition during the COVID-19 pandemic. Nature Reviews. Nephrology; https://doi.org/10.1038/s41581-020-0279-4.
  38. Sah R, Abdelaal A, Reda A, Katamesh BE, Manirambona E, Abdelmonem H, et al. Monkeypox and its Possible Sexual Transmission: Where are we now with its evidence? Preprints 2022, 2022070314. [Cited 2022 July 31]. doi: 10.20944/preprints202207. 0314.v1.
  39. Monkeypox situation update, as of 8 August 2022 (europa.eu). European Centre for Disease Prevention and Control. [Cited 2022 August 11]. Available from: https://www.ecdc.europa.eu/en/monkeypox-multi-country-outbreak/situation-update-eueea-western-balkans-turkey.
  40. WHO: 14,000 monkeypox cases worldwide, 5 deaths | CIDRAP (umn.edu). [Cited 2022 July 30]. Available from: https://www.cidrap.umn.edu/news-perspective/2022/07/who-14000-monkeypox-cases-worldwide-5-deaths
  41. Bisset V. First monkeypox deaths reported in Brazil and Spain - The Washington Post, 2022. [Cited 2022 July 30]. Available from: https://www.washingtonpost.com/world/2022/07/30/monkeypox-deaths-brazil-spain/.
  42. Al Jazeera. Spain reports second monkeypox death | Health News | Al Jazeera. 2022. [Cited 2022 July 31]. Available from: https://www.aljazeera.com/news/2022/7/30/spain-reports-second-monkeypox-death.
  43. MacIntyre CR, Das A, Chen X, De Silva C, Doolan C. Evidence of Long-Distance Aerial Convection of Variola Virus and Implications for Disease Control. Viruses 2020; 12:33. doi: 10.3390/v12010033.
  44. Reynolds MG, McCollum AM, Nguette B, Shongo Lushima R, Petersen BW. Improving the Care and Treatment of Monkeypox Patients in Low-Resource Settings: Applying Evidence from Contemporary Biomedical and Smallpox Biodefense Research. Viruses. 2017;9(12):380. doi: 10.3390/v9120380.
  45. Bragazzi NL, Kong JD, Wu J. Monkeypox and laboratory medicine: more data are urgenty needed. ResearchGate Preprint 2022; June 2022; [Cited 2022 July 31]. Available from: https://www.researchgate.net/publication/361411982_Monkeypox_and_laboratory_medicine_more_data_are_urgently_needed.
  46. Meng X, Leman M, Xiang Y. Variola Virus IL-18 Binding Protein Interacts with three Human IL-18 Residues That are Part of a Binding Site for Human IL-18 Receptor Alpha Subunit. Virology 2007; 358(1):211-220.
  47. Su HP, Garman SC, Allison TJ, Fogg C, Moss B, Barboczi DN. The 1.51-A structure of the poxvirus L1 protein, a target of potent neutralizing antibodies. PNAS 2005; 102(12): 4240-4245.
  48. Tree JA, Hall G, Rayner E, Graham VA, Steeds K, Bewley KR, Hatch GJ, Dennis M, Taylor I, Roberts AD, Funnell SGP, Vipond J. Sequence of pathogenic Events in Cynomolgus Infected with Aerosolized Monekypox Virus. Journal of Virology 2015; 89(9): 4335-4342.
  49. Lazar AM. Hyperferritinemia: the link between COVID-19, inflammation, and patient comorbidities. Journal of Ideas in Health 2021; 4(Special4):615-22. DOI: https://doi.org/10.47108/jidhealth.Vol4.Iss4.193.
  50. Hudson PN, Self J, Weiss S, Braden Z, Xiao Y, Girgis NM, et al. Elucidating the Role of the Complement Control Protein in Monkeypox Pathogenicity. PloS ONE 2012; 7(4):e35086.
  51. Wan Y, Shang J, Sun S, Tai W, Chen J, Geng Q, He L, Chen Y, Wu J, Shi Z, et al. (2020). Molecular Mechanism for Antibody-Dependent Enhancement of Coronavirus Entry. Journal of Virology 94(5), e02015-19.
  52. Lazar AM. Renin-angiotensin-aldosterone system inhibitors – a realm of confusion in COVID-19. Journal of Ideas in Health 2021; 4 (Special2): 389-394. https://doi.org/10.47108/jidhealth.Vol4.IssSpecial2.125.
  53. Lazar AM. ACE2 enzymatic role in the SARs-CoV-2 activation: a perspective through the evolutionary promiscuy and substrate diversity of enzymes. Journal of Ideas in Health 2021; 4(4): 581-587. https://doi.org/10.47108/jidhealth.Vol4Iss4.169.
  54. WHO. Statement: Vaccines alone won't end the monkeypox outbreak – at-risk individuals will have to take action, too (who.int). [Cited 2022 July 31]. Available from: https://www.who.int/europe/news/item/26-07-2022-statement--vaccines-alone-won-t-end-the-monkeypox-outbreak---at-risk-individuals-will-have-to-take-action-too.
  55. Ali Jadoo SA (2020). The second wave of COVID-19 is knocking at the doors: have we learned the lesson? Journal of Ideas in Health 2020; 3 (Special 1):183-184; https://doi.org/10.47108/jidhealth.Vol3.IssSpecial1.7.
  56. Ali Jadoo SA, Dastan I, Al-Samarrai MAM, Yaseen SM, Abbasi A, Alkhdar H, Al Saad M, Danfour OM. Knowledge, attitude, and practice towards COVID-19 among Syrian people resident in Turkey. Journal of Ideas in Health 2020; 3(Special2):278-85. https://doi.org/10.47108/jidhealth.Vol3.IssSpecial2.6.
  57. Ali Jadoo SA. COVID -19 Pandemic Is a Worldwide Typical Biopsychosocial Crisis. Journal of Ideas in Health 2020; 3 (2):152-54. https://doi.org/10.47108/jidhealth.Vol3.Iss2.58.


How to Cite

1.
Lazar AM. Monkeypox in the COVID-19 era. jidhealth [Internet]. 2022 Aug. 17 [cited 2023 Feb. 9];5(3):716-24. Available from: https://jidhealth.com/index.php/jidhealth/article/view/231