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Cidofovir and Brincidofovir
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Graciela Andrei, Robert Snoeck
BrinCDV has been used to manage a disseminated vaccinia virus infection in a patient who was vaccinated for smallpox and later found to have leukemia (Lederman et al., 2012). The patient was treated for 21 days with vaccinia immunoglobulin, oral and topical ST-246, and granulocyte colony-stimulating factor (G-CSF). Although the patient developed ST-246 resistance during treatment, he had resolution of progressive vaccinia. However, the recovery cannot be exclusively ascribed to BrinCDV because the patient was treated with multiple agents.
Monkeypox pandemic containment: does the ACAM2000 vaccine play a role in the current outbreaks?
Published in Expert Review of Vaccines, 2023
Basant E. Katamesh, Maysa Madany, Fatma Labieb, Abdelaziz Abdelaal
ACAM2000 side effects include constitutional symptoms such as fever, malaise, headache, myalgia, and lymphadenitis. Severe side effects are rare but may occur such as skin infection, progressive vaccinia, generalized vaccinia, erythema multiform, myocarditis, pericarditis, post-vaccination encephalitis, encephalopathy and encephalomyelitis have been reported [15] [Table 1]. One study showed that 1 in 175 vaccinated people experience myocarditis or pericarditis [16], approximately 5.73 myocarditis cases, and 0.54 myopericarditis cases per 1000 individuals [14]. Among 730,580 members of the Department of Defense vaccinated with ACAM2000 there were 3 cases of post-vaccination encephalitis and 43 reported mild generalized vaccinia [11]. Another study conducted in 2021 on 897,227 US military service members reported 384 cardiovascular side effects including 144 cases of myocarditis, 106 pericardial disease, 82 pericarditis, and 33 acute myocardial infarctions, event onset was within 30 days of vaccination. Non-cardiovascular side effects included 336 cases of chest pain, 137 dyspnea, 77 syncope, and 28 cases of palpitations [17]. Another registry-based study analyzed 1149 reports of ACAM2000 vaccines, of which 14.7% had serious adverse events requiring hospitalization (defined as life-threatening illnesses leading to permanent disabilities or death) [18].
Mpox: epidemiology, clinical manifestations and recent developments in treatment and prevention
Published in Expert Review of Anti-infective Therapy, 2023
Nikil Selvaraj, Shreya Shyam, Puvin Dhurairaj, Kaviarasan Thiruselvan, Akil Thiruselvan, Yochana Kancherla, Pritika Kandamaran
The FDA granted approval in 2018 to use Tecovirimat to treat smallpox infections. In addition, the European Medicines Agency authorized it in January 2022 for the management of cowpox and smallpox [20]. As part of a multidrug therapy regimen, it has been utilized in multiple cases for the treatment of disseminated and ocular infections due to cowpox and vaccinia infection. A 19-year-old patient who had the smallpox vaccine and was soon after diagnosed with Acute Myeloid Leukemia (AML) also received tecovirimat as prophylactic to stop the development of progressive vaccinia. In this instance, tecovirimat was administered continuously for 61 days with the goal of serving as prophylactic for the patient receiving leukemia treatment. After receiving a vaccine, the patient unintentionally auto inoculated, resulting in skin sores that did not grow or spread [5]. A patient who had keratoconjunctivitis brought on by cowpox was also treated with tecovirimat, albeit there is not a thorough clinical account of this case [5]. A laboratory worker who had been exposed to the vaccinia virus by a needlestick injury also received tecovirimat [5].
Poxvirus-based vector systems and the potential for multi-valent and multi-pathogen vaccines
Published in Expert Review of Vaccines, 2018
Natalie A. Prow, Rocio Jimenez Martinez, John D. Hayball, Paul M. Howley, Andreas Suhrbier
The Sementis Copenhagen Vector (SCV) was developed by Sementis Ltd. and was generated from the Copenhagen strain of vaccinia by deletion of D13L, which encodes an essential viral assembly protein [45] (Figure 1). This deletion renders SCV unable to produce infectious progeny in vaccine recipients (Figure 1(b)), with the ensuing favorable safety profile illustrated by the lack of adverse clinical responses following infection of immunocompromised mice in the SCID mouse model of lethal progressive vaccinia [46]. Genome amplification is preserved in SCV-infected cells, permitting late-phase expression of vaccine immunogens from the amplified genomes in the vaccine recipients (Figure 1(b)). This genetically targeted attenuation in the SCV system contrasts with MVA, which has a series of deletions and mutations that may cooperate in some manner to produce the attenuated phenotype [47]. Whether efficient genome amplification represents a key advantage for the performance of recombinant SCV vaccines (compared with rMVA vaccines) remains to be established.