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The Smallpox Story
Published in Rae-Ellen W. Kavey, Allison B. Kavey, Viral Pandemics, 2020
Rae-Ellen W. Kavey, Allison B. Kavey
Variola has been classified as a member of the Orthopox group. Four orthopox viruses cause infection in humans: Variola (major and minor), Vaccinia, cowpox, and monkeypox. The Variola virus infects only humans in nature, although primates and other animals have been infected in a laboratory setting. Vaccinia, cowpox, and monkeypox viruses can infect both humans and other animals. Variola minor, Variola major and Vaccinia share common amino acid sequences: this explains the immunity to all three diseases that develops after infection with any one of them and the effectiveness of a vaccine based on Vaccinia in preventing development of Variola.39
Diagnostic Approach to Rash and Fever in the Critical Care Unit
Published in Cheston B. Cunha, Burke A. Cunha, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
Lee S. Engel, Charles V. Sanders, Fred A. Lopez
Monkeypox, an emerging zoonotic disease with increased incidence since the eradication of smallpox, is an orthopoxvirus that was first discovered in an outbreak of monkeys imported from Central Africa to Denmark in 1958 [222]. Possible reasons for the increased monkeypox include cessation of smallpox vaccination in 1980, more frequent exposures to the animal reservoir, increased human-to-human transmission, and advances in diagnostic testing [223]. Smallpox vaccination provides about 85% protection against monkeypox [224]. The first human case was identified in a 9-year-old child in Zaire (1970) [225]. Monkeypox is endemic in Central and West Africa, and imported cases have occurred in many countries, including the United States [223]. Transmission is thought to occur from primary animal to humans by direct contact with infected animal body fluids, bites, and scratches. Secondary human-to-human transmission is thought to occur through large respiratory droplets or contact with body fluid, lesion material, and contaminated surfaces [223].
Medical theory, medical care, and preventive medicine
Published in Lois N. Magner, Oliver J. Kim, A History of Medicine, 2017
In addition to worrying about the threat that bioterrorists might use smallpox as a weapon, virologists worry that new diseases, such as monkeypox, might emerge from obscurity to become serious threats. Monkeypox virus was discovered in the 1950s in monkeys from the Democratic Republic of the Congo (formerly Zaire), but it was later found in rodents in western and central Africa. Since the end of smallpox vaccinations, cases of monkeypox increased dramatically. Transmission from animals to humans likely occurs when people are bitten or when hunters butcher infected animals. Monkeypox is not highly contagious but it can be transmitted from person to person. Until 2003, monkeypox had been reported only in Africa, but the virus was brought to the United States when Gambian giant pouched rats were shipped from Ghana to American pet stores where the virus jumped from the Gambian rats to prairie dogs. Close to 100 people in the United States contracted monkeypox from infected pet prairie dogs. The demand for exotic pets means that new, potentially deadly pathogens are never more than a jet flight away, or perhaps as close as your local pet store.
Comparative evaluation of the clinical presentation and epidemiology of the 2022 and previous Mpox outbreaks: a rapid review and meta-analysis
Published in Infectious Diseases, 2023
George N. Okoli, Paul Van Caeseele, Nicole Askin, Ahmed M. Abou-Setta
Mpox is caused by the monkeypox virus, a double stranded DNA virus and member of the Orthopoxvirus genus in the family Poxviridae [3]. Despite the name of this virus suggesting that it originated from monkeys, the natural reservoir of the virus is likely rodents, although this remains debateable [4–6]. The virus has been found in many animals in Africa, including the tree and rope squirrels [7], Gambian pouched rats [5], and different species of monkeys [8]. The monkeypox virus is transmitted to humans via close contact with a carrier animal or with contaminated materials from a carrier animal. Transmission from person to person is usually through close contact with lesions or body fluids of an infected person, through prolonged face to face contact, or if a susceptible person touches a contaminated surface and then their nose, mouth or eyes with the contaminated hand [9–11].
Monkeypox: another pandemic in the making?
Published in Baylor University Medical Center Proceedings, 2023
Prinay Sohal, Aakanksha Gupta, Shefali Gupta, Vasu Gupta, Ridhimaa Jain, Rohit Jain
Unlike the case of COVID-19 in 2020, several laboratory methods are already available for diagnosing monkeypox infection, including viral isolation, molecular diagnosis, immunohistochemistry in tissues, serology, electron microscopy, and real-time PCR.10,32–39 Specimens of rash, crusts, blister fluid, or nasopharyngeal or oropharyngeal secretions are collected; Vero cell lines infected with the specimen are then grown in a virus growth medium for isolation and identification of the virus. Round-oval intracytoplasmic inclusions may be observed under an electron microscope with centrally located sausage-shaped structures. Immunohistochemistry and immunofluorescence can be used to assist in the diagnosis of monkeypox, and serological assays are mainly used for epidemiological investigation.30 As orthopoxviruses are serologically cross-reactive, antigen and antibody detection methods do not provide monkeypox-specific confirmation.13 PCR is the preferred laboratory test due to its high accuracy and sensitivity. For this, diagnostic samples from skin lesions are required and must be stored in a cold, dry, and sterile environment.13 PCR tests from blood samples are usually inconclusive, as the virus cannot survive in the blood for long.13 The date of development of fever, rash, current stage of rash, patient age, and specimen collection are all needed to interpret test findings.40
Lessons learned from the SARS-CoV-2 pandemic; from nucleic acid nanomedicines, to clinical trials, herd immunity, and the vaccination divide
Published in Expert Opinion on Drug Delivery, 2023
Hiba Hussain, Aishwarya Ganesh, Lara Milane, Mansoor Amiji
Fast-tracking SARS-CoV-2 clinical trials was an important response to managing the pandemic and protecting the global population from the high mortality rate of the virus. Drug development, pre-clinical, and clinical testing soared through to emergency use approval in less than a year. The extreme fast-tracking and streamlining of SARS-CoV-2 vaccine clinical trials changed the previously unwavering clinical trial process. For example, although the multi-country outbreak of monkeypox began in May 2022, a smallpox vaccine developed in 1959 (Modified Vaccinia Ankara; MVA) with very little and dated testing, is already being used in Canada, the United States, and the United Kingdom to vaccinate close contacts of infected individuals [47]. Unfortunately, this vaccine was not previously tested against monkeypox and has demonstrated low efficacy. Fortunately, the paid approval of this vaccine despite a lack of evidence-based medicine, did not lead to patient toxicity. The successful post-market phase of the fast-tracked SARS-CoV-2 vaccines has questioned the 20-year process of drug development and approval.