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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.
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
The activity of CDV against orthopoxviruses has been assessed in several animal models using mice (most frequently), rabbits, or monkeys (Smee, 2008; Smee and Sidwell, 2003). Treatment of vaccinia virus infections has been well studied in models involving infection either of scarified skin, or resulting from intravenous, intraperitoneal, intracerebral or intranasal virus inoculation (see Table 216.3). Cowpox virus has been used in intranasal or aerosol infection studies to evaluate the treatment with CDV of lethal respiratory infections. Rabbitpox, monkeypox, and variola (smallpox) viruses have been employed to a lesser extent than the other viruses. The efficacy of topical CDV against orf virus in lambs has been described (Scagliarini et al., 2007). Two reviews have extensively revised the activity of CDV and other drugs active against orthopoxviruses in animal models (Smee, 2008; Smee and Sidwell, 2003). CDV prophylaxis of nonhuman primates exposed to large quantities of monkeypox virus or variola virus completely protected the animals, with no signs of illness and control of viral replication in blood, while the placebo-treated animals had > 850 lesions and levels of virus in blood > 107 genomes/ml. CDV treatment as late as 48 hours after infection also reduced viral load and lesions count (Huggins et al., 2004).
Risk, Relative Risk and Attack Rate
Published in Johan Giesecke, Modern Infectious Disease Epidemiology, 2017
In a similar fashion, factors influencing attack rate can be studied by looking at the number of secondary cases in different groups around a primary case. An obvious such factor is how close one lives to the infected person. In the 1980s there was much concern about the attack rate of monkeypox, since it was known that vaccination against smallpox also protected against monkeypox, but since smallpox had been eradicated this vaccination was no longer necessary. In one study, 147 persons who had caught monkeypox virus from monkeys in Zaire were identified [2]. For each case the investigators counted all the people who had lived in the same residence, and the number of these who became cases. They also tried to calculate the number of more remote contacts that the cases had had and the number of transmissions to these.
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].
Therapeutic strategies to address monkeypox
Published in Expert Review of Anti-infective Therapy, 2022
Monkeypox is usually a self-limited disease with the symptoms lasting from 2 to 4 weeks, but severe cases do occur, with some studies revealing a case fatality rate of 3–10% [10,11]. There are no treatments specifically approved for monkeypox virus infections [12]. However, due to the genetic similarity between monkeypox and smallpox, antiviral drugs developed to treat smallpox, including tecovirimat and brincidofovir, may have clinical applications in the treatment of monkeypox, although clinical experience with these agents is limited [13]. This manuscript reviews what is known about these treatments based on a literature search of PubMed through 9 August 2022.
Best management of patients with an acute sore throat – a critical analysis of current evidence and a consensus of experts from different countries and traditions
Published in Infectious Diseases, 2023
Ronny K. Gunnarsson, Mark Ebell, Robert Centor, Paul Little, Theo Verheij, Morten Lindbæk, Pär-Daniel Sundvall
Some patients have a longer duration of sore throat and symptoms of fatigue (Table 3). In these patients, with potentially complicated acute sore throat, one should consider viral infections such as infectious mononucleosis, and, in rare cases, acute HIV. The monkeypox virus has recently acquired attention and can cause symptoms that mimic an acute sore throat. It is currently unclear if Monkeypox will remain a relevant differential acute sore throat diagnosis or if it will vanish. Patients with a prolonged illness should undergo appropriate testing and this is especially important in adolescents and young adults.