The current mpox outbreak has challenged previous understanding of the disease, with human-to-human transmission being a significant mode of transmission, particularly among gay, bisexual, and other men who have sex with men (GBMSM). A knowledge gap exists on MSM's mpox experiences in Nigeria's restrictive sociolegal context. This study explored mpox awareness, knowledge, and experiences among MSM in Lagos, Nigeria, through 28 in-depth interviews. We analysed the interview transcripts thematically. Findings showed low awareness and knowledge of mpox among MSM, who prefer seeking healthcare outside public health facilities due to stigma. Intimate contact during sexual intercourse is a likely source of infection among MSM. The Nigerian mpox response does not centre MSM, and centreing them may not be ideal due to potential stigma. MSM seek care through various means, including drugs, herbal remedies, and KP-friendly sexual and reproductive health (SRH) services, but face stressful care-seeking due to limited social support and stigma. The study shows that Nigeria's mpox situation differs from the situation in mpox non-endemic contexts. The homophobic legal and social environment and heterogenous spread require unique disease framing and context-sensitive response. The study concludes that further surveillance is needed to deepen understanding around mpox care seeking among MSM in Nigeria.

Mpox is a zoonotic disease caused by the mpox virus (MPXV), which has recently exhibited human-to-human transmission globally. Due to its hidden nature and high-risk behaviors, men who have sex with men (MSM) has become a focal point for mpox prevention and control. This study evaluates the impact of health interventions on mpox knowledge awareness among MSM.

Through pre- and post-MIP surveys, we analyzed the awareness of mpox knowledge, preferences for acquiring mpox information, and preferred channels among MSM. Data collection occurred from August 2023 to March 2024, with a total of 1514 valid questionnaires collected. The Mpox Intervention Program (MIP) included the development and distribution of educational materials, Voluntary Counseling and testing (VCT) clinic consultations, and surveys.

Post-intervention, the total score for mpox knowledge awareness significantly increased from 58.50 to 68.47 (P <0.001), and the knowledge awareness rate rose from 48.66 % to 64.60 % (P <0.001). The intervention significantly improved participants' understanding of mpox incubation period, asymptomatic infections, transmission routes, and prevention measures (P <0.001). MSM preferred obtaining mpox knowledge through new media and internet social platforms, with no significant changes in preferences pre- and post-MIP.

The MIP effectively improved mpox knowledge awareness and cognitive levels among MSM. These findings provide scientific evidence for optimizing health education strategies and controlling the spread of mpox.

The outbreak of Mpox in China has rendered the promotion of effective preventive measures among susceptible populations particularly crucial. We aimed to explore the correlates and develop a model for Mpox vaccination intention.

We distributed a questionnaire to a sample of 2403 men who have sex with men to investigate whether they would get a Mpox vaccine. The participants were randomly split into a training set and a testing set in a ratio of 3:1. We screened relevant variables by the least absolute shrinkage and selection operator (LASSO) regression analysis and included them into a Mpox vaccination intention model, which used a multivariate logistic regression analysis and presented the findings as a nomogram. We used the receiver operating characteristic curve, calibration curve, Kolmogorov-Smirnov test, lift test, and population stability index to test the validity and stability of the model.

Of the 2403 participants in our sample, 87.1% intended to get an Mpox vaccine. Five of the thirty-one screened variables, i.e. Mpox knowledge, social support, vaccination internal rewards, vaccination external rewards, and vaccination response efficacy, were included in the vaccination intention model. The model demonstrated strong risk differentiation (Kolmogorov-Smirnov value = 0.46), moderate predictive power (training area under the curve = 0.7709), and good calibration fit, indicating robust performance.

Our proposed model has a good performance and is highly stable, while our findings suggest that governments should design targeted public health strategies, integrating social engagement and leveraging peer and community education to promote Mpox vaccination.

The persistent monkeypox outbreaks intensify the demand for monkeypox vaccines. Based on the mRNA vaccine platform, we conduct a systematic screening of monkeypox virus (MPXV) surface proteins from two types of viral particles, extracellular enveloped viruses (EVs) and intracellular mature viruses (MVs). This screening unveils 12 important antigens with diverse levels of neutralizing immunogenicity. Further assessment reveals that the combinations of 4, 8, and 12 of these antigens, namely Mix-4, Mix-8, and Mix-12, induce varying degrees of immune protection, with Mix-12 being the most potent. This finding demonstrates the significance of not only the level but also the diversity of the neutralizing antibodies in providing potent immune protection. Additionally, we utilize a T cell-epitope enrichment strategy, analyzing the complete proteome sequence of the MPXV to predict antigenic epitope-rich regions. Integration of these epitope-rich regions into a cellular immune-targeting antigen, named MPX-EPs, showcases that a cellular immune-targeting mRNA vaccine can independently confer immune protection. Furthermore, co-immunization with Mix-12 and MPX-EPs achieves complete protection against MPXV challenge. Overall, these results suggest an effective approach to enhance the immune protection of mRNA vaccines through the specific coordination of humoral and cellular immune responses.

The recent Monkeypox (Mpox) outbreak has disproportionately affected men who have sex with men (MSM), amplifying stigma and discrimination. While prior research examined media portrayals and public perceptions, little is known about MSM's direct experiences. To address this gap, we assess discrimination, stigma, and psychosocial impact across social and healthcare settings.

A cross-sectional observational study was conducted using a structured, pilot-tested survey to assess discrimination against MSM in media, family, socio-occupational, and healthcare environments.

Among 115 MSM surveyed, 81.7% observed discriminatory comments in media, while discrimination was noted in workplaces (41.7%), by family/friends (45.2%), cohabitants (15.7%), and healthcare (34.8%). Stigma significantly impacted healthcare-seeking behavior, with 33% avoiding medical care due to fear of discrimination. Psychologically, 50.4% reported low mood/anxiety, and 72.7% of those frequently fearing Mpox also experienced these symptoms. The outbreak led 71.3% to alter sexual behavior, primarily reducing encounters (60%). Fear of Mpox was strongly associated with behavioral changes (p < 0.001).

The Mpox outbreak has exacerbated stigma toward MSM, highlighting an urgent need for intervention. Authorities, media, and community leaders must disseminate accurate information and implement psychological support programs to mitigate stigma and its detrimental effects on MSM.

Human mpox has been an increasing concern in the United States and California since late 2022. While the Jynneos vaccine offers a degree of cross-protection against the disease, vaccine hesitancy is common among those recommended for vaccination. The purpose of this study was to assess vaccine knowledge, facilitators, and barriers to vaccine uptake among individuals previously diagnosed with mpox, or mpox cases, in Santa Clara County, California. In-depth interviews were conducted by public health department staff among mpox cases diagnosed in Santa Clara County between July and September 2022. Responses were analyzed using a grounded theory data analysis approach. Among the 47 participants, 36 (77%) had heard of mpox before diagnosis, and of these, 20 (56%) did not think they were at risk of developing mpox, and 28 (78%) were aware that a vaccine was available. Those who did not receive the vaccine stated vaccine access and availability were the main barriers. Among the six participants not interested in the vaccine, the main hesitancies were lack of perceived risk, stigma of being branded by scarring and labeled gay, and vaccine safety. Overall, the following themes were attributed to reasons for vaccine hesitancy: (a) lack of awareness of the disease and vaccine, including perceived risks; (b) lack of vaccine availability and accessibility; and (c) stigma associated with receiving the vaccine, including being publicly labeled as "gay" and the scarring on forearm potentially seen as branding. We recommend tailoring outreach and educational campaigns to address reasons for mpox vaccine hesitancy.

In May 2022, when the COVID-19 pandemic began to recede from public view, another infectious disease surprised the world-mpox (formerly monkeypox). It appeared to disproportionately affect gay, bisexual and other men who have sex with men (GBMSM). Using qualitative thematic analysis and social representations theory, we analysed a corpus of 91 items from a variety of news outlets that included GBMSM community members' personal accounts of living through an mpox outbreak. The aim was to study the various ways in which members of a marginalised group created social representations of mpox and to ascertain whether these challenged older representations related to HIV and AIDS and newer ones related to COVID-19. Commentators anchored mpox to known, culturally accessible phenomena to render this previously unfamiliar disease familiar; objectified aspects of mpox, especially pain, through emotive language, making it 'real' and psychologically tangible; personified it by linking it to accounts of celebrity activists; and ontologised it through visually vivid descriptions. Challenging stigma was a cross-cutting theme in people's accounts. In contrast to the stigmatising imagery of health issues affecting GBMSM, these accounts contribute to the development of social representations designed to challenge such stigmatisation, which, in the contexts of HIV and AIDS and COVID-19, has hindered effective medical interventions, promoted misinformation and fuelled denigration.

Grounded in the risk information seeking and processing (RISP) model, this study investigated how individual characteristics and socio-psychological factors influenced Americans' information seeking about the Monkeypox (Mpox) outbreak. The RISP model proposes that one's cognitive need for information (i.e. information insufficiency) and desire to fulfill social expectations about their own information level (i.e. informational subjective norms) are key factors that motivate information seeking. Further, risk judgment and affective response contribute to these two primary motivational factors. Based on a nationally representative sample of U.S. adults (N = 1000), results indicated that social dominance orientation contributed to information seeking indirectly through risk judgment, information insufficiency, and relevant channel beliefs. These findings suggest that it is important to consider individual attribute such as social dominance orientation when communicating to the public about a public health crisis that affected marginal social groups disproportionately.

In 2022, an unprecedented mpox epidemic rapidly swept the globe, primarily transmitted through sexual contact among men who have sex with men (MSM). However, our understanding of how changes in human behavior influence this outbreak remains incomplete. In this study, we introduce a two-layer network model to investigate the impact of human behavior on mpox transmission within the United States during 2022-2023, leveraging surveillance data. We theoretically explore mpox transmission under behavioral changes using homogeneous and heterogeneous mean-field approximations. While the heterogeneous model captures differences in individual behavior, its variations do not significantly affect the overall spread, validating the feasibility of using only homogeneous models to study behavioral changes. Utilizing infection data, we exhibit the influence of behavior changes across varying transmission levels of mpox, emphasize the significant role of sexual behavior among MSM, and recommend enhancing surveillance of nonsexual cases to enable timely control of spread. Utilizing vaccination data, we demonstrate the critical impact of behavior changes on the transmission capacity of mpox virus, contrasting the limited effectiveness of vaccine campaigns. This study highlights the importance of human behavior in controlling the spread of future outbreaks, offering valuable insights for the strategic development of public health interventions aimed at mitigating such occurrences.

Mpox, a zoonotic disease, has emerged as a significant international public health concern due to an increase in the number of cases diagnosed in non-endemic countries. To support public health response efforts to interrupt Mpox transmission in the community, this study aims to identify epidemiological and clinical aspects of Mpox in Jakarta, Indonesia.

The study collected Mpox data from the Provincial Health Department in Jakarta, Indonesia, from October 2023 to February 2024. This included the symptom characteristics and demographics of polymerase chain reaction (PCR)-confirmed and PCR-negative Mpox cases, which were then compared using the χ2 test.

Of the PCR-confirmed total of 58 Mpox cases, most were males (96.6%, 56/58). Of these, 67.2% (39/58) reported recent sexual activity within the 21 days prior to the disease onset date, with 41.4% (24/58) reporting only 1 sexual partner during that period. Among PCR-confirmed Mpox cases, common symptoms included fever (81.1%, 47/58), rash (63.8%, 37/58), and lesions (93.1%, 54/58).

The predominance of male Mpox cases indicates transmission within men who have sex with men (MSM) networks, while higher prevalence among individuals with HIV or syphilis is due to shared behaviors, highlighting the need for surveillance, contact tracing, and targeted public health interventions.

The recent outbreak of mpox epidemic, caused by monkeypox virus (MPXV), poses a new threat to global public health. Here, we initially assessed the preexisting antibody level to the MPXV B6 protein in vaccinia vaccinees born before the end of the immunization program and then identified two monoclonal antibodies (MAbs), hMB621 and hMB668, targeting distinct epitopes on B6, from one vaccinee. Binding assays demonstrate that both MAbs exhibit broad binding abilities to B6 and its orthologs in vaccinia (VACV), variola (VARV) and cowpox viruses (CPXV). Neutralizing assays reveal that the two MAbs showed potent neutralization against VACV. Animal experiments using a BALB/c female mouse model indicate that the two MAbs showed effective protection against VACV via intraperitoneal injection. Additionally, we determined the complex structure of B6 and hMB668, revealing the structural feature of B6 and the epitope of hMB668. Collectively, our study provides two promising antibody candidates for the treatment of orthopoxvirus infections, including mpox.

Behavioral adjustments to mitigate increasing risk of STIs can increase or decrease the likelihood of pregnancy. This paper measures the effects of the arrival and spread of AIDS across U.S. cities in the 1980s and 1990s on births and abortions. I show that the AIDS epidemic increased the birth rate by 0.55 percent and the abortion rate by 1.77 percent. I find support for two underlying mechanisms to explain the increase in pregnancies. Some women opted into monogamous partnerships in response to the AIDS epidemic, with a corresponding increase in the marriage rate and improvement in infant health. Others switched from prescription contraceptive methods to condoms. These behavioral changes lowered the incidence of other sexually transmitted infections, but increased both planned and unplanned pregnancies.

Monkeypox is a zoonotic viral infection caused by the monkeypox virus (MPXV), which belongs to the Poxviridae family of the Orthopoxvirus (OPXV) genus. Monkeypox is transmitted from animals to humans and humans to humans; therefore, the accurate and early detection of MPXV is crucial for reducing mortality. A novel graphene-based material, graphene quantum rods (GQRs) was synthesized and confirmed using high-resolution transmission electron microscopy (HR-TEM) and atomic force microscopy (AFM). In this study, molybdenum oxide was electrodeposited and one-pot electrodeposition of MoO3-GQRs composite on carbon fiber paper (CFP) enabled by an antibody (Ab A29)/MoO3-GQRs immunoprobe was developed for the early diagnosis of MPXV protein (A29P). Several studies were conducted to analyze the MoO3-GQRs composite, and the prepared Ab A29/MoO3-GQRs immunoprobe selectively bound to the A29P antigen that was measured using differential pulse voltammetry (DPV) analysis and impedance spectroscopy. The antigen-antibody interaction was analyzed using X-ray photoelectron spectroscopy. DPV analysis showed a wide linear range of detection from 0.5 nM to 1000 nM, a detection limit of 0.52 nM, and a sensitivity of 4.51 µA in PBS. The prepared immunoprobe was used to analyze A29P in serum samples without reducing electrode sensitivity. This system is promising for the clinical analysis of A29P antigen and offers several advantages, including cost-effectiveness, ease of use, accuracy, and high sensitivity.

The worldwide human monkeypox (mpox) outbreak in 2022 mainly affected men who have sex with men (MSM). In China, young men who have sex with men (YMSM) were at a potential high risk of mpox infection due to their sexual activeness and the eased COVID-19 restrictions at the end of 2022.

This study aimed to investigate the behavioral intention of receiving mpox vaccination and undergoing mpox testing in 4 different scenarios and explore their associations with background and behavioral theory-related factors among Chinese YMSM.

An online cross-sectional survey was conducted among YMSM aged 18-29 years from 6 representative provinces of China in September 2022. Participants recruited (recruitment rate=2918/4342, 67.2%) were asked to self-administer an anonymous questionnaire designed based on prior knowledge about mpox and classic health behavior theories. Data on the participants' background, mpox knowledge and cognition, mpox vaccination and testing cognition, and the behavioral intention of receiving mpox vaccination and undergoing mpox testing were collected. Descriptive analysis and univariate and multivariate linear regressions were performed. Geodetector was used to measure the stratified heterogeneity of behavioral intention.

A total of 2493 YMSM with a mean age of 24.6 (SD 2.9) years were included. The prevalence of having a behavioral intention of receiving mpox vaccination ranged from 66.2% to 88.4% by scenario, varying in epidemic status and cost. The prevalence of having an mpox testing intention was above 90% in all scenarios regardless of the presence of symptoms and the cost. The positive factors related to vaccination intention included mpox knowledge (ba=0.060, 95% CI 0.016-0.103), perceived susceptibility of mpox (ba=0.091, 95% CI 0.035-0.146), perceived severity of mpox (ba=0.230, 95% CI 0.164-0.296), emotional distress caused by mpox (ba=0.270, 95% CI 0.160-0.380), perceived benefits of mpox vaccination (ba=0.455, 95% CI 0.411-0.498), self-efficacy of mpox vaccination (ba=0.586, 95% CI 0.504-0.668), and having 1 male sex partner (ba=0.452, 95% CI 0.098-0.806), while the negative factor was perceived barriers to vaccination (ba=-0.056, 95% CI -0.090 to -0.022). The positive factors related to testing intention were perceived severity of mpox (ba=0.283, 95% CI 0.241-0.325), perceived benefits of mpox testing (ba=0.679, 95% CI 0.636-0.721), self-efficacy of mpox testing (ba=0.195, 95% CI 0.146-0.245), having 1 male sex partner (ba=0.290, 95% CI 0.070-0.510), and having in-person gatherings with MSM (ba=0.219, 95% CI 0.072-0.366), while the negative factor was emotional distress caused by mpox (ba=-0.069, 95% CI -0.137 to -0.001).

Among Chinese YMSM, the intention of undergoing mpox testing is optimal, while the mpox vaccination intention has room for improvement. A future national response should raise YMSM's mpox knowledge, disseminate updated information about mpox and preventive measures, improve preventive service accessibility and privacy, and provide advice on positively coping with the associated emotional distress.

The 2022 multi-country mpox outbreak raised public concern globally. Self-isolation and informing close contacts after developing mpox-related symptoms are critical measures in controlling the outbreak. This study investigated behavioral intentions of self-isolation and informing close contacts after developing mpox-related symptoms and associated factors among young men who have sex with men (YMSM) aged 18-29 years in China. The cross-sectional study was conducted among 2493 YMSM in six provincial regions in China from September 10th to 30th, 2022. Descriptive and logistic analyses were applied, using the intentions of self-isolation and informing close contacts after developing mpox-related symptoms as binary outcomes. The mean age of the participants was 24.6 (SD = 2.9) years. The prevalence of having intentions of self-isolation and informing close contacts after developing mpox-related symptoms was 88.6% (95% CI: 87.3%-89.9%) and 84.9% (95% CI: 83.5%-86.3%). Participants who were employed (adjusted odds ratio (AOR) = 1.474, 95% CI: 1.035-2.097; AOR = 1.371, 95% CI:1.002, 1.876), had higher mpox knowledge scores (AOR = 1.474, 95% CI: 1.035-2.097; AOR = 1.371, 95% CI: 1.002-1.876), and had higher perceived threats of mpox (AOR = 1.079, 95% CI: 1.030-1.130; AOR = 1.045, 95% CI: 1.002-1.090) were more likely to intend to self-isolate and inform close contacts. Participants who had MSM in-person gatherings in the past 6 months were more likely to intend to self-isolate (AOR = 1.392, 95% CI: 1.066-1.208). Participants with higher depression scores (AOR = 0.968, 95% CI: 0.948-0.989) and self-stigma (AOR = 0.975, 95% CI: 0.954-0.997) were less likely to intend to self-isolate and inform close contacts, respectively. Self-isolation and informing close contacts when developing disease-related symptoms are acceptable measures in response to mpox in China. Strengthening targeted risk communication and self-efficacy, raising disease knowledge, providing mental support, and reducing stigma toward the affected community are warranted.

Objectives. To estimate the impact of communicating to the public that men who have sex with men (MSM) are most at risk for mpox on potential stigmatization and risk perception. Methods. We conducted a survey experiment randomizing exposure to messages about mpox among a sample of the South Korean public (n = 1500) in July 2022. We randomized respondents to receive an informational message about mpox that was (1) a neutral informational message about mpox that did not highlight its origins or risk groups (control group), (2) a message explaining that the virus originated in Africa, or (3) a message emphasizing that MSM are most at risk. Results. We found that emphasizing that MSM are most at risk increases support for policies that would restrict lesbian, gay, bisexual, transgender/-sexual, queer or questioning-related events by about 7 percentage points compared with the control condition. However, the message describing African origins did not affect support for restricting travel from Africa. Neither changed risk perceptions or willingness to be vaccinated against mpox. Conclusions. Messages aimed at educating the public about most at-risk groups may trigger increased stigmatization of those groups in ways that could contribute to unnecessary persecution. (Am J Public Health. 2023;113(10):1120-1127. https://doi.org/10.2105/AJPH.2023.307347).

High population density and tourism in Southeast Asia increase the risk of mpox due to frequent interpersonal contacts. Our wastewater surveillance in six Southeast Asian countries revealed positive signals for Monkeypox virus (MPXV) DNA, indicating local transmission. This alerts clinicians and helps allocate resources like testing, vaccines and therapeutics in resource-limited countries.

Mpox caused a worldwide outbreak in 2022, disproportionately affecting MSM reporting high-risk sexual behaviors. The aim of this study was to compare the characteristics of people receiving MVA-BN vaccination with those of individuals diagnosed with mpox to guide future vaccination policies. This was a retrospective study on people with mpox infection or vaccination at San Raffaele Scientific Institute, Milan, Italy, from May to November 2022. Characteristics were compared using Mann-Whitney or chi-square/Fisher's exact tests; multivariable logistic regression and classification tree analysis were applied. Overall, 473 vaccinated individuals and 135 with mpox were included; 472/473 and 134/135 were MSM. People with mpox were more frequently living with HIV (48.9% vs. 22.4%, p < 0.001), had ≥1 previous STI (75.6% vs. 35.7%, p < 0.001), were chemsex users (37.8% vs. 6.34%, p < 0.001), were with a higher number of partners (23.0% vs. 1.69%, p < 0.001), and had engaged in group sex (55.6% vs. 24.1%, p < 0.001). At multivariable analysis, PLWH (aOR = 2.86, 95%CI = 1.59-5.19, p < 0.001), chemsex users (aOR = 2.96, 95%CI = 1.52-5.79, p = 0.001), those with previous syphilis (aOR = 4.11, 95%CI = 2.22-7.72, p < 0.001), and those with >10 partners (aOR = 11.56, 95%CI = 6.60-21.09, p < 0.001) had a higher risk of infection. This study underscores the importance of prioritizing MSM with prior STIs and multiple partners as well as chemsex users in vaccination policies to curb mpox spread. A destigmatized assessment of sexual history is vital for comprehensive sexual health strategies.

Monkeypox virus infections (mpox) in humans have become increasingly common since the virus was first identified in 1970. Coverage of the ongoing mpox outbreak has emphasized the role of skin-to-skin contact in monkeypox virus transmission and has focused on the community of men who have sex with men. While close contact from sexual activity is currently the main mechanism of monkeypox virus transmission, the potential for contact sports to exacerbate the 2022 outbreak has largely been overlooked. Infectious diseases rapidly spread in sports with significant skin-to-skin contact (i.e., wrestling and other combat sports, American football, and rugby). Mpox has not yet reached the athletic community, but once it does, it may follow a similar pattern of other infectious skin diseases in sports. Thus, it is critical to initiate a discussion of the risk of mpox and potential preventive measures within a sports context. This Current Opinion aims to provide stakeholders within the sports community with a brief review of infectious skin diseases in athletes, an overview of mpox and why it is relevant to athletes, and recommendations to reduce the risk of monkeypox virus transmission within sports settings. Guidelines for sports participation in athletes exposed to mpox and those with suspected, probable, and confirmed cases of monkeypox are provided.

Before its eradication, the smallpox virus was a significant cause of poor obstetric outcomes, including maternal and fetal morbidity and mortality. The mpox (monkeypox) virus is now the most pathogenic member of the Orthopoxvirus genus infecting humans. The 2022 global mpox outbreak has focused attention on its potential effects during pregnancy.

To understand the comparative effects of different poxvirus infections on pregnancy, including mpox virus, variola virus, vaccinia virus, and cowpox virus. The impact on the pregnant individual, fetus, and placenta will be examined, with particular attention to the occurrence of intrauterine vertical transmission and congenital infection.

The data are obtained from the authors' cases and from various published sources, including early historical information and contemporary publications.

Smallpox caused maternal and perinatal death, with numerous cases reported of intrauterine transmission. In endemic African countries, mpox has also affected pregnant individuals, with up to a 75% perinatal case fatality rate. Since the start of the 2022 mpox outbreak, increasing numbers of pregnant women have been infected with the virus. A detailed description is given of the congenital mpox syndrome in a stillborn fetus, resulting from maternal-fetal transmission and placental infection, and the potential mechanisms of intrauterine infection are discussed. Other poxviruses, notably vaccinia virus and, in 1 case, cowpox virus, can also cause perinatal infection. Based on the historical evidence of poxvirus infections, mpox remains a threat to the pregnant population, and it can be expected that additional cases will occur in the future.

Monkeypox (Mpox) is a zoonotic disease caused by the Orthopoxvirus monkeypox virus (MPXV). Since 1970, outbreaks of MPXV have occurred in several Sub-Saharan African countries. However, from May 2022 to April 2023, recent outbreaks of Mpox occurred in several countries outside of Africa, and these cases quickly spread to over 100 non-endemic countries on all continents. Most of these cases were found in the region of the Americas and the Europe region. In Latin America, the highest all-age Mpox rates per million inhabitants were in Peru, Colombia, Chile, and Brazil. Given its global impact, Mpox was declared as an international Public Health Emergency by WHO in July 2022. MPXV infection disproportionately affects men who have sex with men and members of the HIV-infected population. Vaccination is the current strategy for controlling and preventing Mpox in high-risk groups. In this context, Peru has the fourth-highest number of Mpox cases in Latin America and faces significant challenges in disease control. Because of this, in this review, we discuss the epidemiology, public health indicators, and prevention of Mpox in the 2022 Peru outbreak so that health authorities can join forces to control MPXV transmission.

Mpox (monkeypox), a disease historically endemic to Africa, has seen its largest outbreak in 2022 by spreading to many regions of the world and has become a public health threat. Informed policies aimed at controlling and managing the spread of this disease necessitate the use of adequate mathematical modeling strategies.

In this scoping review, we sought to identify the mathematical models that have been used to study mpox transmission in the literature in order to determine what are the model classes most frequently used, their assumptions, and the modelling gaps that need to be addressed in the context of the epidemiological characteristics of the ongoing mpox outbreak.

This study employed the methodology of the PRISMA guidelines for scoping reviews to identify the mathematical models available to study mpox transmission dynamics. Three databases (PubMed, Web of Science and MathSciNet) were systematically searched to identify relevant studies.

A total of 5827 papers were screened from the database queries. After the screening, 35 studies that met the inclusion criteria were analyzed, and 19 were finally included in the scoping review. Our results show that compartmental, branching process, Monte Carlo (stochastic), agent-based, and network models have been used to study mpox transmission dynamics between humans as well as between humans and animals. Furthermore, compartmental and branching models have been the most commonly used classes.

There is a need to develop modeling strategies for mpox transmission that take into account the conditions of the current outbreak, which has been largely driven by human-to-human transmission in urban settings. In the current scenario, the assumptions and parameters used by most of the studies included in this review (which are largely based on a limited number of studies carried out in Africa in the early 80s) may not be applicable, and therefore, can complicate any public health policies that are derived from their estimates. The current mpox outbreak is also an example of how more research into neglected zoonoses is needed in an era where new and re-emerging diseases have become global public health threats.

In May 2022, the world witnessed the re-emergence of the zoonotic disease monkeypox. While this was not the first epidemic of this disease, what differentiated the outbreak was the rapid global spread and increase of cases, which led the WHO to declare monkeypox a global health emergency. Although the disease spreads mainly through inadequately cooked meat of various rodent species, this virus also shows droplet, respiratory, sexual, and even vertical transmission. Monkeypox further multiplies in lymphoproliferative organs and presents with a classical smallpox-like rash, fever, headache, and muscle aches. Diagnosis is confirmed with a polymerase-chain-reaction test and is managed largely supportively with possible usage of some antivirals and immunoglobulins. Moreover, some pre-exposure and postexposure prophylactic vaccines have been developed. This paper aims to conduct an in-depth review of the historical epidemics, transmission, pathophysiology, clinical presentation, and management of the monkeypox disease.

The worldwide outbreak of monkeypox has evidenced the usefulness of the dermatologic manifestations for its diagnosis.

To describe the histopathologic and immunohistochemical findings of monkeypox cutaneous lesions.

This is a retrospective histopathologic and immunohistochemical study of 20 patients with positive Monkeypox virus DNA polymerase chain reaction and immunohistochemical positivity for Vaccinia virus in cutaneous lesions. Four cases were also examined by electron microscopy.

The most characteristic histopathologic findings consisted of full-thickness epidermal necrosis with hyperplasia and keratinocytic ballooning at the edges. In some cases, the outer root sheath of the hair follicle and the sebaceous gland epithelium were affected. Intraepithelial cytoplasmic inclusion bodies and scattered multinucleated keratinocytes were occasionally found. Immunohistochemically, strong positivity with anti-Vaccinia virus antibody was seen in the cytoplasm of ballooned keratinocytes. Electron microscopy study demonstrated numerous viral particles of monkeypox in affected keratinocytes.

Small sample size. Electron microscopic study was only performed in 4 cases.

Epidermal necrosis and keratinocytic ballooning are the most constant histopathologic findings. Immunohistochemical positivity for Vaccinia virus was mostly detected in the cytoplasm of the ballooned keratinocytes. These findings support the usefulness of histopathologic and immunohistochemical studies of cutaneous lesions for diagnosis of monkeypox.

With the rapid spread of the mpox epidemic, cases have emerged in multiple countries, mainly among men who have sex with men. Because of the connectedness of today's world, countries have to be prepared to face risks in advance. Therefore, this study aimed to investigate awareness of mpox-related knowledge among men who have sex with men in China.

With the assistance of the social organizations of men who have sex with men, a cross-sectional survey of men who have sex with men in China was conducted through an online questionnaire between July 1 and July 18, 2022. A nationwide sample of Chinese men who have sex with men (N = 3,257) was recruited.

Only 36.9% of participants had mpox-related knowledge. Awareness of mpox-related knowledge among respondents was positively associated with those in older age groups (33 to 42 years and 51 years or older) (adjusted odds ratio [AOR] = 1.31; 95% confidence interval [CI]: 1.03-1.67, AOR = 1.61; 95% CI: 1.16-2.24; respectively), married (AOR = 1.55; 95% CI: 1.09-2.19), and those with a graduate degree or above (AOR = 2.14; 95% CI: 1.11-4.13), while negatively associated with those living in the western parts of China (AOR = 0.74; 95% CI: 0.60-0.92), and those who were unsure of their history of Human Immunodeficiency Virus (HIV) status (AOR = 0.44; 95% CI: 0.30-0.63).

Mpox-related knowledge is fairly low among men who have sex with men in China. China needs to spread knowledge to the public through multiple channels, especially in key populations (men who have sex with men, HIV-infected, etc.), and take preventive measures to effectively avoid outbreaks of mpox.

Since May 2022, multiple human Monkeypox cases were identified in nonendemic countries, mainly among men who have sex with men. We aimed to report the features, clinical course, management, and outcome of the Monkeypox cases diagnosed in the Dermatology and Infectious Disease Units of the San Martino Hospital, Genoa, Italy. We performed an observational study of the Monkeypox cases diagnosed from July 1 until August 31, 2022, collecting clinical, laboratory, and histological data. We studied 16 Monkeypox-infected men (14 homosexual, 2 bisexual) with a median age of 37 years. Three were HIV-infected. All patients reported multiple sexual partners and/or unprotected sex in the 2 weeks before the diagnosis. Most patients had prodromal signs/symptoms before the appearance of the skin/mucosal eruption, consisting of erythematous papules/vesicles/pustules in the anogenital area, which tended to erode evolving into crusts and ulcers. Lesions were often associated with local and/or systemic symptoms. Histopathology showed overlapping features in all cases: epidermal ulceration and dermal inflammatory infiltrate consisting of lymphocytes and neutrophils with an interstitial and perivascular/peri-adnexal pattern and endothelial swelling. Concomitant sexually transmitted infections (STIs) (gonococcal/nongonococcal proctitis and anal high-risk human papillomavirus [HR-HPV] infection) were frequent. Four patients were hospitalized, and one received specific treatment. The overall outcome was good. At the follow-up visit, three patients presented skin scars. Our series confirms the features of the current Monkeypox outbreak; however, different from other studies, we found a considerable rate of concomitant STIs, such as anal HR-HPV infection, that should be kept in mind because this persistent infection is the main cause of anal cancers.

An international outbreak of the monkeypox (MPX) virus is ongoing with a different clinical presentation than previously reported.

A monocentric retrospective study was designed to investigate clinical predictors of confirmed MPX cases among a group of patients referred for MPX screening. Furthermore, the additional value of performing a real-time polymerase chain reaction (RT-PCR) on multiple anatomical sites was analyzed.

Between 28/05/2022 and 22/07/2022, the medical records of patients referred for MPX screening were investigated. Patients with positive RT-PCR were defined as cases, while the ones with negative RT-PCR as controls. Multivariable regression analysis was performed to estimate predictors of MPX diagnosis.

Among the 141 included patients, 85 (60%) had at least one positive RT-PCR for MPX. Carrying out RT-PCR only on the swab obtained by skin lesion sampling, 7 patients (7/85: 8%) would have been misdiagnosed. Multivariable regression analysis showed significant differences in the independent variables: "being men who have sex with men (MSM)", "living with HIV", "having multiple sexual partners in the last 3 weeks", and "having skin lesions in the anogenital area" for prediction of MPX diagnosis. These four discriminants were used to create a score to improve diagnosis in patients screened for MPX.

MPX diagnosis was associated with being MSM, living with HIV, having multiple sexual partners, and presenting with anogenital skin lesions. In this study, the derived score had good sensitivity and specificity to predict MPX diagnosis. Finally, performing multi-site swabs for MPX RT-PCR might lower false negative rates.

The monkeypox virus has emerged as an uncommon zoonotic infection. The recent outbreak of MPXV in Europe and abroad in 2022 presented a major threat to individuals at risk. At present, no specific MPXV vaccinations or medications are available.

In this study, we predicted the most effective siRNA against the conserved region of the MPXV and validated the activity by performing molecular docking studies.

Ultimately, the most efficient siRNA molecule was shortlisted against the envelope protein gene (B6R) based on its toxicity, effectivity, thermodynamic stability, molecular interaction, and molecular dynamics simulations (MD) with the Human Argonaute 2 protein.

Thus, the strategy may offer a platform for the development of potential antiviral RNA therapeutics that target MPXV at the genomic level.

To model the spread of monkeypox (MPX) in a metropolitan area for assessing the risk of possible outbreaks, and identifying essential public health measures to contain the virus spread. The animal reservoir is the key element in the modeling of zoonotic disease. Using a One Health approach, we model the spread of the MPX virus in humans considering potential animal hosts such as rodents (e.g., rats, mice, squirrels, chipmunks, etc.) and emphasize their role and transmission of the virus in a high-risk group, including gay and bisexual men-who-have-sex-with-men (gbMSM). From model and sensitivity analysis, we identify key public health factors and present scenarios under different transmission assumptions. We find that the MPX virus may spill over from gbMSM high-risk groups to broader populations if the efficiency of transmission increases in the higher-risk group. However, the risk of outbreak can be greatly reduced if at least 65% of symptomatic cases can be isolated and their contacts traced and quarantined. In addition, infections in an animal reservoir will exacerbate MPX transmission risk in the human population. Regions or communities with a higher proportion of gbMSM individuals need greater public health attention. Tracing and quarantine (or "effective quarantine" by postexposure vaccination) of contacts with MPX cases in high-risk groups would have a significant effect on controlling the spreading. Also, monitoring for animal infections would be prudent.

Human monkeypox is a viral zoonosis endemic to West and Central Africa that has recently generated increased interest and concern on a global scale as an emerging infectious disease threat in the midst of the slowly relenting COVID-2019 disease pandemic. The hallmark of infection is the development of a flu-like prodrome followed by the appearance of a smallpox-like exanthem. Precipitous person-to-person transmission of the virus among residents of 100 countries where it is nonendemic has motivated the immediate and widespread implementation of public health countermeasures. In this review, we discuss the origins and virology of monkeypox virus, its link with smallpox eradication, its record of causing outbreaks of human disease in regions where it is endemic in wildlife, its association with outbreaks in areas where it is nonendemic, the clinical manifestations of disease, laboratory diagnostic methods, case management, public health interventions, and future directions.

Therapeutic and vaccine development for human poxvirus infections (e.g., monkeypox (mpox) virus, variola virus, molluscum contagiosum virus, orf virus) has been largely deserted, especially after the eradication of smallpox by 1980. Human mpox is a self-limited disease confined to Central and West Africa for decades. However, since April 2022, mpox has quickly emerged as a multi-country outbreak, urgently calling for effective antiviral agents and vaccines to control mpox. Here, this review highlights possible therapeutic options (e.g., tecovirimat, brincidofovir, cidofovir) and other strategies (e.g., vaccines, intravenous vaccinia immune globulin) for the management of human poxvirus infections worldwide.

Amidst the ongoing monkeypox outbreak, global awareness has been directed towards the prevention of viral transmission and case management, with the World Health Organization declaring the outbreak a public health emergency of international concern. Monkeypox virus is one of several species in the Orthopoxvirus genus, with other species of the genus including the variola, cowpox, mousepox, camelpox, raccoonpox, skunkpox, and volepox viruses. Although the nomenclature of these species is based on the animal host from which they were originally isolated, transmission from animals to humans has been reported with several species. The progression of disease, following an incubation period, typically consists of a prodromal phase with systemic flu-like symptoms. Various organ systems may be affected in addition to the formation of pathognomonic skin lesions. As monkeypox poses a continued public health concern, the ophthalmic sequelae of monkeypox virus, especially those leading to vision loss, warrant consideration as well. This review provides a comprehensive summary of the ophthalmic implications of poxviruses in clinical and laboratory settings reported in the literature, as well as areas of unmet need and future research.

The current Monkeypox virus (MPX) outbreak is not only the largest known outbreak to date caused by a strain belonging to the West-African clade, but also results in remarkably different clinical and epidemiological features compared to previous outbreaks of this virus. Here, we consider the possibility that mutations in the viral genome may be responsible for its changed characteristics.

Six genome sequences of isolates from the current outbreak were compared to five genomes of isolates from the 2017 outbreak in Nigeria and to two historic genomes, all belonging to the West-African clade. We report differences that are consistently present in the 2022 isolates but not in the others. Although some variation in repeat units was observed, only two were consistently found in the 2022 genomes only, and these were located in intergenic regions. A total of 55 single nucleotide polymorphisms were consistently present in the 2022 isolates compared to the 2017 isolates. Of these, 25 caused an amino acid substitution in a predicted protein.

The nature of the substitution and the annotation of the affected protein identified potential candidates that might affect the virulence of the virus. These included the viral DNA helicase and transcription factors.

This bioinformatic analysis provides guidance for wet-lab research to identify changed properties of the MPX.

Since its first confirmation in London on 12 May 2022, many monkeypox cases have been reported worldwide. Noticeably, the epidemiology, pathology, and clinical features of the current emergence have been compared to those of smallpox, a severe contagious disease historically epidemic worldwide for nearly 3,000 years. However, some characteristics of the present outbreak differed from those of previous monkeypox outbreaks. Herein, we ask if this emergence of monkeypox could cause another global pandemic similar to smallpox or influenza or if it is only the re-emergence of a new strain. To address these questions, we reviewed its virology, transmission, clinical characteristics, experimental diagnosis, and prevention and intervention, giving our commentary along the way.

Recent monkeypox (MPX) outbreaks are major ones in non-endemic countries. The present study analyzed molecular phylogenetics, divergence, epidemiology, the geographical distribution, entropy diversity of genome, mutational landscape, and evolution of the monkeypox virus (MPXV) genome and the current MPXV is entitled "hMPXV1." We used different in-silico and statistical methods to study our objectives. The developed phylogram from molecular phylogenetics describes the origin and evolution of hMPXV1 of A, A.1, A.1.1, A.2, and B.1 lineages. The microevolution of B.1 lineage shows its evolution from May to August 2022. B.1 lineage is further adapting and showing more mutation and sub-lineages. The scatter plot of all lineages shows the clustering pattern of lineages and the divergence. We also developed two statistical models of confirmed cases and a diagram of the age-related pattern of infected cases to illustrate the epidemiology of the MPX outbreaks. The entropy diversity and mutational landscape of the hMPXV1 genome were analyzed in nucleotide and codon contexts. Our study has shown the in-depth evolution pattern of different lineages of the hMPXV1. We found B.1 lineage is associated with the current outbreaks. The mutational landscape informs about the slow mutation of the virus. Finally, the study might assists the new therapeutic development considering all the above points and would help the researcher to set up their future research directions.

The current monkeypox outbreak reawakens the concern that poxviridae have a high potential for zoonotic spillover and causing a pandemic. Much fieldwork and research have been done by health care and public health workers in Africa during previous human outbreaks, and their knowledge should inform our global response to the current outbreak. However, unusual clinical presentations now have potential implications for recognizing the disease. In addition, infections from poxviridae, such as monkeypox, have common cutaneous signs that occur early, may be related to periods of transmissibility, and can leave scarring. Therefore, dermatologists will play a key role in recognizing and diagnosing infections and educating and preparing frontline health care workers for the early detection of new cases and clusters of monkeypox.