Case of apparent mpox reinfection

Abstract

We present an apparent second episode of mpox (monkeypox) genital ulcerative disease in a non-immunosuppressed MSM (man who has sex with men) patient who had completely recovered from a primary mpox infection 4 months previously. The patient had also received a complete two-dose course of smallpox vaccination between the two presentations. This case highlights the importance of continuing to include mpox in the differential diagnoses for individuals presenting with genital or mucosal ulceration, regardless of assumed immunity derived from prior infection or vaccination.

Various mpox recombinant subunits induce broadly reactive antibodies against orthopoxvirus in mice

“…Recently, several published cases of mpox-reinfection have occurred, suggesting that due to the lack of neutralizing antibody response against key mpox subunits. [18][19][20] Several studies demonstrated that antibodies against both IMV and EEV were required for optimal protection. Hence the development of more effective vaccines is a must.…”

Suspected case of monkeypox reinfection versus reactivation in a immunocompetent patient, Barcelona, 2022

“…A similar case of suspected Mpox reinfection was recently published. 15 If we consider them a reinfection, it opens the possibility of unrevealed virus circulation due to asymptomatic infections in the context of a population with currently high immunization rates due to natural or vaccine-acquired immunity. This should be taken into account due to the risk of resurgent/new outbreaks and the current exclusion of patients who already had Mpox infection in the general pre-exposure vaccine recommendations.…”

Breakthrough infection and reinfection in patients with mpox

“…To date, 10 cases of MPXV reinfection were reported in various countries including Spain, the United Kingdom, Switzerland, Nigeria, Italy, Brazil, and others. 16,[28][29][30][31][32][33] Table 2 presents basic information of these cases.…”

“…According to research reports, people who have vaccinated with the smallpox vaccine for many years are less likely to be infected with MPXV than those who have not vaccinated with the smallpox vaccine 12 . Nevertheless, some cases of breakthrough infection and reinfection of MPXV have been reported, 13–19 but little is known about the causes and clinical symptoms of Mpox breakthrough infection and reinfection.…”

“…12 According to research reports, people who have vaccinated with the smallpox vaccine for many years are less likely to be infected with MPXV than those who have not vaccinated with the smallpox vaccine. 12 Nevertheless, some cases of breakthrough infection and reinfection of MPXV have been reported, [13][14][15][16][17][18][19] but little is known about the causes and clinical symptoms of Mpox breakthrough infection and reinfection. This literature review aims to summarize the clinical characteristics of patients confirmed with breakthrough infection and reinfection of MPXV, to discuss the potential causes of breakthrough infection and reinfection, and to provide scientific basis for optimizing the vaccination strategies and preventing the enlargement of the Mpox epidemic.…”