Molecular epidemiology, transmission and clinical features of 2022‐mpox outbreak: A systematic review

Abstract

Background and AimsThe 2022‐mpox outbreak has spread worldwide in a short time. Integrated knowledge of the epidemiology, clinical characteristics, and transmission of mpox are limited. This systematic review of peer‐reviewed articles and gray literature was conducted to shed light on the epidemiology, clinical features, and transmission of 2022‐mpox outbreak.MethodsWe identified 45 peer‐reviewed manuscripts for data analysis. The standards of the Preferred Reporting Items for Systematic Review and Meta‐Analysis (PRISMA) Statement and Cochrane Collaboration were followed for conducting the study.ResultsThe case number of mpox has increased about 100 times worldwide. About 99% of the cases in 2022 outbreak was from non‐endemic regions. Men (70%–98% cases) were mostly infected with homosexual and bisexual behavior (30%–60%). The ages of the infected people ranged between 30 and 40 years. The presence of HIV and sexually transmitted infections among 30%–60% of cases were reported. Human‐to‐human transmission via direct contact and different body fluids were involved in the majority of the cases (90%–100%). Lesions in genitals, perianal, and anogenital areas were more prevalent. Unusually, pharyngitis (15%–40%) and proctitis (20%–40%) were more common during 2022 outbreak than pre‐2022 outbreaks. Brincidofovir is approved for the treatment of smallpox by FDA (USA). Two vaccines, including JYNNEOSTM and ACAM2000®, are approved and used for pre‐ and post‐prophylaxis in cases. About 100% of the cases in non‐endemic regions were associated with isolates of IIb clade with a divergence of 0.0018–0.0035. Isolates from B.1 lineage were the most predominant followed by B.1.2 and B.1.10.ConclusionThis study will add integrated knowledge of the epidemiology, clinical features, and transmission of mpox.

Epidemiology of mpox: Focus on men with HIV

“…Case fatality rate of patients co-infected with mpox-HIV was higher than patients with mpox alone. Previous case series analysis in 2017 in Nigeria [ 22 ] have also found higher case fatality rate among the HIV co-infected cohort. We have also found reports of bacterial secondary infection in the genitals of mpox-HIV co-infected patients, which resulted in hospitalization and prolonged illness in this 2022 outbreak [ 10 ].…”

“…The characteristics muco-cutaneous lesions of mpox have been most frequently isolated from the genitals, anogenital and perineal areas than other organs of the body, which was higher in face, arms, and legs in previous outbreaks [ 2 , [4] , [5] , [6] , [7] , [9] , [10] , [11] , 21 , 16 , 17 ]. Recent studies have reported higher prevalence (54–100 %) and concentration of mpox DNA in semen sample of the infected men [ 7 , 9 , 11 , [13] , [21] , [14] , [20] , [15] , [16] , [17] , [18] , [19] , [22] ]. Several studies have found that isolated DNA of mpox from the lesions of anogenital skin and semen have capability to infect cell lines like Vero E6 cells and produce cytopathic effects [ 12 , 13 ].…”

Fast and Ultrasensitive Detection of Monkeypox by a Pyrococcus furiosus Argonaute System Coupled with a Short Amplification

“…In this WHO report published on 22 December 2023, a total of 2024 cases were reported, including one death since September 2022 for the first imported case in China [ 3 ]. The MPXV, which can be transmitted through sexual intercourse and direct contacting lesions, saliva, aerosols, as well as contaminated fomite [ 4 ], might cause an epidemic. The symptoms of infections caused by MPXV vary from mild to severe, including skin lesions, lymphadenectasis, fever, vomiting, sepsis, etc.…”

“…The symptoms of infections caused by MPXV vary from mild to severe, including skin lesions, lymphadenectasis, fever, vomiting, sepsis, etc. [ 1 , 4 ]. The MPXV, a large double-stranded DNA virus (about 197 kb), belongs to the genus of orthopoxvirus of the Poxviridae family, along with three other viruses: variola virus (VARV), cowpox virus (CPXV), and vaccinia virus (VACV).…”

Concerns With Analysis in Study of Tecovirimat for Mpox Among People With HIV—Reply

“…Mpox symptoms during the 2022 global outbreak are well characterized from large cohorts . Our manual data abstraction process included over 50 fields related to clinical course with coding guidelines for each field, which optimized collection of data, such as symptom onset date.…”