Update on Mpox: a brief narrative review.

Q2 Medicine Infezioni in Medicina Pub Date : 2023-01-01 DOI:10.53854/liim-3103-1
Spinello Antinori, Giacomo Casalini, Andrea Giacomelli, Alfonso J Rodriguez-Morales
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Abstract

Mpox (formerly Monkeypox), a neglected tropical disease once confined to Central and West Africa, emerged as a global epidemic outbreak in May, 2022 with 87,529 cases reported as of May, 23, 2023. It predominantly affected men (96.2%) who have sex with men (84-100%), although other transmission routes have been reported, including occupational exposure and vertical transmission. Concomitant HIV infection has been recorded in 21-46.9% and pre-exposure prophylaxis against HIV infection has been reported in 11-57% of published cases. The current outbreak clinical presentation differs from endemic cases with prodromal symptoms that could be absent: the number of lesions is generally low, with skin lesions predominantly localised in the ano-genital areas and frequent lesions present in different stages of progression (i.e., asynchronous). Asymptomatic Mpox infection can occur in 1.8-6.5% of at-risk subjects. People living with HIV with severe immunodeficiency (less than 100 CD4+ lymphocytes per microliter) are at risk of more severe clinical manifestations and death. According to a systematic review and meta-analysis, the hospitalisation rate is around 6% and the observed case-fatality rate is less than 0.1%. Tecovirimat is the drug of choice for treating severe cases although there is no evidence of efficacy from randomised controlled trials. Immunization with a live non-replicating vaccine (JYNNEOS) effectively reduces the disease's incidence.

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关于麻疹的最新情况:简要回顾。
Mpox(以前称为猴痘)是一种被忽视的热带病,曾经局限于中非和西非,于2022年5月成为全球流行病暴发,截至2023年5月23日报告了87,529例。它主要影响男男性行为者(96.2%)(84-100%),尽管报告了其他传播途径,包括职业接触和垂直传播。同时发生艾滋病毒感染的比例为21-46.9%,在已公布的病例中,有11-57%报告了暴露前预防艾滋病毒感染。当前暴发的临床表现与可能不存在前体症状的地方性病例不同:病变数量普遍较低,皮肤病变主要局限于非生殖器区域,病变频繁出现在不同的进展阶段(即不同步)。无症状麻疹感染可发生在1.8-6.5%的高危人群中。患有严重免疫缺陷的艾滋病毒感染者(每微升CD4+淋巴细胞少于100个)面临更严重的临床表现和死亡的风险。根据系统评价和荟萃分析,住院率约为6%,观察到的病死率低于0.1%。虽然没有随机对照试验的疗效证据,但替科维莫是治疗重症病例的首选药物。使用非复制活疫苗(JYNNEOS)进行免疫接种可有效降低该病的发病率。
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来源期刊
Infezioni in Medicina
Infezioni in Medicina Medicine-Infectious Diseases
CiteScore
8.40
自引率
0.00%
发文量
62
期刊介绍: The Journal publishes original papers, in Italian or in English, on topics concerning aetiopathogenesis, prevention, epidemiology, diagnosis, clinical features and therapy of infections, whose acceptance is subject to the referee’s assessment. The Journal is of interest not only to infectious disease specialists, microbiologists and pharmacologists, but also to internal medicine specialists, paediatricians, pneumologists, and to surgeons as well. The Editorial Board includes experts in each of the above mentioned fields.
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