Human monkeypox – After 40 years, an unintended consequence of smallpox eradication

Smallpox eradication, coordinated by the WHO and certified 40 years ago, led to the cessation of routine smallpox vaccination in most countries. It is estimated that over 70% of the world’s population is no longer protected against smallpox, and through cross-immunity, to closely related orthopox viruses such as monkeypox. Monkeypox is now a re-emerging disease. Monkeypox is endemic in as yet unconfirmed animal reservoirs in sub-Saharan Africa, while its human epidemiology appears to be changing.

Monkeypox in small animals imported from Ghana as exotic pets was at the origin of an outbreak of human monkeypox in the USA in 2003.

Travellers infected in Nigeria were at the origin of monkeypox cases in the UK in 2018 and 2019, Israel in 2018 and Singapore in2019. Together with sporadic reports of human infections with other orthopox viruses, these facts invite speculation that emergent or re-emergent human monkeypox might fill the epidemiological niche vacated by smallpox.
  • An ad-hoc and unofficial group of interested experts met to consider these issues at Chatham House, London in June 2019, in order to review available data and identify monkeypox-related research gaps.
  • Gaps identified by the experts included:The experts further agreed on the need for a better understanding of the genomic evolution and changing epidemiology of orthopox viruses, the usefulness of in-field genomic diagnostics, and the best disease control strategies, including the possibility of vaccination with new generation non-replicating smallpox vaccines and treatment with recently developed antivirals.
  • Monkeypox is a viral zoonotic disease on the rise across endemic habitats. Despite the growing importance of monkeypox virus, our knowledge on its host spectrum and sylvatic maintenance is limited.
  • Here, we describe the recent repeated emergence of monkeypox virus in a wild, human-habituated western chimpanzee (Pan troglodytes verus, hereafter chimpanzee) population from Taï National Park, Ivory Coast.
  • Through daily monitoring, we show that further to causing its typical exanthematous syndrome, monkeypox can present itself as a severe respiratory disease without a diffuse rash. By analysing 949 non-invasively collected samples, we identify the circulation of at least two distinct monkeypox virus lineages and document the shedding of infectious particles in faeces and flies, suggesting that they could mediate indirect transmission.
  • We also show that the carnivorous component of the Taï chimpanzees’ diet, mainly consisting of the sympatric monkeys they regularly hunt, did not change nor shift towards rodent consumption (the presumed reservoir) before the outbreaks, suggesting that the sudden emergence of monkeypox virus in this population is probably due to changes in the ecology of the virus itself.
  • Using long-term mortality surveillance data from Taï National Park, we provide evidence of little to no prior viral activity over at least two decades. We conclude that great ape sentinel systems devoted to the longitudinal collection of behavioural and health data can help clarify the epidemiology and clinical presentation of zoonotic pathogens.

 

Monkeypox (MP) is a rare zoonotic disease that most commonly transmits from bush animals to humans in the Congo Basin of Africa.

However, an increase in cases of MP has been observed over the past decades with frequent outbreaks as well as export of the disease out of the African continent. MP belongs to the same genus of viruses as smallpox, the Orthopoxvirus, and vaccination against smallpox gives some protection against MP. With the eradication of smallpox in 1980, vaccination against smallpox has ceased.
The resulting decrease of immunity against Orthopoxvirus is thought to be related to the increase in MP cases. Furthermore, closer contact between humans and bush animals could play a role along with the ongoing difficulties of controlling HIV in the same geographical area. MP remains a diagnostic challenge. Lack of knowledge about the disease among health personnel plays an important role, as well as access to diagnostic tools is limited. Treatment of MP is for now symptomatic. We report the case of a 4-year-old boy from the DR Congo with the clinical diagnosis of MP. This case illustrates some of the abovementioned challenges related to the management of MP in the field.
After the first, imported, laboratory-confirmed case of monkeypox in human was reported in Singapore on May 2019, countries in Asia started to strengthen disease surveillance systems.

One challenge in preventing monkeypox is a lack of knowledge, particularly among healthcare workers.

The aim of this study was to assess the knowledge of monkeypox among general practitioners (GPs) in Indonesia. A cross-sectional online survey was conducted. The survey collected participants’ knowledge on a 21-item scale and explanatory variables. A two-step logistic regression analysis was employed to assess the predictors of knowledge of monkeypox. A total of 432 GPs were included; 10.0% and 36.5% of them had a good knowledge using an 80% and 70% cutoff point for knowledge domain, respectively. No explanatory variables were associated with knowledge when using 80% cutoff point.
Using the lower cutoff, there was lower knowledge among GPs who graduated from universities located in Sumatra or other islands versus Java (adjusted odds ratio (aOR): 0.53; 95%CI: 0.28-0.97, p = 0.041) and among those were older than 30 years compared to younger GPs (aOR: 0.61; 95%CI: 0.39-0.96, p = 0.033). GPs working in private clinics had less knowledge compared to GPs in community health centers (aOR: 0.55; 95%CI: 0.31-0.99, p = 0.047). In conclusion, knowledge of monkeypox among GPs in Indonesia is relatively low in all groups. Increasing knowledge of monkeypox will be key to improving the capacity of GPs to respond to human monkeypox cases and to report into a disease surveillance system.

The current re-emergence of human monkeypox (HMPX) is a global concern for endemic and non-endemic countries, but healthcare workers in some regions, like Asia, have less experience with identifying and treating HMPX cases.

This study aimed to assess the confidence and its predictors in HMPX case management among general practitioners (GPs), the frontline doctors in Indonesia, and to explore their perspectives on HMPX. Between May and July 2019, GPs in Indonesia completed an online-based survey. The questionnaire collected information on GPs’ confidence, perspective, sociodemographic, workplace and professional characteristics, exposure to HMPX information and knowledge on HMPX.
A logistic regression analysis was employed to explore the explanatory variables influencing the confidence and the perspective. We included 395 GPs in our analysis (77.4% out of 510 responses received) of which 10.1% and 34.9% were classified having good confidence using an 80% and 70% cut-off for confidence score, respectively. In the adjusted analysis, receiving information about HMPX during medical training was the only variable significantly associated with good confidence (adjusted odds ratio 2.74, 95% confidence interval 1.57 to 4.78 and p<0.001). Approximately 73.6% and 77.9% of GPs agreed that HMPX is an important infectious disease and it has potential to detrimentally impact the Indonesian economy, respectively.

Recombivirus Monkey Anti-monkeypox IgG ELISA kit, 96 tests, Quantitative

AE-311150-1 Alpha Diagnostics 1 kit 834 EUR

Monkey Anti-Paragonimus IgG ELISA kit

E09A2101-192T BlueGene 192 tests 1270 EUR

Monkey Anti-Paragonimus IgG ELISA kit

E09A2101-48 BlueGene 1 plate of 48 wells 520 EUR

Monkey Anti-Paragonimus IgG ELISA kit

E09A2101-96 BlueGene 1 plate of 96 wells 685 EUR

Monkey anti cardiolipin antibody IgG,ACA IgG ELISA kit

E09A2051-192T BlueGene 192 tests 1270 EUR

Monkey anti cardiolipin antibody IgG,ACA IgG ELISA kit

E09A2051-48 BlueGene 1 plate of 48 wells 520 EUR

Monkey anti cardiolipin antibody IgG,ACA IgG ELISA kit

E09A2051-96 BlueGene 1 plate of 96 wells 685 EUR

Monkey Anti tissue transglutaminase IgG,IgG tTG ELISA kit

E09A2131-192T BlueGene 192 tests 1270 EUR

Monkey Anti tissue transglutaminase IgG,IgG tTG ELISA kit

E09A2131-48 BlueGene 1 plate of 48 wells 520 EUR

Monkey Anti tissue transglutaminase IgG,IgG tTG ELISA kit

E09A2131-96 BlueGene 1 plate of 96 wells 685 EUR

Monkey Anti myocardial antibody IgG ELISA kit

E09A0560-192T BlueGene 192 tests 1270 EUR

Monkey Anti myocardial antibody IgG ELISA kit

E09A0560-48 BlueGene 1 plate of 48 wells 520 EUR

Monkey Anti myocardial antibody IgG ELISA kit

E09A0560-96 BlueGene 1 plate of 96 wells 685 EUR

Monkey Anti nucleosome antibody IgG ELISA kit

E09A0829-192T BlueGene 192 tests 1270 EUR

Monkey Anti nucleosome antibody IgG ELISA kit

E09A0829-48 BlueGene 1 plate of 48 wells 520 EUR

Monkey Anti nucleosome antibody IgG ELISA kit

E09A0829-96 BlueGene 1 plate of 96 wells 685 EUR

Monkey anti gliadin antibody (IgG) ELISA kit

E09A2073-192T BlueGene 192 tests 1270 EUR

Monkey anti gliadin antibody (IgG) ELISA kit

E09A2073-48 BlueGene 1 plate of 48 wells 520 EUR

Monkey anti gliadin antibody (IgG) ELISA kit

E09A2073-96 BlueGene 1 plate of 96 wells 685 EUR

Monkey IgG ELISA Kit

E-85G Immunology Consultants Laboratory 1 x 96 well plate 461 EUR

Monkey IgG ELISA kit

55R-2248 Fitzgerald 96 tests 1238 EUR

Ibrutinib drug-Human IgG Conjugate

IBT17-IgG Alpha Diagnostics 100 ug 529 EUR

Rabbit Anti-Monkey IgG

FNSA-0099 FN Test 500 uL 306.6 EUR

Goat anti Monkey IgG

40R-IG002 Fitzgerald 1 mg 275 EUR

Goat anti Monkey IgG

41C-CB1605 Fitzgerald 1 mg 275 EUR

Bovine Immunoglobulin G (IgG) ELISA Kit

DLR-IgG-b-48T DL Develop 48T 456 EUR

Bovine Immunoglobulin G (IgG) ELISA Kit

DLR-IgG-b-96T DL Develop 96T 590 EUR

Canine Immunoglobulin G (IgG) ELISA Kit

DLR-IgG-c-48T DL Develop 48T 441 EUR

Canine Immunoglobulin G (IgG) ELISA Kit

DLR-IgG-c-96T DL Develop 96T 570 EUR

Equine Immunoglobulin G (IgG) ELISA Kit

DLR-IgG-Eq-48T DL Develop 48T 360 EUR

Equine Immunoglobulin G (IgG) ELISA Kit

DLR-IgG-Eq-96T DL Develop 96T 457 EUR

Goat Immunoglobulin G (IgG) ELISA Kit

DLR-IgG-g-48T DL Develop 48T 464 EUR

Goat Immunoglobulin G (IgG) ELISA Kit

DLR-IgG-g-96T DL Develop 96T 601 EUR

Human Immunoglobulin G (IgG) ELISA Kit

DLR-IgG-Hu-48T DL Develop 48T 239 EUR

Human Immunoglobulin G (IgG) ELISA Kit

DLR-IgG-Hu-96T DL Develop 96T 292 EUR

Mouse Immunoglobulin G (IgG) ELISA Kit

DLR-IgG-Mu-48T DL Develop 48T 328 EUR

Mouse Immunoglobulin G (IgG) ELISA Kit

DLR-IgG-Mu-96T DL Develop 96T 415 EUR

Porcine Immunoglobulin G (IgG) ELISA Kit

DLR-IgG-p-48T DL Develop 48T 456 EUR

Porcine Immunoglobulin G (IgG) ELISA Kit

DLR-IgG-p-96T DL Develop 96T 590 EUR

Rat Immunoglobulin G (IgG) ELISA Kit

DLR-IgG-Ra-48T DL Develop 48T 334 EUR

Rat Immunoglobulin G (IgG) ELISA Kit

DLR-IgG-Ra-96T DL Develop 96T 422 EUR

Rabbit Immunoglobulin G (IgG) ELISA Kit

DLR-IgG-Rb-48T DL Develop 48T 337 EUR

Rabbit Immunoglobulin G (IgG) ELISA Kit

DLR-IgG-Rb-96T DL Develop 96T 426 EUR

Bovine Immunoglobulin G (IgG) ELISA Kit

RDR-IgG-b-48Tests Reddot Biotech 48 Tests 473 EUR

Bovine Immunoglobulin G (IgG) ELISA Kit

RDR-IgG-b-96Tests Reddot Biotech 96 Tests 654 EUR

Canine Immunoglobulin G (IgG) ELISA Kit

RDR-IgG-c-48Tests Reddot Biotech 48 Tests 455 EUR

Canine Immunoglobulin G (IgG) ELISA Kit

RDR-IgG-c-96Tests Reddot Biotech 96 Tests 629 EUR

Equine Immunoglobulin G (IgG) ELISA Kit

RDR-IgG-Eq-48Tests Reddot Biotech 48 Tests 358 EUR

Equine Immunoglobulin G (IgG) ELISA Kit

RDR-IgG-Eq-96Tests Reddot Biotech 96 Tests 490 EUR

Goat Immunoglobulin G (IgG) ELISA Kit

RDR-IgG-g-48Tests Reddot Biotech 48 Tests 482 EUR

Goat Immunoglobulin G (IgG) ELISA Kit

RDR-IgG-g-96Tests Reddot Biotech 96 Tests 667 EUR

Human Immunoglobulin G (IgG) ELISA Kit

RDR-IgG-Hu-48Tests Reddot Biotech 48 Tests 216 EUR

Human Immunoglobulin G (IgG) ELISA Kit

RDR-IgG-Hu-96Tests Reddot Biotech 96 Tests 287 EUR

Mouse Immunoglobulin G (IgG) ELISA Kit

RDR-IgG-Mu-48Tests Reddot Biotech 48 Tests 321 EUR

Mouse Immunoglobulin G (IgG) ELISA Kit

RDR-IgG-Mu-96Tests Reddot Biotech 96 Tests 438 EUR

Porcine Immunoglobulin G (IgG) ELISA Kit

RDR-IgG-p-48Tests Reddot Biotech 48 Tests 473 EUR

Porcine Immunoglobulin G (IgG) ELISA Kit

RDR-IgG-p-96Tests Reddot Biotech 96 Tests 654 EUR

Rat Immunoglobulin G (IgG) ELISA Kit

RDR-IgG-Ra-48Tests Reddot Biotech 48 Tests 328 EUR

Rat Immunoglobulin G (IgG) ELISA Kit

RDR-IgG-Ra-96Tests Reddot Biotech 96 Tests 447 EUR

Rabbit Immunoglobulin G (IgG) ELISA Kit

RDR-IgG-Rb-48Tests Reddot Biotech 48 Tests 331 EUR

Rabbit Immunoglobulin G (IgG) ELISA Kit

RDR-IgG-Rb-96Tests Reddot Biotech 96 Tests 451 EUR

Bovine Immunoglobulin G (IgG) ELISA Kit

RD-IgG-b-48Tests Reddot Biotech 48 Tests 453 EUR

Bovine Immunoglobulin G (IgG) ELISA Kit

RD-IgG-b-96Tests Reddot Biotech 96 Tests 625 EUR

Porcine Immunoglobulin G (IgG) ELISA Kit

RD-IgG-p-48Tests Reddot Biotech 48 Tests 453 EUR

Porcine Immunoglobulin G (IgG) ELISA Kit

RD-IgG-p-96Tests Reddot Biotech 96 Tests 625 EUR

Rat Immunoglobulin G (IgG) ELISA Kit

RD-IgG-Ra-48Tests Reddot Biotech 48 Tests 314 EUR

Rat Immunoglobulin G (IgG) ELISA Kit

RD-IgG-Ra-96Tests Reddot Biotech 96 Tests 428 EUR

Rabbit Polyclonal antibody Anti-CRBN

Anti-CRBN ImmunoStep 50 µg 349 EUR

Monkey β Anti galactan proteins IgG ELISA kit

E09A0011-192T BlueGene 192 tests 1270 EUR

Monkey β Anti galactan proteins IgG ELISA kit

E09A0011-48 BlueGene 1 plate of 48 wells 520 EUR

Monkey β Anti galactan proteins IgG ELISA kit

E09A0011-96 BlueGene 1 plate of 96 wells 685 EUR

Monkey Anti Alpha Fodrin IgG/IgA ELISA kit

E09A0749-192T BlueGene 192 tests 1270 EUR

Monkey Anti Alpha Fodrin IgG/IgA ELISA kit

E09A0749-48 BlueGene 1 plate of 48 wells 520 EUR

Monkey Anti Alpha Fodrin IgG/IgA ELISA kit

E09A0749-96 BlueGene 1 plate of 96 wells 685 EUR

Monkey anti Endomysial antibody (EMA)(IgG) ELISA kit

E09A1848-192T BlueGene 192 tests 1270 EUR

Monkey anti Endomysial antibody (EMA)(IgG) ELISA kit

E09A1848-48 BlueGene 1 plate of 48 wells 520 EUR

Monkey anti Endomysial antibody (EMA)(IgG) ELISA kit

E09A1848-96 BlueGene 1 plate of 96 wells 685 EUR

Monkey anti ganglioside (GM1)antibody(IgG) ELISA kit

E09A1878-192T BlueGene 192 tests 1270 EUR

Monkey anti ganglioside (GM1)antibody(IgG) ELISA kit

E09A1878-48 BlueGene 1 plate of 48 wells 520 EUR

Monkey anti ganglioside (GM1)antibody(IgG) ELISA kit

E09A1878-96 BlueGene 1 plate of 96 wells 685 EUR

Monkey anti lupus anticoagulant antibody(IgG) ELISA kit

E09A2036-192T BlueGene 192 tests 1270 EUR

Monkey anti lupus anticoagulant antibody(IgG) ELISA kit

E09A2036-48 BlueGene 1 plate of 48 wells 520 EUR

Monkey anti lupus anticoagulant antibody(IgG) ELISA kit

E09A2036-96 BlueGene 1 plate of 96 wells 685 EUR

Monkey anti-angiostrongylus cantonensis antibody(IgG) ELISA kit

E09A2041-192T BlueGene 192 tests 1270 EUR

Monkey anti-angiostrongylus cantonensis antibody(IgG) ELISA kit

E09A2041-48 BlueGene 1 plate of 48 wells 520 EUR

Monkey anti-angiostrongylus cantonensis antibody(IgG) ELISA kit

E09A2041-96 BlueGene 1 plate of 96 wells 685 EUR

Monkey anti Inhibin B antibody (IgG) ELISA kit

E09A2085-192T BlueGene 192 tests 1270 EUR

Monkey anti Inhibin B antibody (IgG) ELISA kit

E09A2085-48 BlueGene 1 plate of 48 wells 520 EUR

Monkey anti Inhibin B antibody (IgG) ELISA kit

E09A2085-96 BlueGene 1 plate of 96 wells 685 EUR

Monkey Anti proteinase 3 antibody IgG ELISA kit

E09P0710-192T BlueGene 192 tests 1270 EUR

Monkey Anti proteinase 3 antibody IgG ELISA kit

E09P0710-48 BlueGene 1 plate of 48 wells 520 EUR

Monkey Anti proteinase 3 antibody IgG ELISA kit

E09P0710-96 BlueGene 1 plate of 96 wells 685 EUR

Guinea pig Immunoglobulin G (IgG) ELISA Kit

DLR-IgG-Gu-48T DL Develop 48T 315 EUR

Guinea pig Immunoglobulin G (IgG) ELISA Kit

DLR-IgG-Gu-96T DL Develop 96T 396 EUR

Guinea pig Immunoglobulin G (IgG) ELISA Kit

RDR-IgG-Gu-48Tests Reddot Biotech 48 Tests 305 EUR

Guinea pig Immunoglobulin G (IgG) ELISA Kit

RDR-IgG-Gu-96Tests Reddot Biotech 96 Tests 415 EUR

Monkey AnuA-IgG ELISA Kit

EMKA0836 Abclonal 96Tests 521 EUR

Monkey Hp-IgG ELISA Kit

EMKH0275 Abclonal 96Tests 521 EUR

Monkey Leptospira IgG ELISA kit

E09L0222-192T BlueGene 192 tests 1270 EUR

Monkey Leptospira IgG ELISA kit

E09L0222-48 BlueGene 1 plate of 48 wells 520 EUR
In addition, 88.8% of GPs suggested that the disease should be incorporated into the National Medical Curriculum of Indonesia. In conclusion, in case of HMPX outbreak, majority of the GPs in Indonesia seem to be less confident in diagnosing and treating cases, using their current knowledge, skills and their workplace facilities. Therefore, a systematic strategy to improve their confidence in managing HMPX is required.

Leave a Reply

Your email address will not be published.

Blog parg antibody

A Tale of Two Viruses: Coinfections of Monkeypox and Varicella Zoster Virus in the Democratic Republic of Congo

Recent enhanced monkeypox (MPX) surveillance in the Democratic Republic of Congo, where MPX is endemic, has uncovered multiple cases of MPX and varicella zoster virus (VZV) coinfections. The purpose of this study was to verify if coinfections occur and to characterize the clinical nature of these cases. Clinical, epidemiological, and laboratory results were used to […]

Read More
Biocidal ZF
Blog Cdna cnn2 mpo assay parg antibody PCR pecy5 Plasmid Product sod assay

biocidal zf spray disinfectant for incubator

Software program for incubators • Empty incubator • Spray Biocidal ZF on all surfaces and let settle • Put cultures correct once more Surfaces shall be protected for 2-4 weeks. (Sooner than disinfecting likelihood is you may clear incubator with Biocidal ZFtm if wanted) Software program in sterile benches • Empty sterile bench • Then […]

Read More