ADDRESSING THE 2022
Monkeypox outbreak
In May 2022, multiple outbreaks of infection by monkeypox were reported in non-endemic areas, such as Europe and the United States. Although monkeypox infection is not life-threatening, the rapid spread of the virus in areas without a history of community transmission raised the awareness of health authorities, which launched public health dictates for containing the outbreaks.
Early evidence tells us that monkeypox infection is behaving different than previous outbreaks. Based on the need to fully understand the infection to make evidence-based decisions on the public health control of the infection, we are working to contribute to the existing evidence gaps, such as transmission dynamics, clinical presentations, diagnostic tools, and vaccine response and immunology.
Publications
Mitjà, Oriol; Alemany, Andrea; Marks, Michael; et al.
Mpox in people with advanced HIV infection: a global case series Journal Article
In: The Lancet, 2023, ISSN: 0140-6736.
@article{monki,
title = {Mpox in people with advanced HIV infection: a global case series},
author = {Oriol Mitjà and Andrea Alemany and Michael Marks and Jezer I. Lezama Mora and Juan Carlos Rodríguez-Aldama and Mayara Secco Torres Silva and Ever Arturo Corral Herrera and Brenda Crabtree-Ramirez and José Luis Blanco and Nicolo Girometti and Valentina Mazzotta and Aniruddha Hazra and Macarena Silva and Juan José Montenegro-Idrogo and Kelly Gebo and Jade Ghosn and María Fernanda Peña Vázquez and Eduardo Matos Prado and Uche Unigwe and Judit Villar-García and Noah Wald-Dickler and Jason Zucker and Roger Paredes and Alexandra Calmy and Laura Waters and Cristina Galvan-Casas and Sharon Walmsley and Chloe M. Orkin and Viviana Leiro and Lucila Marchetta and Patricia Fernandez Pardal and María Inés Figueroa and Pedro Cahn and Katharina Grabmeier-Pfistershammer and Agnes Libois and Laurens Liesenborghs and Beatriz Grinsztejn and Mauro Schechter and Alberto Lemos and Alvaro Furtado Costa and Simone Queiroz Rocha and José Valdez Madruga and Darrell H. S. Tan and Sharmistha Mishra and Shreya Shah and Camila Jorquera and Alberto Castillo and Mauricio Carrión and Nelson Cevallos and Romain Palich and Valerie Pourcher and Emma Rubenstein and Pascal Migaud and Christoph Boesecke and Christian Hoffmann and Konstantinos Protopapas and Silvia Nozza and Anna Maria Cattelan and Cristina Mussini and Antonella Monforte and Raúl Adrian Cruz Flores and Edgar Pérez Barragán and Alma Leticia Rodríguez Guzmán and Dimie Ogoina and Nneka Marian Chika-Igwenyi and Onyeaghala Chizaram and Jenny Valverde López and Angelica García Tello and Maria Ubals and Martí Vall and Adrià Mendoza and Clara Suñer and Bonaventura Clotet and Jordi Bechini and Jose A. Lepe and M. Dolores Navarro-Amuedo and Jose Ignacio Bernadino and Alba Català and Eloy José Tarín Vicente and Borja González Rodríguez and Sergi Rodriguez-Mercader and Francisca Sánchez-Martinez and Esperanza Cañas-Ruano and Laura Parra-Navarro and Finn Filén and Carmen Tallón de Lara and Dominique Braun and Vanja Piezzi and Michael Burkhard and Helen Kovari and Anja Mönch and Jake Dunning and Pedro Simoes and Achyuta Nori and Sarah Keegan and John P. Thornhill and Vanessa Apea and Teymur Noori and Joyce L. Jones and Seth Judson and Elizabeth A. Gilliams and Matthew Hammill and Jeanne Keruly and Andrés F. Henao Martínez and Aung Lin and Jessica So and Kusha Davar and Diana Villareal},
doi = {https://doi.org/10.1016/S0140-6736(23)00273-8},
issn = {0140-6736},
year = {2023},
date = {2023-01-01},
journal = {The Lancet},
publisher = {Elsevier},
abstract = {BackgroundPeople living with HIV have accounted for 38?50% of those affected in the 2022 multicountry mpox outbreak. Most reported cases were in people who had high CD4 cell counts and similar outcomes to those without HIV. Emerging data suggest worse clinical outcomes and higher mortality in people with more advanced HIV. We describe the clinical characteristics and outcomes of mpox in a cohort of people with HIV and low CD4 cell counts (CD4 <350 cells per mm3).},
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pubstate = {published},
tppubtype = {article}
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BackgroundPeople living with HIV have accounted for 38?50% of those affected in the 2022 multicountry mpox outbreak. Most reported cases were in people who had high CD4 cell counts and similar outcomes to those without HIV. Emerging data suggest worse clinical outcomes and higher mortality in people with more advanced HIV. We describe the clinical characteristics and outcomes of mpox in a cohort of people with HIV and low CD4 cell counts (CD4 <350 cells per mm3).
Suñer, Clara; Ubals, Maria; Tarín-Vicente, Eloy José; et al.
Viral dynamics in patients with monkeypox infection: a prospective cohort study in Spain Journal Article
In: The Lancet Infectious Diseases, 2023, ISSN: 1473-3099.
@article{sunyer2023,
title = {Viral dynamics in patients with monkeypox infection: a prospective cohort study in Spain},
author = {Clara Suñer and Maria Ubals and Eloy José Tarín-Vicente and Adrià Mendoza and Andrea Alemany and Águeda Hernández-Rodríguez and Cristina Casañ and Vicente Descalzo and Dan Ouchi and Aurélien Marc and Àngel Rivero and Pep Coll and Xènia Oller and José Miguel Cabrera and Martí Vall-Mayans and María Dolores Folgueira and María Ángeles Melendez and Manuel Agud-Dios and Elena Gil-Cruz and Alexia Paris de Leon and Aída Ramírez Marinero and Vira Buhiichyk and Cristina Galván-Casas and Roger Paredes and Nuria Prat and Maria-Rosa Sala Farre and Josep Maria Bonet-Simó and Magí Farré and Pablo L. Ortiz-Romero and Bonaventura Clotet and Vicente García-Patos and Jordi Casabona and Jeremie Guedj and Pere-Joan Cardona and Ignacio Blanco and José Ramón Santos and Lucía Bailón and Susana Benet and Jorge Arroyo Andres and Lorena Calderón Lozano and María Carrasco Díaz and Carla Budria Serrano and Enola Crespillo Galán and Ana Isabel Parra Manzano and Pamela Nef Rabadán and Laura Muntané and Cristina Sánchez-Lafuente Doncel and Yesinei Marina Marrero Pueo and Aroa Muñoz Quinto and Marlon Acosta and Patricia Alvarez and Maider Arando and Jorge N. García and Arnau Monforte and Yolanda Maltas Hidalgo and Ramona Hervas Perez and Laura Clotet Romero and Michael Marks and Oriol Mitjà},
doi = {https://doi.org/10.1016/S1473-3099(22)00794-0},
issn = {1473-3099},
year = {2023},
date = {2023-01-01},
journal = {The Lancet Infectious Diseases},
publisher = {Elsevier},
abstract = {BackgroundMonkeypox DNA has been detected in skin lesions, saliva, oropharynx, urine, semen, and stool of patients infected during the 2022 clade IIb outbreak; however, the viral dynamics within these compartments remain unknown. We aimed to characterise the viral load kinetics over time in various parts of the body.},
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pubstate = {published},
tppubtype = {article}
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BackgroundMonkeypox DNA has been detected in skin lesions, saliva, oropharynx, urine, semen, and stool of patients infected during the 2022 clade IIb outbreak; however, the viral dynamics within these compartments remain unknown. We aimed to characterise the viral load kinetics over time in various parts of the body.
Tarín-Vicente, Eloy José; Alemany, Andrea; Agud-Dios, Manuel; et al.
Clinical presentation and virological assessment of confirmed human monkeypox virus cases in Spain: a prospective observational cohort study Journal Article
In: The Lancet, vol. 400, no. 10353, pp. 661-669, 2022, ISSN: 0140-6736.
@article{Tarín-Vicente2022,
title = {Clinical presentation and virological assessment of confirmed human monkeypox virus cases in Spain: a prospective observational cohort study},
author = {Eloy José Tarín-Vicente and Andrea Alemany and Manuel Agud-Dios and Maria Ubals and Clara Suñer and Andrés Antón and Maider Arando and Jorge Arroyo-Andrés and Lorena Calderón-Lozano and Cristina Casañ and José Miguel Cabrera and Pep Coll and Vicente Descalzo and María Dolores Folgueira and Jorge N. García-Pérez and Elena Gil-Cruz and Borja González-Rodríguez and Christian Gutiérrez-Collar and Águeda Hernández-Rodríguez and Paula López-Roa and María Ángeles Meléndez and Julia Montero-Menárguez and Irene Muñoz-Gallego and Sara Isabel Palencia-Pérez and Roger Paredes and Alfredo Pérez-Rivilla and María Piñana and Nuria Prat and Aída Ramirez and Ángel Rivero and Carmen Alejandra Rubio-Muñiz and Martí Vall and Kevin Stephen Acosta-Velásquez and An Wang and Cristina Galván-Casas and Michael Marks and Pablo L. Ortiz-Romero and Oriol Mitjà},
doi = {https://doi.org/10.1016/S0140-6736(22)01436-2},
issn = {0140-6736},
year = {2022},
date = {2022-01-01},
journal = {The Lancet},
volume = {400},
number = {10353},
pages = {661-669},
publisher = {Elsevier},
abstract = {In May, 2022, several European countries reported autochthonous cases of monkeypox, which rapidly spread globally. Early reports suggest atypical presentations. We aimed to investigate clinical and virological characteristics of cases of human monkeypox in Spain.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
In May, 2022, several European countries reported autochthonous cases of monkeypox, which rapidly spread globally. Early reports suggest atypical presentations. We aimed to investigate clinical and virological characteristics of cases of human monkeypox in Spain.
Alemany, Andrea; Millat-Martinez, Pere; Corbacho-Monné, Marc; et al.
In: The Lancet Respiratory Medicine, 2022, ISSN: 2213-2600.
@article{ref1,
title = {High-titre methylene blue-treated convalescent plasma as an early treatment for outpatients with COVID-19: a randomised, placebo-controlled trial},
author = {Andrea Alemany and Pere Millat-Martinez and Marc Corbacho-Monné and Pierre Malchair and Dan Ouchi and Anna Ruiz-Comellas and Anna Ramírez-Morros and Joana Rodríguez Codina and Rosa Amado Simon and Sebastian Videla and Gèlia Costes and Mar Capdevila-Jáuregui and Pamela Torrano-Soler and Alba San José and Glòria Bonet Papell and Jordi Puig and Aurema Otero and Jose Carlos Ruibal Suarez and Alvaro Zarauza Pellejero and Ferran Llopis Roca and Orlando Rodriguez Cortez and Vanesa Garcia Garcia and Josep Vidal-Alaball and Anna Millan and Enric Contreras and Joan-Ramon Grifols and Àgueda Ancochea and Ivan Galvan-Femenia and Francini Piccolo Ferreira and Mireia Bonet and Jordi Cantoni and Núria Prat and Jordi Ara and Anna Forcada Arcarons and Magí Farré and Edwards Pradenas and Julià Blanco and Miquel Àngel Rodriguez-Arias and Gema Fernández Rivas and Michael Marks and Quique Bassat and Ignacio Blanco and Bàrbara Baro and Bonaventura Clotet and Oriol Mitjà and Susana Ferrer and Mireia Gallardo and Maria Ubals and Camila González-Beiras and Martí Vall-Mayans and Clara Suñer and Clàudia Laporte-Villar and Aroa Nieto and Xavier Comas-Leon and Zahida Jiménez and Ferran Ramírez-Viaplana and Maria Delgado-Capel and Beatriz Díez Sánchez and Maria Pons Barber and Cristian Gonzalez Ruiz and Laura Navarrete Gonzalez and David González García and Ainhoa Vivero Larraza and Victor Carceles Peiró and Clàudia Roquer López and Neus Robert and Carles Palet and Carlota Gudiol and Pablo Casares Gonzalez and Gemma Arcos Vila and Begoña Flores Aguilera and Graciela Rodríguez-Sevilla and Macarena Dastis Arias and Judit Roca Font and Katherine M. Carrasco Matos and Glòria Saüch Valmaña and Carla Vidal Obradors and Silvia Tarres García and Margarida Curriu Sabatès and Raquel Nieto Rodríguez and Rosa Línio and Míriam Fornos and Natàlia Casamitjana and Eva Alonso and Núria Martínez and Laura Analía Maglio and Laura Comellas Fernandez and Nadia Garcia and Luis Hernández and Maria Isabel González and Anna Bravo and Yolanda García and Silvia Sauleda Oliveras and Tatiana Vertiz and Sergio Benavent and Andrea Sofia Bianco and Joaquim Verdaguer and Ney Nicanor Briones Zambrano and Maria Viozquez Meya and Águeda Hernández and Cristina Casaña Lopez and Antoni E. Bordoy and Victoria González Soler and Montserrat Giménez and Alexa París and Silvia Marfil and Benjamin Trinité and Eulàlia Grau},
doi = {10.1016/S2213-2600(21)00545-2},
issn = {2213-2600},
year = {2022},
date = {2022-01-01},
journal = {The Lancet Respiratory Medicine},
publisher = {Elsevier},
abstract = {Convalescent plasma has been proposed as an early treatment to interrupt the progression of early COVID-19 to severe disease, but there is little definitive evidence. We aimed to assess whether early treatment with convalescent plasma reduces the risk of hospitalisation and reduces SARS-CoV-2 viral load among outpatients with COVID-19.},
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pubstate = {published},
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Convalescent plasma has been proposed as an early treatment to interrupt the progression of early COVID-19 to severe disease, but there is little definitive evidence. We aimed to assess whether early treatment with convalescent plasma reduces the risk of hospitalisation and reduces SARS-CoV-2 viral load among outpatients with COVID-19.
Mitjà, Oriol; Ogoina, Dimie; Titanji, Boghuma K.; et al.
Monkeypox Journal Article
In: The Lancet, 2022, ISSN: 0140-6736.
@article{ref1_mitjas,
title = {Monkeypox},
author = {Oriol Mitjà and Dimie Ogoina and Boghuma K. Titanji and Cristina Galvan and Jean-Jacques Muyembe and Michael Marks and Chloe M. Orkin},
doi = {https://doi.org/10.1016/S0140-6736(22)02075-X},
issn = {0140-6736},
year = {2022},
date = {2022-01-01},
journal = {The Lancet},
publisher = {Elsevier},
abstract = {Monkeypox is a zoonotic illness caused by the monkeypox virus, an Orthopoxvirus in the same genus as the variola, vaccinia, and cowpox viruses. Since the detection of the first human case in the Democratic Republic of the Congo in 1970, the disease has caused sporadic infections and outbreaks, mainly restricted to some countries in west and central Africa. In July, 2022, WHO declared monkeypox a Public Health Emergency of International Concern, on account of the unprecedented global spread of the disease outside previously endemic countries in Africa and the need for global solidarity to address this previously neglected disease. The 2022 outbreak has been primarily associated with close intimate contact (including sexual activity) and most cases have been diagnosed among men who have sex with men, who often present with novel epidemiological and clinical characteristics. In the 2022 outbreak, the incubation period ranges from 7 days to 10 days and most patients present with a systemic illness that includes fever and myalgia and a characteristic rash, with papules that evolve to vesicles, pustules, and crusts in the genital, anal, or oral regions and often involve the mucosa. Complications that require medical treatment (eg, antiviral therapy, antibacterials, and pain control) occur in up to 40% of patients and include rectal pain, odynophagia, penile oedema, and skin and anorectal abscesses. Most patients have a self-limited illness; between 1% and 13% require hospital admission (for treatment or isolation), and the case-fatality rate is less than 0·1%. A diagnosis can be made through the presence of Orthopoxvirus DNA in PCRs from lesion swabs or body fluids. Patients with severe manifestations and people at risk of severe disease (eg, immunosuppressed people) could benefit from antiviral treatment (eg, tecovirimat). The current strategy for post-exposure prophylaxis or pre-exposure prophylaxis for people at high risk is vaccination with the non-replicating modified vaccinia Ankara. Antiviral treatment and vaccines are not yet available in endemic countries in Africa.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Monkeypox is a zoonotic illness caused by the monkeypox virus, an Orthopoxvirus in the same genus as the variola, vaccinia, and cowpox viruses. Since the detection of the first human case in the Democratic Republic of the Congo in 1970, the disease has caused sporadic infections and outbreaks, mainly restricted to some countries in west and central Africa. In July, 2022, WHO declared monkeypox a Public Health Emergency of International Concern, on account of the unprecedented global spread of the disease outside previously endemic countries in Africa and the need for global solidarity to address this previously neglected disease. The 2022 outbreak has been primarily associated with close intimate contact (including sexual activity) and most cases have been diagnosed among men who have sex with men, who often present with novel epidemiological and clinical characteristics. In the 2022 outbreak, the incubation period ranges from 7 days to 10 days and most patients present with a systemic illness that includes fever and myalgia and a characteristic rash, with papules that evolve to vesicles, pustules, and crusts in the genital, anal, or oral regions and often involve the mucosa. Complications that require medical treatment (eg, antiviral therapy, antibacterials, and pain control) occur in up to 40% of patients and include rectal pain, odynophagia, penile oedema, and skin and anorectal abscesses. Most patients have a self-limited illness; between 1% and 13% require hospital admission (for treatment or isolation), and the case-fatality rate is less than 0·1%. A diagnosis can be made through the presence of Orthopoxvirus DNA in PCRs from lesion swabs or body fluids. Patients with severe manifestations and people at risk of severe disease (eg, immunosuppressed people) could benefit from antiviral treatment (eg, tecovirimat). The current strategy for post-exposure prophylaxis or pre-exposure prophylaxis for people at high risk is vaccination with the non-replicating modified vaccinia Ankara. Antiviral treatment and vaccines are not yet available in endemic countries in Africa.
Ayove, Telek; Houniei, Wendy; Wangnapi, Regina; et al.
Sensitivity and specificity of a rapid point-of-care test for active yaws: a comparative study Journal Article
In: The Lancet Global Health, vol. 2, no. 7, pp. e415-e421, 2014, ISSN: 2214-109X.
@article{Ayove2014,
title = {Sensitivity and specificity of a rapid point-of-care test for active yaws: a comparative study},
author = {Telek Ayove and Wendy Houniei and Regina Wangnapi and Sibauk V. Bieb and Walter Kazadi and Lisol-Nirau Luke and Clement Manineng and Penias Moses and Raymond Paru and Javan Esfandiari and Pedro L. Alonso and Elisa Lazzari and Quique Bassat and David Mabey and Oriol Mitjà},
doi = {10.1016/S2214-109X(14)70231-1},
issn = {2214-109X},
year = {2014},
date = {2014-01-01},
journal = {The Lancet Global Health},
volume = {2},
number = {7},
pages = {e415-e421},
publisher = {Elsevier},
abstract = {To eradicate yaws, national control programmes use the Morges strategy (initial mass treatment and biannual resurveys). The resurvey component is designed to actively detect and treat remaining yaws cases and is initiated on the basis of laboratory-supported reactive non-treponemal serology (using the rapid plasma reagin [RPR] test). Unfortunately, the RPR test is available rarely in yaws-endemic areas. We sought to assess a new point-of-care assay?the Dual Path Platform (DPP) syphilis assay, which is based on simultaneous detection of antibodies to treponemal and non-treponemal antigens?for guiding use of antibiotics for yaws eradication. A secondary goal was to ascertain at what timepoint the DPP assay line reverted to negative after treatment.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
To eradicate yaws, national control programmes use the Morges strategy (initial mass treatment and biannual resurveys). The resurvey component is designed to actively detect and treat remaining yaws cases and is initiated on the basis of laboratory-supported reactive non-treponemal serology (using the rapid plasma reagin [RPR] test). Unfortunately, the RPR test is available rarely in yaws-endemic areas. We sought to assess a new point-of-care assay?the Dual Path Platform (DPP) syphilis assay, which is based on simultaneous detection of antibodies to treponemal and non-treponemal antigens?for guiding use of antibiotics for yaws eradication. A secondary goal was to ascertain at what timepoint the DPP assay line reverted to negative after treatment.
