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Monkeypox Infection Characterized And Followed Up In A New Case Study

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Monkeypox Infection Characterized And Followed Up In A New Case Study

CTN NEWS –  Monkeypox outbreaks have historically been found in Central and West Africa. A zoonotic infection caused by the virus (MPXV) is known as the person-to-person transmission of orthopoxvirus (OPV).

Monkeypox was a rare disease outside Africa until 2022. The recent detection of monkeypox outside Africa was found to be linked to patients’ household contacts. Interestingly, a monkeypox case outside Africa was reported in 2003 connected to importing exotic pets.

Background

The monkeypox outbreaks in Australia, Europe, Israel, and the U.S., were reported in May 2022. This infection was predominantly found in men involved in sexual activity with other men.

Interestingly, compared to the previous outbreaks, the new virus outbreak exhibited distinct clinical symptoms with localized rashes and mucosal lesions, mainly in the genital area

Apart from these clinical manifestations, patients with this virus also suffered lymphadenopathy and fever. In a recent monkeypox case in Sweden, scientists focussed on clinical symptoms, viral kinetics, and microbial diagnostics. Additionally, bioinformatic analysis of genomic sequences was performed.

This case study is available in Emerging Infectious Diseases.

Case study

The current study analyzed a male patient with monkeypox from Sweden. He did not have a history of smallpox vaccination and was otherwise healthy.

The patient reported an inguinal swelling on day 0, with a manifestation of a small skin change on his foreskin the following day. This change in the foreskin quickly transformed into a deeper and well-circumscribed lesion with local lymphadenopathy within the next few days.

The real-time PCRs analysis for orthopoxvirus DNA and MPXV DNA was conducted using the genital swab samples. This test showed a positive result that was reconfirmed using the Sanger sequencing method.

Electron microscopic analysis of skin lesions revealed characteristics of orthopoxviruses that were 220–450-nm long and 140–260-nm wide. Metagenomics sequencing of the extracted DNA sample from genital lesions helped the viral genomic reconstruction.

Implications

Monkeypox is being reported every day in different countries. The clinical symptoms and transmission route of new cases have been found to be different from previous monkeypox infection symptoms.

These new aspects strongly influence the clinical management of the infection, and the formulation of public health measures. There is an urgent need to control the monkeypox outbreak at an early stage and prevent further transmission of infection.

Phylogenetic analyses showed that the new strain of virus belongs to the Western African clade of monkeypox, which has exhibited lower mortality rates compared to the Central African clade. The current study presented a fast and accurate bioinformatic analysis to classify viruses at a relatively low cost.

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