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A special issue of Tropical Medicine and Infectious Disease (ISSN 2414-6366). This special issue belongs to the section "Infectious Diseases".

Deadline for manuscript submissions: closed (25 February 2023) | Viewed by 36915

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Dr. Matteo Riccò

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Local Health Unit of Reggio Emilia, 42122 Reggio Emilia, Italy
Interests: public health; vaccines; prevention; infectious diseases; prevention and protection at work; mass gathering and public health risks
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Monkeypox virus (MPX) has been regarded as a neglected tropical pathogen (i.e., pathogens that are especially common in tropical areas where people do not have access to advanced medical resources), but during the second half of 2022, an unprecedented and unexpected international outbreak has rapidly changed its status to a potentially global pathogen. While up-to-date data are gathered all around the globe, in this Special Issue, we will try to summarize the existing information, current research, and the lacunae in our knowledge of the clinical spectrum, disease evolution, diagnostic methods, treatment modalities and indication, and prevention for this previously uncommon viral disorder.

Moreover, the present Special Issue will focus on the following questions: how travel medicine should cope with the 2022 international outbreak of MPX; which differences may be identified between the situation in endemic regions of Western and Central Africa compared to other, previously not endemic areas; which occupational countermeasures could be planned to better protect healthcare workers; and how the MPX outbreak and its burden will overlap with the still ongoing COVID-19 pandemic.

We hope this issue will help to provide guidance to providers of healthcare, both residents of endemic areas and those travelling to and from regions of transmission risk.

Dr. Matteo Riccò
Guest Editor

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Keywords

monkeypox virus
vaccine preventable diseases
pandemic
sexually-transmitted diseases
dermatology
social stigma

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Published Papers (10 papers)

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Research

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12 pages, 1585 KiB

Open AccessArticle

Are Saudi Healthcare Workers Willing to Receive the Monkeypox Virus Vaccine? Evidence from a Descriptive-Baseline Survey

by Abdullah M. Alarifi, Najim Z. Alshahrani and Ranjit Sah

Trop. Med. Infect. Dis. 2023, 8(8), 396; https://doi.org/10.3390/tropicalmed8080396 - 2 Aug 2023

Cited by 7 | Viewed by 2000

Abstract

Since Saudi Arabia has already confirmed multiple monkeypox (Mpox) cases, it is essential to initiate timely preventive measures, including the implementation of vaccines. In this cross-sectional study, an online survey was conducted among healthcare workers (HCWs) in Saudi Arabia to understand their willingness to receive the Mpox vaccine. A structured questionnaire was used to gather the data. The study comprised 734 samples. Our study found that among study participants, 52.7% were willing to receive the Mpox vaccine and showed that sociodemographic factors were not significantly associated with vaccine willingness. Previous vaccination history (such as influenza and COVID-19) was significantly associated with Mpox vaccine willingness. The respondents reported that the main reasons for receiving the Mpox vaccine were their trust in the Saudi Health Ministry (57.7%) and their understanding that the vaccine was a social responsibility (44.6%). Furthermore, the majority of the respondents (74.7%) reported that they were motivated by the need to protect themselves, their family and their friends. Insufficient vaccine information and fear of unknown adverse reactions were the most reported reasons for an unwillingness to receive the Mpox vaccine. In conclusion, increasing Mpox vaccine-related awareness and focusing on greater information dissemination to reduce fear and increase vaccine uptake is highly recommended. Full article

(This article belongs to the Special Issue Rising Stars in Mpox Research)

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17 pages, 349 KiB

Open AccessArticle

Knowledge, Attitude and Conspiracy Beliefs of Healthcare Workers in Lebanon towards Monkeypox

by Diana Malaeb, Malik Sallam, Nesreen A. Salim, Mariam Dabbous, Samar Younes, Yves Nasrallah, Katia Iskandar, Matta Matta, Sahar Obeid, Souheil Hallit and Rabih Hallit

Trop. Med. Infect. Dis. 2023, 8(2), 81; https://doi.org/10.3390/tropicalmed8020081 - 23 Jan 2023

Cited by 23 | Viewed by 3862

Abstract

The emergence of a monkeypox (MPOX) outbreak in 2022 represented the most recent recognizable public health emergency at a global level. Improving knowledge and attitude towards MPOX, particularly among healthcare workers (HCWs), can be a valuable approach in public health preventive efforts aiming to halt MPOX virus spread. The aim of the current study was to evaluate the knowledge and attitude of HCWs in Lebanon towards MPOX and to assess their conspiratorial attitude towards emerging virus infections (EVIs). The current study was based on a cross-sectional online survey distributed via Google Forms during September–December 2022 implementing a convenience sampling approach. The final study sample comprised a total of 646 HCWs: physicians (n = 171, 26.5%), pharmacists (n = 283, 43.8%), and nurses (n = 168, 26.0%), among others (n = 24, 3.7%). Variable defects in MPOX knowledge were detected, with a third of the participants having MPOX knowledge above the 75th percentile (n = 218, 33.7%). Satisfactory attitude towards MPOX (>75th percentile) was observed in less than a third of the participants (n = 198, 30.7%), while a quarter of the study sample endorsed conspiracy beliefs towards EVIs at a high level (>75th percentile, n = 164, 25.4%). Slightly more than two thirds of the participants agreed that MPOX vaccination should be used in disease prevention (n = 440, 68.1%). Better levels of MPOX knowledge and attitude were significantly associated with postgraduate education and older age. Physicians had significantly higher MPOX knowledge compared to other occupational categories. Less endorsement of conspiracies towards EVIs was significantly associated with male sex, occupation as a physician, and postgraduate education. Higher MPOX knowledge was associated with better attitude towards the disease. The current study showed unsatisfactory MPOX knowledge among Lebanese HCWs. Educational efforts can be valuable to improve the attitude towards the disease. Despite the relatively low level of embracing conspiracy beliefs regarding EVIs among HCWs in this study compared to previous studies, this area should be considered based on its potential impact on health-seeking behavior. Full article

(This article belongs to the Special Issue Rising Stars in Mpox Research)

11 pages, 545 KiB

Open AccessArticle

Public Knowledge and Perceptions about the Emerging Human Mpox in Jordan: A Cross-Sectional Study

by Rana K. Abu-Farha, Karem H. Alzoubi, Tareq L. Mukattash, Rama Alkhawaldeh, Muna Barakat and Samar Thiab

Trop. Med. Infect. Dis. 2023, 8(1), 41; https://doi.org/10.3390/tropicalmed8010041 - 5 Jan 2023

Cited by 6 | Viewed by 2713

Abstract

Hundreds of human mpox cases are spreading outside of Western and Central Africa, which could be considered a significant world health problem. In this study, we sought to assess public knowledge and perceptions of human mpox. The study was a cross-sectional survey conducted in Jordan in September–October 2022. All participants were approached through social media portals. A total of 1195 participants agreed to participate in this study. The participants showed a low median knowledge score about human mpox (4.0 out of 15.0, IQR = 5.0), with only 27.9% of the participants (n = 334) correctly identifying that human mpox is not a bacterial disease, and around half of them (n = 589, 49.3%) knowing that this disease affects both genders. Higher monthly income (≥400 JD/month) was significantly associated with better knowledge about the disease. Social media was the most comprehensive source of information about mpox (n = 1018, 85.2%). Finally, 57.3% of the participants (n = 685) believed that mpox would affect social and economic life, like the COVID-19 pandemic. These findings highlight the urgent need for systematic strategies that should be promoted to increase public knowledge of mpox, which will be critical in improving the capacity to respond to the disease. Full article

(This article belongs to the Special Issue Rising Stars in Mpox Research)

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24 pages, 7661 KiB

Open AccessArticle

Artificial Neural Networks for the Prediction of Monkeypox Outbreak

by Balakrishnama Manohar and Raja Das

Trop. Med. Infect. Dis. 2022, 7(12), 424; https://doi.org/10.3390/tropicalmed7120424 - 8 Dec 2022

Cited by 23 | Viewed by 2638

Abstract

While the world is still struggling to recover from the harm caused by the widespread COVID-19 pandemic, the monkeypox virus now poses a new threat of becoming a pandemic. Although it is not as dangerous or infectious as COVID-19, new cases of the disease are nevertheless being reported daily from many countries. In this study, we have used public datasets provided by the European Centre for Disease Prevention and Control for developing a prediction model for the spread of the monkeypox outbreak to and throughout the USA, Germany, the UK, France and Canada. We have used certain effective neural network models for this purpose. The novelty of this study is that a neural network model for a time series monkeypox dataset is developed and compared with LSTM and GRU models using an adaptive moment estimation (ADAM) optimizer. The Levenberg–Marquardt (LM) learning technique is used to develop and validate a single hidden layer artificial neural network (ANN) model. Different ANN model architectures with varying numbers of hidden layer neurons were trained, and the K-fold cross-validation early stopping validation approach was employed to identify the optimum structure with the best generalization potential. In the regression analysis, our ANN model gives a good R-value of almost 99%, the LSTM model gives almost 98% and the GRU model gives almost 98%. These three model fits demonstrated that there was a good agreement between the experimental data and the forecasted values. The results of our experiments show that the ANN model performs better than the other methods on the collected monkeypox dataset in all five countries. To the best of the authors’ knowledge, this is the first report that has used ANN, LSTM and GRU to predict a monkeypox outbreak in all five countries. Full article

(This article belongs to the Special Issue Rising Stars in Mpox Research)

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18 pages, 1739 KiB

Open AccessArticle

Conspiratorial Attitude of the General Public in Jordan towards Emerging Virus Infections: A Cross-Sectional Study Amid the 2022 Monkeypox Outbreak

by Malik Sallam, Huda Eid, Nour Awamleh, Ala’a B. Al-Tammemi, Muna Barakat, Rabaa Y. Athamneh, Souheil Hallit, Harapan Harapan and Azmi Mahafzah

Trop. Med. Infect. Dis. 2022, 7(12), 411; https://doi.org/10.3390/tropicalmed7120411 - 30 Nov 2022

Cited by 21 | Viewed by 3612

Abstract

Conspiracy theories accompany the emergence of infectious diseases and the 2022 multi-country monkeypox (MPX) outbreak is no exception. It is possible that the adoption of conspiracy beliefs negatively impacts health behavior. We aimed to assess the prevalence of conspiratorial attitudes towards emerging virus infections (EVIs) and the response measures aiming to control these infections among the general public in Jordan. In addition, we assessed MPX knowledge and the belief in the role of men who have sex with men (MSM) in virus spread. The online survey data were collected during 24 May 2022–28 June 2022. The survey instrument was based on previously published scales designed to measure MPX knowledge and EVI conspiracies. A total of 611 respondents formed the final study sample, with a mean age of 44 years and a majority of females (n = 433, 70.9%). On a scale ranging from −10 to +10, the median MPX knowledge score in the study sample was +3 (interquartile range: +1 to +5). Educational level was a determinant of MPX knowledge in multivariate analysis. More than 50% of the participants agreed at least to some extent with 9 out of 12 of the EVI conspiracy items. Multivariate analysis showed that embracing conspiracy beliefs about EVIs was associated with being female, and agreeing with or having no opinion regarding the role of MSM in MPX spread. The current study revealed the high prevalence of belief in conspiracies surrounding EVIs, and its accompanying intervention measures, among the general public in Jordan. In addition, a lower level of MPX knowledge was observed compared to previous studies among university students and health professionals in the country. We recommend evaluating the impact of the widely prevalent conspiracy beliefs on health aspects in future studies. This aim is particularly relevant in the Middle Eastern countries where embracing specific conspiracy ideas is a common occurrence. Full article

(This article belongs to the Special Issue Rising Stars in Mpox Research)

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Review

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15 pages, 2247 KiB

Open AccessReview

Global Research Trends on Monkeypox Virus: A Bibliometric and Visualized Study

by Hafiz Muhammad Zeeshan, Aqsa Rubab, Hilda Dhlakama, Ropo Ebenezer Ogunsakin and Moses Okpeku

Trop. Med. Infect. Dis. 2022, 7(12), 402; https://doi.org/10.3390/tropicalmed7120402 - 28 Nov 2022

Cited by 7 | Viewed by 2489

Abstract

Monkeypox is a zoonotic viral disease that has recently emerged as another global infection disease. A double-stranded enveloped deoxyribonucleic acid virus the cause of this disease. Since monkeypox is an evolving field of study with a growing interest in public health, it is crucial to study the scientific trend and research activities. This study provides an essential insight into the research response to scientific trends of monkeypox using the bibliometric analysis technique. A literature search for published articles on LSD from 2001 to 2021 was conducted in Scopus on 24 July 2022. Visualization analysis was performed using R statistical software. The growth and trend of documents, country-level distribution of publications and collaborations, and the relationship between authors and co-authors were analyzed. Findings revealed a significant increase in the research conducted, mainly from the United States (US). The top 12 institutions published papers on the monkeypox virus, accounting for 33.09 percent of the articles. The US was the most productive nation, producing 275 documents (54.34%), or one-third of all publications in this sector worldwide. Centers for Disease Control and Prevention in Georgia in the United States were the organization that produced the most (365 publications). The Journal of Virology garnered the most citations, with an h-index of 18. In the last year, there has been an increase in the publication of monkeypox virus-related studies. The importance of the monkeypox virus highlights the necessity for continued research to help international health organizations identify areas that require prompt action to implement suitable solutions. This study also provides scaling-up analysis, evidence dissemination on the monkeypox virus, emerging hotspots, and perceptive remarks on the technological advances in this field. Full article

(This article belongs to the Special Issue Rising Stars in Mpox Research)

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15 pages, 681 KiB

Open AccessReview

Prevention, Risk Exposure, and Knowledge of Monkeypox in Occupational Settings: A Scoping Review

by Lucrezia Ginevra Lulli, Antonio Baldassarre, Nicola Mucci and Giulio Arcangeli

Trop. Med. Infect. Dis. 2022, 7(10), 276; https://doi.org/10.3390/tropicalmed7100276 - 29 Sep 2022

Cited by 33 | Viewed by 4984

Abstract

With ongoing climate change, which alters the conditions for pathogens and vectors, zoonotic diseases such as monkeypox virus will become a challenge and a great threat impacting global health in future decades. A current outbreak of monkeypox is occurring in over 125 countries, with a report of thousands of cases in countries where this virus has never appeared. Occupational exposure to the monkeypox virus has recently been identified as an issue of major concern for occupational health, especially in healthcare settings. A scoping review following the PRISMA guidelines was performed, aiming to analyze the effects that the current monkeypox outbreak has in workplaces, given the potential exposure of healthcare workers to the virus, the possible spread of the virus in occupational settings, and the preventive measures that are necessary to implement. At the end of the selection process, 21 studies were included in the review. Healthcare workers are considered at a high risk, and similar preventive measures to those adopted during the SARS-CoV-2 pandemic must be implemented in all healthcare settings. The main recommendations for preventing and managing monkeypox in occupational settings are the vaccination of exposed workers, the prompt identification and isolation of infected individuals, and good hygiene practices. Education and specific training are necessary in non-endemic countries to make healthcare workers able to recognize the disease and prevent further contagions. Although monkeypox seems unlikely to reach the pandemic spread of COVID-19, an approach to global health even to avoid future zoonotic epidemics is required by all stakeholders. Full article

(This article belongs to the Special Issue Rising Stars in Mpox Research)

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12 pages, 648 KiB

Open AccessSystematic Review

Virus Identification for Monkeypox in Human Seminal Fluid Samples: A Systematic Review

by Joshuan J. Barboza, Darwin A. León-Figueroa, Hortencia M. Saldaña-Cumpa, Mario J. Valladares-Garrido, Emilly Moreno-Ramos, Ranjit Sah, D. Katterine Bonilla-Aldana and Alfonso J. Rodriguez-Morales

Trop. Med. Infect. Dis. 2023, 8(3), 173; https://doi.org/10.3390/tropicalmed8030173 - 14 Mar 2023

Cited by 8 | Viewed by 2860

Abstract

Public health officials around the world are extremely concerned about the global outbreak of monkeypox (MPX), which has been claimed to have originated in Africa. As a result, studies into the origins and reasons behind the outbreak’s rapid spread have been sped up. The goal of the current investigation is to determine whether the monkeypox virus (MPXV) is present in seminal fluid samples from MPX cases that have been verified. Up until 6 January 2023, PubMed, Scopus, Web of Science, Embase, and ScienceDirect databases were used to conduct a thorough evaluation of the literature. The search technique returned a total of 308 items. Fourteen studies reporting the presence of MPXV in the seminal fluid of MPX-confirmed cases were included after the duplicates (n = 158) and searches by title, abstract, and full text were eliminated. In 84 out of the 643 confirmed MPX cases (13.06% or n = 643), MPXV was discovered in seminal fluid. Reverse transcriptase polymerase chain reaction (RT-PCR) was used to identify MPXV, and samples taken from skin lesions (96.27%), pharynx or oropharynx (30.48%), and blood all had higher positivity rates than other samples (12.44%). Additionally, 99.85% of respondents were male with a mean age of 36, 98.45% engaged in MSM (men who have sex with men) sexual conduct, and human immunodeficiency virus (HIV) accounted for 56.9% of all STD cases. This study offers proof that MPXV can be found in the seminal fluid of MPX sufferers. Our data imply that MPXV transmission is a possibility in these samples and that MSM are more vulnerable to it. The creation of hygienic standards is essential for the early identification of MPX cases. Full article

(This article belongs to the Special Issue Rising Stars in Mpox Research)

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7 pages, 674 KiB

Open AccessCase Report

Mpox Infection in a Developed Country: A Case Report

by Tal Patalon, Galit Perez, Guy Melamed, Tamar Wolf and Sivan Gazit

Trop. Med. Infect. Dis. 2023, 8(1), 15; https://doi.org/10.3390/tropicalmed8010015 - 27 Dec 2022

Cited by 3 | Viewed by 5836

Abstract

This is the first Israeli case report of mpox (monkeypox) disease, as it is manifested in the current outbreak. This manuscript depicts two detailed patient journeys of Israeli men in their 30s who were diagnosed in recent months, depicting their symptoms, presumed exposure, and outcomes. The two cases were atypical compared to the clinical presentation prior to the current outbreak but were similar to other recent reported cases; they differed in their prodromal presentation. Importantly, both patients described that significant anxiety around the diagnosis dominated their journey while sharing that a concern is rising in the GBMSM community, a concern that should be addressed by healthcare providers. Full article

(This article belongs to the Special Issue Rising Stars in Mpox Research)

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18 pages, 710 KiB

Open AccessSystematic Review

Epidemiological Situation of Monkeypox Transmission by Possible Sexual Contact: A Systematic Review

by Darwin A. León-Figueroa, Joshuan J. Barboza, Edwin A. Garcia-Vasquez, D. Katterine Bonilla-Aldana, Milagros Diaz-Torres, Hortencia M. Saldaña-Cumpa, Melissa T. Diaz-Murillo, Olga Campos-Santa Cruz and Alfonso J. Rodriguez-Morales

Trop. Med. Infect. Dis. 2022, 7(10), 267; https://doi.org/10.3390/tropicalmed7100267 - 27 Sep 2022

Cited by 28 | Viewed by 4654

Abstract

Monkeypox (MPX), a zoonotic infection caused by the monkeypox virus (MPXV), has re-emerged worldwide with numerous confirmed cases with person-to-person transmission through close contacts, including in sexual networks. Therefore, this study aimed to determine the epidemiological situation of monkeypox transmission by possible sexual contact. A systematic literature review was conducted using PubMed, Scopus, Web of Science, and Embase databases until 18 August 2022. The key search terms used were “monkeypox”, “sexual contact”, “sexual intercourse” and “sexual transmission”. A total of 1291 articles were retrieved using the search strategy. After eliminating duplicates (n = 738) and examining by title, abstract, and full text, 28 studies reporting case reports of monkeypox with a detailed description of clinical features, sexually transmitted diseases, method of diagnosis, location and course of skin lesions, and treatment were included. A total of 4222 confirmed cases of monkeypox have been reported, of which 3876 monkeypox cases are the result of transmission by sexual contact distributed in twelve countries: 4152 cases were male with a mean age of 36 years. All confirmed cases of monkeypox were diagnosed by reverse transcriptase-polymerase chain reaction (RT-PCR). The most frequent clinical manifestations were fever, lymphadenopathy, headache, malaise, and painful perianal and genital lesions. The most frequent locations of the lesions were perianal, genital, oral, trunk, upper and lower extremities. Patients were in good clinical condition, with treatment based on analgesics and antipyretics to relieve some symptoms of monkeypox. A high proportion of STIs and frequent anogenital symptoms were found, suggesting transmissibility through local inoculation during close skin-to-skin or mucosal contact during sexual activity. The highest risk of monkeypox transmission occurs in men who have sex with men, and MPXV DNA could be recovered in seminal fluid. It is essential to establish health policies for the early detection and management of patients with monkeypox. Full article

(This article belongs to the Special Issue Rising Stars in Mpox Research)

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