Monkeypox: In Quest of Effective Vaccines
DOI:
https://doi.org/10.35652/IGJPS.2024.14002Keywords:
Monkeypox, ACAM2000, JYNNEOS, MVA-BN, Orthopox virus, Tecovirimat, BrincidofovirAbstract
Purpose: The main objective of the study includes various aspects of monkeypox, its biology and transmutability that are relevant for risk assessment and preparedness for a monkeypox epidemic, with an emphasis on recent progress in the understanding the virus host range, evolutionary potential, neutralization targets, and promising treatment options.
Methods: Published research including the origin, epidemiology, pathophysiology, signs & symptoms, transmission route, therapy, and vaccinations of monkeypox were carefully reviewed from various servers like Google Scholar, ScienceDirect, ResearchGate and others. Primary searches included the keywords 'monkeypox', 'Orthopox virus', 'etiology of monkeypox', 'symptoms', 'transmission', 'possibility', and 'antiviral medications' Secondary searches used 'vaccine for monkeypox', 'possible drug candidate', 'antimicrobial', 'therapeutic impact', 'pathogenesis', 'prevention', We examined relevant search results.
Results: Human monkeypox is a rare viral zoonosis indigenous to central and western Africa that has re-emerged in several nations, threatening public health. The significant number of human monkeypox cases and lack of direct ties to endemic nations after May 2022 raises worries about a probable shift in transmission pattern that might represent a wider global danger. Due to monkeypox's similarity to smallpox, smallpox vaccinations are a potential therapy for this epidemic. Antiviral medicines, vaccinia immune globulin, DNA polymerase inhibitors, anti-poxvirus monoclonal antibodies, nucleoside analogue compounds, and reverse transcriptase inhibitors are being researched to treat monkeypox. Before discussing treatment alternatives, monkeypox and smallpox differential diagnostic processes must be addressed.
Conclusion: A comprehensive understanding of the virulence and transmissibility of human monkeypox is crucial, yet epidemiological limits have rendered it infrequent and self-limiting. Further extensive research is highly recommended to find efficient vaccines against monkeypox before it’s too late.
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References
Cho CT, Wenner HA. Monkeypox virus. Bacteriological reviews. 1973 Mar;37(1):1-8. PMID: 4349404 PMCID: PMC413801 DOI: 10.1128/br.37.1.1-18.1973
Minhaj FS, Ogale YP, Whitehill F, Schultz J, Foote M, Davidson W, Hughes CM, Wilkins K, Bachmann L, Chatelain R, Donnelly MA. Monkeypox outbreak—nine states, May 2022. Morbidity and Mortality Weekly Report. 2022 Jun 6;71(23):764. PMID: 35679181 PMCID: PMC9181052 DOI: 10.15585/mmwr.mm7123e1
Louten J. Virus structure and classification. Essential human virology. 2016:19. PMCID: PMC7150055. DOI: 10.1016/B978-0-12-800947-5.00002-8
McCollum AM, Damon IK. Human Monkeypox. Clinical infectious diseases. 2014 Jan 15;58(2):260-7. PMID: 24158414; DOI: 10.1093/cid/cit703
Heymann DL, Szczeniowski M, Esteves K. Re-emergence of Monkeypox in Africa: a review of the past six years. British medical bulletin. 1998 Jan 1;54(3):693-702. PMID: 10326294 DOI: 10.1093/oxfordjournals.bmb.a011720
Mauldin MR, McCollum AM, Nakazawa YJ, Mandra A, Whitehouse ER, Davidson W, Zhao H, Gao J, Li Y, Doty J, Yinka-Ogunleye A. Exportation of monkeypox virus from the African continent. The Journal of infectious diseases. 2022 Apr 15;225(8):1367-76. PMID: 32880628 PMCID: PMC9016419 DOI: 10.1093/infdis/jiaa559
Duque MP, Ribeiro S, Martins JV, Casaca P, Leite PP, Tavares M, Mansinho K, Duque LM, Fernandes C, Cordeiro R, Borrego MJ. Ongoing monkeypox virus outbreak, Portugal, April 29 to May 23 2022. Eurosurveillance. 2022 Jun 2;27(22):2200424. PMID: 35656830; PMCID: PMC9164676; DOI: 10.2807/1560-7917.ES.2022.27.22.2200424
Vivancos R, Anderson C, Blomquist P, Balasegaram S, Bell A, Bishop L, Brown CS, Chow Y, Edeghere O, Florence I, Logan S. Community transmission of Monkeypox in the United Kingdom, April to May 2022. Eurosurveillance. 2022 Jun 2;27(22):2200422. PMID: 35656834; PMCID: PMC9164677; DOI: 10.2807/1560-7917.ES.2022.27.22.2200422
Xiang Y, White A. Monkeypox virus emerges from the shadow of its more infamous cousin: family biology matters. Emerging Microbes & Infections. 2022 Dec 31;11(1):1768-77. PMID: 35751396 PMCID: PMC9278444 DOI: 10.1080/22221751.2022.2095309
Thornhill JP, Barkati S, Walmsley S, Rockstroh J, Antinori A, Harrison LB, Palich R, Nori A, Reeves I, Habibi MS, Apea V. Monkeypox virus infection in humans across 16 countries—April–June 2022. New England Journal of Medicine. 2022 July 21. PMID: 36546638 DOI: 10.1056/NEJMc2213969
Guarner J, Del Rio C, Malani PN. Monkeypox in 2022—what clinicians need to know. JAMA. 2022 Jul 12;328(2):139-40. PMID: 35696257 DOI: 10.1001/jama.2022.10802
Rao AK, Schulte J, Chen TH, Hughes CM, Davidson W, Neff JM, Markarian M, Delea KC, Wada S, Liddell A, Alexander S. Monkeypox in a traveler returning from Nigeria—Dallas, Texas, July 2021. Morbidity and Mortality Weekly Report. 2022 Apr 4;71(14):509.
Centers for Disease Control and Prevention. 2022 Monkeypox and orthopoxvirus outbreak global map. Accessed June 8, 2022. https://www.cdc.gov/poxvirus/monkeypox/response/2022/world-map.html
Centers for Disease Control and Prevention. US monkeypox 2022: situation summary overview. Accessed June 9, 2022. https://www.cdc.gov/poxvirus/monkeypox/response/2022/index.html
Alakunle E, Moens U, Nchinda G, Okeke MI. Monkeypox virus in Nigeria: infection biology, epidemiology, and evolution. Viruses. 2020 Nov 5;12(11):1257.
Kugelman JR, Johnston SC, Mulembakani PM, Kisalu N, Lee MS, Koroleva G, McCarthy SE, Gestole MC, Wolfe ND, Fair JN, Schneider BS. Genomic variability of monkeypox virus among humans, Democratic Republic of the Congo. Emerging infectious diseases. 2014 Feb;20(2):232.
Schmidt FI, Bleck CK, Mercer J. Poxvirus host cell entry. Current opinion in virology. 2012 Feb 1;2(1):20-7.
Sanjuán R, Domingo-Calap P. Mechanisms of viral mutation. Cellular and molecular life sciences. 2016 Dec;73(23):4433-48.
Siggs OM. Dissecting mammalian immunity through mutation. Immunology and cell biology. 2014 May;92(5):392-9.
Kumar N, Acharya A, Gendelman HE, Byrareddy SN. The 2022 outbreak and the pathobiology of the monkeypox virus. Journal of Autoimmunity. 2022 Jun 25:102855.
World Health Organisation. Monkeypox. Accessed August 18, 2022. https://www.who.int/news-room/fact-sheets/detail/monkeypox
Angelo KM, Petersen BW, Hamer DH, Schwartz E, Brunette G. Monkeypox transmission among international travellers—serious monkey business?. Journal of travel medicine. 2019;26(5):taz002.
Grant R, Nguyen LB, Breban R. Modelling human-to-human transmission of Monkeypox. Bulletin of the World Health Organization. 2020 Sep 1;98(9):638.
Peter OJ, Kumar S, Kumari N, Oguntolu FA, Oshinubi K, Musa R. Transmission dynamics of Monkeypox virus: a mathematical modelling approach. Modeling Earth Systems and Environment. 2021 Oct 15:1-2.
Yinka-Ogunleye A, Aruna O, Dalhat M, Ogoina D, McCollum A, Disu Y, Mamadu I, Akinpelu A, Ahmad A, Burga J, Ndoreraho A. Outbreak of human Monkeypox in Nigeria in 2017–18: a clinical and epidemiological report. The Lancet Infectious Diseases. 2019 Aug 1;19(8):872-9.
Ogoina D, Iroezindu M, James HI, Oladokun R, Yinka-Ogunleye A, Wakama P, Otike-Odibi B, Usman LM, Obazee E, Aruna O, Ihekweazu C. Clinical course and outcome of human Monkeypox in Nigeria. Clinical Infectious Diseases. 2020 Oct 15;71(8):e210-4.
Whitehouse ER, Bonwitt J, Hughes CM, Lushima RS, Likafi T, Nguete B, Kabamba J, Monroe B, Doty JB, Nakazawa Y, Damon I. Clinical and Epidemiological Findings from Enhanced Monkeypox Surveillance in Tshuapa Province, Democratic Republic of the Congo During 2011–2015. The Journal of Infectious Diseases. 2021 Jun 1;223(11):1870-8.
Kulesh DA, Loveless BM, Norwood D, Garrison J, Whitehouse CA. Monkeypox detection in rodents using real-time 3'minor groove binder Taqman assays on the Roche LightCycler, Laboratory Investigation 84: 1200-1208. ARMY MEDICAL RESEARCH INST OF INFECTIOUS DISEASES FORT DETRICK MD; 2004 June 21.
Li Y, Olson VA, Laue T, Laker MT, Damon IK. Detection of monkeypox virus with real-time PCR assays. Journal of Clinical Virology. 2006 Jul 1;36(3):194-203.
Olson VA, Laue T, Laker MT, Babkin IV, Drosten C, Shchelkunov SN, Niedrig M, Damon IK, Meyer H. Real-time PCR system for detection of orthopoxviruses and simultaneous identification of smallpox virus. Journal of clinical microbiology. 2004 May;42(5):1940-6.
Shchelkunov SN, Shcherbakov DN, Maksyutov RA, Gavrilova EV. Species-specific identification of variola, Monkeypox, cowpox, and vaccinia viruses by multiplex real-time PCR assay. Journal of virological methods. 2011 Aug 1;175(2):163-9.
Karem KL, Reynolds M, Braden Z, Lou G, Bernard N, Patton J, Damon IK. Characterization of acute-phase humoral immunity to Monkeypox: use of immunoglobulin M enzyme-linked immunosorbent assay for detection of monkeypox infection during the 2003 North American outbreak. Clinical and Vaccine Immunology. 2005 Jul;12(7):867-72.
Reed KD, Melski JW, Graham MB, Regnery RL, Sotir MJ, Wegner MV, Kazmierczak JJ, Stratman EJ, Li Y, Fairley JA, Swain GR. The detection of Monkeypox in humans in the Western Hemisphere. New England Journal of Medicine. 2004 Jan 22;350(4):342-50.
Goldsmith CS, Miller SE. Modern uses of electron microscopy for detection of viruses. Clinical microbiology reviews. 2009 Oct;22(4):552-63.
Molina-Ruiz AM, Santonja C, Rütten A, Cerroni L, Kutzner H, Requena L. Immunohistochemistry in the diagnosis of cutaneous viral infections-part II: cutaneous viral infections by parvoviruses, poxviruses, paramyxoviridae, picornaviridae, retroviruses and filoviruses. The American Journal of Dermatopathology. 2015 Feb 1;37(2):93-106.
Keasey S, Pugh C, Tikhonov A, Chen G, Schweitzer B, Nalca A, Ulrich RG. Proteomic basis of the antibody response to monkeypox virus infection examined in cynomolgus macaques and a comparison to human smallpox vaccination. PLoS One. 2010 Dec 30;5(12):e15547.
Townsend MB, MacNeil A, Reynolds MG, Hughes CM, Olson VA, Damon IK, Karem KL. Evaluation of the Tetracore Orthopox BioThreat® antigen detection assay using laboratory grown orthopoxviruses and rash illness clinical specimens. Journal of virological methods. 2013 Jan 1;187(1):37-42.
Chadha J, Khullar L, Gulati P, Chhibber S, Harjai K. Insights into the Monkeypox virus: making of another pandemic within the pandemic?. Environmental Microbiology.
Petersen BW, Kabamba J, McCollum AM, Lushima RS, Wemakoy EO, Tamfum JJ, Nguete B, Hughes CM, Monroe BP, Reynolds MG. Vaccinating against Monkeypox in the Democratic Republic of the Congo. Antiviral research. 2019 February 1;162:171-7.
Rimoin AW, Graham BS. Whither monkeypox vaccination. Vaccine. 2011 Dec 30;29:D60-4.
Beer EM, Rao VB. A systematic review of the epidemiology of human monkeypox outbreaks and implications for outbreak strategy. PLoS neglected tropical diseases. 2019 Oct 16;13(10):e0007791.
Rizk JG, Lippi G, Henry BM, Forthal DN, Rizk Y. Prevention and treatment of Monkeypox. Drugs. 2022 Jun 28:1-7.
Townsend MB, Keckler MS, Patel N, Davies DH, Felgner P, Damon IK, Karem KL. Humoral immunity to smallpox vaccines and monkeypox virus challenge: proteomic assessment and clinical correlations. Journal of virology. 2013 Jan 15;87(2):900-11.
Edghill-Smith Y, Golding H, Manischewitz J, King LR, Scott D, Bray M, Nalca A, Hooper JW, Whitehouse CA, Schmitz JE, Reimann KA. Smallpox vaccine–induced antibodies are necessary and sufficient for protection against monkeypox virus. Nature medicine. 2005 Jul;11(7):740-7.
Harapan H, Wagner AL, Yufika A, Setiawan AM, Anwar S, Wahyuni S, Asrizal FW, Sufri MR, Putra RP, Wijayanti NP, Salwiyadi S. Acceptance and willingness to pay for a hypothetical vaccine against Monkeypox viral infection among frontline physicians: A cross-sectional study in Indonesia. Vaccine. 2020 Oct 7;38(43):6800-6.
Courtney B, Sherman S, Penn M. Federal legal preparedness tools for facilitating medical countermeasure use during public health emergencies. The Journal of Law, Medicine & Ethics. 2013 Mar;41:22-7.
Frey SE, Newman FK, Kennedy JS, Sobek V, Ennis FA, Hill H, Yan LK, Chaplin P, Vollmar J, Chaitman BR, Belshe RB. Clinical and immunologic responses to multiple doses of IMVAMUNE®(Modified Vaccinia Ankara) followed by Dryvax® challenge. Vaccine. 2007 Dec 12;25(51):8562-73.
Kennedy JS, Greenberg RN. IMVAMUNE®: modified vaccinia Ankara strain as an attenuated smallpox vaccine. Expert review of vaccines. 2009 Jan 1;8(1):13-24.
Vollmar J, Arndtz N, Eckl KM, Thomsen T, Petzold B, Mateo L, Schlereth B, Handley A, King L, Hülsemann V, Tzatzaris M. Safety and immunogenicity of IMVAMUNE, a promising candidate as a third generation smallpox vaccine. Vaccine. 2006 Mar 15;24(12):2065-70.
von Krempelhuber A, Vollmar J, Pokorny R, Rapp P, Wulff N, Petzold B, Handley A, Mateo L, Siersbol H, Kollaritsch H, Chaplin P. A randomized, double-blind, dose-finding phase II study to evaluate immunogenicity and safety of the third generation smallpox vaccine candidate IMVAMUNE®. Vaccine. 2010 Feb 3;28(5):1209-16.
Cono J, Casey CG, Bell DM. Smallpox vaccination and adverse reactions; guidance for clinicians.
Casey C, Vellozzi C, Mootrey GT, Chapman LE, McCauley M, Roper MH, Damon I, Swerdlow DL. Surveillance guidelines for smallpox vaccine (vaccinia) adverse reactions. Morbidity and Mortality Weekly Report: Recommendations and Reports. 2006 Feb 3;55(1):1-CE.
Heraud JM, Edghill-Smith Y, Ayala V, Kalisz I, Parrino J, Kalyanaraman VS, Manischewitz J, King LR, Hryniewicz A, Trindade CJ, Hassett M. Subunit recombinant vaccine protects against Monkeypox. The Journal of Immunology. 2006 Aug 15;177(4):2552-64.
Brennan G, Kitzman JO, Rothenburg S, Shendure J, Geballe AP. Adaptive gene amplification as an intermediate step in the expansion of virus host range. PLoS pathogens. 2014 Mar 13;10(3):e1004002.
Centers for Disease Control and Prevention (CDC. Supplemental recommendations on adverse events following smallpox vaccine in the pre-event vaccination program: recommendations of the Advisory Committee on Immunization Practices. MMWR. Morbidity and mortality weekly report. 2003 Apr 4;52(13):282-4.
Frey SE, Newman FK, Kennedy JS, Ennis F, Abate G, Hoft DF, Monath TP. Comparison of the safety and immunogenicity of ACAM1000, ACAM2000 and Dryvax® in healthy vaccinia-naive adults. Vaccine. 2009 Mar 4;27(10):1637-44.
Greenberg RN, Kennedy JS. ACAM2000: a newly licensed cell culture-based live vaccinia smallpox vaccine. Expert opinion on investigational drugs. 2008 Apr 1;17(4):555-64.
Acambis I. ACAM2000™ smallpox vaccine: Vaccines and Related Biological Products Advisory Committee (VRBPAC). FDA C, ed. 2007.
Heskin J, Belfield A, Milne C, Brown N, Walters Y, Scott C, Bracchi M, Moore LS, Mughal N, Rampling T, Winston A. Transmission of monkeypox virus through sexual contact–A novel route of infection. Journal of Infection. 2022 June 1.
Volkmann A, Williamson AL, Weidenthaler H, Meyer TP, Robertson JS, Excler JL, Condit RC, Evans E, Smith ER, Kim D, Chen RT. The Brighton Collaboration standardized template for collection of key information for risk/benefit assessment of a Modified Vaccinia Ankara (MVA) vaccine platform. Vaccine. 2021 May 21;39(22):3067-80.
Verheust C, Goossens M, Pauwels K, Breyer D. Biosafety aspects of modified vaccinia virus Ankara (MVA)-based vectors used for gene therapy or vaccination. Vaccine. 2012 Mar 30;30(16):2623-32.
Volz A, Sutter G. Modified vaccinia virus Ankara: history, value in basic research, and current perspectives for vaccine development. Advances in virus research. 2017 Jan 1;97:187-243.
Karita E, Nyombayire J, Ingabire R, Mazzei A, Sharkey T, Mukamuyango J, Allen S, Tichacek A, Parker R, Priddy F, Sayinzoga F. Safety, reactogenicity, and immunogenicity of a 2-dose Ebola vaccine regimen of Ad26. ZEBOV followed by MVA-BN-Filo in healthy adult pregnant women: study protocol for a phase 3 open-label randomized controlled trial. Trials. 2022 Dec;23(1):1-23.
Overton ET, Lawrence S, Stapleton J, Weidenthaler H, Schmidt D, Nopora K, Meyer T, Maclennan J, Koenen B, Silbernagl G, Volkmann A. MVA-BN as monkeypox vaccine for healthy and immunocompromised. International Journal of Infectious Diseases. 2020 December 1;101:464.
Moore M, Zahra F. Monkeypox. InStatPearls [Internet] 2021 Sep 8. StatPearls Publishing.
Munang'andu HM, Mutoloki S, Evensen Ø. Non‐replicating vaccines. Fish Vaccination. 2014 Mar 12:22-32.
Xiao Y, Isaacs SN. Therapeutic vaccines and antibodies for treatment of orthopoxvirus infections. Viruses. 2010 Oct;2(10):2381-403.
Kenner J, Cameron F, Empig C, Jobes DV, Gurwith M. LC16m8: an attenuated smallpox vaccine. Vaccine. 2006 Nov 17;24(47-48):7009-22.
Saijo M, Ami Y, Suzaki Y, Nagata N, Iwata N, Hasegawa H, Ogata M, Fukushi S, Mizutani T, Sata T, Kurata T. LC16m8, a highly attenuated vaccinia virus vaccine lacking expression of the membrane protein B5R, protects monkeys from Monkeypox. Journal of virology. 2006 Jun 1;80(11):5179-88.
Rock MT, Yoder SM, Talbot TR, Edwards KM, Crowe JE. Cellular immune responses to diluted and undiluted aventis pasteur smallpox vaccine. The Journal of infectious diseases. 2006 Aug 15;194(4):435-43.
Buchman GW, Cohen ME, Xiao Y, Richardson-Harman N, Silvera P, DeTolla LJ, Davis HL, Eisenberg RJ, Cohen GH, Isaacs SN. A protein-based smallpox vaccine protects non-human primates from a lethal monkeypox virus challenge. Vaccine. 2010 Sep 14;28(40):6627-36.
Duraffour S, Lorenzo MM, Zöller G, Topalis D, Grosenbach D, Hruby DE, Andrei G, Blasco R, Meyer H, Snoeck R. ST-246 is a key antiviral to inhibit the viral F13L phospholipase, one of the essential proteins for orthopoxvirus wrapping. Journal of Antimicrobial Chemotherapy. 2015 May;70(5):1367-80.
Centers for Disease Control and Prevention. Interim clinical guidance for the treatment of Monkeypox. Accessed June 9, 2022. https://www.cdc.gov/poxvirus/monkeypox/treatment.html
Wogu JO, Chukwu CO, Orekyeh ES, Nwankiti CO, Okoye-Ugwu S. Assessment of media reportage of Monkeypox in southern Nigeria. Medicine. 2020 Jan;99(5).
Baker RO, Bray M, Huggins JW. Potential antiviral therapeutics for smallpox, Monkeypox and other orthopoxvirus infections. Antiviral research. 2003 Jan 1;57(1-2):13-23.
Merchlinsky M, Albright A, Olson V, Schiltz H, Merkeley T, Hughes C, Petersen B, Challberg M. The development and approval of tecoviromat (TPOXX®), the first antiviral against smallpox. Antiviral research. 2019 August 1;168:168-74.
Durski KN, McCollum AM, Nakazawa Y, Petersen BW, Reynolds MG, Briand S, Djingarey MH, Olson V, Damon IK, Khalakdina A. Emergence of Monkeypox—west and central Africa, 1970–2017. Morbidity and mortality weekly report. 2018 Mar 16;67(10):306.
Sarkar JK, Mitra AC, Mukherjee MK. The minimum protective level of antibodies in smallpox. Bulletin of the World Health Organization. 1975;52(3):307.
Hopkins RJ, Lane JM. Clinical efficacy of intramuscular vaccinia immune globulin: a literature review. Clinical infectious diseases. 2004 Sep 15;39(6):819-26.
Fogg C, Lustig S, Whitbeck JC, Eisenberg RJ, Cohen GH, Moss B. Protective immunity to vaccinia virus induced by vaccination with multiple recombinant outer membrane proteins of intracellular and extracellular virions. Journal of virology. 2004 Oct 1;78(19):10230-7.
Lustig S, Fogg C, Whitbeck JC, Eisenberg RJ, Cohen GH, Moss B. Combinations of polyclonal or monoclonal antibodies to proteins of the outer membranes of the two infectious forms of vaccinia virus protect mice against a lethal respiratory challenge. Journal of virology. 2005 Nov 1;79(21):13454-62.
Xu C, Meng X, Yan B, Crotty S, Deng J, Xiang Y. An epitope conserved in orthopoxvirus A13 envelope protein is the target of neutralizing and protective antibodies. Virology. 2011 Sep 15;418(1):67-73.
Moss B. Smallpox vaccines: targets of protective immunity. Immunological reviews. 2011 Jan;239(1):8-26.
Benhnia MR, McCausland MM, Su HP, Singh K, Hoffmann J, Davies DH, Felgner PL, Head S, Sette A, Garboczi DN, Crotty S. Redundancy and plasticity of neutralizing antibody responses are cornerstone attributes of the human immune response to the smallpox vaccine. Journal of virology. 2008 Apr 1;82(7):3751-68.
Petersen E, Kantele A, Koopmans M, Asogun D, Yinka-Ogunleye A, Ihekweazu C, Zumla A. Human monkeypox: epidemiologic and clinical characteristics, diagnosis, and prevention. Infectious Disease Clinics. 2019 Dec 1;33(4):1027-43.
Roess AA, Monroe BP, Kinzoni EA, Gallagher S, Ibata SR, Badinga N, Molouania TM, Mabola FS, Mombouli JV, Carroll DS, MacNeil A. Assessing the effectiveness of a community intervention for monkeypox prevention in the Congo basin. PLoS neglected tropical diseases. 2011 Oct 18;5(10):e1356.
Kaler J, Hussain A, Flores G, Kheiri S, Desrosiers D. Monkeypox: A Comprehensive Review of Transmission, Pathogenesis, and Manifestation. Cureus. 2022 Jul 3;14(7).
Thakur V, Thakur P, Srivastava S, Kumar P. Monkeypox virus (MPX) in humans a concern: Trespassing the global boundaries–Correspondence. International Journal of Surgery (London, England). 2022 Aug;104:106703.
Alavi-Moghaddam M. Monkeypox Outbreak in Non-Endemic Areas: Will it Cause a New Pandemic? a Letter to Editor. Archives of Academic Emergency Medicine. 2022;10(1):e60-.
Reynolds MG, Carroll DS, Karem KL. Factors affecting the likelihood of Monkeypox's emergence and spread in the post-smallpox era. Current Opinion in Virology. 2012 Jun 1;2(3):335-43.
Benenson AS. Smallpox. InViral Infections of Humans 1984 (pp. 541-568). Springer, Boston, MA.
Cadet VE. Discovering Novel Poxvirus-specific Drug Targets (Doctoral dissertation, University of Georgia).
Cohen J. Monkeypox outbreak questions intensify as cases soar. Science (New York, NY). 2022 May 27;376(6596):902-3.
Fahrni ML, Sharma A, Choudhary OP. Monkeypox: Prioritizing public health through early intervention and treatment. International Journal of Surgery (London, England). 2022 Aug;104:106774.
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