Search Results (268)

Background: Torquetenovirus (TTV) viremia is increasingly recognized as a biomarker of host immune competence. We assessed the association between baseline TTV DNA levels and immune responses to the Mpox virus (MPXV) and dengue virus (DGV) vaccines in two prospective cohorts. Methods: A total of 248 individuals were enrolled, and TTV DNA was quantified before vaccination. Humoral and cellular responses to MVA-BN (for MPXV) and QDENGA (for DGV) vaccines were measured by using serology, neutralization assays, and interferon-γ ELISpot, and correlations with TTV viremia were investigated. Results: TTV DNA was detected in 81.2% of individuals, with a significantly higher prevalence and viral loads in the Mpox-Vac group than in the DGV-Vac group. Between both groups, the only significant association observed was an inverse correlation between pre-vaccination TTV load and DGV neutralizing antibody titers in the DGV-Vac group and was limited to the subset of TTV-positive individuals; no additional correlations with antibody and T responses were identified. For the Mpox-Vac group, stratified analyses in people living with HIV (PLWH) confirmed this lack of association. Conclusions: TTV viremia does not predict vaccine immunogenicity in immunocompetent or mildly immunosuppressed individuals. These results, which derive from within-cohort analyses and do not rely on direct comparisons between heterogeneous vaccine populations, support the role of TTV as a marker of immune status along a continuum of immunosuppression, with predictive value likely confined to populations with more severe immune impairment. Full article

Monkeypox (Mpox), a zoonotic Orthopoxvirus disease, was declared a Public Health Emergency of International Concern by the WHO in 2022. While the global fatality rate is approximately 0.7%, mortality risks vary significantly across regions and remain high for vulnerable groups, necessitating precise predictive models for public health resource allocation. This study proposes TRAGIC, a novel fusion model integrating Transformer, GRU, and Quick Attention mechanisms to predict monkeypox death cases. Utilizing a global dataset with a comprehensive set of 16 input features, the TRAGIC model was benchmarked against traditional GRU, LSTM, Transformer, and Trans-GRU architectures. Experimental results demonstrate that TRAGIC consistently outperforms existing deep learning models, particularly in capturing non-linear patterns and long-term dependencies in epidemic time-series data. The findings suggest that the TRAGIC model offers superior accuracy and stability, providing a robust tool for forecasting infectious disease mortality and supporting global health policymaking. Full article

Background: Mpox vaccination is an important prevention strategy for men who have sex with men (MSM), yet responses to vaccination may not be adequately captured by a simple willing-versus-unwilling framing. We examined correlates of vaccination willingness and heterogeneity within the delayed/refused responses subgroup in Changsha, China. Methods: A cross-sectional survey was conducted using respondent-driven sampling (RDS). Vaccination willingness was classified as immediate willingness versus delayed/refused responses. Analyses included cluster-robust logistic regression, RDS-weighted regression, generalized estimating equations, and a recruiter-linked network-lag model. Among respondents with delayed/refused responses, concern profiles were explored using unsupervised clustering of standardized concern items. Results: Among 405 recruited MSM without a self-reported mpox infection history, immediate willingness and delayed/refused responses were nearly equally distributed, indicating that lack of immediate willingness was common. Across primary models, ever use of pre-exposure prophylaxis (PrEP) and higher mpox-related information exposure frequency were the most consistent correlates of immediate willingness versus delayed/refused responses, whereas basic sociodemographic variables showed little evidence of independent association. Within the delayed/refused group, three partially overlapping patterns emerged: broadly elevated cross-domain concern, low-concern delay with few strongly endorsed barriers, and more selective safety- and burden-related concerns. These findings suggest that a lack of immediate willingness may arise through different psychosocial pathways rather than a single common mechanism. Conclusions: Mpox vaccination willingness among MSM in Changsha appeared to be shaped more by prevention-related behaviors and psychosocial factors than by basic sociodemographic profiles alone. Vaccination strategies may benefit from cross-topic sexual-health communication, integrated prevention efforts, and subgroup-sensitive approaches to delayed or refused willingness. Full article

Mpox is a rare but potentially serious vaccine-preventable disease. The 2022 United States outbreak disproportionately impacted gay, bisexual, and other men who have sex with men, people living with HIV, and people of transgender experience. Early vaccination efforts revealed substantial racial and geographic inequities, with lower uptake among Black and Hispanic cisgender men, transgender women, and residents of rural areas. To address these challenges, Fairview’s Minnesota Immunization Networking Initiative (MINI), a 20-year-old mobile health collaborative, partnered with state and local public health agencies and community-based organizations to expand mpox vaccine access. With support from governmental outbreak response funding and stockpiled vaccine, mobile clinics were deployed in trusted community settings, including Pride events and recurring community sites. Targeted outreach, education, and coordination with local providers supported stigma reduction and second-dose series completion. Program data were collected from October 2022 through December 2024. MINI hosted 125 community-based mpox vaccination events, administered 2259 doses to individuals from 220 cities across the United States, including 195 cities in the Midwest. Pride events were key entry points for first-dose vaccination, particularly in rural areas; urban non-Pride clinics played a complementary role in facilitating second-dose completion. Program-level vaccination-to-case ratios were highest among populations experiencing disproportionate mpox burden, including Black, Hispanic, and American Indian/Alaska Native male participants, suggesting alignment of preventive resources with community need. MINI’s mobile, partnership-driven approach demonstrates the value of pairing large-scale community events with recurring clinics to address barriers to both vaccine access and series completion. These findings underscore the importance of flexible, community-centered infrastructure in advancing health equity and strengthening outbreak preparedness. Full article

Background/Objectives: Febrile illness in returning travelers presents a diagnostic and operational challenge for emergency medicine clinicians as early symptoms of high-consequence tropical infections often overlap with common viral syndromes. This review synthesizes current evidence to guide frontline clinicians in the systematic evaluation, diagnosis, and management of internally acquired febrile illnesses with a focus on pathogen of greatest relevance to United States (US) emergency departments (ED). Methods: We conducted a narrative review of the literature addressing epidemiology, clinical presentation, diagnostic testing, and management strategies for key travel-associated infections. Special consideration was given to rapid diagnostic modalities, pediatric risk factors, and infections most frequently implicated in returning travelers, including chikungunya (CHIK), dengue virus (DENV) disease, Ebola virus (EBV) disease, malaria, Mpox, typhoid fever (TF), yellow fever (YF), and Zika virus (ZIKV) disease. Results: Effective evaluation begins with a detailed travel and exposure history, recognition of epidemiologic and clinical red flags, and targeted use of rapid diagnostic tests. Malaria remains the most common life-threatening cause of post-travel fever and the only pathogen with reliable Food and Drug Administration (FDA)-cleared rapid testing available in the ED. Arboviral infections such as DENV, CHIK, ZIKV, and YFrequire region-specific consideration and phase-appropriate molecular or serologic evaluation. Emerging and high-consequence pathogens, including Mpox and EBV, necessitate strict infection control measures and coordination with public health authorities. Pediatric travelers, particularly those visiting friends and relatives, face disproportionate risk for severe systemic infections and often require broader diagnostic testing. Conclusions: A structured approach integrating travel history, focused examination, rapid diagnostics, and early recognition of high-risk features is essential to improving outcomes for febrile returning travelers. Strengthened vector control, enhanced vaccination uptake, and global surveillance are critical to reducing future disease burden. Full article

Monkeypox (Mpox), caused by the monkeypox virus (MPXV), has re-emerged as a significant global public health concern, particularly following the 2022 outbreaks. Understanding its transmission dynamics is essential for designing effective control strategies. In this study, we develop and analyze a deterministic compartmental model that captures both human-to-human and rodent-to-human transmission pathways in order to better reflect the zoonotic nature of the disease. The model is investigated using qualitative and quantitative analytical techniques, including stability analysis, bifurcation theory, and sensitivity analysis. The basic reproduction number, $R_0$, is derived and used to determine threshold conditions for disease persistence or eradication. We show that the disease-free equilibrium is globally asymptotically stable when $R_0<1$, while an endemic equilibrium exists and is stable when $R_0>1$. Furthermore, the model exhibits backward bifurcation, indicating that reducing $R_0$ below unity may not be sufficient for disease elimination. Sensitivity analysis identifies key parameters driving transmission, particularly the rodent-to-human and human-to-human contact rates. Numerical simulations further demonstrate that reducing cross-species transmission and improving isolation of infected individuals significantly decrease disease burden. These findings highlight the complexity of Mpox transmission and emphasize that effective control requires not only lowering $R_0$, but also targeting critical transmission pathways. This study provides useful insights for public health planning by identifying priority intervention strategies such as minimizing rodent–human interactions and strengthening isolation measures. Full article

The rapid detection of organophosphorus (OP) compounds is crucial for safeguarding human health and ensuring food safety. This study presents a novel wearable electrochemical biosensor that integrates miniaturized screen-printed electrodes with wearable devices to achieve real-time, on-site OP detection. The biosensor was fabricated by constructing a screen-printed carbon electrode (SPCE) on a thermoplastic polyurethane (TPU) substrate, sequentially modified with graphene (GR), gold nanoparticles (AuNPs), and organophosphorus hydrolase (OPH), and finally encapsulated with Nafion. This SPCE/GR/AuNPs/OPH/Nafion configuration yields a highly flexible and portable device. The detection principle relies on the enzymatic hydrolysis of methyl paraoxon (MPOX) by OPH, generating p-nitrophenol (PNP), which is quantitatively measured via square wave voltammetry (SWV). The sensor exhibits a broad linear detection range (30–400 μM) with a strong linear correlation (R² = 0.995) and a low detection limit (0.321 μM). It demonstrates excellent selectivity against common interfering substances, including urea, sucrose, and various metal ions. Application to real-world samples such as cabbage and tap water yielded high recoveries (107.2% for cabbage and 101.2% for tap water), with relative standard deviations (RSDs) below 8%. Furthermore, the biosensor maintains robust flexibility and mechanical resilience, with less than 5% signal loss after 100 bending cycles, confirming its suitability for wearable applications and reliable operation under mechanical stress. This innovative, flexible electrochemical biosensor provides a powerful and reliable platform for rapid OP detection, particularly in complex testing environments. Full article

Since the elimination of smallpox, mpox (monkeypox) is the most medically significant orthopoxvirus infection. As a result of numerous regional, national and global outbreaks of MPXV (mpox virus), there is an abundance of new data available on the effects of the different viral clades on clinical obstetrical and perinatal outcomes when infection occurs in pregnancy. In addition, there have been additional placentas from cases of congenital MPXV infection available for study. These recent data indicate that there are prominent differences between viral strains and their effects on the fetus, with MPXV Clade I strains (Ia, Ib) having the greatest risk for an adverse outcome in pregnancy, and Clade II strains (IIa, IIb) having far less risk. In particular, the ongoing outbreak of MPXV Clade Ib in the DRC indicates that there is a significant risk for adverse perinatal outcomes associated with infection in pregnancy, especially during the first trimester. These outcomes include spontaneous abortion, stillbirth, neonatal death and congenital mpox. The placenta in cases of congenital infection demonstrates abundant virus in the chorionic villi, with prominent involvement of Hofbauer cells. Similar to smallpox, transplacental transmission and adverse pregnancy outcomes are an important feature of certain strains of this orthopoxvirus infection when occurring in pregnant women. Full article

Background: The resurgence of Mpox (formerly known as monkeypox) since the 2022 global outbreak has exposed weaknesses in surveillance, diagnosis, and public risk communication systems. Despite increased clinical understanding, limitations in knowledge, attitudes, and practices (KAP) among both healthcare workers (HCWs) and the general population continue to challenge prevention and control measures. Numerous systematic reviews have been published on KAP toward Mpox, yet their findings remain fragmented. This review aimed to consolidate the existing evidence from published systematic reviews to provide a unified understanding of global KAP levels related to Mpox. Methods: We followed the PRISMA guidelines for this systematic review of systematic reviews. The article search was conducted in PubMed, Embase, and the Cochrane Library for systematic reviews published between January 2010 and October 2025. Data was extracted on study design, population, and reported quantitative outcomes. Results: Five studies met the inclusion criteria: three focused on HCWs, while two focused on the general population. Among HCWs, knowledge ranged from 26.0% to 46.7%, and attitudes from 28.2% to 62.2%. In the general population, knowledge ranged from 33.0% to 46.6%, attitudes from 40.0% to 71.9%, and perceptions averaged around 40.0%. Across both groups, Mpox knowledge was limited, attitudes were moderately positive, and preventive behaviors remained consistently low, revealing a persistent gap between awareness and practice. Conclusions: This review highlights persistent gaps in knowledge, attitudes, and practices among HCWs and the general population. Although global attention increased substantially following the 2022 outbreak, important weaknesses remain in translating knowledge into consistent preventive behaviors. Addressing these gaps requires structured and context-specific interventions. Integrating Mpox-focused modules into mandatory Continuing Medical Education credits for HCWs could ensure sustained competency in diagnosis, infection prevention, and outbreak response beyond peak epidemic periods. For the general population, strategic risk communication campaigns should leverage trusted community leaders and social media influencers in high-risk regions to counter misinformation, reduce stigma, and promote evidence-based preventive behaviors. Embedding these targeted strategies within broader pandemic preparedness and global health security frameworks will be essential to strengthening early detection, public trust, and coordinated outbreak response in future Mpox or other emerging infectious disease events. Full article

Monkeypox (Mpox) disease, caused by the Monkeypox virus (Mpox virus), emerged as a significant global health threat during the 2022 outbreak, prompting the World Health Organisation (WHO) to declare it a Public Health Emergency of International Concern (PHEIC). Rapid evolution through genomic modifications enhanced its outbreak potential. Zoonotic transmission occurs through close contact with infected rodents or primates; human-to-human transmission occurs via close contact or homosexual intercourse. The virus disseminates via the lymphatic system, causing symptoms ranging from mild skin lesions to severe multi-system complications or even death. Diagnosis incorporates clinical symptoms as well as advanced molecular and immunological methods. Currently, no specific antiviral medications or vaccines are available for Mpox, necessitating reliance on conventional therapeutic supports and treatments developed for smallpox. Raising awareness, promoting protective practices, implementing surveillance, enabling rapid diagnosis, ensuring timely treatment, and promoting mass vaccination are crucial to curb Mpox transmission. This narrative review provides a comprehensive overview of the current knowledge on epidemiology, evolution, transmission, pathogenesis, clinical signs, diagnosis, treatment, vaccination, and prevention strategies for Mpox. Full article

Mpox is a zoonosis caused by the monkeypox virus. Here, we report Mali’s index Mpox case, which was clinically identified at the Mali–Guinea border by the national telemedicine center and confirmed by PCR. The library prepared with NextGenPCR™ MPXV Sequencing Library Prep and sequenced on Minion MK1C revealed a genome length of 197,122 bp with an average depth of 1284.4×. The strain belonged to Clade IIb G1 lineage and exhibited 85 mutations relative to NC_063383.1. To decipher genomic epidemiology, genomes ≥ 195 kb were retrieved from NCBI and aligned with MAFFT. Time-resolved phylogenetic reconstruction and ancestral trait inference were performed with TreeTime v0.11.4. A median joining network was built with Popart v1.7. Phylogeographic analysis revealed clustering with Clade IIb (G.1 lineage) linked to the May 2025 outbreak in Sierra Leone. Full article

Background: In 2022, Romania experienced a sharp increase in hepatitis A virus (HAV) infections, with evidence of predominant fecal–oral transmission through sexual contact, raising concern for an outbreak among men who have sex with men (MSM). Methods: We conducted a prospective multicenter study between 1 March 2022 and 1 March 2023 in two tertiary hospitals in Bucharest. HAV infection was defined by a compatible clinical presentation, elevated liver enzymes, and positive anti-HAV IgM serology. Clinical and laboratory characteristics were compared by transmission route and HIV status. Results: A total of 191 patients were diagnosed with HAV, including 105 MSM and 86 with foodborne transmission. All were unvaccinated. Most patients were male (82.2%), with a median age of 30 years (IQR 24–38). MSM were significantly younger and reported higher-risk sexual behaviors, including chemsex and multiple or occasional partners (p < 0.0001). Among MSM, 48 (25.1%) were living with HIV, most with preserved immune status and undetectable viral loads. Clinical manifestations were similar across groups, with jaundice being most frequent (89.5%). However, MSM exhibited more severe hepatocellular injury, reflected by higher ASAT and ALAT levels and lower prothrombin concentration, independent of HIV status. MSM were also more likely to have concomitant sexually transmitted infections, including syphilis and mpox (p < 0.001). Disease was predominantly mild, although MSM had longer hospital stays. Conclusions: The 2022 HAV surge in Romania was driven by both sexual and foodborne transmission. Targeted HAV vaccination, along with integrated sexual health services and harm-reduction strategies, is essential to prevent future outbreaks. Full article

The 2022 global mpox outbreak represented a turning point in the Monkeypox virus (MPXV) epidemiology, highlighting the incredible capability of this virus to adapt to different conditions, also in a non-endemic context. To investigate the genomic dynamics of MPXV 2022 strains, we performed whole-genome sequencing of 40 clinical samples from 16 Italian patients across multiple anatomical sites and timepoints between May and December 2022. Combining single-nucleotide analysis with detailed investigation of short tandem repeats (STRs), we explored inter- and intra-host viral dynamics. We identified 19 STR loci located near or within genes involved in immune modulation and virion morphogenesis. While most STRs remained stable across patients, a subset displayed locus- or matrix-specific variation. Among these, STR-VII—embedded within the coding sequence of OPG153, an envelope-associated protein implicated in viral attachment—showed a 12-nucleotide in-frame deletion, resulting in the loss of four aspartic acid residues (Δ4D variant). Structural modeling indicated that this deletion slightly alters a disordered acidic loop without affecting the global fold, potentially modulating surface charge and immune recognition. Integrating STR profiling into genomic surveillance may enhance resolution in outbreak reconstruction and reveal subtle adaptive processes underlying poxvirus–host interaction and immune escape. Full article