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Hot Topics of the Day are picked by experts to capture the latest information and publications on public health genomics and precision health for various diseases and health topics. Sources include published scientific literature, reviews, blogs and popular press articles.

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30 hot topic(s) found with the query "Monkeypox"

Use of Wastewater for Mpox Outbreak Surveillance in California.
Wolfe Marlene K et al. The New England journal of medicine 2023 1 (Posted: Jan 19, 2023 6AM)

As part of the response to the spread of MPXV infection, we adapted and deployed polymerase-chain-reaction assays targeting MPXV genomic DNA5 as part of our ongoing wastewater surveillance program. Testing was implemented within a month after the first identified case of MPXV infection in the United States, and the results were used in real time for the public health response in California.


Development of an amplicon-based sequencing approach in response to the global emergence of human monkeypox virus
NFG Chen et al, MEDRXIV, January 13, 2023 (Posted: Jan 16, 2023 7AM)

Highly multiplexed amplicon-based sequencing (PrimalSeq) was initially developed for sequencing of Zika virus, and later adapted as the main sequencing approach for SARS-CoV-2. Here, we used PrimalScheme to develop a primer scheme for human monkeypox virus that can be used with many sequencing and bioinformatics pipelines implemented in public health laboratories during the COVID-19 pandemic. We sequenced clinical samples that tested presumptive positive for human monkeypox virus with amplicon-based and metagenomic sequencing approaches.


Detection of Monkeypox Virus DNA in Airport Wastewater, Rome, Italy.
La Rosa Giuseppina et al. Emerging infectious diseases 2022 12 (1) (Posted: Dec 10, 2022 7AM)

Wastewater surveillance for SARS-CoV-2 was adapted for MPX virus detection from the wastewater treatment plant of an international airport with >3M passengers monthly (Rome, Italy, May–Aug 2022). Real-time and nested PCR assays were modified to detect mpox DNA in 24hr composite wastewater samples collected 2x/week. Among 20 samples, 3 had detectable MPXV. Average quantification cycle (Cq) ranged from 38.37–40.18, indicating relatively low DNA concentrations. Consensus sequences found 100% similarity with MPXV strains available in GenBank.


A Multi-Laboratory Evaluation of Commercial Monkeypox Molecular Tests
O Erster et al, MEDRXIV, November 29, 2022 (Posted: Nov 30, 2022 8AM)

In this report, we describe the first national scale multi-laboratory evaluation of commercial quantitative PCR kits for detection of Monkeypox virus (MPXV) DNA. The objective of this study was to assess the performance of two kits by different diagnostic laboratories across Israel. A panel of 10 standardized samples was tested simultaneously using the Novaplex (15 laboratories) and Bio-Speedy (seven laboratories) kits. An in-house assay based on previously published tests was used as reference. Comparison of the results showed high intra-assay consistency between laboratories, with small variations for most samples.


Evaluating the accuracy of self-collected swabs for the diagnosis of monkeypox.
Ubals Maria et al. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2022 11 (Posted: Nov 16, 2022 7AM)

Paired physician- and self-collected specimens were evaluated from men with monkeypox symptoms (n=50, median age 33.5y, Spain, 2022). Agreement was 98% for skin lesion swabs (48/49), 90% for rectal specimens (9/10, kappa 0.60), and 79% for oropharyngeal specimens (30/38, kappa 0.49). Self-collected swabs had similar PCR cycle threshold values to physician-collected swabs. Authors suggest self-collection could increase access to diagnostic testing for monkeypox.


Exploration of wastewater surveillance for Monkeypox virus
EM Meijia et al, MEDRXIV, November 14, 2022 (Posted: Nov 15, 2022 7AM)


Multiple lineages of monkeypox virus detected in the United States, 2021-2022.
Gigante Crystal M et al. Science (New York, N.Y.) 2022 10 eadd4153 (Posted: Oct 26, 2022 1PM)

We identified two lineages of monkeypox virus (MPXV) among two 2021 and seven 2022 U.S. monkeypox cases: the major 2022 outbreak variant, B.1, and a minor contemporaneously sampled variant called A.2. Analyses of mutations among these two variants revealed an extreme preference for GA-to-AA mutations indicative of human APOBEC3 cytosine deaminase activity among Clade IIb MPXV (previously West African, Nigeria) sampled since 2017. Such mutations were not enriched within other MPXV clades. These findings suggest that APOBEC3 editing may be a recurrent and a dominant driver of MPXV evolution within the current outbreak.


Monkeypox: Virus DNA is widespread in treatment rooms, study finds
L Taylor, BMJ, October 12, 2022 (Posted: Oct 12, 2022 11AM)

Healthcare workers treating patients with monkeypox should use personal protective equipment (PPE), regularly disinfect any frequently touched surfaces, and practice hand hygiene to protect themselves from becoming infected, researchers have said, after they found that viral DNA circulated widely in the air in hospital isolation treatment rooms.


The monkeypox virus is mutating. Are scientists worried?
M Koslov, Nature, October 5, 2022 (Posted: Oct 06, 2022 8AM)

In some samples, large chunks of the virus’s genome have disappeared — but understanding whether the mutations affect its behavior will be difficult. Although scientists aren’t alarmed, they are monitoring the situation carefully to understand why the alterations have appeared, and what they might mean for the global monkeypox outbreak. These mutations are a stark reminder that even poxviruses — which are DNA viruses that tend to evolve more slowly than RNA viruses, such as the SARS-CoV-2 coronavirus — will change over time.


Clinical characteristics and comparison of longitudinal qPCR results from different specimen types in a cohort of ambulatory and hospitalized patients infected with monkeypox virus.
Nörz Dominik et al. Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology 2022 9 105254 (Posted: Oct 02, 2022 9AM)

Longitudinal viral-DNA load measurements in a well characterized cohort of outpatients and hospitalized patients with monkeypox virus infection. Cutaneous lesion swab samples were consistently positive throughout the observation period, while oropharyngeal swabs and blood returned negative repeatedly for some patients. Patients with a know HIV-Infection under treatment exhibited increased numbers of pustulae and higher viral-DNA loads in blood.


Clinical Performance and Trends During the First Two Months of Monkeypox Virus PCR Testing at Two United States Reference Labs
NAP Lieberman et al, MEDRXIV, September 21, 2022 (Posted: Sep 22, 2022 6AM)

We examine epidemiological characteristics, specimen collection practices, and cycle threshold (Ct) values for MPXV PCR tests performed at two reference laboratories. Results from both laboratories support public health data showing a high positivity rate in men (>30%) and those ages 30-49 (25-35%). The overall positivity rate decreased during the study period but remains elevated (~20%). There was a significant difference in Ct values between laboratories (ARUP 23.86 vs. UW 25.40) and collection method (22.79 for dry swab vs. 24.44 for VTM).


Wastewater based epidemiology beyond SARS-CoV-2: Spanish wastewater reveals the current spread of Monkeypox virus
G Guzman et al, MEDRXIV, September 19, 2022 (Posted: Sep 20, 2022 6AM)

This study shows that MPXV DNA can be reproducibly detected by qPCR in longitudinal samples collected from different Spanish wastewater treatment plants. According to data from the National Epidemiological Surveillance Network (RENAVE) in Spain a total of 6,119 cases have been confirmed as of August 19, 2022. However, and based on the wastewater data, the reported clinical cases seem to be underestimated and asymptomatic infections may be more frequent than expected.


Wastewater Surveillance for Monkeypox Virus in Nine California Communities
MK Wolfe et al, MEDRXIV, September 9, 2022 (Posted: Sep 10, 2022 10AM)

MPXV DNA was detected at all nine sites between June 19 and August 1, 2022; 5 of 9 sites detected MPXV DNA prior to or within a day of the first case identified in the source sewershed. At the four sites with >10 positive detections, we observed a positive, statistically significant correlation (p <0.001) between MPXV DNA in wastewater solids and incidence rate of reported cases.


First detection of the Monkeypox virus using wastewater-based surveillance in Miami-Dade County
ME Sharkey al, Research Square, September 1, 2022 (Posted: Sep 04, 2022 8AM)

A similar situation early in the COVID-19 pandemic led to expansion of efforts with sampling of wastewater as an alternative means of clinical testing for community surveillance. Here we discuss an opportunity to use similar sampling processes for detection of MPXV. Recent data from different body fluids suggests shedding may occur via multiple body sites as the virus has been detected by PCR in saliva, semen, urine, and feces, fluids which may ultimately be potentially discarded in the wastewater.


Detection of Monkeypox virus DNA in the wastewater of an airport in Rome, Italy: expanding environmental surveillance to emerging threats
G La Rosa et al, MEDRXIV, August 19, 2022 (Posted: Aug 22, 2022 5AM)

This study aimed to investigate whether Monkeypox DNA can be detected in wastewater from a transportation hub. Twenty samples were collected in Italy’s first airport in Rome and tested using published and modified real-time PCR assays targeting the G2R region (TFN gene), F3L, and N3R genes. Nested PCR assays were also used for confirmation by sequencing. Three samples tested positive by real-time PCR and/or by nested PCR, confirming the occurrence of the virus in the airport’s wastewater.


Wide mismatches in the sequences of primers and probes for Monkeypox virus diagnostic assays
F Wu et al, MEDRXIV, August 11, 2022 (Posted: Aug 16, 2022 6PM)

Rapid and accurate diagnosis of the infections is fundamental for the viral disease containment. Here, we analyzed the primer and probe sequences in the CDC recommended monkeypox virus (MPV) generic real-time PCR assay by aligning against 683 reported MPV genomes worldwide. Sequence mismatches were found in more than 92% of genomes for the MPV generic forward and reverse primers. We also evaluated the specificity of seven other real-time PCR assays for MPV and orthopoxvirus (OPV) detection, and identified two assays (MPV_F3L and OPV_F8L) with the highest matching score (>99.4%) to the global MPV genome database


Monkeypox DNA correlates with virus infectivity in clinical samples
N Paran et al, BIORXIV, August 3, 2022 (Posted: Aug 06, 2022 6AM)

We show strong correlation between viral DNA content and virus infectivity in clinical specimens. Moreover, we define a PCR threshold value which correspond to non-infectious virus, and suggest that our data can be translated into informed decision-making regarding risk assessment, protective measures and guidelines for Monkeypox patients.


The human host response to monkeypox infection: a proteomic case series study
Z Wang et al, MEDRXIV, July 29, 2022 (Posted: Jul 30, 2022 6AM)


Detection of monkeypox viral DNA in a routine wastewater monitoring program
MK Wolfe et al, MEDRXIV, July 26, 2022 (Posted: Jul 28, 2022 6AM)

To test whether monkeypox can be detected and monitored in wastewater during a period when publicly reported monkey cases in the region were increasing, we deployed digital PCR assays that target genomic DNA from the monkeypox virus in our routine, ongoing wastewater surveillance program in the Greater Bay Area of California, USA. We measured monkeypox virus DNA daily in settled solids samples from nine wastewater plants over the period of approximately 4 weeks. During that period, we detected monkeypox virus DNA in wastewater solids at nearly all the wastewater plants we routinely sample.


Monkey Pox Virus (MPXV): Phylogenomics, Host-Pathogen Interactome, and Mutational Cascade
R Kumar et al, BIORXIV, July 25, 2022 (Posted: Jul 27, 2022 11AM)

We have thus analysed the genome sequences of reported isolates of Monkeypox in the present study through phylogenomics. Host-pathogen interactions, mutation prevalence and evolutionary dynamics of this virus were investigated for all the documented isolates. Phylogenetic exploration revealed the clustering of strain Israel 2018 (MN 648051.1) from Clade I with the four isolates reported from the recent outbreak. An in-depth scrutiny of the host-pathogen interactome identified protein E3, serine protease inhibitor-2 (SPI-2), protein K7, and cytokine response-modifying protein B (CrmB) as the major regulatory hubs


Tecovirimat is highly efficient on the Monkeypox virus lineage responsible for the international 2022 outbreak
GF Feyrat et a, BIORIV, July 20, 2022 (Posted: Jul 27, 2022 11AM)

The ongoing monkeypox virus (MPXV) outbreak is the largest ever recorded outside of Africa. Genomic analysis revealed a divergent phylogenetic lineage within clade 3, and atypical clinical presentations have been noted. We report the sequencing and isolation of the virus from the first clinical case diagnosed in France in May 2022. We tested the in vitro effect of tecovirimat (ST-246), a FDA approved drug, against this novel strain, showing efficacy at the nanomolar range. In comparison, cidofovir showed activity at micromolar concentrations.


The WHO Declaration of Monkeypox as a Global Public Health Emergency
JB Nuzzo et al, JAMA, July 27, 2022 (Posted: Jul 27, 2022 11AM)


Monkeypox declared a global emergency: will it help contain the outbreak? The window for containment is rapidly closing, researchers say.
M Koslow, Nature, July 25, 2022 (Posted: Jul 27, 2022 10AM)


Monkeypox genomic surveillance will challenge lessons learned from SARS-CoV-2.
Pfaff Florian et al. Lancet (London, England) 2022 7 (10345) 22-23 (Posted: Jul 11, 2022 8AM)

Circulating monkeypox virus might be undergoing adaption for the human host, so we must keep its genetic changes under tight surveillance so as to be prepared when sudden epidemiological changes and prevent the emergence of a variola virus epigone. This surveillance, however, will require a conceptual shift from observing lone single nucleotide polymorphisms, as with SARS-CoV-2 variants, towards watching closely for the integrity and stability of the monkeypox virus genomic termini.


Phylogenomic characterization and signs of microevolution in the 2022 multi-country outbreak of monkeypox virus
J Isidro et al, Nature Medicine, June 25, 2022 (Posted: Jun 25, 2022 11AM)

Here, shotgun metagenomics allowed the rapid reconstruction and phylogenomic characterization of the first MPXV outbreak genome sequences, showing that this MPXV belongs to clade 3 and that the outbreak most likely has a single origin. Although 2022 MPXV (lineage B.1) clustered with 2018-2019 cases linked to an endemic country, it segregates in a divergent phylogenetic branch, likely reflecting continuous accelerated evolution.


Monkeypox outbreaks: 4 key questions researchers have.
Kozlov Max et al. Nature 2022 5 (7913) 238-239 (Posted: Jun 09, 2022 7AM)

Could a genetic change in the virus explain the latest outbreaks? Understanding whether there is a genetic basis for the virus’s unprecedented spread outside Africa will be incredibly difficult. Researchers are still struggling to determine precisely which genes are responsible for the higher virulence and transmissibility of the Central African strain compared with the West African one more than 17 years after they identified a difference between the two. To understand how the virus evolves, it would also be useful to sequence the virus in animals. The virus is known to infect animals — mainly rodents such as squirrels and rats — but scientists have yet to discover its natural animal reservoir in the affected areas of Africa.


Genetic data indicate at least two separate monkeypox outbreaks underway, suggesting wider spread
H Branswell, StatNews, June 3, 2022 (Posted: Jun 04, 2022 7AM)

New genetic sequencing data indicate there are at least two distinct monkeypox outbreaks underway outside Africa — a surprise finding that one official said suggests international spread is wider, and has been occurring for longer than has been previously realized. Three of 10 viruses the CDC has sequenced from recent U.S. monkeypox cases — two from 2021 and eight from 2022 — are different from the viruses that have been sequenced by several countries involved in the large outbreak that is spreading in and from Europe.


U.S. Monkeypox 2022: Situation Summary
CDC, June 2022 Brand (Posted: Jun 03, 2022 8AM)

Scientists at the Centers for Disease Control and Prevention (CDC) are tracking multiple cases of monkeypox that have been reported in several countries that don’t normally report monkeypox, including the United States. It’s not clear how the people were exposed to monkeypox, but early data suggest that gay, bisexual, and other men who have sex with men make up a high number of cases. However, anyone who has been in close contact with someone who has monkeypox is at risk.


What the surprising mutations in the monkeypox virus could indicate about the new outbreak
A Joseph, Stat News, June 2, 2022 (Posted: Jun 03, 2022 8AM)

What do these sequences show in terms of mutations? Most notably, there are a whole lot of mutations that appear across the new sequences. The genomes from the current outbreak share 40-some mutations with each other that distinguish them from their closest relatives, which were from around 2018. This accelerated evolution seems to have taken off in about 2017, based on available sequences. The pattern of mutations could be evidence that the virus has been circulating among people at low levels since then. The lineage only gained notice more recently as cases outside the virus’ endemic area exploded, perhaps propelled by events like festivals and the return of global travel.


Monkeypox
From NCATS Genetic and Rare Diseases Information Center Brand (Posted: Jan 01, 2011 0AM)



Disclaimer: Articles listed in Hot Topics of the Day are selected by Public Health Genomics Branch to provide current awareness of the scientific literature and news. Inclusion in the update does not necessarily represent the views of the Centers for Disease Control and Prevention nor does it imply endorsement of the article's methods or findings. CDC and DHHS assume no responsibility for the factual accuracy of the items presented. The selection, omission, or content of items does not imply any endorsement or other position taken by CDC or DHHS. Opinion, findings and conclusions expressed by the original authors of items included in the Clips, or persons quoted therein, are strictly their own and are in no way meant to represent the opinion or views of CDC or DHHS. References to publications, news sources, and non-CDC Websites are provided solely for informational purposes and do not imply endorsement by CDC or DHHS.
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