Acta Scientific Medical Sciences (ASMS)(ISSN: 2582-0931)

Review Article Volume 9 Issue 1

Are We Sure that Drug Can Cure or the Vaccine is Genuine to Restrain Mpox to be Benign: A Brief Review

Tapas Kumar Goswami1* and Siddhartha Narayan Joardar2

1Institute of Veterinary Science and Animal Husbandry, Siksha "O" Anusandhan (Deemed to be University), Bhubaneswar, Odisha
2Department of Veterinary Microbiology, West Bengal University of Animal and Fishery Sciences, Kolkata, West Bengal

*Corresponding Author: Tapas Kumar Goswami, Institute of Veterinary Science and Animal Husbandry, Siksha "O" Anusandhan (Deemed to be University), Bhubaneswar, Odisha.

Received: November 05, 2024; Published: December 11, 2024

Abstract

Earlier monkeypox was considered as a neglected disease of human. Presently it has received media attention due to a growing number of cases being reported in USA and beyond African territory. The first documented case of the illness in monkeys was reported in 1958 from Denmark, accordingly it has been named as monkeypox. To avoid stigmatizing language, WHO has renamed the disease as Mpox in the year 2022. As per scientific report, Democratic Republic of the Congo (DRC) is the country from which first human case of Mpox was detected in the year 1970. In real sense Mpox is a misnomer and in true sense it has very little to do with monkeys. No more monkeys are affected with this virus rather human cases are predominant. Mpox virus originates in rodents, and act as reservoir host for this virus. The experts have opined that cessation of smallpox vaccination may have set the stage for a resurgence of Mpox. Mpox is considered as “little cousin” of smallpox in part, because the illness resembles smallpox and the virus is grouped under the genus Orthopoxvirus; the same genus also includes variola virus (causes smallpox), vaccinia virus (used in the smallpox vaccine), and cowpox virus. Mostly the disease is self-limiting in nature, but the fatality rate may escalate up to 10% under extreme illness with certain clads of virus. Mpox has never been considered as sex transmitted disease, yet in several cases lesions usually appear on genital parts of homosexual individuals. Genital lesions are mostly found among men sex with men that is adding complexity in clinical settings. Invariably smallpox vaccines are recommended to control the Mpox virus infection. Non-replicating modified live attenuated virus are used to prevent Mpox illness in human being. Few antiviral drugs have been approved to treat the cases with moderate efficacy. We have to remember that Mpox does have the potential for a wider spillover. It has been observed that partly due to mutation in viral genome and unusual sexual behaviour of men sex with men is the contributing factor for proliferation of Mpox illness in African population. Contrary to mutational theory researchers have indicated that more than half of the mutations observed in viral genome during 2018 through 2020 are “silent” mutation without any major impact on the severity of the disease. Therefore, mutation in viral genome may not be the sole culprit of viral spread, rather climate change and changes in human behaviour might be playing certain role for the unprecedented spread of this illness. Are there strategies that could eradicate mpox? Answer is not so simple. Once again ring vaccination using smallpox vaccine can be initiated to control the Mpox outbreak is a matter of scientific debate but uniform consensus has not been reached among advisory groups of WHO.

 Keywords: Antiviral Drug; Dryvax; LC16m8; Monkeypox; MOPICE; PEPV; Tecovirimat

References

  1. Piparva K G., et al. “Monkeypox: From Emerging Trends to Therapeutic Concerns”. Cureus 4 (2024): e58866.
  2. WHO (2022).
  3. Krishnasamy L. “Outbreak of Mpox an emerging epidemic and a warning to the world”. Indian Journal of Microbiology Research 2 (2024): 122-123.
  4. Goswami T K. “Why to be serious about monkeypox virus”. Indian Journal of Animal Health1 (2022): 188-192.
  5. Bunge E M., et al. “The changing epidemiology of human monkeypox a potential threat? A systematic review”. PLoS Neglected Tropical Disease 16 (2022): e0010141.
  6. Adetifa I., et al. “Mpox neglect and the smallpox niche: a problem for Africa, a problem for the world”. Lancet10390 (2023): 1822-1824.
  7. Cohen J and Tsanni A. “Pulling back the curtain”. Science 6711 (2024): 818-823.
  8. Rimoin A W., et al. “Major increase in human monkeypox incidence 30 years after smallpox vaccination campaigns cease in the Democratic Republic of Congo”. Proceeding of National Academy of Sciences USA 107 (2010): 16262-16267.
  9. von Magnus , et al. “A pox-like disease in cynomolgus monkeys”. Acta Patholgica Microbiolgica Scandinavica 46 (1959): 156-176.
  10. Randa E., et al. “Monkeypox: A comprehensive review of a multifaceted virus”. Infectious Medicine2 (2023): 74-88.
  11. Rivers C., et al. “The Resurgence of Mpox in Africa”. Journal of American Medical Association JAMA13 (2024)1045-1046.
  12. Gessain A., et al. “Monkeypox”. New England Journal of Medicine19 (2022): 1783-1793.
  13. Nachega J B., et al. “Mpox in Pregnancy-Risks, Vertical Transmission, Prevention, and Treatment”. New England Journal of Medicine14. (2024): 1267-1270
  14. Bruno G., et al. “Antivirals against Monkeypox (Mpox) in Humans: An Updated Narrative Review”. Life (Basel)10 (2023): 1969.
  15. Cho C T and Wenner H A. “Monkeypox virus”. Bacteriology Review1 (1973): 1-18.
  16. Reed K D., et al. “The detection of monkeypox in humans in the Western Hemisphere”. New England Journal of Medicines4 (2004): 342-350.
  17. Ladnyj I D., et al. “A human infection caused by monkeypox virus in Basankusu Territory, Democratic Republic of the Congo”. Bulletin World Health Organization 46 (1972): 593-597.
  18. Jezek Z and Fenner F. “Human monkeypox”. Monograph in Virology 17 (1988): 1-140.
  19. Manes N P., et al. “Comparative Proteomics of Human Monkeypox and Vaccinia Intracellular Mature and Extracellular Enveloped Virions”. Journal Proteome Research 3 (2008): 960-968.
  20. Alkhalil A., et al. “Gene expression profiling of monkeypox virus-infected cells reveals novel interfaces for host-virus interactions”. Virology Journal 7 (2010): 173.
  21. Ochu C L., et al. “Global human monkeypox outbreak: atypical presentation demanding urgent public health action”. Lancet Microbe8 (2022): e554-e555.
  22. Uvarova E A., et al. “The gene of the complement-binding protein, an important anti-inflammatory factor of orthopoxviruses, is deleted from the genome of Western African strains of monkeypox virus”. Doklady Biochemistry and Biophysics 400 (2005): 14-26.
  23. Harris E. “What to know about Monkeypox”. The Journal of the American Medical Association 327 (2022): 2278-2279.
  24. Oakley L P., et al. “Mpox Cases Among Cisgender Women and Pregnant Persons- United States, May 11-November 7,2022”. MMWR Morbidity and Mortality Weekly Report 1 (2023): 9-14.
  25. Sanchez C N., et al. “Paediatric, maternal, and congenital mpox: a systematic review and meta-analysis”. Lancet Glob Health4 (2024): e572-e588.
  26. Xiang Y and White A. “Monkeypox virus emerges from the shadow of its more infamous cousin: family biology matters”. Emerging Microbes Infections1 (2022): 1768-1777.
  27. Isidro J., et al. “First draft genome sequence of Monkeypox virus associated with the suspected multi-country outbreak, May 2022 (confirmed case in Portugal)”. (2022).
  28. O'Toole Á., et al. “APOBEC3 deaminase editing in mpox virus as evidence for sustained human transmission since at least 2016”. Science 6670 (2023): 595-600.
  29. Song H., et al. “Monkeypox virus infection of rhesus macaques induce massive expansion of natural killer cells but suppresses natural killer cell functions”. PLoS ONE 10 (2013): e77804.
  30. Chahroudi A., et al. “Vaccinia virus tropism for primary hematolymphoid cells is determined by restricted expression of a unique virus receptor”. Journal of Virology 79 (2005): 10397-10407.
  31. Zhao Y., et al. “Preferential replication of vaccinia virus in the ovaries is independent of immune regulation through IL-10 and TGF- β”. Viral Immunology 24 (2011): 387-396.
  32. Pruc M., et al. “Monkey pox- a serious threat or not, and what about EMS?” Disaster Emerging Medicine Journal 7 (2022): 136-138.
  33. Goswami T. “Tribute to Prof. Frank Fenner an Eminent Virologist Who Contributed for Eradication of Small Pox (1914-2010)”. Indian Journal of Virology 22 (2011): 152-153.
  34. Karem K L., et al. “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 Diagnostic Laboratory Immunology 12 (2005): 867-872.
  35. Townsend M B., et al. “Evaluation of the Tetracore Orthopox BioThreat® antigen detection assay using laboratory grown orthopoxviruses and rash illness clinical specimens”. Journal of Virological Methods1 (2013): 37-42.
  36. Song H., et al. “Poxvirus antigen staining of immune cells as a biomarker to predict disease outcome in monkeypox and cowpox virus infection in non-human primates”. PLoS One4 (2013): e60533.
  37. Goswami T K., et al. “Evaluation of ovine neutrophil functions: its possible role in protection against viral infection”. PolivetII (2000): 2019-221.
  38. Nagata N., et al. “Pathogenesis of fulminant monkeypox with bacterial sepsis after experimental infection with West African monkeypox virus in a cynomolgus monkey”. International Journal of Clinical Experimental Pathology7 (2014): 4359-4370.
  39. Byrd D., et al. “Primary human macrophages serve as vehicles for vaccinia virus replication and dissemination”. Journal of Virology12 (2014): 6819-6831.
  40. Earl PL., et al. “Natural killer cells expanded in vivo or ex vivo with IL-15 overcomes the inherent susceptibility of CAST mice to lethal infection with orthopoxviruses”. PLoS Pathology4 (2020): e1008505.
  41. Rubins K H., et al. “The host response to smallpox: analysis of the gene expression program in peripheral blood cells in a nonhuman primate model”. Proceeding of National Academy of Sciences USA42 (2004): 15190.
  42. Dee K., et al. “Smallpox vaccination campaigns resulted in age-associated population cross-immunity against monkeypox virus”. Journal of General Virology6 (2024): 001999.
  43. Mariotti S., et al. “Antibodies Induced by Smallpox Vaccination after at Least 45 Years Cross-React with and In Vitro Neutralize Mpox Virus: A Role for Polyclonal B Cell Activation?” Viruses4 (2024): 620.
  44. Hammarlund E., et al. “Monkeypox virus evades antiviral CD4+ and CD8+ T cell responses by suppressing cognate T cell activation”. Proceeding of Natural Academy of Science U S A38 (2008): 14567-14572.
  45. Sanz-Muñoz I., et al. “Possible Mpox Protection from Smallpox Vaccine-Generated Antibodies among Older Adults”. Emerging Infectious Diseases3 (2023): 656-658.
  46. Heberling R L and Kalter S. “Induction, course, and transmissibility of monkeypox in the baboon (Papio cynocephalus)”. Journal of Infectious Disease1 (1971): 33-38.
  47. Thornhill J P., et al. “Monkeypox Virus Infection in Humans across 16 Countries - April-June 2022”. The New England Journal of Medicine 8 (2022): 679-691.
  48. Shamim M A., et al. “The use of antivirals in the treatment of human monkeypox outbreaks: a systematic review”. International Journal of Infectious Diseases 127 (2023): 150-161.
  49. Aggarwal J and Sharma P. “In silico analysis of tecovirimat a repurposed drug against the monkeypox virus, its off target human proteins, and impact on human health”. International Journal of Applied Pharmaceutics6 (2023): 206-210.
  50. Andrei G and Snoeck R. “Cidofovir activity against poxvirus infections has been described”. Viruses 2 (2010): 2803-2830.
  51. Imran M., et al. “Oral brincidofovir therapy for monkeypox outbreak: a focused review on the therapeutic potential, clinical studies, patent literature, and prospects”. Biomedicines 11 (2023): 278.
  52. Baker R O., et al. “Potential antiviral therapeutics for smallpox, monkeypox and other orthopoxvirus infections”. Antiviral Research1-2 (2003): 13-23.
  53. Poland G A., et al. “Prevention of monkeypox with vaccines: a rapid review”. The Lancet Infectious Disease12 (2022): e349-e358.
  54. McCollum A M and Damon I K. “Human monkeypox”. Clinical Infectious Disease2 (2014): 260-267.
  55. Strategic Advisory Group of Experts on Immunization. Monkeypox vaccines technical documents, Vaccines and immunization for monkeypox: Interim guidance. November 16 (2022) 1-15. Geneva: WHO (2022).
  56. Grabenstein J D., et al. “Vaccines against mpox: MVA-BN and LC16m8”. Expert Review Vaccines 1 (2024): 796-811.
  57. Herrlich A and Mayr A. “Comparative experimental works on cow pox virus vaccines”. Archiv fur Hygiene und Bakteriologie (Munich) 138.7 (1954): 479-504.
  58. Stickl H and Hochstein-Mintzel V. “Intracutaneous smallpox vaccination with a weak pathogenic vaccinia virus (MVA virus)”. Munchener MedZinische Wochenschrift 27 (1971): 1149.
  59. Meyer H., et al. “Mapping of deletions in the genome of the highly attenuated vaccinia virus MVA and their influence on virulence”. Journal of General Virology 72 (1991): 1031-1038.
  60. Sutter G and Moss B. “Novel vaccinia vector derived from the host range restricted and highly attenuated MVA strain of vaccinia virus”. Developments in Biological Standardization 84 (1995): 195-200.
  61. Ludwig H., et al. “Role of viral factor E3L in modified vaccinia virus ankara infection of human HeLa Cells: regulation of the virus life cycle and identification of differentially expressed host genes”. Journal of Virology4. (2005): 2584-2596.
  62. McCurdy L H., et al. “Modified vaccinia Ankara: potential as an alternative smallpox vaccine”. Clinical Infectious Disease 38 (2004): 1749-1753.
  63. Hashizume S., et al. “Properties of attenuated mutant of vaccinia virus, LC16m8, derived from Lister strain”. In: Quinnan GV, ed. Vaccinia Virus as Vectors for Vaccine Antigens. New York, NY: Elsevier Science Publishing Co Inc; (1985): 87-99.
  64. “Report on the deliberation results, Freeze-dried Smallpox Vaccine Prepared in Cell Culture LC16 KMB Pharmaceutical affairs and food sanitation council”. 2022 August 1 (English) Tokyo: (2022).
  65. Saito T., et al. “Clinical and Immunological Response to Attenuated Tissue-Cultured Smallpox Vaccine LC16m8”. Journal of American Medical Association (JAMA)10 (2009): 1025-1033.
  66. Weltzin R., et al. “Clonal vaccinia virus grown in cell culture as a new smallpox vaccine”. Nature Medicine 9 (2003): 1125-1130.
  67. Greenberg R N and Kennedy J S. “ACAM2000: a newly licensed cell culture-based live vaccinia smallpox vaccine”. Expert Opinion Investigational Drugs4 (2008): 555-564.
  68. Shang W., et al. “Spatiotemporal cluster of mpox in men who have sex with men: A modelling study in 83 countries”. Journal of Medical Virology10 (2023): e29166.

Citation

Citation: Tapas Kumar Goswami and Siddhartha Narayan Joardar. “Are We Sure that Drug Can Cure or the Vaccine is Genuine to Restrain Mpox to be Benign: A Brief Review”.Acta Scientific Medical Sciences 9.1 (2025): 44-56.

Copyright

Copyright: © 2025 Tapas Kumar Goswami and Siddhartha Narayan Joardar. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




Metrics

Acceptance rate30%
Acceptance to publication20-30 days
Impact Factor1.403

Indexed In





Contact US