Department of Medicine, University of Toronto, Toronto, Canada.
Division of Infectious Diseases, Department of Medicine, St. Michael's Hospital, MAP Centre for Urban Health Solutions, University of Toronto, Toronto, Canada.
BMC Infect Dis. 2022 Dec 12;22(1):928. doi: 10.1186/s12879-022-07900-7.
In May 2022, a new global outbreak of mpox (formerly, human monkeypox) emerged that was declared a public health emergency of international concern by the World Health Organization on July 23, 2022. With new patterns of person-to-person spread within sexual networks in nonendemic countries and several differences from the classic disease course, we performed a comprehensive review of existing literature on human monkeypox to discuss epidemiology, modes of transmission, clinical presentation and asymptomatic infection, diagnostics, therapeutics, and vaccines with the primary aim to identify important areas for future research of this new epidemic form of the disease. A comprehensive literature search was performed of all published literature to August 15, 2022. Historically, in regions of monkeypox virus endemicity, human outbreaks have occurred related to discrete zoonotic events. The animal reservoir is unknown, but the virus has been isolated from rodents. Traditionally, transmission occurred by direct or indirect contact with an infected animal. In nonendemic countries affected in the 2022 outbreak, almost exclusive person-to-person spread has been observed, and most cases are connected to sexual networks of gay, bisexual, and other men who have sex with men. After an incubation period of approximately 13 days, in traditional human cases affected persons developed a febrile prodrome preceding a rash that started on the face and body, spread centrifugally to the palms and soles and healed monomorphically over two to four weeks. However, in the 2022 outbreak, the febrile illness is often absent or occurs after the onset of the rash. The rash presents primarily in the anogenital region and face before disseminating throughout the body, with lesions displaying regional pleomorphism. There is a paucity of data for the role of antiviral agents or vaccines. The epidemiology and clinical course of mpox has changed in the 2022 epidemic from that observed with the endemic disease. There is an urgent need to establish rapid and collaborative research platforms to diagnose, treat and prevent disease and inform important public health and other strategies to stop the spread of disease.
2022 年 5 月，一种新的猴痘（以前称为人类猴痘）全球疫情爆发，世界卫生组织于 2022 年 7 月 23 日宣布其为国际关注的突发公共卫生事件。在非流行国家的性网络中出现了新的人际传播模式，且疾病的临床表现和无症状感染等方面与经典疾病过程存在若干差异，因此我们对现有的人类猴痘文献进行了全面回顾，讨论了该病的流行病学、传播途径、临床表现和无症状感染、诊断、治疗和疫苗等内容，主要目的是确定这种新的疾病流行形式的未来研究的重要领域。我们对截至 2022 年 8 月 15 日所有已发表文献进行了全面的文献检索。历史上，在猴痘病毒流行地区，人类疫情的发生与离散的人畜共患事件有关。动物储存宿主尚不清楚，但已从啮齿动物中分离出该病毒。传统上，通过直接或间接接触受感染的动物传播。在 2022 年疫情中受影响的非流行国家，几乎只观察到人际传播，且大多数病例与男同性恋、双性恋和其他与男性发生性关系的男性的性网络有关。潜伏期约为 13 天后，在传统的人类病例中，发热前驱期后出现皮疹，皮疹首先出现在面部和身体，然后向手掌和脚底离心性扩散，在 2 至 4 周内痊愈，表现为单形性。然而，在 2022 年的疫情中，发热性疾病往往在皮疹出现后才出现。皮疹主要出现在生殖器区域和面部，然后扩散到全身，皮损呈区域性多形性。抗病毒药物或疫苗的作用数据较少。在 2022 年的疫情中，猴痘的流行病学和临床过程与流行疾病相比已经发生了变化。迫切需要建立快速和协作的研究平台，以诊断、治疗和预防疾病，并为重要的公共卫生和其他策略提供信息，以阻止疾病的传播。
