Since May 2022, Monkeypox virus (MPXV) cases have dramatically increased worldwide. In this comprehensive review, we describe the basic characteristics, transmission routes, and susceptible individuals of MPXV as well as discuss the main causes of the current outbreak. The history, clades, genetic evolution, and transmission tendency of MPXV are depicted. Regarding viral transmission analysis in several geographical spots, we would like to point out that men who have sex with men (MSM) could play important roles in the process of transmission that eventually causes viral outbreaks. Susceptible populations at high risk of infection alert society to raise awareness on the protection of these special individuals. We also highlight that airline traveling is a driving force in causing international MPXV transmission. Further summarization of the clinical implications, the prevention of MPXV, and clinical measures of viral detection can enable the rapid diagnosis of MPXV.

Postnatal cytomegalovirus (HCMV) infection is well characterized in preterm infants, where it can lead to severe symptomatic infection. We analyzed the rate and route of transmission of postnatal HCMV infections in full-term babies during the first year of life. A cohort of 120 HCMV seropositive mothers and their 122 newborns were tested after delivery for HCMV DNA shedding in different bodily fluids. Postnatal HCMV infection was defined as the detection of >2.5×10 2 HCMV-DNA copies/mL in infants’ saliva swabs. Maternal neutralizing antibody serum titer, HCMV specific T-cell response, and HCMV glycoprotein B (gB) IgG on breastmilk were analyzed. HCMV shedding was detected in 67 of 120 mothers (55.8%), and 20 of 122 infants (16.4%) developed HCMV infection within the first three months of life. Six additional infants were infected during the first year, for a postnatal infection rate of 21.3%. Viral shedding was more frequent in breastmilk than saliva, urine and vaginal secretions, and the mothers of infected infants showed higher levels of HCMV-DNA in milk. No association was found between the antibody levels in serum or milk and maternal viral shedding, whereas a slightly lower frequency of HCMV-specific CD4 + T-cells with long-term memory phenotype was observed in women with HCM-DNA-positive milk. About one out of five infants develop HCMV infection within the first year of life. Breastmilk appears the major route of transmission of the infection, maternal saliva have a minor role whereas the role of vaginal secretions is negligible.

Background: Here we conducted this study to find the changes in the hematological parameters of healthy individuals that can predict their immune status, also this study aims to find out whether herd immunity against COVID-19 is developing or not in the Pakistani population. Methods: A comparative cross-sectional study of 210 healthy individuals was conducted. All individuals were divided into three groups i.e IgG positive, IgG negative, and IgG and IgM both positive based on ELISA results. Data analysis was done by SPSS version 25 for windows. Results: A statistically significant effect was found among the three groups in terms of mean hemoglobin level, mean hematocrit, mean corpuscular hemoglobin concentration, mean red blood cells count, RDW-CV, mean lymphocyte, mean neutrophil, mean eosinophils, and mean basophil. The study also showed that 52.8% (n=74) had neither taken vaccination nor had any history of previous covid infection but still their antibodies were positive. Conclusion: There was a statistically significant difference among hematological parameters between immune and nonimmune groups and can predict the covid immune status also the study predicted that herd immunity against COVID-19 is developing in Pakistan.

A document by Abayomi Ajagbe͓. Click on the document to view its contents.

Background. Sexual transmission of human papillomavirus (HPV) types 6 and 11 causes 90% of condyloma acuminata (CA) and the prevalence of CA in the younger generation is not low. Human papillomavirus vaccines containing types 6 and 11 are highly effective in preventing condyloma acuminatum transmission. By getting immunized promptly, college students who have not had sexual experience as a catch-up group can minimize the potential emotional and financial stress of CA. However, no comprehensive research has been undertaken on the views of this population about the CA vaccination. Methods. This study aimed to examine HPV knowledge and CA vaccination acceptance among college students without sexual experience in Guangdong, China. We used WeChat web-based questionnaires to conduct a cross-sectional survey of respondents. College students identified as having never had sexual relations were maintained, and 2,139 valid questionnaires were ultimately collected. Results. Knowledge of CA (26.2%) and HPV (18.8%) was poor among college students who had never engaged in sexual activity, as was the vaccination rate (2.9%). However, acceptance of the vaccine was relatively high (54.8%). More respondents received the CA vaccine if they were full-time students (OR = 1.962), had heard of CA (OR = 1.505), had actively learned about CA (OR = 1.812), considered the vaccine safe (OR = 2.310), and believed it was successful in preventing CA (OR = 3.925). Conclusions. Overall, this population has limited knowledge about the CA and HPV vaccines. To protect young people’s health and lessen the disease burden, society should pay more attention to CA and HPV vaccination education.

SARS-CoV-2 infection in already-vaccinated individuals is still possible and may require hospitalization. The aim of the present study was to evaluate the clinical evolution of patients with COVID-19 admitted in a public hospital. The outcomes were assessed in relation to the predominant viral variant and the vaccination status. This retrospective study was performed on 1,295 COVID-19-positive patients who attended a 352-bed university hospital between 2021 and 2022. Clinical variables and vaccination status were recorded. Of the patients, 799 had not been vaccinated (NV, 61.7%), 449 were partially vaccinated (PV, 34.7%) and 47 were completely vaccinated (CV, 3.6%). The mean age of the CV patients was significantly higher than that of PV and NV. Also, they had higher percentages of chronic diseases. The outcomes depended on age but not on vaccination status. There were 209 patients admitted during the Omicron-infection period, from which 70 (33.5%) were NV, 135 (64.6%) PV, and 4 (1.9%) CV. In conclusion: Correct vaccination greatly reduces the risk of acquiring severe COVID-19. Partial vaccination does not guarantee protection of the population. This highlights the need for continuous vaccination promotion with all recommended doses, while investigating alternative treatments for those patients who do not respond to the vaccines.

Objective: To construct a reproductive risk score (RRS) and an air pollution score (APS) and assess independent and joint associations between the two with incident COPD risk. Design: Population-based prospective cohort study. Setting: UK Biobank. Population: 78,218 female participants aged 40–69 years without baseline COPD recruited between 2006 to 2010. Methods: RRS was constructed by 17 women’s reproductive health-related items, and APS incorporating PM 2.5, PM 2.5-10, PM 10, NO 2, and NO x was calculated to assess the joint exposure level. The associations of RRS and APS with COPD were examined by Cox proportional hazards regression. Main Outcome Measures: The outcome of the incident COPD was identified through the in-patient hospital register. Results: Higher RRS was associated with an increased risk of COPD (adjusted HR: 1.15, 95% CI: 1.12-1.19, P trend < 0.001). A dose-response manner can be observed between higher quintile APS and increased COPD risk (P trend < 0.001). The RERI of 0.030 (95% CI: 0.012-0.048) showed additive interaction between RRS and APS on COPD was significant. In the joint analysis, the combinations of both higher RRS and APS signified higher incident COPD risk. Conclusions: High RRS and high APS were associated with increased COPD risks in a dose-response pattern. Using comprehensive indicators to identify women’s reproductive risk factors, together with the control of air pollution, is effective for COPD prevention.

Early in the 2022 Mpox (MPX) global outbreak, caseloads in the New York Metropolitan area climbed rapidly before other US urban areas. This case series summarizes the authors’ clinical experience detecting and treating MPX, during a quickly evolving outbreak. Clinical outcomes were recorded with a focus on varied clinical presentation and outcomes such as complications and response to experimental tecovirimat therapy. A focal or multifocal rash was the most common presenting symptom in 91% of patients. Almost two thirds (62%) of patients had anogenital involvement. Proctitis was one of the most painful presentations with 75% requiring antiviral treatment and 3 patients needing hospitalization for pain management. Most patients responded promptly to antiviral treatment with tecovirimat. Five out of 10 patients treated with tecovirimat reported symptom resolution within 48 – 72 hours of therapy and another 3 saw resolution within first 96 hours. Two patients had poor response to tecovirimat. This series includes the only reported case of an HIV positive, immunocompetent patient who experienced recurrent anal ulcers due to Mpox and required a second course of tecovirimat. Other unique presentations included urethritis, abscess formation and MPX infection post-vaccination. Control of this current Mpox outbreak was possible due to timely diagnosis and the availability of both a licensed vaccine and an investigational drug.

Objectives: Despite its low sensitivity for the interstitial syndrome, chests X-Ray (XR) have been used on COVID-19 patients to exclude alternative diagnoses. Computed tomography (CT) scans can both exclude other pathological conditions and display a high level of sensitivity for the COVID-19 pneumonia. We therefore decided to compare the performance of lung ultrasonography (LUS) with that of lung CT scans in suspect or confirmed COVID-19 patients for the presence of interstitial pneumonia and the degree of lung injury. Methods: In a cross-sectional clinical study, LUS an CT were compared for the presence of interstitial pneumonia and the degree of lung injury in COVID-19 patients. Pearson’s and Spearman correlations analysis were performed to measure the degree of association between two methods. Bland–Altman plot was generated to provide a graphical visualization of the agreement between the two measurement methods. All statistical tests in this study were two-sided and p-values ≤ 0.05 were considered as statistically significant. Results: A good correlation between LUS and CT scan was obtained for estimates of lung injury in pneumonia in a group of COVID-19 suspect and diagnosed patients (R 2= 0.7613; p <0.01). Agreement between LUS and CT values is assessed by constructing Bland-Altman plot. Conclusions: LUS, as compared to CT scans, is an effective method to estimate degrees of lung injury in COVID-19 patients in the emergency department.

Objective: To identify factors contributing to maternal mortality in Kazakhstan. Design: A retrospective study of the health and demography data set of Kazakhstan from 2000 to 2020. Setting and population: The data from the annual statistical report “Population health and healthcare organizations’ performance in the Republic of Kazakhstan from 2000 to 2020”. Kazakhstan and its 14 regions and 3 main cities for the period 2019-2020. Methods: We analyzed the MMR trend in Kazakhstan and in all 14 regions and 3 main cities for the period 2000-2020. We applied Univariate Linear Regression Models with Logarithmic Transformation of the outcome and predictors to detect determinants of MMR for 2019 and 2020 in Kazakhstan. Main Outcome Measures: Maternal mortality ratio and determinants. Results: Trends in MMR in many regions of Kazakhstan show a steady decline starting from 2000 until 2010-2015 with a subsequent increase by 2020. MMR was associated with factors such as socio-economic, health service-related, and population health indicators. An increase in most of these indicators leads to a decrease in maternal mortality, except obstetric beds per 1000 births, number of inpatient facilities, and population median age, which leads to an increase in MMR. Conclusions: Maternal mortality is a complex issue that is influenced by various socio-economic factors, healthcare system factors, and disease burden. Despite Kazakhstan’s alignment with the SDG goals, including reducing maternal mortality, the country’s middle-income status may have led to fluctuations in MMR.

Observational studies have reported that COVID-19 is associated with alterations in retinal layer thickness, including changes in the ganglion cell inner plexiform layer (GCIPL) and retinal nerve fiber layer (RNFL). However, observational studies are susceptible to confounding factors and reverse causality. Therefore, we assessed the direction and strength of the causal relationship between COVID-19 patient phenotypes (susceptibility, hospitalization, and severity) and GCIPL and RNFL thicknesses using a bidirectional two-sample Mendelian randomization (MR) design. The inverse-variance weighted (IVW) method is the primary approach used to estimate causal effects. MR Egger, weighted median, weighted mode, MR Egger (bootstrap), and penalized weighted median methods were applied. In addition, we performed sensitivity analyses using RadialMR, MRPRESSO, MR Egger regression, Cochran’s Q statistic, and Leave-one-out analysis. Forward MR analysis revealed that genetically identified COVID-19 susceptibility significantly increased the risk of GCIPL thickness (OR: 2.428, 95% confidence interval[CI]:1.493-3.947, PIVW=3.579 ×10 -4) and RNFL thickness (OR: 1.735,95%CI:1.198-2.513, PIVW=3.580×10 -3). The results after excluding MRPRESSO and RadialMR to identify outliers and SNPs associated with confounding factors showed RNFL thickness(OR:1.800,95%CI: 1.192-2.717, PIVW=5.147×10 -3).Reverse MR analysis did not indicate a significant causal association between GCIPL and RNFL thicknesses and COVID-19 phenotypes. In conclusion, the host genetic liability to COVID-19 susceptibility was causally associated with increased GCIPL and RNFL thicknesses. Documenting this association increases our understanding of the pathophysiological mechanisms underlying COVID-19 susceptibility in retinopathy.

A group of viruses, collectively known as Pteropine orthoreoviruses (PRVs), have recently been found in fruit bats and humans in Southeast Asia, Australia, and some African countries. This article intends to briefly discuss what is known about these viruses and their potential significance in public health and to advocate for increased surveillance of these zoonotic viruses to prevent potential future disease outbreaks, as well as to highlight a recent publication on this topic that was selected as an editor’s choice article in the Journal of Medical Virology 1.

A document by Yasmin Ahmad. Click on the document to view its contents.

Varicella is a highly prevalent infectious disease with a similar transmission pathway to coronavirus disease 2019 (COVID-19). In the context of the COVID-19 pandemic, anti-COVID-19 non-pharmaceutical interventions (NPIs) have been implemented to prevent the spread of the infection. This study aims to analyze varicella’s epidemiological characteristics and further investigate the effect of anti-COVID-19 NPIs on varicella in Xi’an, northwestern China. Based on the varicella surveillance data, search engine indices, meteorological factors from 2011 to 2021 in Xi’an, and different levels of emergency response to COVID-19 during the pandemic, we applied Bayesian Structural Time Series models and interrupted time series analysis to predict the counterfactual incidence of varicella and quantify the impact of varying NPIs intensities on varicella. From 2011 to 2021, varicella incidence increased, especially in 2019, with a high incidence of 111.69/100,000. However, there was a sharp decrease of 43.18% in 2020 compared with 2019, and the peak of varicella incidence in 2020 was lower than in previous years from the 21st to the 25th week. In 2021, the seasonality of varicella incidence gradually returned to a seasonal pattern in 2011-2019. The results suggest that anti-COVID-19 NPIs effectively reduce the incidence of varicella, and this reduction has spatiotemporal heterogeneity.

On December 7 th of 2022, the province and the country experienced a huge adjustment of the prevention and control measures against SARS-CoV-2, which was called the ten actions. But we still performed regular SARS-CoV-2 nucleic acid testing for hospitalized patients before their admission, which could to some extent reflect the infection rates of the total society. A total of 2212 cases and 439 positive cases were enrolled in the study. The infection rate increases from the first to the third week, and then decreases from the third to the eighth period. The infection rate of the eighth week returned nearly to the rate of the first week. The adjustment on the prevention and control measures resulted in rapid increase of SARS-CoV-2 infection rate among hospitalized children through the first three weeks, and it took nearly eight weeks for the infection to recover to the rate at the beginning of the adjustment. Continuous monitoring of the infection is required in the future to help reduce the infection.

To date (2/5/2023), nearly three years after the official declaration of the COVID-19 pandemic, a total of 754, 018, 841 cases and 6,817,478 deaths have been officially reported to the world health organization (WHO) ([https://covid19.who.int/](https://covid19.who.int/)). During this time, the global populace has witnessed the devastating effects of this pandemic, which can undoubtedly be considered the sanitary event of the century. In my opinion, understanding the mechanisms associated with the evolution of SARS-CoV-2 is the most important aspect of understanding the course of this pandemic. In this respect, the millions of viral sequences generated during the pandemic (1) have significantly aided in the tracking of the pandemic, resulting in the identification of multiple variants of concern.

Background: As the global prevalence of allergy increases, it is clear that more individuals are presenting with complex and multiple allergies. The impact of various demographic and clinical risk factors on developing allergies has not been explored at a population level. Objectives: To ascertain if age, gender, ethnicity, UK geographical region of residence and being diagnosed with another allergy affect the risk of having allergies. Methods: A retrospective analysis was performed using cross-sectional data for the year 2018 extracted from the from the health improvement network (THIN) database. THIN is a live primary care database which holds entries about 6% of the UK population. A logistic regression analysis was carried out using demographic data and allergy diagnoses as independent variables. Results: Of the 3.03 million records analysed, 49.8% were male and 19.7% were children (aged < 18 yrs). There were gender, ethnicity and region-based differences in the prevalence of GP diagnosed allergic diseases in the UK. The odds of developing anaphylaxis are highest in individuals with food allergy [OR: 54.57 (95%CI: 45.65-65.22); p<0.001 for children and OR:18.05 (95% CI:16.79-19.41); p<0.001 for adults respectively]. Individuals with any diagnosed allergy had significantly higher odds of being diagnosed with others. Conclusions: Having an allergy significantly increases the odds of being diagnosed with others. There are age, gender, ethnicity and region based differences in the prevalence of allergies. These data suggest that the number of individuals with multiple allergies is increasing and that the needs of increasingly cosmopolitan populations should be taken into account when planning allergy services.

A method using questionnaire data for estimating the level of under reporting during an outbreak is presented. It is based on rewriting the conditional probabilities for getting tested, being infected, and having symptoms. It shows very good agreement with seroprevalence studies of blood donors. On the one hand, this shows the strength of questionnaires when testing the general population during an outbreak as a means to find the true prevalence. On the other, applying it to covid-19 demonstrates that the asymptomatic cases likely make up around 50% of the infected.

The number of measles cases reported worldwide has increased in recent years, and in 2015, there was a measles outbreak in Xi’an, China. However, the epidemiology of measles and the seroepidemiology of healthy people after 2015 have not been fully understood. We collected fingertip blood samples from healthy people around each suspected measles case in Xi’an in 2016-2018 and tested IgG using ELISA. Eighty measles cases were reported in Xi’an in 2016–2018, with an average annual incidence of 0.29 per 100,000 persons. Children aged ≤ 5 years and adults aged 25-29 accounted for a large proportion of measles cases. More than half of the cases in the 0-year group were under 8 months. A total of 5476 blood samples from healthy people were collected. Apart from 1-4 years and over 40, other age groups’ seroprevalence was 93%. Our findings suggest that the first vaccine shot should be administered at 6 months or earlier, the second at 12 months, and the third at 10 years, and couples prepared for [pregnancy](javascript:showjdsw(’showlj_1’,’lj_1’)) should be vaccinated with another dose. The findings may provide novel insights into measles elimination.

Abstract: Importance: There are conflicting data regarding the safety of the use of Angiotensin-converting enzyme inhibitors or Angiotensin receptor blockers (ACEI/ARBs ) medications in hypertensive patients who are susceptible to COVID-19. Objective: Our study assesses the association between COVID-19 severity and mortality and the use of ACEI/ARBs among hospitalized patients with hypertension. Research design, setting and participants: This was a retrospective cohort study. Using the EPIC system of Beaumont Health, we identified 5490 patients with COVID-19 who were admitted to the eight Beaumont hospitals. After excluding subjects who have no hypertension and those with missing data, we included 2129 COVID-19 patients who have hypertension. Logistic regression and Cox proportional hazard models were used to analyze the association history of ACEI/ARBs use, ICU admission rate and COVID-19 mortality. Exposure: Using of ACEI/ARBs as documented in the medical records before admission to the hospitals. Main outcome: 30 days COVID-19 mortality and ICU admission rates . Results: There were 1281 subjects (60%) with prior ACEI/ARBs use and 848 subjects ( 40%) with no ACEI/ARBs use. There was no significant association between ICU admission and use of ACEI/ARBs (odds ratio was 0.95, 95% CI [0.76, 1.19] and p-value was 0.6). Although the unadjusted logistic regression model demonstrated a statistically significant association between history of use of ACEI/ARBs and COVID-19 mortality (odds ratio= 1.31, 95% CI [1.05, 1.66], p-value= 0.02), the adjusted logistic regression model failed to show this statistically significant association (odds ratio= 1.20, 95% CI [0.93, 1.54], p-value= 0.14). Moreover, we were not able to reveal a statistically significant association between 30 days COVID-19 survival and prior use of ACEI/ARBs in the adjusted Cox-proportional hazard model (Hazard ratio (HR) = 1.11, 95% CI [0.91, 1.40], p-value =0.14). Conclusion: In a large retrospective study, we conclude that there was no statistically significant association between prior history of ACEI/ARBs use and COVID-19 ICU admission rates or mortality in hypertensive patients hospitalized with COVID-19.

Continuous evaluation of real-world treatment effectiveness of COVID-19 medicines is required due to the ongoing evolution of SARS-CoV-2 and the possible emergence of resistance. Therefore, this study aimed to analyze the outcomes in patients hospitalized with COVID-19 during the pandemic waves dominated by Delta and Omicron variants and treated with remdesivir (RDV) (n=762) in comparison to the demographically and clinically matched group not treated with any antivirals (n=1060). During the Delta wave, the RDV-treated group revealed 2-fold lower mortality (10.8 vs. 23.2%, p<0.001) and 1.5-fold lower during the Omicron-dominated period (11.4 vs. 16.8%, p=0.05). RDV-treated groups were characterized by a lower percentage of patients requiring mechanical ventilation, but the difference was not statistically significant. This study is the first real-world evidence that RDV remains effective during the dominance of more pathogenic SARS-CoV-2 variants and those that cause a milder course of the disease and continues to be an essential element of COVID-19 therapy.

Aim: The present study aimed to evaluate time to onset, incidence rates, and outcomes for pembrolizumab-induced cardiac adverse events (AEs) in patients with cancer using the Japanese Adverse Drug Event Report database. Methods: We analysed data for the period from April 2004 to March 2022. Data on cardiac AEs were extracted and relative risks of AEs were estimated using the reporting odds ratio. Results: We analysed 2,021,907 reports and identified 15,306 reports of AEs caused by pembrolizumab. Of these, 399 cardiac AEs were associated with pembrolizumab. Signals were detected for six cardiac AEs: myocarditis, immune-mediated myocarditis, pericardial effusion, cardiac tamponade, pericarditis, and pericarditis malignant. A histogram of median times to onset showed occurrence from 33 to 138 days, but some cases occurred even more than 1 year after the start of administration. Among these, myocarditis was the most frequently reported (27.1%), with fatal cases also reported. Conclusion: This study focused on cardiac AEs caused by pembrolizumab as post-marketing AEs. Some cases could potentially involve serious outcomes, so patients should be monitored for signs of onset of these AEs not only at the start of administration, but also over an extended period, especially for myocarditis.

Background: Atopic dermatitis (AD) is one of the most prevalent chronic inflammatory skin disorders that causes great disease burdens world-wide. The demographics and clinical characteristics of AD are different between countries, regions, and age groups yet these differences were not well characterized in China. To get well guidance for AD clinicians, we described the demographics, clinical characteristics, comorbidities, patient-identified aggravating factors and treatment of AD in all-age patients in China. Methods: This study included Chinese individuals diagnosed with AD by accredited clinicians in the department of dermatology of 205 hospitals from 31/34 provincial administrative divisions across China during August, 2021 to September, 2022. All included patients completed dermatologist-lead interviews regarding their general medical history, comorbidities, AD-related aggravating factors and medications. Two-level mixed ordered logistic regression was used to evaluate factors for aggravation of the disease. Results: Overall, 16838 respondents were included in the final analysis with a mean age of 30.94 years (standard deviation, ± 24.08 years). The proportion of patients with severe AD was the highest in patients with onset of AD at ≥60 years old (26.73%). Allergic rhinitis and hypertension were the most common atopic and non-atopic comorbidities, respectively. AD severity was significantly associated with chronic urticaria, food allergy and diabetes. There was a high proportion of severe AD in patients who had aggravating factors such as seafood, lamb and beef, chili peppers, alcohol, seasonal changes, and psychological factors. Cross-sectional survey revealed unmet needs of severe AD in treatment strategy, in lack of immunosuppressants’ and biological agents’ application. Conclusion: Treatment of comorbidities and control of aggravating factors significantly contribute to AD management. Improving systemic immunotherapy could reduce the incidence of severe AD.

The mortality rate due to COVID-19 in immunocompromised cases is considerably high. Monoclonal antibody (mAb) therapy is essential in managing SARS-CoV-2 infection, especially in immunocompromised cases. The mutation in the spike protein RBD region of the SARS-CoV-2 leads to the substitution of amino acids resulting in an altered ACE2 binding affinity. The mAbs must be tested in-vitro using standard neutralisation assays designed against emerging SARS-CoV-2 variants to estimate the mAb therapy efficacy. Based on already available data on the mAb efficacy for known SARS-CoV-2 variants, it is plausible to draw inferences for other closely related SARS-CoV-2 variants in circulation owing to the similar spike protein RBD amino acid sequence. In this article, we have attempted to analyse the data of mAb efficacy tested against SARS-CoV-2 variants and extrapolate on other emerging omicron sublineages like BA.2.75, BF.7 and BQ.1.