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      Spatial and Epidemiological Aspects of Monkeypox (MPX) in Rio Grande do Sul Translated title: Aspectos Espaciais e Epidemiológicos da Monkeypox (MPX) no Rio Grande do Sul

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          Abstract

          Abstract This study analyzes the prevalence and spatial aspects of Monkeypox (MPX) in Rio Grande do Sul, considering the public health emergency declared by the World Health Organization in July 2022 and its relation to the high incidence of the disease in gay men and other men who have sex with men (MSM). Data were provided by the Rio Grande do Sul State Health Department via the Access to Information Law and revealed an incidence rate 53 times higher in MSM populations compared to heterosexual people and 48 times higher compared to bisexual people. In addition, MPX disproportionately afetos Black and Brown people, with an incidence rate three times higher than the White population. Spatial analysis of the disease demonstrated its concentration in metropolitan areas. It is suggested that disseminating evidence-based information is essential to avoid stigmatization of these groups and that ring vaccination is crucial to prevent the endemic spread of the disease. It is concluded that Black and Brown gay men and MSM are at the highest risk for MPX, and preventive actions should be implemented to protect these vulnerable groups, avoid disease spread and ensure health equity.

          Translated abstract

          Resumo Este estudo analisa a prevalência e os aspectos espaciais da Monkeypox (MPX) no Rio Grande do Sul, considerando a emergência de saúde pública declarada pela Organização Mundial da Saúde em julho de 2022 e a alta incidência da doença em homens gays e outros homens que fazem sexo com homens (HSH). Os dados foram fornecidos pela Secretaria Estadual de Saúde por meio da Lei de Acesso a Informação e revelaram uma taxa de incidência 53 vezes maior em populações gay/HSH em relação a heterossexuais e 48 vezes maior em relação a bissexuais. Além disso, a MPX afeta desproporcionalmente as pessoas negras (pretas e pardas), com uma taxa de três vezes maior em comparação com a população branca. A análise dos aspectos espaciais da doença demonstrou a sua concentração em áreas metropolitanas. É sugerido que a disseminação de informações baseada em evidências científicas é essencial para evitar a estigmatização desses grupos e que a vacinação por anéis é imprescindível para impedir a endemização da doença. Conclui-se que os homens gays e HSH negros são as populações em maior risco para MPX, e que ações preventivas devem ser implementadas para proteger esses grupos vulneráveis, evitando a disseminação da doença e garantindo a equidade em saúde.

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          Outbreak of human monkeypox in Nigeria in 2017–18: a clinical and epidemiological report

          Background In September, 2017, human monkeypox re-emerged in Nigeria, 39 years after the last reported case. We aimed to describe the clinical and epidemiological features of the 2017–18 human monkeypox outbreak in Nigeria. Methods We reviewed the epidemiological and clinical characteristics of cases of human monkeypox that occurred between Sept 22, 2017, and Sept 16, 2018. Data were collected with a standardised case investigation form, with a case definition of human monkeypox that was based on previously established guidelines. Diagnosis was confirmed by viral identification with real-time PCR and by detection of positive anti-orthopoxvirus IgM antibodies. Whole-genome sequencing was done for seven cases. Haplotype analysis results, genetic distance data, and epidemiological data were used to infer a likely series of events for potential human-to-human transmission of the west African clade of monkeypox virus. Findings 122 confirmed or probable cases of human monkeypox were recorded in 17 states, including seven deaths (case fatality rate 6%). People infected with monkeypox virus were aged between 2 days and 50 years (median 29 years [IQR 14]), and 84 (69%) were male. All 122 patients had vesiculopustular rash, and fever, pruritus, headache, and lymphadenopathy were also common. The rash affected all parts of the body, with the face being most affected. The distribution of cases and contacts suggested both primary zoonotic and secondary human-to-human transmission. Two cases of health-care-associated infection were recorded. Genomic analysis suggested multiple introductions of the virus and a single introduction along with human-to-human transmission in a prison facility. Interpretation This study describes the largest documented human outbreak of the west African clade of the monkeypox virus. Our results suggest endemicity of monkeypox virus in Nigeria, with some evidence of human-to-human transmission. Further studies are necessary to explore animal reservoirs and risk factors for transmission of the virus in Nigeria. Funding None.
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            Community transmission of monkeypox in the United Kingdom, April to May 2022

            Between 7 and 25 May, 86 monkeypox cases were confirmed in the United Kingdom (UK). Only one case is known to have travelled to a monkeypox virus (MPXV) endemic country. Seventy-nine cases with information were male and 66 reported being gay, bisexual, or other men who have sex with men. This is the first reported sustained MPXV transmission in the UK, with human-to-human transmission through close contacts, including in sexual networks. Improving case ascertainment and onward-transmission preventive measures are ongoing.
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              Human monkeypox: an emerging zoonotic disease.

              Zoonotic monkeypox virus is maintained in a large number of rodent and, to a lesser extent, nonhuman primate species in West and central Africa. Although monkeypox virus was discovered in 1958, the prototypic human cases were not witnessed until the early 1970s. Before this time, it is assumed that infections were masked by smallpox, which was then widely endemic. Nevertheless, since the 1970s, reported monkeypox virus infections of humans have escalated, as have outbreaks with reported human-to-human transmission. This increase is likely due to numerous factors, such as enhanced surveillance efforts, environmental degradation and human urbanization of areas where monkeypox virus is maintained in its animal reservoir(s) and, consequently, serve as a nidus for human infection. Furthermore, viral genetic predispositions enable monkeypox virus to infect many animal species, represented in expansive geographic ranges. Monkeypox virus was once restricted to specific regions of Africa, but its environ has expanded, in one case intercontinentally--suggesting that human monkeypox infections could continue to intensify. As a zoonotic agent, monkeypox virus is far less sensitive to typical eradication measures since it is maintained in wild-animal populations. Moreover, human vaccination is becoming a less viable option to control poxvirus infections in today's increasingly immunocompromised population, particularly with the emergence of HIV in Sub-Saharan Africa. An increased frequency of human monkeypox virus infections, especially in immunocompromised individuals, may permit monkeypox virus to evolve and maintain itself independently in human populations.
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                Author and article information

                Journal
                sn
                Sociedade & Natureza
                Soc. nat.
                Editora da Universidade Federal de Uberlândia - EDUFU (Uberlândia, MG, Brazil )
                0103-1570
                1982-4513
                2023
                : 35
                : e68188
                Affiliations
                [3] Porto Alegre Rio Grande do Sul orgnameUniversidade Federal do Rio Grande do Sul Brazil prrnogueira@ 123456hotmail.com
                [1] Porto Alegre RS orgnameInstituto Federal do Rio Grande do Sul - IFRS Brazil mauricio.polidoro@ 123456gmail.com
                [2] Porto Alegre Rio Grande do Sul orgnameUniversidade Federal do Rio Grande do Sul Brazil daniel.canavese@ 123456gmail.com
                Article
                S1982-45132023000100231 S1982-4513(23)03500000231
                10.14393/sn-v35-2023-68188x
                e10766ad-2ac9-4a43-a8eb-53b9c7cb6401

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 14 June 2023
                : 04 February 2023
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 38, Pages: 0
                Product

                SciELO Brazil

                Categories
                Papers

                MPX,Monkeypox,Smallpox,Disinformation,Varíola,Desinformação
                MPX, Monkeypox, Smallpox, Disinformation, Varíola, Desinformação

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