Mpox virus - Revision history

Aidan at 17:07, 27 September 2024

2024-09-27T17:07:30Z

← Older revision		Revision as of 17:07, 27 September 2024
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	==Management==		==Management==

			* A few antivirals exist that may be helpful[[CiteRef::siegrist2022an]]
	* A few antivirals exist that may be helpful<ref>Emily A Siegrist, Joseph Sassine, Antivirals With Activity Against Mpox: A Clinically Oriented Review, ''Clinical Infectious Diseases'', Volume 76, Issue 1, 1 January 2023, Pages 155–164, https://doi.org/10.1093/cid/ciac622</ref>
	* [[Tecovirimat]] (TPoxx) 600 mg (3x200 mg capsules) p.o. bid for 14 days		* [[Tecovirimat]] (TPoxx) 600 mg (3x200 mg capsules) p.o. bid for 14 days
	** Specific to [[Orthopoxviridae]]		** Specific to [[Orthopoxviridae]]

Aidan at 01:52, 2 April 2023

2023-04-02T01:52:48Z

← Older revision		Revision as of 01:52, 2 April 2023
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	*Encephalitis (rare)		*Encephalitis (rare)
	*Corneal scarring		*Corneal scarring

			== Diagnosis ==

			* Swab of a lesion is about 85% sensitive
			** Sensitivity can be increased with 2-3 swabs
			* Consider rectal swab if risk factors, regardless of symptoms

	==Management==		==Management==
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	*[[Brincidofovir]] 200 mg p.o. once weekly for 2 doses (i.e. day 1 and day 8)		*[[Brincidofovir]] 200 mg p.o. once weekly for 2 doses (i.e. day 1 and day 8)

	===Post-~~exposure~~ ~~prophylaxis~~===		===Post-Exposure Prophylaxis===

	*Can consider using a [[smallpox]] vaccine for adults with high risk contact of a confirmed of probable case		*Can consider using a [[smallpox]] vaccine for adults with high risk contact of a confirmed of probable case
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	*****Actions that result in contact between intact skin or sleeves or other parts of an individual’s clothing and the patient’s skin lesions, bodily fluids, or soiled linens (e.g., turning, bathing, or assisting with transfer) while not wearing appropriate PPE.		*****Actions that result in contact between intact skin or sleeves or other parts of an individual’s clothing and the patient’s skin lesions, bodily fluids, or soiled linens (e.g., turning, bathing, or assisting with transfer) while not wearing appropriate PPE.
	***Low-risk contact:		***Low-risk contact:
	****Community settings: no direct physical contact, unlikely droplet exposure.		****Community settings: no direct physical contact, unlikely droplet exposure
	****Health-care settings:		****Health-care settings:
	*****Health care worker was in a patient room without wearing eye protection, regardless of duration of exposure.		*****Health care worker was in a patient room without wearing eye protection, regardless of duration of exposure
	*****Health care worker wore gown, gloves, eye protection, and a surgical/procedural mask during all visits in the patient care area or room		*****Health care worker wore gown, gloves, eye protection, and a surgical/procedural mask during all visits in the patient care area or room
	*****Health care worker was in the patient care area with no close or prolonged contact with an unmasked patient without wearing, at a minimum, a surgical/procedural mask.		*****Health care worker was in the patient care area with no close or prolonged contact with an unmasked patient without wearing, at a minimum, a surgical/procedural mask
	***No/very low-risk contact: An exposure deemed not meeting criteria for other risk categories (e.g., transient or brief community interactions that did not involve close or prolonged contact, or risk of direct contact with an infectious lesion)		***No/very low-risk contact: An exposure deemed not meeting criteria for other risk categories (e.g., transient or brief community interactions that did not involve close or prolonged contact, or risk of direct contact with an infectious lesion)
	**PEP is recommended for high-risk exposures, can be considered for intermediate-risk exposures, and is not recommended for low-/very low-/no-risk exposures		**PEP is recommended for high-risk exposures, can be considered for intermediate-risk exposures, and is not recommended for low-/very low-/no-risk exposures
	**PEP is with Imvamune vaccine		**PEP is with Imvamune vaccine
	***Accessed through the Public Health units (in Ontario), at EOCoperations.MOH@ontario.ca or 1-866-212-2272		***Accessed through the Public Health units (in Ontario), at EOCoperations.MOH@ontario.ca or 1-866-212-2272
	***
	[[Category:Poxviridae]]		[[Category:Poxviridae]]

Aidan: /* Management */

2023-03-01T11:29:33Z

Management

← Older revision		Revision as of 11:29, 1 March 2023
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	==Management==		==Management==

			* A few antivirals exist that may be helpful<ref>Emily A Siegrist, Joseph Sassine, Antivirals With Activity Against Mpox: A Clinically Oriented Review, ''Clinical Infectious Diseases'', Volume 76, Issue 1, 1 January 2023, Pages 155–164, https://doi.org/10.1093/cid/ciac622</ref>
	* [[Tecovirimat]] (TPoxx) 600 mg (3x200 mg capsules) p.o. bid for 14 days		* [[Tecovirimat]] (TPoxx) 600 mg (3x200 mg capsules) p.o. bid for 14 days
	** Specific to [[Orthopoxviridae]]		** Specific to [[Orthopoxviridae]]

Aidan: /* Clinical Manifestations */

2023-03-01T11:28:53Z

Clinical Manifestations

← Older revision		Revision as of 11:28, 1 March 2023
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	===Microbiology===		===Microbiology===

	*~~Monkeypox~~ virus (MPXV) is in the genus ''Orthopoxvirus'' and family ''Poxviridae''		*Mpox virus (MPXV) is in the genus ''Orthopoxvirus'' and family ''Poxviridae''

	===Epidemiology===		===Epidemiology===
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	*Clinically indistinguishable from [[smallpox]], though may have much more pronounced [[lymphadenopathy]]		*Clinically indistinguishable from [[smallpox]], though may have much more pronounced [[lymphadenopathy]]
	*Incubation period about [[Usual incubation period::12 days]] (possibly up to 21 days)		*Incubation period about [[Usual incubation period::12 days]] (possibly up to 21 days)
	*[[Causes::~~Fever~~]], [[Causes::~~rash~~]], [[Causes::lymphadenopathy]] (cervical, submandibular, and sublingual)		*Often followed by a prodrome lasting 1 to 4 days of [[Causes::fever]], [[Causes::fatigue]], [[Causes::headache]], and [[Causes::lymphadenopathy]] (cervical, submandibular, and sublingual)
			*Followed by the rash
	*~~Rash usually~~ starts on the face and spreads to the body		**Usually starts on the face and spreads to the body (centrifugal)
	**May involve mucous membranes and genitals, as well as palms and soles		**May involve mucous membranes and genitals, as well as [[Rashes involving palms and soles\|palms and soles]]
	**Progresses through macules, papules, vesicles, pustules, and finally ~~stabs~~		**Progresses through macules, papules, vesicles, pustules, and finally scabs
			***Classically, well-circumscribed, umbilicated lesions
			***All lesions are at the same stage
			**May be thousands of lesions in unvaccinated patients
	*Typically self-resolves over 2 to 4 weeks		*Typically self-resolves over 2 to 4 weeks
	*Atypical presentations may include painful genital or oral lesions		*Atypical presentations may include painful genital or oral lesions

			=== Complications ===
	*Mortality 1-10% (per WHO)		*Mortality 1-10% (per WHO)
			*Pitting and scarring
			*Secondary bacterial infections
			*Pulmonary involvement
			*Vomiting or diarrhea with dehydration
			*Encephalitis (rare)
			*Corneal scarring

	==Management==		==Management==

	* [[Tecovirimat]] (TPoxx) 600 mg (3x200 mg capsules) p.o. bid for 14 days		* [[Tecovirimat]] (TPoxx) 600 mg (3x200 mg capsules) p.o. bid for 14 days
			** Specific to [[Orthopoxviridae]]
			*[[Cidofovir]] 5 mg/kg IV once weekly for 2 weeks, possibly followed by same dose every other week
			*[[Brincidofovir]] 200 mg p.o. once weekly for 2 doses (i.e. day 1 and day 8)

	===Post-exposure prophylaxis===		===Post-exposure prophylaxis===

Aidan: Aidan moved page Monkeypox virus to Mpox virus

2023-02-06T15:19:27Z

Aidan moved page Monkeypox virus to Mpox virus

← Older revision	Revision as of 15:19, 6 February 2023
(No difference)

Aidan at 12:41, 5 June 2022

2022-06-05T12:41:16Z

@@ Line 16: / Line 16: @@
 *Clinically indistinguishable from [[smallpox]], though may have much more pronounced [[lymphadenopathy]]
-*Incubation period about [[Usual incubation period::12 days]]
+*Incubation period about [[Usual incubation period::12 days]] (possibly up to 21 days)
 *[[Causes::Fever]], [[Causes::rash]], [[Causes::lymphadenopathy]] (cervical, submandibular, and sublingual)
 *Mortality 1-10% (per WHO)
 ==Management==
 [[Category:Poxviridae]]

Aidan: /* Clinical Manifestations */

2020-08-05T13:43:22Z

Clinical Manifestations

← Older revision		Revision as of 13:43, 5 August 2020
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	==Clinical Manifestations==		==Clinical Manifestations==

	*Clinically ~~indistinguishible~~ from smallpox, though may have much more pronounced lymphadenopathy		*Clinically indistinguishable from [[smallpox]], though may have much more pronounced [[lymphadenopathy]]
	*Incubation period about [[Usual incubation period::12 days]]		*Incubation period about [[Usual incubation period::12 days]]
	*[[Causes::Fever]], [[Causes::rash]], [[Causes::lymphadenopathy]] (cervical, submandibular, and sublingual)		*[[Causes::Fever]], [[Causes::rash]], [[Causes::lymphadenopathy]] (cervical, submandibular, and sublingual)

Aidan: /* Clinical Manifestations */

2020-08-05T13:43:00Z

Clinical Manifestations

← Older revision		Revision as of 13:43, 5 August 2020
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	== ~~Microbiology~~ ==		==Background==
			===Microbiology===

	* Monkeypox virus (MPXV) is in the genus ''Orthopoxvirus'' and family ''Poxviridae''		*Monkeypox virus (MPXV) is in the genus ''Orthopoxvirus'' and family ''Poxviridae''

	== Epidemiology ==		===Epidemiology===

	* Zoonotic disease endemic to west and central Africa		*Zoonotic disease endemic to west and central Africa
	** Hosts include non-human primates and prairie dogs, squirrels, and possibly other rodents		**Hosts include non-human primates and prairie dogs, squirrels, and possibly other rodents
	** Endemic countries include DRC (most common), Liberia, Ivory Coast, Sierra Leone, Nigeria, Benin, Cameroon, Gabon, and South Sudan		**Endemic countries include DRC (most common), Liberia, Ivory Coast, Sierra Leone, Nigeria, Benin, Cameroon, Gabon, and South Sudan
	* Human infection is associated with animal trapping, hunting, and skinning, and other exposures to animals including bites, feces, urine, or respiratory droplets		*Human infection is associated with animal trapping, hunting, and skinning, and other exposures to animals including bites, feces, urine, or respiratory droplets
	** Global outbreaks may happen with the global trafficking in exotic pets		**Global outbreaks may happen with the global trafficking in exotic pets
	* Human-to-human transmission possible, but less than smallpox		*Human-to-human transmission possible, but less than smallpox

	== Clinical Manifestations ==		==Clinical Manifestations==

	* Clinically indistinguishible from smallpox, though may have much more pronounced lymphadenopathy		*Clinically indistinguishible from smallpox, though may have much more pronounced lymphadenopathy
	* Incubation period about 12 days		*Incubation period about [[Usual incubation period::12 days]]
	* Fever, rash, lymphadenopathy (cervical, submandibular, and sublingual)		*[[Causes::Fever]], [[Causes::rash]], [[Causes::lymphadenopathy]] (cervical, submandibular, and sublingual)
	* Mortality 1-10% (per WHO)		*Mortality 1-10% (per WHO)

	== Management ==		==Management==

	=== Post-exposure prophylaxis ===		===Post-exposure prophylaxis===

	* ??smallpox vaccine??		*??smallpox vaccine??

	[[Category:Poxviridae]]		[[Category:Poxviridae]]

Aidan: Text replacement - "Clinical Presentation" to "Clinical Manifestations"

2020-07-22T00:53:05Z

Text replacement - "Clinical Presentation" to "Clinical Manifestations"

← Older revision		Revision as of 00:53, 22 July 2020
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	* Human-to-human transmission possible, but less than smallpox		* Human-to-human transmission possible, but less than smallpox

	== Clinical ~~Presentation~~ ==		== Clinical Manifestations ==

	* Clinically indistinguishible from smallpox, though may have much more pronounced lymphadenopathy		* Clinically indistinguishible from smallpox, though may have much more pronounced lymphadenopathy

Aidan: Aidan moved page Monkeypox to Monkeypox virus

2019-10-15T14:14:40Z

Aidan moved page Monkeypox to Monkeypox virus

← Older revision	Revision as of 14:14, 15 October 2019
(No difference)