PDF(Pubmed)
Abstract：
The monkeypox virus (MPXV) outbreak, primarily endemic to Africa, has spread globally, with Brazil reporting the second-highest number of cases. The emergence of MPXV in non-endemic areas has raised concerns, particularly due to the co-circulation of other exanthematous viruses such as varicella-zoster virus (VZV) and molluscum contagiosum virus (MOCV). To perform an accurate differential diagnosis of MPXV during the ongoing outbreak in Minas Gerais, Brazil, a 5PLEX qPCR assay targeting orthopoxviruses (OPV), VZV, and MOCV was used to retrospectively analyze all clinical samples that tested negative for MPXV in the initial screening conducted at Funed. In summary, our study analyzed 1,175 clinical samples received from patients suspected of MPXV infection and found a positivity rate of 33.8% (397 samples) for MPXV using the non-variola qPCR assay. Testing the 778 MPXV-negative clinical samples using the 5PLEX qPCR assay revealed that 174 clinical samples (22.36%) tested positive for VZV. MOCV DNA was detected in 13 and other OPV in 3 clinical samples. The sequencing of randomly selected amplified clinical samples confirmed the initial molecular diagnosis. Analysis of patient profiles revealed a significant difference in the median age between groups testing positive for MPXV and VZV and a male predominance in MPXV cases. The geographic distribution of positive cases was concentrated in the most populous mesoregions of Minas Gerais state. This study highlights the challenges posed by emerging infectious diseases. It emphasizes the importance of epidemiological surveillance and accurate diagnosis in enabling timely responses for public health policies and appropriate medical care.
OBJECTIVE: Brazil ranks second in the number of cases during the global monkeypox epidemic. The study, conducted in Minas Gerais, the second most populous state in Brazil with over 20 million inhabitants, utilized differential diagnostics, revealing a significant number of positive cases for other exanthematous viruses and emphasizing the need for accurate diagnoses. During the study, we were able to assess the co-circulation of other viruses alongside monkeypox, including varicella-zoster virus, molluscum contagiosum virus, and other orthopoxviruses. The significance of the research is underscored by the concentration of positive cases in populous areas, highlighting the challenges posed by emerging infectious diseases. This demographic context further amplifies the importance of the research in guiding public health policies and medical interventions, given the substantial population at risk. The study not only addresses a global concern but also holds critical implications for a state with such a large population and geographic expanse within Brazil. Overall, the study emphasizes the pivotal role of surveillance and precise diagnosis in guiding effective public health responses and ensuring appropriate medical interventions.
OBJECTIVE: Brazil ranks second in the number of cases during the global monkeypox epidemic. The study, conducted in Minas Gerais, the second most populous state in Brazil with over 20 million inhabitants, utilized differential diagnostics, revealing a significant number of positive cases for other exanthematous viruses and emphasizing the need for accurate diagnoses. During the study, we were able to assess the co-circulation of other viruses alongside monkeypox, including varicella-zoster virus, molluscum contagiosum virus, and other orthopoxviruses. The significance of the research is underscored by the concentration of positive cases in populous areas, highlighting the challenges posed by emerging infectious diseases. This demographic context further amplifies the importance of the research in guiding public health policies and medical interventions, given the substantial population at risk. The study not only addresses a global concern but also holds critical implications for a state with such a large population and geographic expanse within Brazil. Overall, the study emphasizes the pivotal role of surveillance and precise diagnosis in guiding effective public health responses and ensuring appropriate medical interventions.
摘要：
猴痘病毒（MPXV）爆发，主要是非洲特有的，已经在全球范围内传播，巴西报告的病例数第二高。MPXV在非流行地区的出现引起了人们的关注，特别是由于水痘-带状疱疹病毒（VZV）和传染性软疣病毒（MOCV）等其他发斑病毒的共同循环。为了在米纳斯吉拉斯州持续爆发期间对MPXV进行准确的鉴别诊断，巴西,针对正痘病毒（OPV）的5PLEXqPCR分析，VZV,和MOCV用于回顾性分析在Funed进行的初始筛查中MPXV检测阴性的所有临床样本.总之,我们的研究分析了1,175份疑似MPXV感染患者的临床样本,发现使用非天花qPCR检测MPXV的阳性率为33.8%(397份).使用5PLEXqPCR测定法测试778个MPXV阴性临床样品揭示了174个临床样品(22.36%)对VZV测试为阳性。在13份临床样品中检测到MOCVDNA，在3份其他OPV中检测到DNA。随机选择的扩增的临床样品的测序证实了最初的分子诊断。对患者概况的分析显示，MPXV和VZV呈阳性的组之间的中位年龄存在显着差异，而MPXV病例中以男性为主。阳性病例的地理分布集中在米纳斯吉拉斯州人口最多的中区。这项研究强调了新出现的传染病带来的挑战。它强调流行病学监测和准确诊断对于及时响应公共卫生政策和适当医疗保健的重要性。
目的：在全球猴痘流行期间，巴西的病例数排名第二。这项研究,在米纳斯吉拉斯州进行，巴西人口第二多的州，人口超过2000万，利用差分诊断，揭示了大量其他发疹病毒的阳性病例，并强调了准确诊断的必要性。在研究期间,我们能够评估其他病毒与猴痘的共同传播，包括水痘-带状疱疹病毒,传染性软疣病毒,和其他正痘病毒。阳性病例集中在人口稠密地区，突显了这项研究的意义。强调新出现的传染病带来的挑战。这种人口统计学背景进一步扩大了研究在指导公共卫生政策和医疗干预方面的重要性。鉴于大量人口处于危险之中。该研究不仅解决了全球关注的问题，而且对巴西人口众多且地理广阔的州也具有重要意义。总的来说,该研究强调了监测和精确诊断在指导有效的公共卫生应对措施和确保适当的医疗干预方面的关键作用。
目的：在全球猴痘流行期间，巴西的病例数排名第二。这项研究,在米纳斯吉拉斯州进行，巴西人口第二多的州，人口超过2000万，利用差分诊断，揭示了大量其他发疹病毒的阳性病例，并强调了准确诊断的必要性。在研究期间,我们能够评估其他病毒与猴痘的共同传播，包括水痘-带状疱疹病毒,传染性软疣病毒,和其他正痘病毒。阳性病例集中在人口稠密地区，突显了这项研究的意义。强调新出现的传染病带来的挑战。这种人口统计学背景进一步扩大了研究在指导公共卫生政策和医疗干预方面的重要性。鉴于大量人口处于危险之中。该研究不仅解决了全球关注的问题，而且对巴西人口众多且地理广阔的州也具有重要意义。总的来说,该研究强调了监测和精确诊断在指导有效的公共卫生应对措施和确保适当的医疗干预方面的关键作用。
