We describe real-world estimates of JYNNEOS vaccine effectiveness (VE) against symptomatic mpox in Los Angeles County (LAC). We conducted a retrospective cohort study of men aged ≥18 years residing in LAC who were at risk for mpox and eligible for the JYNNEOS vaccine from 5/19/2022 to 1/1/2023. Case demographics and route of JYNNEOS administration were obtained through vaccine administration data systems. HIV and sexually transmitted infection (STI) status was obtained through disease reporting systems for HIV and STI diagnoses in LAC. To estimate VE, we calculated weekly incidence of confirmed mpox for unvaccinated, partially vaccinated (episode date ≥14 days after first dose), and fully vaccinated (episode date ≥14 days after second dose) cohorts starting on 8/29/2022, when fully vaccinated coverage exceeded 3 %, and ending on 1/1/2023. Overall, 2,171 men had confirmed mpox, and 1,002 (46 %) of those were persons living with diagnosed HIV (PLWDH). 2,019 (93 %) mpox cases were unvaccinated, 114 (5 %) were partially vaccinated and 38 (2 %) were fully vaccinated. VE was 69 % (95 % CI 59-77) for partially vaccinated and 84 % (95 % CI 80-87) for fully vaccinated individuals. Among PLWDH, VE was 72 % (95 % CI 57-82) for fully vaccinated and 28 % (95 % CI -96 to 73) VE for partially vaccinated individuals. Among persons not living with diagnosed HIV, VE was 88 % (95 % CI 86-90) for fully vaccinated and 80 % (95 % CI 76-83) for partially vaccinated individuals. Of 111 individuals hospitalized with mpox, one was partially vaccinated, and the remaining were unvaccinated. Our results align with other published studies that reported that two doses of the JYNNEOS vaccine provided significant protection against symptomatic mpox.

UNASSIGNED: This sub-analysis seeks to delineate and characterize factors influencing hospitalization in individuals diagnosed with Mpox disease amidst the initial outbreak in Spain in the onset of 2022.
UNASSIGNED: Employing a non-probabilistic convenience sampling approach, a retrospective multicenter investigation was carried out to examine Monkeypox virus infection within Spanish healthcare facilities.
UNASSIGNED: The median duration of the disease was 16 days, with 4.2 % of cases resulting in hospitalization. There was a single ICU admission leading to fatality. Sequelae were observed in 2.3 % of cases. Multivariate analysis revealed that hospitalization decisions were influenced by immunosuppression and severe symptoms, including gastrointestinal, neurological, ear-nose-throat, and respiratory manifestations. Significant analytical parameter differences were restricted to hemoglobin levels at diagnosis.
UNASSIGNED: This study elucidates factors influencing hospitalization decisions for Monkeypox patients in Spain, emphasizing the importance of immunosuppression and extracutaneous symptoms involving the gastrointestinal, ear-nose-throat, and respiratory pathways. In summary, hospitalization determinations arise from the interplay of these crucial dimensions.

The rising number of cases of human Mpox has emerged as a major global concern due to the daily increase of cases in several countries. The disease presents various skin symptoms in infected individuals, making it crucial to promptly identify and isolate them to prevent widespread community transmission. Rapid determination and isolation of infected individuals are therefore essential to curb the spread of the disease. Most research in the detection of Mpox disease has utilized convolutional neural network (CNN) models and ensemble methods. However, to the best of our knowledge, none have utilized a meta-heuristic-based ensemble approach. To address this gap, we propose a novel metaheuristics optimization-based weighted average ensemble model (MO-WAE) for detecting Mpox disease. We first train three transfer learning (TL)-based CNNs (DenseNet201, MobileNet, and DenseNet169) by adding additional layers to improve their classification strength. Next, we use a weighted average ensemble technique to fuse the predictions from each individual model, and the particle swarm optimization (PSO) algorithm is utilized to assign optimized weights to each model during the ensembling process. By using this approach, we obtain more accurate predictions than individual models. To gain a better understanding of the regions indicating the onset of Mpox, we performed a Gradient Class Activation Mapping (Grad-CAM) analysis to explain our model\'s predictions. Our proposed MO-WAE ensemble model was evaluated on a publicly available Mpox dataset and achieved an impressive accuracy of 97.78%. This outperforms state-of-the-art (SOTA) methods on the same dataset, thereby providing further evidence of the efficacy of our proposed model.

Monkeypox (MPOX) is a zoonotic disease that affects humans and other primates, resulting in a smallpox-like illness. It is caused by monkeypox virus (MPXV), which belongs to the Poxviridae family. Clinically manifested by a range of cutaneous and systemic findings, as well as variable disease severity phenotypes based on the genetic makeup of the virus, the cutaneous niche and respiratory mucosa are the epicenters of MPXV pathogenicity. Herein, we describe the ultrastructural features of MPXV infection in both human cultured cells and cutaneous clinical specimens collected during the 2022-2023 MPOX outbreak in New York City that were revealed through electron microscopy. We observed typical enveloped virions with brick-shaped morphologies that contained surface protrusions, consistent with the classic ultrastructural features of MPXV. In addition, we describe morpho-functional evidence that point to roles of distinct cellular organelles in viral assembly during clinical MPXV infection. Interestingly, in skin lesions, we found abundant melanosomes near viral assembly sites, particularly in the vicinity of mature virions, which provides further insight into virus-host interactions at the subcellular level that contribute to MPXV pathogenesis. These findings not only highlight the importance of electron microscopic studies for further investigation of this emerging pathogen but also in characterizing MPXV pathogenesis during human infection.