The current monkeypox virus (MPXV) outbreak, raging since May 2022, is the largest ever observed on a world-wide scale. Despite previously being endemic in west and central Africa with a mortality rate of up to 10%, it remained a neglected tropical disease. Along with other recent pandemics gaining much attention, this MPXV outbreak has provided an opportunity to improve our understanding of its physiopathology and better define management strategies, particularly in patients with more serious disease. From the ophthalmologist\'s perspective, eyelid involvement and conjunctivitis or keratoconjunctivitis are frequently observed and may precede systemic signs or even remain the major site of involvement. While the course of MPXV keratoconjunctivitis is most often favorable, severe cases pose a functional threat, in particular for immunocompromised patients. This review provides an overview of MPXV pathophysiology, diagnosis and treatment, as well as considerations for prevention of transmission. During such an epidemic, the ophthalmologist can be the first to diagnose MPXV, treat the ocular involvement, and set up adequate preventative measures in collaboration with infectious disease specialists.

Monkeypox infection is an emerging problem and a new challenge for modern medicine. With an increasing number of new cases worldwide, new data regarding the clinical manifestations, characteristics of the patients, risk factors and treatment options are coming to light. Knowing more about the disease will allow to elaborate new helpful methods to facilitate its diagnosis. Special attention should be paid to the careful dermatologic and dermoscopic examination of the patient. The analysis of available data also suggests possible strategies for the prevention of Monkeypox virus spread; the vaccine against Smallpox seems to be an effective solution. This case report describes the diagnostic approach and management of a non-vaccinated adult patient with several risk factors and a history of sexually transmitted disease. The patient had no history of travel abroad. Even though a clinical diagnose of Monkeypox can be challenging due to its similarities with skin rashes caused by other Orthopoxviral infections, there are fine differences between the rashes which can be helpful in their differentiation, although laboratory analysis is required for a definitive identification. A careful study of the characteristics of the rash, such as diameter, its presence on palms and soles and its evolution in time, provided important clues for the diagnosis of Monkeypox infection. The lack of vaccinations in the history of the patient was another crucial finding in the diagnostic process.

Monkeypox is a zoonotic disease, endemic in central and west African regions, and has re-emerged, currently causing an outbreak as of May 2022. In this systematic review, we aimed to characterize the current face of the disease, with a detailed categorization of mucocutaneous, as well as systemic symptoms of the disease. We searched four main online databases with the keywords \"monkeypox\" and \"Orthopoxvirus\". A total of 46 articles were included, with a cumulative number of 1984 confirmed cases. Patients were predominantly men who have sex with men, who were mostly in their 30s, with a history of unprotected sexual contact or international travel. Among mucocutaneous manifestations, anogenital lesions were the most commonly observed, followed by lesions on the limbs, face, trunk, and palms or soles. Among lesion types, vesiculopustular, pustular or pseudo-pustular, vesicular-umbilicated and papular lesions were the most common, mainly presenting asynchronously, with less than 10 lesions on each patient. Almost all patients also reported systemic manifestations, namely fever, lymphadenopathy, fatigue, myalgia, headaches, pharyngitis, and proctitis. Sexual contact is the main pathway of transmission in the current outbreak, with viral shedding in bodily fluids playing a key role. We\'ve compared these idiosyncratic findings of the new outbreak with previous outbreaks. We\'ve also gathered and categorized images from our included studies to make a \"clinical atlas\" for this \"new\" face of monkeypox, which can be of utmost importance for clinicians to be familiarized with, and have a clear picture of monkeypox for their differential diagnoses.

In this paper, we present stochastic synchronous cellular automaton defined on a square lattice. The automaton rules are based on the SEIR (susceptible → exposed → infected → recovered) model with probabilistic parameters gathered from real-world data on human mortality and the characteristics of the SARS-CoV-2 disease. With computer simulations, we show the influence of the radius of the neighborhood on the number of infected and deceased agents in the artificial population. The increase in the radius of the neighborhood favors the spread of the pandemic. However, for a large range of interactions of exposed agents (who neither have symptoms of the disease nor have been diagnosed by appropriate tests), even isolation of infected agents cannot prevent successful disease propagation. This supports aggressive testing against disease as one of the useful strategies to prevent large peaks of infection in the spread of SARS-CoV-2-like diseases.

BACKGROUND: Silesia is one of the regions in Poland most affected by the COVID-19 epidemic. The high number of infections among the inhabitants of the region increases the already high risk of infection of SARS-CoV-2 virus of medical workers who, due to their work, are more likely to be exposed to people with SARS-CoV-2 than people from the general population. The aim of this study is to assess the prevalence of SARS-CoV-2 infection among healthcare workers in the Upper Silesia Metropolitan Area based on the results of a seroepidemiological study.
METHODS: The seroepidemiological study was carried out in October- November 2020 among the inhabitants of the Upper Silesia Metropolitan Area (including medical professionals who were selected, creating a research group of healthcare workers). Apart from the questionnaire examination necessary to determine the declared symptoms, circumstances and risk factors conducive to infection, the level of specific antibodies against the SARS-CoV-2 virus in the IgG and IgM class was assessed.
RESULTS: In the study participated 575 people declaring their medical profession. A positive test for the presence of IgG antibodies was confirmed in 19.1% of the respondents, while a positive test for IgM concerned 4.3% of the subjects. The most common positive results indicating infection with the SARS-CoV-2 virus concerned people declaring prior contact with an infected person (p = 0.001) and those undergoing quarantine (p < 0.0001).
CONCLUSIONS: The frequency of SARS-CoV-2 virus infections in medical personnel in the Upper Silesia Metropolitan Area, assessed on the basis of a positive IgG antibody test result, was 16.1-22.5%. Med Pr. 2022;73(2):125-33.
UNASSIGNED: Śląsk jest jednym z regionów Polski najbardziej dotkniętych przez epidemię COVID-19. Wysoka liczba zakażeń wśród mieszkańców zwiększa i tak wysokie ryzyko zakażenia SARS-CoV-2 pracowników medycznych, którzy ze względu na swoją pracę są narażeni na kontakt z nosicielami SARS-CoV-2 częściej niż osoby z populacji ogólnej. Celem niniejszego badania była ocena na podstawie wyników badania seroepidemiologicznego rozpowszechnienia zakażenia SARS-CoV-2 wśród pracowników ochrony zdrowia z Aglomeracji Górnośląskiej.
UNASSIGNED: Badanie seroepidemiologiczne przeprowadzono w okresie październik–listopad 2020 r. wśród mieszkańców Aglomeracji Górnośląskiej (objęło m.in. osoby wykonujące zawody medyczne, które wyselekcjonowano, tworząc grupę badanych pracowników medycznych). Poza przeprowadzeniem badania kwestionariuszowego, niezbędnego do ustalenia objawów, okoliczności oraz czynników ryzyka sprzyjających zakażeniu, oceniono obecność swoistych przeciwciał przeciwko SARS-CoV-2 w klasach IgG oraz IgM.
UNASSIGNED: W badaniu wzięło udział 575 osób deklarujących wykonywanie zawodu medycznego. Dodatni wynik testu na obecność przeciwciał w klasie IgG uzyskano u 19,1% badanych, a w klasie IgM – u 4,3% badanych. Dodatnie wyniki, wskazujące na zakażenie SARS-CoV-2, najczęściej dotyczyły osób deklarujących wcześniejszy kontakt z osobą zakażoną (p = 0,001) oraz odbywających kwarantannę (p < 0,0001).
UNASSIGNED: Częstość zakażeń SARS-CoV-2 u personelu medycznego w Aglomeracji Górnośląskiej, oceniana na podstawie pozytywnego wyniku testu przeciwciał w klasie IgG, wynosi 16,1–22,5%. Med. Pr. 2022;73(2):125–133.

In the spring of 1656, an epidemic of bubonic plague suddenly fell on Naples, the capital of the Kingdom of the Two Sicilies. The epidemic had put a strain on the government authorities, forcing them to take sometimes drastic measures but, in most cases, scarcely decisive. The current health emergency caused by Covid-19 disease has many similarities with the epidemics of the past. Here we report the parallelism among plague and Covid-19 in several respects. Taking as a paradigm the plague epidemic of Naples of 1656, we can easily understand how history, showing us how past epidemics were managed and overcome, even with the intrinsic differences due to the limits of time and scientific progress, can still give us a useful lesson to face the present.

Recommendations of the Main Board of the Polish Society of Otorhinolaryngologists, Head and Neck Surgeons for providing services during the COVID-19 pandemic constitute the guidance to outpatient and hospital practices in all cases where contact with a patient whose status of COVID-19 is unknown. They have been created based on world publications and recommendations due to the current state of the COVID-19 pandemic. Justification for suspension of planned provision of services in the first phase of a pandemic was presented. The indication of the best medical practices for the time of stabilization, but with the persistence of the risk of COVID-19 infection in the population are discussed. The possibility of providing services in the following months of the pandemic is important. We provide the rationale for launching medical activities and indicate optimal practices until the consolidation of SARS COV-2 prevention and treatment methods.

OBJECTIVE: The lack of ressources and coordination to face the epidemic of coronavirus raises concerns for the health of patients with mental disorders in a country where we keep in memory the dramatic experience of famine in psychiatric hospitals during the Second World War. This article aims at proposing guidance to ensure mental health care during the SARS-CoV epidemy in France.
METHODS: Authors performed a narrative review identifying relevant results in the scientific and medical literature and local initiatives in France.
RESULTS: We identified four types of major vulnerabilities in patients suffering from mental disorders during this pandemic: (1) medical comorbidities that are more frequently found in patients suffering from mental disorders (cardiovascular and pulmonary pathologies, diabetes, obesity, etc.) which represent risk factors for severe infections with Covid-19; (2) age (the elderly constituting the population most vulnerable to coronavirus); (3) cognitive and behavioral troubles which can hamper compliance with confinement and hygiene measures and finally and (4) psychosocial vulnerability due to stigmatization and/or socio-economic difficulties. Furthermore, the mental health healthcare system is more vulnerable than other healthcare systems. Current government plans are poorly adapted to psychiatric establishments in a context of major shortage of organizational, material and human resources. In addition, a certain number of structural aspects make the psychiatric institution particularly vulnerable: many beds are closed, wards have a high density of patients, mental health community facilities are closed, medical teams are understaffed and poorly trained to face infectious diseases. We could also face major issues in referring patients with acute mental disorders to intensive care units. To maintain continuity of psychiatric care in this pandemic situation, several directions can be considered, in particular with the creation of Covid+ units. These units are under the dual supervision of a psychiatrist and of an internist/infectious disease specialist; all new entrants should be placed in quarantine for 14 days; the nurse staff should benefit from specific training, from daily medical check-ups and from close psychological support. Family visits would be prohibited and replaced by videoconference. At the end of hospitalization, in particular for the population of patients in compulsory ambulatory care situations, specific case-management should be organized with the possibility of home visits, in order to support them when they get back home and to help them to cope with the experience of confinement, which is at risk to induce recurrences of mental disorders. The total or partial closure of mental health community facilities is particularly disturbing for patients but a regular follow-up is possible with telemedicine and should include the monitoring of the suicide risk and psychoeducation strategies; developing support platforms could also be very helpful in this context. Private psychiatrists have also a crucial role of information with their patients on confinement and barrier measures, but also on measures to prevent the psychological risks inherent to confinement: maintenance of sleep regularity, physical exercise, social interactions, stress management and coping strategies, prevention of addictions, etc. They should also be trained to prevent, detect and treat early warning symptoms of post-traumatic stress disorder, because their prevalence was high in the regions of China most affected by the pandemic.
CONCLUSIONS: French mental healthcare is now in a great and urgent need for reorganization and must also prepare in the coming days and weeks to face an epidemic of emotional disorders due to the containment of the general population.

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