Monkeypox: Immune response, vaccination and preventive efforts

doi:10.52225/narra.v2i3.90

Review

. 2022 Dec;2(3):e90.

doi: 10.52225/narra.v2i3.90. Epub 2022 Oct 22.

Monkeypox: Immune response, vaccination and preventive efforts

Youdiil Ophinni^{1

2}, Andri Frediansyah³, Salin Sirinam⁴, Dewi Megawati^{5

6}, Ana M Stoian⁷, Seyi S Enitan⁸, Richard Y Akele⁹, Ranjit Sah¹⁰, Krit Pongpirul^{11

12

13}, Ziad Abdeen¹⁴, Sevda Aghayeva¹⁵, Aamer Ikram¹⁶, Yohannes Kebede¹⁷, Uwe Wollina¹⁸, Kannan Subbaram¹⁹, Ai Koyanagi²⁰, Abdulwahed Al Serouri²¹, H Blaise Nguendo-Yongsi²², Jeffrey Edwards²³, Dina E Sallam²⁴, Yousef Khader²⁵, Sandro G Viveiros-Rosa²⁶, Ziad A Memish^{27

28}, Mehrdad Amir-Behghadami²⁹, Sandro Vento³⁰, Marius Rademaker³¹, Malik Sallam^{32

33

34}

Affiliations

¹ Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, United States.
² Laboratory of Host Defense, WPI Immunology Frontier Research Center (IFReC), Osaka University, Osaka, Japan.
³ PRTPP-National Research and Innovation Agency (BRIN), Yogyakarta, Indonesia.
⁴ Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
⁵ Department of Veterinary Pathobiology, School of Veterinary Medicine, University of Missouri, Columbia, MO, United States.
⁶ Department of Microbiology and Parasitology, School of Medicine, Universitas Warmadewa, Bali, Indonesia.
⁷ Department of Medical Microbiology and Immunology, School of Medicine, University of California Davis, CA, United States.
⁸ Department of Medical Laboratory Science, Babcock University, Ilishan-Remo, Nigeria.
⁹ Department of Biomedical Science, School of Applied Science, University of Brighton, London, United Kingdom.
¹⁰ Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal.
¹¹ Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
¹² Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
¹³ Bumrungrad International Hospital, Bangkok, Thailand.
¹⁴ Department of Community Health, Faculty of Medicine, Al-Quds University, Jerusalem.
¹⁵ Department of Gastroenterology, Baku Medical Plaza Hospital, Baku, Azerbaijan.
¹⁶ National Institute of Heath, Islamabad, Pakistan.
¹⁷ Department of Health, Behavior and Society, Faculty of Public Health, Jimma University, Jimma, Ethiopia.
¹⁸ Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Dresden, Germany.
¹⁹ School of Medicine, The Maldives National University, Maldives.
²⁰ Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Barcelona, Spain.
²¹ Yemen Field Epidemiology Training Program, Sana'a, Yemen.
²² Department of Epidemiology, School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon.
²³ Medical Research Foundation of Trinidad and Tobago, Port of Spain, Trinidad.
²⁴ Department of Pediatrics and Pediatric Nephrology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
²⁵ The Center of Excellence for Applied Epidemiology, The Eastern Mediterranean Public Health Network (EMPHNET), Amman, Jordan.
²⁶ National Institute of Industrial Property, Rio de Janeiro, Rio de Janeiro, Brazil.
²⁷ Research & Innovation Centre, King Saud Medical City, Ministry of Health, Riyadh, Kingdom of Saudi Arabia.
²⁸ College of Medicine, AlFaisal University, Riyadh, Kingdom of Saudi Arabia.
²⁹ Iranian Center of Excellence in Health Management, Department of Health Service Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
³⁰ Faculty of Medicine, University of Puthisastra, Phnom Penh, Cambodia.
³¹ Clinical Trial New Zealand, Waikato Hospital Campus, Hamilton, New Zealand.
³² Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan.
³³ Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman, Jordan.
³⁴ Department of Translational Medicine, Faculty of Medicine, Lund University, Malmö, Sweden.

PMID: 38449905
PMCID: PMC10914130
DOI: 10.52225/narra.v2i3.90

Review

Monkeypox: Immune response, vaccination and preventive efforts

Youdiil Ophinni et al. Narra J. 2022 Dec.

. 2022 Dec;2(3):e90.

doi: 10.52225/narra.v2i3.90. Epub 2022 Oct 22.

Authors

Affiliations

¹ Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, United States.
² Laboratory of Host Defense, WPI Immunology Frontier Research Center (IFReC), Osaka University, Osaka, Japan.
³ PRTPP-National Research and Innovation Agency (BRIN), Yogyakarta, Indonesia.
⁴ Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
⁵ Department of Veterinary Pathobiology, School of Veterinary Medicine, University of Missouri, Columbia, MO, United States.
⁶ Department of Microbiology and Parasitology, School of Medicine, Universitas Warmadewa, Bali, Indonesia.
⁷ Department of Medical Microbiology and Immunology, School of Medicine, University of California Davis, CA, United States.
⁸ Department of Medical Laboratory Science, Babcock University, Ilishan-Remo, Nigeria.
⁹ Department of Biomedical Science, School of Applied Science, University of Brighton, London, United Kingdom.
¹⁰ Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal.
¹¹ Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
¹² Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
¹³ Bumrungrad International Hospital, Bangkok, Thailand.
¹⁴ Department of Community Health, Faculty of Medicine, Al-Quds University, Jerusalem.
¹⁵ Department of Gastroenterology, Baku Medical Plaza Hospital, Baku, Azerbaijan.
¹⁶ National Institute of Heath, Islamabad, Pakistan.
¹⁷ Department of Health, Behavior and Society, Faculty of Public Health, Jimma University, Jimma, Ethiopia.
¹⁸ Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Dresden, Germany.
¹⁹ School of Medicine, The Maldives National University, Maldives.
²⁰ Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Barcelona, Spain.
²¹ Yemen Field Epidemiology Training Program, Sana'a, Yemen.
²² Department of Epidemiology, School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon.
²³ Medical Research Foundation of Trinidad and Tobago, Port of Spain, Trinidad.
²⁴ Department of Pediatrics and Pediatric Nephrology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
²⁵ The Center of Excellence for Applied Epidemiology, The Eastern Mediterranean Public Health Network (EMPHNET), Amman, Jordan.
²⁶ National Institute of Industrial Property, Rio de Janeiro, Rio de Janeiro, Brazil.
²⁷ Research & Innovation Centre, King Saud Medical City, Ministry of Health, Riyadh, Kingdom of Saudi Arabia.
²⁸ College of Medicine, AlFaisal University, Riyadh, Kingdom of Saudi Arabia.
²⁹ Iranian Center of Excellence in Health Management, Department of Health Service Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
³⁰ Faculty of Medicine, University of Puthisastra, Phnom Penh, Cambodia.
³¹ Clinical Trial New Zealand, Waikato Hospital Campus, Hamilton, New Zealand.
³² Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan.
³³ Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman, Jordan.
³⁴ Department of Translational Medicine, Faculty of Medicine, Lund University, Malmö, Sweden.

PMID: 38449905
PMCID: PMC10914130
DOI: 10.52225/narra.v2i3.90

Abstract

Infectious threats to humans are continuously emerging. The 2022 worldwide monkeypox outbreak is the latest of these threats with the virus rapidly spreading to 106 countries by the end of September 2022. The burden of the ongoing monkeypox outbreak is manifested by 68,000 cumulative confirmed cases and 26 deaths. Although monkeypox is usually a self-limited disease, patients can suffer from extremely painful skin lesions and complications can occur with reported mortalities. The antigenic similarity between the smallpox virus (variola virus) and monkeypox virus can be utilized to prevent monkeypox using smallpox vaccines; treatment is also based on antivirals initially designed to treat smallpox. However, further studies are needed to fully decipher the immune response to monkeypox virus and the immune evasion mechanisms. In this review we provide an up-to-date discussion of the current state of knowledge regarding monkeypox virus with a special focus on innate immune response, immune evasion mechanisms and vaccination against the virus.

Keywords: MPXV; Monkeypox virus; emerging viral infectious disease; outbreak; zoonosis.

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Conflict of interest statement

All the authors declare that there are no conflicts of interest.

Figures

**Figure 1.**
Global distribution of confirmed cases (A) and deaths (B) of monkeypox. The data were retrieved from OurWorldInData.org as of 12 September 2022 [5].

**Figure 2.**
Clinical and laboratory features of monkeypox in humans.

**Figure 3.**
Monkeypox virus under transmission electron microscope. (A) utilizing ultrathin stained sections; Bar = 200 nm, (B) utilizing negative stained; Bar = 200 nm. *mature: oval-shaped virus particles, immature: crescents and spherical shape. Source: Robert Koch Institute (https://www.rki.de) 4 September 2022 [61].

See this image and copyright information in PMC

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References

1. WHO . Director-General's statement at the press conference following IHR Emergency Committee regarding the multi-country outbreak of monkeypox. Available from: https://www.who.int/director-general/speeches/detail/who-director-genera.... Accessed: 23 July 2022.
1. CDC . Monkeypox outbreak global map. Available from: https://www.cdc.gov/poxvirus/monkeypox/response/2022/world-map.html. Accessed: 23 July 2022.
1. Bunge EM, Hoet B, Chen L, et al. . The changing epidemiology of human monkeypox—A potential threat? A systematic review. PLoS Negl Trop Dis 2022; 16(2):e0010141. - PMC - PubMed
1. Sklenovska N, Van Ranst M. Emergence of monkeypox as the most important orthopoxvirus infection in humans. Front Public Health 2018; 6:241. - PMC - PubMed
1. Mathieu E, Dattani S, Ritchie H, et al. . Monkeypox: Cumulative confirmed cases, by date of confirmation, Sept 9, 2022. Available from: https://ourworldindataorg/monkeypox. Accessed: 9 September 2022.

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[1] WHO . Director-General's statement at the press conference following IHR Emergency Committee regarding the multi-country outbreak of monkeypox. Available from: https://www.who.int/director-general/speeches/detail/who-director-genera.... Accessed: 23 July 2022.

[2] WHO . Director-General's statement at the press conference following IHR Emergency Committee regarding the multi-country outbreak of monkeypox. Available from: https://www.who.int/director-general/speeches/detail/who-director-genera.... Accessed: 23 July 2022.

[3] CDC . Monkeypox outbreak global map. Available from: https://www.cdc.gov/poxvirus/monkeypox/response/2022/world-map.html. Accessed: 23 July 2022.

[4] CDC . Monkeypox outbreak global map. Available from: https://www.cdc.gov/poxvirus/monkeypox/response/2022/world-map.html. Accessed: 23 July 2022.

[5] Bunge EM, Hoet B, Chen L, et al. . The changing epidemiology of human monkeypox—A potential threat? A systematic review. PLoS Negl Trop Dis 2022; 16(2):e0010141. - PMC - PubMed

[6] Bunge EM, Hoet B, Chen L, et al. . The changing epidemiology of human monkeypox—A potential threat? A systematic review. PLoS Negl Trop Dis 2022; 16(2):e0010141. - PMC - PubMed

[7] Sklenovska N, Van Ranst M. Emergence of monkeypox as the most important orthopoxvirus infection in humans. Front Public Health 2018; 6:241. - PMC - PubMed

[8] Sklenovska N, Van Ranst M. Emergence of monkeypox as the most important orthopoxvirus infection in humans. Front Public Health 2018; 6:241. - PMC - PubMed

[9] Mathieu E, Dattani S, Ritchie H, et al. . Monkeypox: Cumulative confirmed cases, by date of confirmation, Sept 9, 2022. Available from: https://ourworldindataorg/monkeypox. Accessed: 9 September 2022.

[10] Mathieu E, Dattani S, Ritchie H, et al. . Monkeypox: Cumulative confirmed cases, by date of confirmation, Sept 9, 2022. Available from: https://ourworldindataorg/monkeypox. Accessed: 9 September 2022.

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Monkeypox: Immune response, vaccination and preventive efforts

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Monkeypox: Immune response, vaccination and preventive efforts

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