Latin America: Situation and preparedness facing the multi-country human monkeypox outbreak
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2022-09
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Still without ceasing the Coronavirus Disease 2019 (COVID-19) pandemic, a new viral threat has now emerged outside its endemic niche in Africa affecting multiple countries and continents. After its appearance in May 2022, a multi-country outbreak of monkeypox disease (MPX) has triggered significant concerns due to its rapid spread and potential for sexual transmission (as suggested by the detection of viral DNA in sexual fluids); this, in addition to the previously known transmission routes described throughout endemic countries of Africa over the last decades or the imported or travel-related cases reported since 2003.1
By June 28, 2022, at least 48 cases in seven Latin American countries (Argentina, Brazil, Chile, Colombia, Mexico, Peru, and Venezuela) have been PCR-confirmed, with at least 16 additional suspected cases (Figure 1).2 Most countries in the region have settled their epidemiological surveillance to detect probable and suspected cases according to national and international case definitions (by the World Health Organization). In addition, the Pan-American Health Organization has issued an epidemiological alert (https://bit.ly/3MUwYNI), with a series of considerations addressing the identification of cases, isolation, follow-up, contact tracing, clinical management, prevention and control. Nevertheless, multiple concerns have been raised, mainly from the healthcare sector, regarding currently available treatments and vaccination. Despite the absence of specific therapeutic alternatives for MPX, drugs with proven experimental efficacy and potential clinical impact such as cidofovir (especially its lipid conjugate brincidofovir) and tecovirimat, are not widely available in the region. Also, although MPX vaccination has been implemented for contacts of positive cases, at this stage, neither non-replicating/replicating-deficient live vaccinia virus-based vaccines with low reactogenicity, such as JYNNEOS®, nor classical anti-smallpox vaccines are available in most Latin American countries.
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Rodriguez-Morales, A. J., Lopardo, G., Verbanaz, S., Orduna, T., Lloveras, S., Azeñas-Burgoa, J. M., Escalera-Antezana, J. P., Alvarado-Arnez, L. E., Barbosa, A. N., Diaz-Quijano, F., Torres, J. R., & Suarez, J. A. (2022). Latin America: Situation and preparedness facing the multi-country human monkeypox outbreak. The Lancet Regional Health - Americas, 13. https://doi.org/10.1016/j.lana.2022.100318