Cargando…

Reassessment of Evidence about Coinfection of Chickenpox and Monkeypox (Mpox) in African Children

In west and central Africa, monkeypox occurs mainly in older children, adolescents and young adults. In two large epidemiology studies of monkeypox outbreaks, the investigators observed a sizable number of coinfections of chickenpox (varicella) and monkeypox. Based on a review of the literature, we...

Descripción completa

Detalles Bibliográficos
Autores principales: Khallafallah, Ola, Grose, Charles
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9781582/
https://www.ncbi.nlm.nih.gov/pubmed/36560805
http://dx.doi.org/10.3390/v14122800
_version_ 1784857109553217536
author Khallafallah, Ola
Grose, Charles
author_facet Khallafallah, Ola
Grose, Charles
author_sort Khallafallah, Ola
collection PubMed
description In west and central Africa, monkeypox occurs mainly in older children, adolescents and young adults. In two large epidemiology studies of monkeypox outbreaks, the investigators observed a sizable number of coinfections of chickenpox (varicella) and monkeypox. Based on a review of the literature, we propose that chickenpox (human herpesvirus-3 infection) is a risk factor for acquisition of monkeypox infection. Our hypothesis states that the chickenpox skin lesion provides an entry site for the monkeypox virus, which is harbored on a fomite in the environment of the patient. The fact that monkeypox can enter via a scratch or abrasion is a known mechanism of spread for three other poxviruses, including mousepox (ectromelia), orf and molluscum contagiosum. There are many similarities in pathogenesis between certain poxviruses and chickenpox, including a viremia with a cellular stress response leading to high levels of the IL-6 cytokine. One very revealing observation in the two epidemiology studies was that the number of pox as well as the severity of disease in children with chickenpox and monkeypox coinfection was not greater than found in children with monkeypox alone. Based on the above observations, we conclude that, when chickenpox precedes monkeypox, priming of the immune system by the earlier chickenpox infection moderates the severity of the secondary infection with monkeypox. This conclusion also has important public health implications about chickenpox surveillance.
format Online
Article
Text
id pubmed-9781582
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-97815822022-12-24 Reassessment of Evidence about Coinfection of Chickenpox and Monkeypox (Mpox) in African Children Khallafallah, Ola Grose, Charles Viruses Review In west and central Africa, monkeypox occurs mainly in older children, adolescents and young adults. In two large epidemiology studies of monkeypox outbreaks, the investigators observed a sizable number of coinfections of chickenpox (varicella) and monkeypox. Based on a review of the literature, we propose that chickenpox (human herpesvirus-3 infection) is a risk factor for acquisition of monkeypox infection. Our hypothesis states that the chickenpox skin lesion provides an entry site for the monkeypox virus, which is harbored on a fomite in the environment of the patient. The fact that monkeypox can enter via a scratch or abrasion is a known mechanism of spread for three other poxviruses, including mousepox (ectromelia), orf and molluscum contagiosum. There are many similarities in pathogenesis between certain poxviruses and chickenpox, including a viremia with a cellular stress response leading to high levels of the IL-6 cytokine. One very revealing observation in the two epidemiology studies was that the number of pox as well as the severity of disease in children with chickenpox and monkeypox coinfection was not greater than found in children with monkeypox alone. Based on the above observations, we conclude that, when chickenpox precedes monkeypox, priming of the immune system by the earlier chickenpox infection moderates the severity of the secondary infection with monkeypox. This conclusion also has important public health implications about chickenpox surveillance. MDPI 2022-12-15 /pmc/articles/PMC9781582/ /pubmed/36560805 http://dx.doi.org/10.3390/v14122800 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Khallafallah, Ola
Grose, Charles
Reassessment of Evidence about Coinfection of Chickenpox and Monkeypox (Mpox) in African Children
title Reassessment of Evidence about Coinfection of Chickenpox and Monkeypox (Mpox) in African Children
title_full Reassessment of Evidence about Coinfection of Chickenpox and Monkeypox (Mpox) in African Children
title_fullStr Reassessment of Evidence about Coinfection of Chickenpox and Monkeypox (Mpox) in African Children
title_full_unstemmed Reassessment of Evidence about Coinfection of Chickenpox and Monkeypox (Mpox) in African Children
title_short Reassessment of Evidence about Coinfection of Chickenpox and Monkeypox (Mpox) in African Children
title_sort reassessment of evidence about coinfection of chickenpox and monkeypox (mpox) in african children
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9781582/
https://www.ncbi.nlm.nih.gov/pubmed/36560805
http://dx.doi.org/10.3390/v14122800
work_keys_str_mv AT khallafallahola reassessmentofevidenceaboutcoinfectionofchickenpoxandmonkeypoxmpoxinafricanchildren
AT grosecharles reassessmentofevidenceaboutcoinfectionofchickenpoxandmonkeypoxmpoxinafricanchildren