Features of the pathogenesis, epidemiology, diagnostics, approaches to the treatment and prevention of small pox, the current state of the problem in Ukraine and the world

Abstract

Introduction. Monkey pox is an anthropozoonous disease caused by orthopoxvirus, characterized by fever, general intoxication and skin rash, in some cases it can lead to fatal consequences; an infectious disease covered by international health regulations (IHR). The causative agent of the disease is classified as a biological agent - agent of a biological weapon. Most of the monkeypox cases associated with the 2022 outbreak are in the Western Hemisphere. Purpose: study of data on etiological, pathogenetic, epidemiological aspects, modern approaches to the diagnosis, treatment and prevention of monkeypox, the state of the problem in Ukraine and the world. Materials and methods: to perform the task, a review of publications was conducted in electronic databases of medical publications PubMed Medline of the US National Library of Medicine (NLM), Cochrane Database of Systematic Reviews, CDC (Centers for Disease Control and Prevention) website of the federal agency of the Ministry of Health USA. Results: The second generation ACAM2000 and third generation JYNNEOS™ monkeypox vaccines are currently available. Both vaccines are able to create immunity against monkeypox. Post-exposure vaccination can help prevent or reduce the severity of monkeypox. ACAM2000 is a single-dose vaccinia vaccine licensed by the FDA for the prevention of smallpox. Full immunity is achieved 4 weeks after vaccination. FDA expanded access to investigational protocol allows use of ACAM2000 for monkeypox immunization during an outbreak. The immunogenicity and protective efficacy of ACAM2000 is equivalent to that of the first generation Dryvax® smallpox vaccine. Smallpox vaccine virus is used as a live attenuated virus in the smallpox vaccine. Cases of encephalitis and Guillain-Barré syndrome following smallpox vaccination show that the incidence varies not only from place to place, but also from year to year in the same place. For the purposes of containment of the outbreak, prevention to reduce the risk of transmission from person to person, immediate detection of new cases and surveillance measures are necessary. Health care workers who provide care to patients with suspected or confirmed monkeypox who work with their specimens should use standard precautions to control infection. Specimens taken from animals or humans suspected of having monkeypox should be handled in equipped laboratories by trained personnel. According to WHO recommendations, samples taken from patients should be appropriately labeled, prepared for transportation using triple packaging. To prevent the further spread of monkeypox through the animal trade, captive animals potentially infected with smallpox must be isolated from other animals and quarantined for 30 days. Conclusions: 1.The monkeypox virus, which used to be endemic to certain regions of Africa, is now a global concern, with cases increasingly being reported in regions of the Western Hemisphere. 2. In connection with the fact that transmission from person to person most often occurs through airborne droplets or through direct contact with the mucous secretions of an infected person, social distancing and contact tracing are advisable. 3. In the last 6 months, cases of monkeypox have been confirmed among middle-aged people, which can be explained by the loss of cross-immunity from the smallpox vaccine. 4. The monkeypox virus multiplies in the cytoplasm and matures, creating primary viremia. Manifestations of a severe course of monkeypox are bronchopneumonia, respiratory distress syndrome, encephalitis, chorioretinal scars on the retina, etc. To minimize the risk of complications, it is advisable to provide timely treatment. 5. Medical organizations around the world are focused on understanding how cases of monkeypox are increasingly occurring in countries in the Western Hemisphere. 6. The study of etiotropic methods of treating monkey pox is promising.