An Overview of Monkeypox Virus and Other Medically Important Poxviruses
Creators
- 1. Department of Medical Microbiology, Gulhane Medical Faculty, University of Health Sciences, Ankara, Türkiye.
- 2. Medical Microbiology Laboratory, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Türkiye.
Description
Özet
Çiçek hastalığı tarihin ilk dönemlerinden beri neden olduğu büyük salgınlar ve yıkım (ölümler) ile insanlık hafızasında derin izler bırakmıştır. Çiçek hastalığı etkeni olan variola virus ve aynı ailede yer alan virüslerden bazıları bilim ve tıp dünyasında birçok sıra dışı değişimin bir parçası olmuştur. Kadim uygarlıklarda aşılamanın ilk örnekleri (variyolasyon), insanlarda kullanılmak üzere geliştirilen ilk güvenli aşılar (sığır çiçeği virusu, vaccinia virus), viral patogenezin ilk enfeksiyon modeli (ectromelia virus) ve dünya genelinde eradike edilen ilk insan enfeksiyonunun (çiçek virusu) poksviruslar olması bu virüsleri bilim dünyasında ayrıcalıklı bir yerde tutmaktadır. Çiçek virusu (variola major) yüksek mortaliteli enfeksiyonlara ve salgınlara neden olması ile biyolojik savaş ajanı olarak sınıflandırılmakta (kategori A) ve dünya genelinde bir endişe kaynağı olmaya devam etmektedir. Bu virüsler çeşitli biyolojik özellikleri ile de benzersizdir. İnsan enfeksiyonları ile ilişkili en büyük virüslerden olan poksviruslar çok sayıda protein kodlamaları, diğer DNA virüslerinden farklı olarak başlıca hücre sitoplazmasında replike olmaları ve sahip oldukları diğer avantajlı özellikleri ile aşı geliştirme ve vektör temelli tedavi çalışmalarında elverişli bir model olarak yaygın bir şekilde kullanılmaktadır. Poksvirusların 10’dan fazla türü insanlarda enfeksiyonlara neden olmaktadır ve sadece insanlardan izole edilen birkaç türü dışında bu virüsler genel olarak zoonotik enfeksiyonlar ile ilişkilidir. Bu türlerden biri olan maymun çiçeği virusu (monkeypox virus, MPXV) çiçek aşısı kaynaklı muhtemel çapraz bağışıklık nedeniyle geçmiş dönemlerde insanlık için bir tehdit olmaktan uzak görülmüştür. Bununla beraber, 1970'lerin başlarında Orta ve Batı Afrika’da raporlanan lokal maymun çiçeği olgularının yerini, 2000’li yıllarda Amerika’daki ve Sudan’daki küçük ölçekli salgınlar almış ve sonraki dönemlerde başta Demokratik Kongo Cumhuriyeti ve Nijerya olmak üzere Afrika ülkelerinde sürekli artan bir şekilde olgu bildirimlerinin yapılması ile bu virüs çiçek virusunun eradikasyonundan sonra Poxviridae ailesinin en önemli türü olarak görülmeye başlanmıştır. Hayvan rezervuarları ile temas olasılığını artıran epidemiyolojik değişikliklerin yanı sıra, çiçek aşısı olmamış nüfusun giderek artan oranı ile yeni ve beklenmedik bulaş paterni insan maymun çiçeği enfeksiyonlarının yoğunlaşmaya devam edebileceğini göstermektedir. Son günlerde birçok ülke ve sağlık otoriteleri maymun çiçeği virusu ve çiçek virusu ile ilgili mevcut ve olası riskleri yeniden değerlendirirken, bazı ülkeler salgın olasılığı ve biyogüvenlik risklerine karşı çeşitli önlemler almaya başladılar. Bu makalenin temel amacı, poksvirus türlerinin genel biyolojik özelliklerini ele almak, konakçı dağılımlarını incelemek ve insan enfeksiyonlarıyla ilişkili poksvirus türlerine atfedilen risklere genel bir bakış sunmaktır.
Abstract
Since the earliest times of history, smallpox left deep traces in the memory of humanity with the great epidemics and destruction (deaths) it caused. Variola virus, which is the causative agent of smallpox, and some other viruses in the same family have been a part of many extraordinary changes in the field of science and medicine. Poxviruses have a privileged position in the scientific world due to the fact that the first examples of immunization (variolation) in ancient civilizations, the first safe vaccines developed for use in humans (cowpox virus, vaccinia virus), first infection model of viral pathogenesis (ectromelia virus), and the first human infection eradicated globally (smallpox). Smallpox virus (variola major) is classified as a biological warfare agent (category A), causing high-mortality infections and epidemics, and remains a worldwide concern. These viruses are also unique with their various biological features. Poxviruses, one of the largest viruses associated with human infections, are widely used as a convenient model in vaccine development and vector-based treatment studies, with large number of protein coding, ability to replicate primarily in the cell cytoplasm (unlike other DNA viruses), and their other advantageous features. More than 10 species of poxviruses cause infections in humans, and except for a few species that are only isolated from humans, these viruses are generally associated with zoonotic infections. Monkeypox virus (MPXV), one of these species, was regarded far from being a threat to humanity in the past due to possible cross-immunity caused by smallpox vaccine. However, local monkeypox cases reported in Central and West Africa in the early 1970s were replaced by small-scale outbreaks in the United States and Sudan in the 2000s, and in the following periods, this virus is considered to be the most important species of the Poxviridae family after the eradication of smallpox virus due to the increasing number of case reports in African countries, especially in the Democratic Republic of Congo and Nigeria. In addition to epidemiological changes that increase the risk of contact with animal reservoirs, the growing proportion of the unvaccinated population and the new and unexpected transmission pattern indicate that human monkeypox infections may continue to intensify. In recent days, while many countries and health authorities have been re-evaluating the existing and potential risks related to monkeypox virus and smallpox virus, some countries have started to take various measures against the possibility of epidemic and biosecurity risks. The main purpose of this article is to consider the general biological characteristics of poxvirus strains, to examine their host distribution, and to provide an overview of the risks attributed to poxvirus strains associated with human infections.
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