Monkeypox (mpox) in immunosuppressed patients [version 1; peer review: 3 approved with reservations]

• Published in: F1000 research 2023, Vol.12, p.127
• Main Authors: Ahmed, Sirwan Khalid, Mohamed, Mona Gamal, Rashad Dabou, Eman Abdelaziz Ahmed, Abuijlan, Israa, Chandran, Deepak, El-Shall, Nahed A., Chopra, Hitesh, Dhama, Kuldeep
• Format: Article
• Language: English
• Subjects: Aged; autoimmune disease; Child; COVID-19; eng; HIV Infections; human immunodeficiency virus; Humans; Immunocompromised Host; immunocompromised patients; Immunosuppression Therapy; management; monkeypox; Mpox (monkeypox); prevention; United States
• ISSN: 2046-1402; 2046-1402
• DOI: 10.12688/f1000research.130272.1

The World Health Assembly declared that smallpox had been completely eradicated from the human population in 1980. Monkeypox, a zoonosis native to damp forested regions in West and Central Africa, is the illness that is most comparable to smallpox clinically and immunologically. Both illnesses could be prevented by the smallpox vaccine. Although the monkeypox virus is a less effective human disease than the smallpox virus, it could now spread among human populations if smallpox had not been eradicated and population-wide immunity had not been developed. A health warning on severe monkeypox in people who are immunocompromised due to Human Immunodeficiency virus (HIV) and other illnesses was released by the U.S. Centers for Disease Control and Prevention (CDC) on September 29, 2022. The advise does not specifically include primary immunodeficiency, but it does define other immunocompromising disorders as "having autoimmune disease with immunodeficiency as a clinical component". The documented severe signs of monkeypox include widespread rashes with secondary fungal or bacterial skin infections or tissue death (necrosis), intestine obstruction, and difficulties with the heart, lungs, urinary system, and nervous system. Both those with healthy immune systems and those with weakened immune systems, such as those who are immunosuppressed, older people, children, etc., have encountered serious health issues, but the latter group is more likely to do so. According to the advisory, "of the people with severe monkeypox manifestations for whom CDC has been consulted, the majority have had HIV with CD4 counts 200 cells/ml, indicating substantial immunosuppression". The current article goes into great detail about monkeypox disease occurring in immunocompromised patients and preventive guidelines.