Publications by authors named "Agam K Rao"

We report a case of mpox in a patient with a signal transducer and activator of transcription 1 gain-of-function mutation. Despite initial improvement with intravenous immune globulin and tecovirimat, severe symptoms developed and the patient died. This underscores the need for immune system optimization and effective virucidal treatments for mpox.

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Background: Borealpox virus (BRPV, formerly known as Alaskapox virus) is a zoonotic member of the Orthopoxvirus genus first identified in a person in 2015. In the six patients with infection previously observed BRPV involved mild, self-limiting illness. We report the first fatal BRPV infection in an immunosuppressed patient.

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The antiviral drug tecovirimat* has been used extensively to treat U.S. mpox cases since the start of a global outbreak in 2022.

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Background: During the ongoing outbreak of clade II (MPXV), many U.S. patients were prescribed tecovirimat, an antiviral drug that was made available under an expanded access Investigational New Drug (EA-IND) program.

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Article Synopsis
  • - Monkeypox virus (MPXV) can spread through direct contact with lesions, respiratory secretions, fomites, and even from the mother to fetus during pregnancy, leading to painful skin lesions in infected individuals.
  • - In 2021-2022, the CDC began investigating aircraft after reports of travelers with mpox, collecting data from a total of 113 infected individuals who traveled on 221 flights during their infectious period.
  • - Despite these investigations, no cases of mpox transmission were reported from flight exposures, suggesting air travel with an infected person poses minimal risk; however, the CDC still advises isolation for those infected and postponing travel until they are no longer contagious.
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Two doses of JYNNEOS vaccine are effective in preventing many mpox cases and can reduce the severity of symptoms in infected persons. However, infections among fully vaccinated persons can occur. During May 2022-May 2024, a total of 271 mpox cases among fully vaccinated persons were reported to CDC from 27 U.

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Clade I monkeypox virus (MPXV), which can cause severe illness in more people than clade II MPXVs, is endemic in the Democratic Republic of the Congo (DRC), but the country has experienced an increase in suspected cases during 2023-2024. In light of the 2022 global outbreak of clade II mpox, the increase in suspected clade I cases in DRC raises concerns that the virus could spread to other countries and underscores the importance of coordinated, urgent global action to support DRC's efforts to contain the virus. To date, no cases of clade I mpox have been detected outside of countries in Central Africa where the virus is endemic.

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Article Synopsis
  • In May 2023, an increase in mpox cases was observed in Chicago, primarily among fully vaccinated individuals, prompting an investigation into the outbreak's characteristics and causes.
  • Researchers assessed demographic and health data from patients, analyzed viral genomes, and evaluated the humoral antibody responses to understand vaccine effectiveness and potential compromises.
  • Of the 49 identified cases, 57% were fully vaccinated, with findings suggesting that increased exposure through higher median numbers of sexual partners was a key factor in the outbreak, despite overall vaccine effectiveness.
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Article Synopsis
  • The study examines the pathology and tissue involvement of the Monkeypox virus (MPXV) in severely ill or deceased patients, emphasizing its impact on immunocompromised individuals.
  • Researchers analyzed samples from 22 patients, finding extensive viral presence in tissues, including lesions in the digestive tract and lungs, along with various complications like necrosis and bronchopneumonia.
  • The findings highlight the prevalence of coinfections, the severe implications for treatment, and the need for improved biosafety protocols in medical settings dealing with mpox cases.
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Background: Rabies expert on demand (REOD) telehealth service is provided by the U.S. Centers for Disease Control and Prevention (CDC) to assist public health practitioners, health providers, and the public to interpret national and international rabies prevention guidelines.

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Article Synopsis
  • Orthopoxviruses, including the monkeypox virus (MPXV), have shown unpredictable patterns of illness and spread, first noted in the late 1950s among primates and later causing human cases in Africa since the 1970s.
  • In May 2022, a new MPXV outbreak emerged notably among gay, bisexual, and other men who have sex with men, marking a shift in transmission dynamics.
  • The article discusses prior knowledge of mpox, insights gained during the 2022 outbreak, and the ongoing research needed to enhance global health measures against this virus.
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Article Synopsis
  • - Since May 2022, mpox (monkeypox) has spread to 108 countries, predominantly affecting gay and bisexual men.
  • - Two studies conducted in mid-2022 revealed that 8% of men who have sex with men in San Francisco had orthopoxvirus antibodies, while approximately 5.6% of samples from across the U.S. tested positive for monkeypox.
  • - The findings suggest that there are likely very few undiagnosed mpox cases in areas with good sexual healthcare access and heightened awareness among patients and healthcare providers.
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Monkeypox (mpox) is a serious viral zoonosis endemic in west and central Africa. An unprecedented global outbreak was first detected in May 2022. CDC activated its emergency outbreak response on May 23, 2022, and the outbreak was declared a Public Health Emergency of International Concern on July 23, 2022, by the World Health Organization (WHO),* and a U.

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As of March 7, 2023, a total of 30,235 confirmed and probable monkeypox (mpox) cases were reported in the United States, predominantly among cisgender men who reported recent sexual contact with another man (1). Although most mpox cases during the current outbreak have been self-limited, cases of severe illness and death have been reported (2-4). During May 10, 2022-March 7, 2023, 38 deaths among persons with probable or confirmed mpox (1.

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Article Synopsis
  • - An 84-year-old man died from rabies six months after being bitten by a rabid bat, despite receiving timely post-exposure prophylaxis (PEP), prompting an investigation into the cause of this rare case.
  • - The investigation included reviewing medical records, conducting whole-genome sequencing, and analyzing the patient's immune response, revealing nonneutralizing rabies antibodies and an underlying unknown immune condition, which likely contributed to the infection.
  • - This case marks the first documented failure of rabies PEP using modern vaccines in the Western Hemisphere, highlighting the need for monitoring rabies antibody levels in patients with potential immune deficiencies after PEP completion.
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Article Synopsis
  • Monkeypox (mpox) is caused by the Monkeypox virus, part of the Orthopoxvirus family, and was notably highlighted during a global outbreak in 2022, mostly affecting men who have sex with men.
  • The CDC recommends supportive care for mpox, but severe cases can lead to serious complications, especially in individuals with weakened immune systems, such as those with advanced HIV.
  • Therapeutic options for severe mpox include FDA-regulated medical countermeasures developed for smallpox, and more research is needed to evaluate their effectiveness in treating mpox in humans.
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Post-exposure prophylaxis (PEP) for rabies is widely administered and highly effective. Nevertheless, sporadic breakthrough infections (ie, rabies in people who have started PEP) have been reported. We conducted a systematic review of articles published between Jan 1, 1980 and June 1, 2022 to characterise breakthrough infections.

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In late August 2021, a boy aged 7 years was bitten by a bat while he was playing outside his apartment home in Medina County, Texas. He informed his parents; however, no rabies postexposure prophylaxis (PEP) was sought because there were no visible bite marks, and the family was unaware that contact with a bat, including in the absence of visible bite marks, might cause rabies. Approximately 2 months later, the child was hospitalized for altered mental status, seizures, and hypersalivation and ultimately received a diagnosis of rabies.

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Data on monkeypox in children and adolescents aged <18 years are limited (1,2). During May 17–September 24, 2022, a total of 25,038 monkeypox cases were reported in the United States, primarily among adult gay, bisexual, and other men who have sex with men (3). During this period, CDC and U.

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Article Synopsis
  • * A CDC report analyzed 57 hospitalized monkeypox patients from August to October 2022, revealing that 82% had HIV, most were male (95%), and 68% were non-Hispanic Black; 30% needed ICU care, and 21% died due to severe symptoms.
  • * Health care providers are advised to test sexually active monkeypox patients for HIV and consider aggressive treatment for those who are severely immunocompromised
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