Transmission dynamics of Monkeypox virus: a mathematical modelling approach

Monkeypox (MPX), similar to both smallpox and cowpox, is caused by the monkeypox virus (MPXV). It occurs mostly in remote Central and West African communities, close to tropical rain forests. It is caused by the monkeypox virus in the Poxviridae family, which belongs to the genus Orthopoxvirus. We develop and analyse a deterministic mathematical model for the monkeypox virus. Both local and global asymptotic stability conditions for disease-free and endemic equilibria are determined.
It is shown that the model undergo backward bifurcation, where the locally stable disease-free equilibrium co-exists with an endemic equilibrium. Furthermore, we determine conditions under which the disease-free equilibrium of the model is globally asymptotically stable. Finally, numerical simulations to demonstrate our findings and brief discussions are provided. The findings indicate that isolation of infected individuals in the human population helps to reduce disease transmission.

Monkeypox

Monkeypox virus was first isolated and identified in 1958 when monkeys shipped from Singapore to a Denmark research facility fell ill. However, the first confirmed human case was in 1970 when the virus was isolated from a child in the Democratic Republic of Congo suspected to have smallpox.
Coincident immunity to monkeypox virus was previously achieved with vaccinia vaccination; however, eradicating smallpox and subsequent lack of vaccination efforts paved the way for monkeypox to gain clinical relevance. Furthermore, because most cases of monkeypox occur in rural Africa, suspected underreporting may translate to an underestimation of the potential threat of this pathogen.

Family cluster of three cases of monkeypox imported from Nigeria to the United Kingdom

Most reported cases of human monkeypox occur in Central and West Africa, where the causing virus is endemic. We describe the identification and public health response to an imported case of West African monkeypox from Nigeria to the United Kingdom (UK) in May 2021. Secondary transmission from the index case occurred within the family to another adult and a toddler. Concurrent COVID-19-related control measures upon arrival and at the hospital, facilitated detection and limited the number of potential contacts.

Misinformation making a disease outbreak worse: outcomes compared for influenza, monkeypox, and norovirus

Health misinformation can exacerbate infectious disease outbreaks. Especially pernicious advice could be classified as “fake news”: manufactured with no respect for accuracy and often integrated with emotive or conspiracy-framed narratives. We built an agent-based model that simulated separate but linked circulating contagious disease and sharing of health advice (classified as useful or harmful). Such advice has potential to influence human risk-taking behavior and therefore the risk of acquiring infection, especially as people are more likely in observed social networks to share bad advice.
We test strategies proposed in the recent literature for countering misinformation. Reducing harmful advice from 50% to 40% of circulating information, or making at least 20% of the population unable to share or believe harmful advice, mitigated the influence of bad advice in the disease outbreak outcomes. How feasible it is to try to make people “immune” to misinformation or control the spread of harmful advice should be explored.

The genomic history of human monkeypox infections in the Central African Republic between 2001 and 2018

Monkeypox is an emerging infectious disease, which has a clinical presentation similar to smallpox. In the two past decades, Central Africa has seen an increase in the frequency of cases, with many monkeypox virus (MPXV) isolates detected in the Democratic Republic of Congo (DRC) and the Central African Republic (CAR). To date, no complete MPXV viral genome has been published from the human cases identified in the CAR. The objective of this study was to sequence the full genome of 10 MPXV isolates collected during the CAR epidemics between 2001 and 2018 in order to determine their phylogenetic relationships among MPXV lineages previously described in Central Africa and West Africa.
Our phylogenetic results indicate that the 10 CAR isolates belong to three lineages closely related to those found in DRC. The phylogenetic pattern shows that all of them emerged in the rainforest block of the Congo Basin. Since most human index cases in CAR occurred at the northern edge of western and eastern rainforests, transmissions from wild animals living in the rainforest is the most probable hypothesis.
In addition, molecular dating estimates suggest that periods of intense political instability resulting in population movements within the country often associated also with increased poverty may have led to more frequent contact with host wild animals. The CAR socio-economic situation, armed conflicts and ecological disturbances will likely incite populations to interact more and more with wild animals and thus increase the risk of zoonotic spillover.

Reemergence of Human Monkeypox and Declining Population Immunity in the Context of Urbanization

A monkeypox outbreak in Nigeria during 2017-2020 provides an illustrative case study for emerging zoonoses. We built a statistical model to simulate declining immunity from monkeypox at 2 levels: At the individual level, we used a constant rate of decline in immunity of 1.29% per year as smallpox vaccination rates fell. At the population level, the cohort of vaccinated residents decreased over time because of deaths and births. By 2016, only 10.1% of the total population in Nigeria was vaccinated against smallpox; the serologic immunity level was 25.7% among vaccinated persons and 2.6% in the overall population.
The substantial resurgence of monkeypox in Nigeria in 2017 appears to have been driven by a combination of population growth, accumulation of unvaccinated cohorts, and decline in smallpox vaccine immunity. The expanding unvaccinated population means that entire households, not just children, are now more susceptible to monkeypox, increasing risk of human-to-human transmission.

Pharmacokinetics and Efficacy of a Potential Smallpox Therapeutic, Brincidofovir, in a Lethal Monkeypox Virus Animal Model

Smallpox, caused by Variola virus (VARV), was eradicated in 1980; however, VARV bioterrorist threats still exist, necessitating readily available therapeutics. Current preparedness activities recognize the importance of oral antivirals and recommend therapeutics with different mechanisms of action. Monkeypox virus (MPXV) is closely related to VARV, causing a highly similar clinical human disease, and can be used as a surrogate for smallpox antiviral testing. The prairie dog MPXV model has been characterized and used to study the efficacy of antipoxvirus therapeutics, including recently approved TPOXX (tecovirimat). Brincidofovir (BCV; CMX001) has shown antiviral activity against double-stranded DNA viruses, including poxviruses.
To determine the exposure of BCV following oral administration to prairie dogs, a pharmacokinetics (PK) study was performed. Analysis of BCV plasma concentrations indicated variability, conceivably due to the outbred nature of the animals. To determine BCV efficacy in the MPXV prairie dog model, groups of animals were intranasally challenged with 9 × 105 plaque-forming units (PFU; 90% lethal dose [LD90]) of MPXV on inoculation day 0 (ID0). Animals were divided into groups based on the first day of BCV treatment relative to inoculation day (ID-1, ID0, or ID1). A trend in efficacy was noted dependent upon treatment initiation (57% on ID-1, 43% on ID0, and 29% on ID1) but was lower than demonstrated in other animal models. Analysis of the PK data indicated that BCV plasma exposure (maximum concentration [C max]) and the time of the last quantifiable concentration (AUClast) were lower than in other animal models administered the same doses, indicating that suboptimal BCV exposure may explain the lower protective effect on survival.

Human Monkeypox Virus IgG (MPXV IgG) ELISA Kit

abx092187-100l Abbexa 100 µl 525 EUR

Human Monkeypox Virus IgG (MPXV IgG) ELISA Kit

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Human Monkeypox Virus IgG (MPXV IgG) ELISA Kit

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Human Monkeypox Virus IgG (MPXV IgG) ELISA Kit

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Monkeypox Virus -MPXV- IgG ELISA Kit

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Monkeypox Virus -MPXV- IgG ELISA Kit

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Monkeypox Virus -MPXV- IgG ELISA Kit

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Monkeypox Virus -MPXV- IgG ELISA Kit

E-EL-E620-96Tests10 Elabscience Biotech 96 Tests *10 5000 EUR

Monkeypox Virus -MPXV- IgG ELISA Kit

E-EL-E620-96Tests5 Elabscience Biotech 96 Tests *5 2500 EUR

Human Monkeypox Virus M1R IgG (MPXV M1R IgG) ELISA Kit

abx395182-100g Abbexa 100 µg 812.5 EUR

Human Monkeypox Virus H3L IgG (MPXV H3L IgG) ELISA Kit

abx395183-25g Abbexa 25 µg 812.5 EUR

Human Monkeypox Virus E8L IgG (MPXV E8L IgG) ELISA Kit

abx395184-50g Abbexa 50 µg 812.5 EUR

Human Monkeypox Virus A29L IgG (MPXV A29L IgG) ELISA Kit

abx395181-50g Abbexa 50 µg 812.5 EUR

Human Monkeypox Virus A35R IgG (MPXV A35R IgG) ELISA Kit

abx395185-100g Abbexa 100 µg 812.5 EUR

Human Monkeypox Virus IgG/IgM (MPXV IgG/IgM) Rapid Test Kit

abx092183-100l Abbexa 100 µl 1000 EUR

Human Monkeypox Virus IgG/IgM (MPXV IgG/IgM) Rapid Test Kit

abx092183-1ml Abbexa 1 ml 12000 EUR

Human Monkeypox Virus IgG/IgM (MPXV IgG/IgM) Rapid Test Kit

abx092183-200l Abbexa 200 µl 3500 EUR

Monkeypox B5R

mpv-002 ProSpec Tany 100µg 200 EUR

Monkeypox A33R

mpv-001 ProSpec Tany 100µg 200 EUR

Monkeypox virus

Oneq-VH747-OneqVH747100D Bioingentech Oneq-VH747-100D 515 EUR

Monkeypox virus

Oneq-VH747-OneqVH747150D Bioingentech Oneq-VH747-150D 594 EUR

Monkeypox virus

Oneq-VH747-OneqVH74750D Bioingentech Oneq-VH747-50D 413 EUR

Recombinant Monkeypox Virus antigen

E41H094 EnoGene 100ug 495 EUR

Recombinant Monkeypox Virus antigen

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Mouse Anti Monkeypox Virus E8L Monoclonal Clone SAA0285

IMSAMPXVE8LSAA0285C100UG Innovative research each 354 EUR

Mouse Anti Monkeypox Virus E8L Monoclonal Clone SAA0285

IMSAMPXVE8LSAA0285C1MG Innovative research each 1417 EUR

Mouse Anti Monkeypox Virus H3L Monoclonal Clone SAA0282

IMSAMPXVH3LSAA0282C100UG Innovative research each 354 EUR

Mouse Anti Monkeypox Virus H3L Monoclonal Clone SAA0282

IMSAMPXVH3LSAA0282C1MG Innovative research each 1417 EUR

Mouse Anti Monkeypox Virus M1R Monoclonal Clone SAA0283

IMSAMPXVM1RSAA0283C100UG Innovative research each 354 EUR

Mouse Anti Monkeypox Virus M1R Monoclonal Clone SAA0283

IMSAMPXVM1RSAA0283C1MG Innovative research each 1417 EUR

Mouse Anti Monkeypox Virus M1R Monoclonal Clone SAA0284

IMSAMPXVM1RSAA0284C100UG Innovative research each 354 EUR

Mouse Anti Monkeypox Virus M1R Monoclonal Clone SAA0284

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Mouse Anti Monkeypox Virus A29L Monoclonal Clone SAA0286

IMSAMPXVA29LSAA0286C100UG Innovative research each 354 EUR

Mouse Anti Monkeypox Virus A29L Monoclonal Clone SAA0286

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Mouse Anti Monkeypox Virus A35R Monoclonal Clone SAA0287

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Monkeypox Virus H3L (MPXV H3L) Antibody

abx376562-96tests Abbexa 96 tests 368.75 EUR

Monkeypox Virus M1R (MPXV M1R) Antibody

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Monkeypox Virus M1R (MPXV M1R) Antibody

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MonkeyPox Virus (MPV) ELISA Kit

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MonkeyPox Virus (MPV) ELISA Kit

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Monkeypox Virus A29L (MPXV A29L) Antibody

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Monkeypox Virus A29L (MPXV A29L) Antibody

abx345842-100l Abbexa 100 µl 350 EUR

Monkeypox Virus A29L (MPXV A29L) Antibody

abx345842-50l Abbexa 50 µl 250 EUR

Monkeypox Virus Real Time PCR Kit

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Monkeypox Virus Real Time PCR Kit

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Monkeypox Virus Real Time PCR Kit

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Monkeypox Virus (MPXV) RT-PCR Kit

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Monkeypox Virus (MPXV) RT-PCR Kit

abx471001-96tests Abbexa 96 tests 2550 EUR

Monkeypox Virus (MPXV) E8L ELISA Kit

RK04609 Abclonal 96T 280 EUR

Monkeypox virus (MPXV) E8L Rabbit mAb

A23087 Abclonal 500μL 1557.4 EUR

Human Monkeypox Virus Antigen (MPXV) ELISA Kit

abx365123-100g Abbexa 100 µg 618.75 EUR

Monkeypox Virus E8L (MPXV_USA_2022_MA001), mFc Tag

E24PVA019 EnoGene 50 μg 262 EUR

Monkeypox Virus P4a (MPXV P4a) Protein

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Monkeypox Virus P4a (MPXV P4a) Protein

abx160093-10g Abbexa 10 µg 2325 EUR

Monkeypox Virus P4a (MPXV P4a) Protein

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Monkeypox Virus B5R (MPXV B5R) Protein

abx620096-100g Abbexa 100 µg 350 EUR

Monkeypox Virus B5R (MPXV B5R) Protein

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Monkeypox Virus B5R (MPXV B5R) Protein

abx620096-200g Abbexa 200 µg 1350 EUR

Monkeypox Virus H3L (MPXV H3L) Protein

abx620102-100g Abbexa 100 µg 350 EUR

Monkeypox Virus H3L (MPXV H3L) Protein

abx620102-1mg Abbexa 1 mg Ask for price

Monkeypox Virus H3L (MPXV H3L) Protein

abx620102-200g Abbexa 200 µg 1350 EUR

Monkeypox Virus M1R (MPXV M1R) Protein

abx620108-100g Abbexa 100 µg 400 EUR

Monkeypox Virus M1R (MPXV M1R) Protein

abx620108-1mg Abbexa 1 mg Ask for price

Monkeypox Virus M1R (MPXV M1R) Protein

abx620108-200g Abbexa 200 µg 1600 EUR

Monkeypox Virus H3L (MPXV H3L) Protein

abx620112-100g Abbexa 100 µg 400 EUR

Monkeypox Virus H3L (MPXV H3L) Protein

abx620112-1mg Abbexa 1 mg Ask for price

Monkeypox Virus H3L (MPXV H3L) Protein

abx620112-200g Abbexa 200 µg 1600 EUR

Monkeypox Virus M1R (MPXV M1R) Protein

abx620116-100g Abbexa 100 µg 350 EUR

Monkeypox Virus M1R (MPXV M1R) Protein

abx620116-1mg Abbexa 1 mg Ask for price

Monkeypox Virus M1R (MPXV M1R) Protein

abx620116-200g Abbexa 200 µg 1350 EUR

Monkeypox Virus F3L (MPXV F3L) Protein

abx620121-100g Abbexa 100 µg 350 EUR

Monkeypox Virus F3L (MPXV F3L) Protein

abx620121-1mg Abbexa 1 mg Ask for price

Monkeypox Virus F3L (MPXV F3L) Protein

abx620121-200g Abbexa 200 µg 1350 EUR

Monkeypox Virus L1R (MPXV L1R) Protein

abx620122-100g Abbexa 100 µg 350 EUR

Monkeypox Virus L1R (MPXV L1R) Protein

abx620122-1mg Abbexa 1 mg Ask for price

Monkeypox Virus L1R (MPXV L1R) Protein

abx620122-200g Abbexa 200 µg 1350 EUR

Recombinant Monkeypox virus A29 Protein

RP01543 Abclonal 100μg 146.25 EUR

Recombinant Monkeypox virus L1R Protein

RP01544 Abclonal 500μg 58.5 EUR

Recombinant Monkeypox virus A29 Protein

RP01546 Abclonal 50μg 58.5 EUR

Recombinant Monkeypox virus D6L Protein

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Rabbit Anti Monkeypox Virus A30L Polyclonal Antigen Affinity Purified

IRBAMPXVA30LAAP100UG Innovative research each 296 EUR

Rabbit Anti Monkeypox Virus B6R Polyclonal Antigen Affinity Purified

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PCR detection kit for Monkeypox Virus

DA1430 Daan Gene 24 test/kit 129.6 EUR

Recombinant Monkeypox virus A30L Protein

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Recombinant Monkeypox virus B16R Protein

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Monkeypox Virus A33R (MPXV A33R) Protein

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Monkeypox Virus A33R (MPXV A33R) Protein

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Monkeypox Virus A33R (MPXV A33R) Protein

abx620095-200g Abbexa 200 µg 1350 EUR

Monkeypox Virus D13L (MPXV D13L) Protein

abx620099-100g Abbexa 100 µg 350 EUR

Monkeypox Virus D13L (MPXV D13L) Protein

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Monkeypox Virus D13L (MPXV D13L) Protein

abx620099-200g Abbexa 200 µg 1350 EUR

Monkeypox Virus A44R (MPXV A44R) Protein

abx620101-100g Abbexa 100 µg 350 EUR

Monkeypox Virus A44R (MPXV A44R) Protein

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Monkeypox Virus A44R (MPXV A44R) Protein

abx620101-200g Abbexa 200 µg 1350 EUR

Monkeypox Virus A26L (MPXV A26L) Protein

abx620104-100g Abbexa 100 µg 350 EUR

Monkeypox Virus A26L (MPXV A26L) Protein

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Monkeypox Virus A26L (MPXV A26L) Protein

abx620104-200g Abbexa 200 µg 1350 EUR

Monkeypox Virus A27L (MPXV A27L) Protein

abx620105-100g Abbexa 100 µg 350 EUR

Monkeypox Virus A27L (MPXV A27L) Protein

abx620105-1mg Abbexa 1 mg Ask for price

Monkeypox Virus A27L (MPXV A27L) Protein

abx620105-200g Abbexa 200 µg 1350 EUR

Monkeypox Virus A29L (MPXV A29L) Protein

abx620109-100g Abbexa 100 µg 400 EUR

Monkeypox Virus A29L (MPXV A29L) Protein

abx620109-1mg Abbexa 1 mg Ask for price

Monkeypox Virus A29L (MPXV A29L) Protein

abx620109-200g Abbexa 200 µg 1600 EUR

Monkeypox Virus D14L (MPXV D14L) Protein

abx620111-100g Abbexa 100 µg 400 EUR

Monkeypox Virus D14L (MPXV D14L) Protein

abx620111-1mg Abbexa 1 mg Ask for price

Monkeypox Virus D14L (MPXV D14L) Protein

abx620111-200g Abbexa 200 µg 1600 EUR

Monkeypox Virus A29L (MPXV A29L) Protein

abx620117-100g Abbexa 100 µg 350 EUR

Monkeypox Virus A29L (MPXV A29L) Protein

abx620117-1mg Abbexa 1 mg Ask for price

Monkeypox Virus A29L (MPXV A29L) Protein

abx620117-200g Abbexa 200 µg 1350 EUR

Monkeypox Virus D14L (MPXV D14L) Protein

abx620119-100g Abbexa 100 µg 350 EUR

Monkeypox Virus D14L (MPXV D14L) Protein

abx620119-1mg Abbexa 1 mg Ask for price

Monkeypox Virus D14L (MPXV D14L) Protein

abx620119-200g Abbexa 200 µg 1350 EUR

Monkeypox Virus A14L (MPXV A14L) Protein

abx620120-100g Abbexa 100 µg 350 EUR

Monkeypox Virus A14L (MPXV A14L) Protein

abx620120-1mg Abbexa 1 mg Ask for price

Monkeypox Virus A14L (MPXV A14L) Protein

abx620120-200g Abbexa 200 µg 1350 EUR

Monkeypox Virus A29L (MPXV A29L) Protein

abx645001-100g Abbexa 100 µg 600 EUR

Monkeypox Virus A29L (MPXV A29L) Protein

abx645001-1mg Abbexa 1 mg Ask for price

Monkeypox Virus A29L (MPXV A29L) Protein

abx645001-200g Abbexa 200 µg Ask for price

Dynamiker Monkeypox Virus Ag Rapid Test

DNK-2114-1 Dynamiker Biotechnology 20 tests 702 EUR

Monkeypox-C19L-protein(C-His-tag)

EGPS018D-50 EnoGene Monkeypox 206.5 EUR

Human Monkeypox Virus Antigen (MPXV) Rapid Test Kit

abx092162-100l Abbexa 100 µl 1000 EUR

Human Monkeypox Virus Antigen (MPXV) Rapid Test Kit

abx092162-1ml Abbexa 1 ml 12000 EUR

Human Monkeypox Virus Antigen (MPXV) Rapid Test Kit

abx092162-200l Abbexa 200 µl 3500 EUR

Recombinant Monkeypox Virus M1R Protein [His]

DAG-WT758 Creative Diagnostics 1 mg 900 EUR

Recombinant Monkeypox Virus B6R Protein [His]

DAG-WT761 Creative Diagnostics 1 mg 900 EUR

Recombinant Monkeypox Virus B6R Protein [His]

DAG-WT773 Creative Diagnostics 1 mg 1600 EUR

Recombinant Monkeypox Virus H3L Protein [His]

DAG-WT776 Creative Diagnostics 1 mg 1200 EUR

Recombinant Monkeypox Virus M1R Protein [His]

DAG-WT779 Creative Diagnostics 1 mg 1600 EUR

Recombinant Monkeypox Virus A29L Protein [His]

DAG-WT759 Creative Diagnostics 1 mg 900 EUR

Recombinant Monkeypox Virus A35R Protein [His]

DAG-WT760 Creative Diagnostics 1 mg 900 EUR

Monkeypox Virus Hemagglutinin (MPXV B2R) Protein

abx620100-100g Abbexa 100 µg 350 EUR

Monkeypox Virus Hemagglutinin (MPXV B2R) Protein

abx620100-1mg Abbexa 1 mg Ask for price

Monkeypox Virus Hemagglutinin (MPXV B2R) Protein

abx620100-200g Abbexa 200 µg 1350 EUR

Monkeypox Virus Hemagglutinin (MPXV B2R) Protein

abx620113-100g Abbexa 100 µg 400 EUR

Monkeypox Virus Hemagglutinin (MPXV B2R) Protein

abx620113-1mg Abbexa 1 mg Ask for price

Monkeypox Virus Hemagglutinin (MPXV B2R) Protein

abx620113-200g Abbexa 200 µg 1600 EUR

Human Monkeypox Virus IgM (MPXV IgM) ELISA Kit

abx392299-100g Abbexa 100 µg 593.75 EUR

Human Monkeypox Virus M1R (MPXV M1R) ELISA Kit

abx395187-50g Abbexa 50 µg 812.5 EUR

Human Monkeypox Virus H3L (MPXV H3L) ELISA Kit

abx395188-1mg Abbexa 1 mg 812.5 EUR

Human Monkeypox Virus E8L (MPXV E8L) ELISA Kit

abx395189-1mg Abbexa 1 mg 812.5 EUR

Human Monkeypox Virus A29L (MPXV A29L) ELISA Kit

abx395186-50g Abbexa 50 µg 812.5 EUR

Human Monkeypox Virus A35R (MPXV A35R) ELISA Kit

abx395190-1mg Abbexa 1 mg 812.5 EUR

Recombinant Monkeypox virus A33R protein (His tag)

PDEV100007-100ug Elabscience Biotech 100ug 118 EUR

Recombinant Monkeypox virus A33R protein (His tag)

PDEV100007-20ug Elabscience Biotech 20ug 68 EUR

Recombinant Monkeypox Virus Chimeric Protein (B21R&A29L)

DAG-WT764 Creative Diagnostics 1 mg 950 EUR

Recombinant Monkeypox virus A26L protein (His,SUMO tag)

PDEV100008-100ug Elabscience Biotech 100ug 118 EUR

Recombinant Monkeypox virus A26L protein (His,SUMO tag)

PDEV100008-20ug Elabscience Biotech 20ug 68 EUR

Recombinant Monkeypox virus MPXV(A29L) protein (His tag)

PDEV100009-100ug Elabscience Biotech 100ug 118 EUR

Recombinant Monkeypox virus MPXV(A29L) protein (His tag)

PDEV100009-20ug Elabscience Biotech 20ug 68 EUR

Monkeypox Virus A5L and A11L (MPXV A5L-A11L) Protein

abx160091-100g Abbexa 100 µg Ask for price

Monkeypox Virus A5L and A11L (MPXV A5L-A11L) Protein

abx160091-10g Abbexa 10 µg 2325 EUR

Monkeypox Virus A5L and A11L (MPXV A5L-A11L) Protein

abx160091-50g Abbexa 50 µg Ask for price

Monkeypox Virus Envelope Protein F13 (MPXV C19L) Protein

abx620098-100g Abbexa 100 µg 350 EUR

Monkeypox Virus Envelope Protein F13 (MPXV C19L) Protein

abx620098-1mg Abbexa 1 mg Ask for price
IMPORTANCE Preparedness activities against highly transmissible viruses with high mortality rates have been highlighted during the ongoing coronavirus disease 2019 (COVID-19) pandemic. Smallpox, caused by variola virus (VARV) infection, is highly transmissible, with an estimated 30% mortality. Through an intensive vaccination campaign, smallpox was declared eradicated in 1980, and routine smallpox vaccination of individuals ceased. Today’s current population has little/no immunity against VARV. If smallpox were to reemerge, the worldwide results would be devastating.
Recent FDA approval of one smallpox antiviral (tecovirimat) was a successful step in biothreat preparedness; however, orthopoxviruses can become resistant to treatment, suggesting the need for multiple therapeutics. Our paper details the efficacy of the investigational smallpox drug brincidofovir in a monkeypox virus (MPXV) animal model. Since brincidofovir has not been tested in vivo against smallpox, studies with the related virus MPXV are critical in understanding whether it would be protective in the event of a smallpox outbreak.

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