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Monkeypox outbreaks associated with human-to-human transmission outside endemic areas

Since May 2022, cases of monkeypox have increased globally, stirring fears of a new pandemic. A study published in the open-access journal PLOS Pathogens…

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Since May 2022, cases of monkeypox have increased globally, stirring fears of a new pandemic. A study published in the open-access journal PLOS Pathogens on September 22nd by Professor Souha Kanj and colleagues at the American University of Beirut Medical Center, Beirut, Lebanon, presents synthesized descriptions of its clinical characteristics, risk factors, infection control and prevention measures, as well as potential treatments.

Credit: Monstera, Pexels (CC0, https://creativecommons.org/publicdomain/zero/1.0/)

Since May 2022, cases of monkeypox have increased globally, stirring fears of a new pandemic. A study published in the open-access journal PLOS Pathogens on September 22nd by Professor Souha Kanj and colleagues at the American University of Beirut Medical Center, Beirut, Lebanon, presents synthesized descriptions of its clinical characteristics, risk factors, infection control and prevention measures, as well as potential treatments.

Historically, monkeypox was mostly confined to endemic areas in Western and Central Africa and was mostly transmitted through contact with infected animals. However, human-to-human transmission has recently become the primary mode of transmission, raising concerns for previous undetected community spread. To better understand the epidemiologic landscape of this emerging outbreak, the authors conducted a literature review of the available evidence on monkeypox. They found that during the current outbreak, confirmed, probable, and/or possible monkeypox cases have increased tenfold across more than seventy-six countries. The data suggest an increase in the disease incidence and possible improved surveillance. Current cases showed a rapid human-to-human transmission, raising concerns for rapid community spread, though not necessarily related to travel to endemic areas in Africa.

The literature review has several limitations, including the small sample size of case studies and the absence of randomized controlled trials on monkeypox therapy, both of which limit generalizability. Larger and more robust studies are needed to determine the specific risk factors, transmission modes, and potential therapeutics, as well as the scope of the current outbreak.

According to the authors, “Key gap information needs to be further studied to provide better answers such as the exact mode of transmission and the role of animal reservoirs. Sexual modes of transmission, genetic mutations, waning immunity from smallpox and previous undetected cases of monkeypox warrant further investigation. Doctors should also keep in mind the atypical presentations and rely on the WHO and CDC criteria to guide patients and help in containing outbreaks”.

Kanj and co-authors add, “Monkeypox has been declared as a public health emergency that warrants special attention and early diagnosis in view of its global widespread and atypical presentation.”

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In your coverage, please use this URL to provide access to the freely available article in PLOS Pathogens: http://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1010768

Citation: El Eid R, Allaw F, Haddad SF, Kanj SS (2022) Human monkeypox: A review of the literature. PLoS Pathog 18(9): e1010768. https://doi.org/10.1371/journal.ppat.1010768

Author Countries: Lebanon

Funding: The authors received no specific funding for this manuscript.


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We can turn to popular culture for lessons about how to live with COVID-19 as endemic

As COVID-19 transitions from a pandemic to an endemic, apocalyptic science-fiction and zombie movies contain examples of how to adjust to the new norm…

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An endemic means that COVID-19 is still around, but it no longer disrupts everyday life. (Shutterstock)

In 2021, conversations began on whether the COVID-19 pandemic will, or even can, end. As a literary and cultural theorist, I started looking for shifts in stories about pandemics and contagion. It turns out that several stories also question how and when a pandemic becomes endemic.


Read more: COVID will likely shift from pandemic to endemic — but what does that mean?


The 2020 film Peninsula, a sequel to the Korean zombie film, Train to Busan, ends with a group of survivors rescued and transported to a zombie-free Hong Kong. In it, Jooni (played by Re Lee) spent her formative years living through the zombie epidemic. When she is rescued, she responds to being informed that she’s “going to a better place” by admitting that “this place wasn’t bad either.”

Jooni’s response points toward the shift in contagion narratives that has emerged since the spread of COVID-19. This shift marks a rejection of the push-for-survival narratives in favour of something more indicative of an endemic.

Found within

Contagion follows a general cycle: outbreak, epidemic, pandemic and endemic. The determinants of each stage rely upon the rate of spread within a specified geographic region.

Etymologically, the word “endemic” has its origins with the Greek words én and dēmos, meaning “in the people.” Thus, it refers to something that is regularly found within a population.

Infectious disease physician Stephen Parodi asserts that an endemic just means that a disease, while still prevalent within a population, no longer disrupts our daily lives.

Similarly, genomics and viral evolution researcher Aris Katzourakis argues that endemics occur when infection rates are static — neither rising nor falling. Because this stasis occurs differently with each situation, there is no set threshold at which a pandemic becomes endemic.

Not all diseases reach endemic status. And, if endemic status is reached, it does not mean the virus is gone, but rather that things have become “normal.”

Survival narratives

We’re most likely familiar with contagion narratives. After all, Steven Soderbergh’s 2011 film Contagion, was the most watched film on Canadian Netflix in March 2020. Conveniently, this was when most Canadian provinces went into lockdown during the early stages of the COVID-19 pandemic.

A clip from the film Contagion showing the disease spreading throughout the world.

In survival-based contagion narratives, characters often discuss methods for survival and generally refer to themselves as survivors. Contagion chronicles the transmission of a deadly virus that is brought from Hong Kong to the United States. In response, the U.S. Centers for Disease Control is tasked with tracing its origins and finding a cure. The film follows Mitch Emhoff (Matt Damon), who is immune, as he tries to keep his daughter safe in a crumbling Minneapolis.

Ultimately, a vaccine is successfully synthesized, but only after millions have succumbed to the virus.

Like many science fiction and horror films that envision some sort of apocalyptic end, Contagion focuses on the basic requirements for survival: shelter, food, water and medicine.

However, it also deals with the breakdown of government systems and the violence that accompanies it.

A “new” normal

In contrast, contagion narratives that have turned endemic take place many years after the initial outbreak. In these stories, the infected population is regularly present, but the remaining uninfected population isn’t regularly infected.

A spin-off to the zombie series The Walking Dead takes place a decade after the initial outbreak. In the two seasons of The Walking Dead: World Beyond (2020-2021) four young protagonists — Hope (Alexa Mansour), Iris (Aliyah Royale), Silas (Hal Cumpston) and Elton (Nicolas Cantu) — represent the first generation to come of age within the zombie-infested world.

The four youth spent their formative years in an infected world — similar to Jooni in Peninsula. For these characters, zombies are part of their daily lives, and their constant presence is normalized.

The trailer for the second season of AMC’s The Walking Dead: World Beyond.

The setting in World Beyond has electricity, helicopters and modern medicine. Characters in endemic narratives have regular access to shelter, food, water and medicine, so they don’t need to resort to violence over limited resources. And notably, they also don’t often refer to themselves as survivors.

Endemic narratives acknowledge that existing within an infected space alongside a virus is not necessarily a bad thing, and that not all inhabitants within infected spaces desire to leave. It is rare in endemic narratives for a character to become infected.

Instead of going out on zombie-killing expeditions in the manner that occurs frequently in the other Walking Dead stories, the characters in World Beyond generally leave the zombies alone. They mark the zombies with different colours of spray-paint to chronicle what they call “migration patterns.”

The zombies have therefore just become another species for the characters to live alongside — something more endemic.

The Walking Dead, Fear the Walking Dead (2015-), Z Nation (2014-18), and many other survival-based stories seem to return to the past. In contrast, endemic narratives maintain a present and sometimes even future-looking approach.

Learning from stories

According to film producer and media professor Mick Broderick, survival stories maintain a status quo. They seek a “nostalgically yearned-for less-complex existence.” It provides solace to imagine an earlier, simpler time when living through a pandemic.

However, the shift from survival to endemic in contagion narratives provides us with many important possibilities. The one I think is quite relevant right now is that it presents us with a way of living with contagion. After all, watching these characters survive a pandemic helps us imagine that we can too.

Krista Collier-Jarvis does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

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Xi Reemerges In 1st Public Appearance After ‘Coup’ Rumors

Xi Reemerges In 1st Public Appearance After ‘Coup’ Rumors

So much for the "coup in China" and "Xi is missing" rumor mill of the past week,…

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Xi Reemerges In 1st Public Appearance After 'Coup' Rumors

So much for the "coup in China" and "Xi is missing" rumor mill of the past week, which at one point saw Chinese President Xi Jinping's name trending high on Twitter...

"Chinese President Xi Jinping visited an exhibition in Beijing on Tuesday, according to state television, in his first public appearance since returning to China from an official trip to Central Asia in mid-September – dispelling unverified rumours that he was under house arrest."

He had arrived in Samarkand, Uzbekistan on September 15 - and attended the days-long Shanghai Cooperation Organization (SCO) summit - where he met with Russian President Vladimir Putin, among others.

Xi is "back"...image via state media screenshot

Importantly, it had been his first foreign trip in two years. Xi had not traveled outside of the country since before the Covid-19 pandemic began.

But upon returning the Beijing, he hadn't been seen in the public eye since that mid-September trip, fueling speculation and rumors in the West and on social media. Some pundits floated the idea that he had been under "house arrest" amid political instability and a possible coup attempt.

According to a Tuesday Bloomberg description of the Chinese leader's "re-emergence" in the public eye, which has effectively ended the bizarre rumors

Xi, wearing a mask, visited an exhibition in Beijing on Tuesday about China's achievements over the past decade, state-run news outlet Xinhua reported. The Chinese leader was accompanied by the other six members of the Politburo Standing Committee, a sign of unity after rumors circulated on Twitter about a challenge to his power.

He'll likely cinch his third five-year term as leader at the major Chinese Communist party’s (CCP) meeting on October 16. The CCP meeting comes only once every half-decade.

What had added to prior rumors was the fact that the 69-year old Xi recently undertook a purge of key senior security officials. This included arrests on corruption charges of the former police chiefs of Shanghai, Chongqing and Shanxi.

More importantly, former vice minister of public security Sun Lijun and former justice minister Fu Zhenghua were also sacked and faced severe charges.

Concerning Sun Lijun, state media made this shocking announcement a week ago: "Sun Lijun, former Chinese vice minister of public security, was sentenced to death with a two-year reprieve for taking more than 646 million yuan of bribes, manipulating the stock market, and illegally possessing firearms, according to the Intermediate People's Court of Changchun in Northeast China's Jilin Province on Friday." The suspended death sentence means he'll spend life in prison.

Tyler Durden Wed, 09/28/2022 - 14:05

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Did the pandemic change our personalities?

Despite a long-standing hypothesis that personality traits are relatively impervious to environmental pressures, the COVID-19 pandemic may have altered…

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Despite a long-standing hypothesis that personality traits are relatively impervious to environmental pressures, the COVID-19 pandemic may have altered the trajectory of personality across the United States, especially in younger adults, according to a new study published this week in the open-access journal PLOS ONE by Angelina Sutin of Florida State University College of Medicine, and colleagues.

Credit: Brian Merrill, Pixabay, CC0 (https://creativecommons.org/publicdomain/zero/1.0/)

Despite a long-standing hypothesis that personality traits are relatively impervious to environmental pressures, the COVID-19 pandemic may have altered the trajectory of personality across the United States, especially in younger adults, according to a new study published this week in the open-access journal PLOS ONE by Angelina Sutin of Florida State University College of Medicine, and colleagues.

Previous studies have generally found no associations between collective stressful events—such as earthquakes and hurricanes—and personality change. However, the coronavirus pandemic has affected the entire globe and nearly every aspect of life.

In the new study, the researchers used longitudinal assessments of personality from 7,109 people enrolled in the online Understanding America Study. They compared five-factor model personality traits—neuroticism, extraversion, openness, agreeableness and conscientiousness—between pre-pandemic measurements (May 2014 – February 2020) and assessments early (March – December 2020) or later (2021-2022) in the pandemic. A total of 18,623 assessments, or a mean of 2.62 per participant, were analyzed. Participants were 41.2% male and ranged in age from 18 to 109.

Consistent with other studies, there were relatively few changes between pre-pandemic and 2020 personality traits, with only a small decline in neuroticism. However, there were declines in extraversion, openness, agreeableness, and conscientiousness when 2021-2022 data was compared to pre-pandemic personality. The changes were about one-tenth of a standard deviation, which is equivalent to about one decade of normative personality change. The changes were moderated by age, with younger adults showing disrupted maturity in the form of increased neuroticism and decreased agreeableness and conscientiousness, and the oldest group of adults showing no statistically significant changes in traits.

The authors conclude that if these changes are enduring, it suggests that population-wide stressful events can slightly bend the trajectory of personality, especially in younger adults.

The authors add: “There was limited personality change early in the pandemic but striking changes starting in 2021. Of most note, the personality of young adults changed the most, with marked increases in neuroticism and declines in agreeableness and conscientiousness. That is, younger adults became moodier and more prone to stress, less cooperative and trusting, and less restrained and responsible.”

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In your coverage please use this URL to provide access to the freely available article in PLOS ONE: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0274542

Citation: Sutin AR, Stephan Y, Luchetti M, Aschwanden D, Lee JH, Sesker AA, et al. (2022) Differential personality change earlier and later in the coronavirus pandemic in a longitudinal sample of adults in the United States. PLoS ONE 17(9): e0274542. https://doi.org/10.1371/journal.pone.0274542

Author Countries: USA, France

Funding: Research reported in this publication was supported by the National Institute on Aging of the National Institutes of Health under Award Number R01AG053297 to ARS. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.


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