Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 26, Number 8—August 2020
Dispatch

Imported Monkeypox, Singapore

Sarah Ee Fang Yong, Oon Tek Ng, Zheng Jie Marc Ho, Tze Minn Mak, Kalisvar Marimuthu, Shawn Vasoo, Tsin Wen Yeo, Yi Kai Ng, Lin Cui, Zannatul Ferdous, Po Ying Chia, Bryan Jun Wei Aw, Charmaine Malenab Manauis, Constance Khia Ki Low, Guanhao Chan, Xinyi Peh, Poh Lian Lim, Li Ping Angela Chow, Monica Chan, Vernon Jian Ming Lee, Raymond Tzer Pin Lin, Mok Kwee Derrick HengComments to Author , and Yee Sin LeoComments to Author 
Author affiliations: Ministry of Health Singapore, Singapore (S.E.F. Yong, Z.J.M. Ho, C.K.K. Low, G. Chan, X. Peh, V.J.M. Lee, M.K.D. Heng); National Centre for Infectious Diseases, Singapore (O.T. Ng, T.M. Mak, K. Marimuthu, S. Vasoo, T.W. Yeo, Y.K. Ng, L. Cui, Z. Ferdous, P.Y. Chia, B.J.W. Aw, C.M. Manauis, P.L. Lim, L.P.A. Chow, M. Chan, R.T.P. Lin, Y.S. Leo); National Public Health Laboratory, Singapore (T.M. Mak, Y.K. Ng, L. Cui, R.T.P. Lin); Tan Tock Seng Hospital, Singapore (O.T. Ng, K. Marimuthu, S. Vasoo, T.W. Yeo, Z. Ferdous, P.Y. Chia, B.J.W. Aw, C.M. Manauis, P.L. Lim, L.P.A. Chow, Y.S. Leo); National University Health System, Singapore (S.E.F. Yong); Nanyang Technological University, Singapore (O.T. Ng, P.Y. Chia, P.L. Lim, Y.S. Leo); National University of Singapore, Singapore (K. Marimuthu, P.L. Lim, Y.S. Leo)

Main Article

Figure 2

Transmission electron microscopy and maximum-likelihood phylogenetic tree of monkeypox virus in 38-year-old man, Singapore, 2019. A, B) Multiple brick-shaped particles, ranging from 230–290 nm by 130–240 nm, were observed from vesicle fluid under transmission electron microscopy. Tubular structures were observed with phosphotungstic acid stain (A), and a central ring-like depression was observed with gadolinium acetate stain (B). C) Phylogeny of monkeypox sequences, with the patient’s monkeypox

Figure 2. Transmission electron microscopy and maximum-likelihood phylogenetic tree of monkeypox virus in 38-year-old man, Singapore, 2019. A, B) Multiple brick-shaped particles, ranging from 230–290 nm by 130–240 nm, were observed from vesicle fluid under transmission electron microscopy. Tubular structures were observed with phosphotungstic acid stain (A), and a central ring-like depression was observed with gadolinium acetate stain (B). C) Phylogeny of monkeypox sequences, with the patient’s monkeypox strain in bold. All strains are identified by GenBank accession number, location, and year. The evolutionary relationships between monkeypox strains was determined based on 184,338 bases within the central core region of the monkeypox genome. The maximum-likelihood tree was created using RAxML (10) with γ-distributed rate differences and 1,000 bootstrap validation. Only bootstrap values >70% are displayed on the internal branches. Central African and West African clades are indicated. Scale bar indicates genetic distance between sequences.

Main Article

References
  1. Yinka-Ogunleye  A, Aruna  O, Dalhat  M, Ogoina  D, McCollum  A, Disu  Y, et al.; CDC Monkeypox Outbreak Team. Outbreak of human monkeypox in Nigeria in 2017-18: a clinical and epidemiological report. Lancet Infect Dis. 2019;19:8729.PubMedGoogle Scholar
  2. Centers for Disease Control and Prevention. Monkeypox in Nigeria. 2019 [cited 2019 Sep 15]. https://wwwnc.cdc.gov/travel/notices/watch/monkeypox-nigeria
  3. Vaughan  A, Aarons  E, Astbury  J, Balasegaram  S, Beadsworth  M, Beck  CR, et al. Two cases of monkeypox imported to the United Kingdom, September 2018. Euro Surveill. 2018;23:23.PubMedGoogle Scholar
  4. Erez  N, Achdout  H, Milrot  E, Schwartz  Y, Wiener-Well  Y, Paran  N, et al. Diagnosis of imported monkeypox, Israel, 2018. Emerg Infect Dis. 2019;25:9803.PubMedGoogle Scholar
  5. Centers for Disease Control and Prevention. 2003 United States outbreak of monkeypox. 2018 [cited 2019 Aug 17]. https://www.cdc.gov/poxvirus/monkeypox/outbreak.html
  6. Kulesh  DA, Baker  RO, Loveless  BM, Norwood  D, Zwiers  SH, Mucker  E, et al. Smallpox and pan-orthopox virus detection by real-time 3′-minor groove binder TaqMan assays on the roche LightCycler and the Cepheid smart Cycler platforms. J Clin Microbiol. 2004;42:6019.PubMedGoogle Scholar
  7. Gelderblom  HR, Madeley  D. Rapid viral diagnosis of orthopoxviruses by electron microscopy: optional or a must? Viruses. 2018;10:E142.PubMedGoogle Scholar
  8. Li  Y, Olson  VA, Laue  T, Laker  MT, Damon  IK. Detection of monkeypox virus with real-time PCR assays. J Clin Virol. 2006;36:194203.PubMedGoogle Scholar
  9. Katoh  K, Standley  DM. MAFFT: iterative refinement and additional methods. Methods Mol Biol. 2014;1079:13146.PubMedGoogle Scholar
  10. Stamatakis  A. RAxML version 8: a tool for phylogenetic analysis and post-analysis of large phylogenies. Bioinformatics. 2014;30:13123.PubMedGoogle Scholar
  11. Centers for Disease Control and Prevention. Monkeypox—transmission. 2015 [cited 2019 Sep 3]. https://www.cdc.gov/poxvirus/monkeypox/transmission.html
  12. Vaughan  A, Aarons  E, Astbury  J, Brooks  T, Chand  M, Flegg  P, et al. Human-to-human transmission of monkeypox virus, United Kingdom, October 2018. Emerg Infect Dis. 2020;26:7825.PubMedGoogle Scholar
  13. Brown  K, Leggat  PA. Human monkeypox: current state of knowledge and implications for the future. Trop Med Infect Dis. 2016;1:8.PubMedGoogle Scholar
  14. Ho  ZJM, Hapuarachchi  HC, Barkham  T, Chow  A, Ng  LC, Lee  JMV, et al.; Singapore Zika Study Group. Outbreak of Zika virus infection in Singapore: an epidemiological, entomological, virological, and clinical analysis. Lancet Infect Dis. 2017;17:81321.PubMedGoogle Scholar
  15. Alirol  E, Getaz  L, Stoll  B, Chappuis  F, Loutan  L. Urbanisation and infectious diseases in a globalised world. Lancet Infect Dis. 2011;11:13141.PubMedGoogle Scholar

Main Article

Page created: April 27, 2020
Page updated: July 18, 2020
Page reviewed: July 18, 2020
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external