{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T16:46:48Z","timestamp":1785257208053,"version":"3.55.0"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2023,6,5]],"date-time":"2023-06-05T00:00:00Z","timestamp":1685923200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,6,5]],"date-time":"2023-06-05T00:00:00Z","timestamp":1685923200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Hamburg-Eppendorf (UKE)"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infection"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>In May 2022, a multi-national mpox outbreak was reported in several non-endemic countries. The only licensed treatment for mpox in the European Union is the orally available small molecule tecovirimat, which in <jats:italic>Orthopox<\/jats:italic> viruses inhibits the function of a major envelope protein required for the production of extracellular virus.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We identified presumably all patients with mpox that were treated with tecovirimat in Germany between the onset of the outbreak in May 2022 and March 2023 and obtained demographic and clinical characteristics by standardized case report forms.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of twelve patients with mpox were treated with tecovirimat in Germany in the study period. All but one patient identified as men who have sex with men (MSM) who were most likely infected with mpox virus (MPXV) through sexual contact. Eight of them were people living with HIV (PLWH), one of whom was newly diagnosed with HIV at the time of mpox, and four had CD4+\u2009counts below 200\/\u00b5l. Criteria for treatment with tecovirimat included severe immunosuppression, severe generalized and\/or protracted symptoms, a high or increasing number of lesions, and the type and location of lesions (e.g., facial or oral soft tissue involvement, imminent epiglottitis, or tonsillar swelling). Patients were treated with tecovirimat for between six and 28\u00a0days. Therapy was generally well-tolerated, and all patients showed clinical resolution.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>In this cohort of twelve patients with severe mpox, treatment with tecovirimat was well tolerated and all individuals showed clinical improvement.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s15010-023-02049-0","type":"journal-article","created":{"date-parts":[[2023,6,5]],"date-time":"2023-06-05T09:02:55Z","timestamp":1685955775000},"page":"1563-1568","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Tecovirimat for the treatment of severe Mpox in Germany"],"prefix":"10.1007","volume":"51","author":[{"given":"Lennart","family":"Hermanussen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas Theo","family":"Brehm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timo","family":"Wolf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Boesecke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Schlabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frauke","family":"Borgans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malte B.","family":"Monin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f6rn-Erik Ole","family":"Jensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Windhaber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Scholten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Jordan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"L\u00fctgehetmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian Schulze zur","family":"Wiesch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marylyn M.","family":"Addo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agata","family":"Mikolajewska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michaela","family":"Niebank","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Schmiedel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,6,5]]},"reference":[{"issue":"5","key":"2049_CR1","first-page":"599","volume":"46","author":"SS Marennikova","year":"1972","unstructured":"Marennikova SS, Seluhina EM, Mal\u2019ceva NN, Cimiskjan KL, Macevic GR. Isolation and properties of the causal agent of a new variola-like disease (monkeypox) in man. Bull World Health Organ. 1972;46(5):599\u2013611.","journal-title":"Bull World Health Organ"},{"issue":"2","key":"2049_CR2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0010141","volume":"16","author":"EM Bunge","year":"2022","unstructured":"Bunge EM, Hoet B, Chen L, Lienert F, Weidenthaler H, Baer LR, et al. The changing epidemiology of human monkeypox-A potential threat? A systematic review. PLoS Negl Trop Dis. 2022;16(2): e0010141.","journal-title":"PLoS Negl Trop Dis"},{"issue":"8","key":"2049_CR3","doi-asserted-by":"publisher","first-page":"1153","DOI":"10.1016\/S1473-3099(22)00228-6","volume":"22","author":"H Adler","year":"2022","unstructured":"Adler H, Gould S, Hine P, Snell LB, Wong W, Houlihan CF, et al. Clinical features and management of human monkeypox: a retrospective observational study in the UK. Lancet Infect Dis. 2022;22(8):1153\u201362.","journal-title":"Lancet Infect Dis"},{"issue":"4","key":"2049_CR4","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1056\/NEJMoa032299","volume":"350","author":"KD Reed","year":"2004","unstructured":"Reed KD, Melski JW, Graham MB, Regnery RL, Sotir MJ, Wegner MV, et al. The detection of monkeypox in humans in the Western Hemisphere. N Engl J Med. 2004;350(4):342\u201350.","journal-title":"N Engl J Med"},{"issue":"5","key":"2049_CR5","doi-asserted-by":"publisher","first-page":"980","DOI":"10.3201\/eid2505.190076","volume":"25","author":"N Erez","year":"2019","unstructured":"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(5):980\u20133.","journal-title":"Emerg Infect Dis"},{"issue":"11","key":"2049_CR6","doi-asserted-by":"publisher","first-page":"1166","DOI":"10.1016\/S1473-3099(19)30537-7","volume":"19","author":"OT Ng","year":"2019","unstructured":"Ng OT, Lee V, Marimuthu K, Vasoo S, Chan G, Lin RTP, et al. A case of imported Monkeypox in Singapore. Lancet Infect Dis. 2019;19(11):1166.","journal-title":"Lancet Infect Dis"},{"issue":"38","key":"2049_CR7","doi-asserted-by":"publisher","first-page":"1800509","DOI":"10.2807\/1560-7917.ES.2018.23.38.1800509","volume":"23","author":"A Vaughan","year":"2018","unstructured":"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(38):1800509.","journal-title":"Euro Surveill"},{"issue":"9","key":"2049_CR8","doi-asserted-by":"publisher","first-page":"1321","DOI":"10.1016\/S1473-3099(22)00411-X","volume":"22","author":"N Girometti","year":"2022","unstructured":"Girometti N, Byrne R, Bracchi M, Heskin J, McOwan A, Tittle V, et al. Demographic and clinical characteristics of confirmed human monkeypox virus cases in individuals attending a sexual health centre in London, UK: an observational analysis. Lancet Infect Dis. 2022;22(9):1321\u20138.","journal-title":"Lancet Infect Dis"},{"issue":"32","key":"2049_CR9","doi-asserted-by":"publisher","first-page":"1018","DOI":"10.15585\/mmwr.mm7132e3","volume":"71","author":"D Philpott","year":"2022","unstructured":"Philpott D, Hughes CM, Alroy KA, Kerins JL, Pavlick J, Asbel L, et al. Epidemiologic and clinical characteristics of Monkeypox cases\u2014United States, May 17\u2013July 22, 2022. MMWR Morb Mortal Wkly Rep. 2022;71(32):1018\u201322.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2049_CR10","unstructured":"World Health Organization (WHO). News release 23 July 2022. https:\/\/www.who.int\/europe\/news\/item\/23-07-2022-who-director-general-declares-the-ongoing-monkeypox-outbreak-a-public-health-event-of-international-concern."},{"key":"2049_CR11","unstructured":"World Health Organization (WHO). Multi-country outbreak of mpox. External Situation Report 18: https:\/\/www.who.int\/publications\/m\/item\/multi-country-outbreak-of-mpox--external-situation-report--18---16-march-2023."},{"key":"2049_CR12","unstructured":"Tecovirimat\u2014Summary of Product Characteristics: https:\/\/www.ema.europa.eu\/en\/documents\/product-information\/tecovirimat-siga-epar-product-information_en.pdf."},{"issue":"1","key":"2049_CR13","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1056\/NEJMoa1705688","volume":"379","author":"DW Grosenbach","year":"2018","unstructured":"Grosenbach DW, Honeychurch K, Rose EA, Chinsangaram J, Frimm A, Maiti B, et al. Oral Tecovirimat for the Treatment of Smallpox. N Engl J Med. 2018;379(1):44\u201353.","journal-title":"N Engl J Med"},{"issue":"13","key":"2049_CR14","doi-asserted-by":"publisher","first-page":"1348","DOI":"10.1001\/jama.2022.15336","volume":"328","author":"AN Desai","year":"2022","unstructured":"Desai AN, Thompson GR 3rd, Neumeister SM, Arutyunova AM, Trigg K, Cohen SH. Compassionate use of tecovirimat for the treatment of Monkeypox infection. JAMA. 2022;328(13):1348\u201350.","journal-title":"JAMA"},{"issue":"37","key":"2049_CR15","doi-asserted-by":"publisher","first-page":"1190","DOI":"10.15585\/mmwr.mm7137e1","volume":"71","author":"K O'Laughlin","year":"2022","unstructured":"O\u2019Laughlin K, Tobolowsky FA, Elmor R, Overton R, O\u2019Connor SM, Damon IK, et al. Clinical use of tecovirimat (Tpoxx) for treatment of Monkeypox under an investigational new drug protocol\u2014United States, May\u2013August 2022. MMWR Morb Mortal Wkly Rep. 2022;71(37):1190\u20135.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2049_CR16","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1016\/j.antiviral.2019.06.005","volume":"168","author":"M Merchlinsky","year":"2019","unstructured":"Merchlinsky M, Albright A, Olson V, Schiltz H, Merkeley T, Hughes C, et al. The development and approval of tecoviromat (TPOXX(\u00ae)), the first antiviral against smallpox. Antiviral Res. 2019;168:168\u201374.","journal-title":"Antiviral Res"},{"key":"2049_CR17","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2210015","author":"F Mbrenga","year":"2022","unstructured":"Mbrenga F, Nakoun\u00e9 E, Malaka C, Bourner J, Dunning J, Vernet G, et al. Tecovirimat for Monkeypox in Central African Republic under expanded access. N Engl J Med. 2022. https:\/\/doi.org\/10.1056\/NEJMc2210015.","journal-title":"N Engl J Med"},{"issue":"9","key":"2049_CR18","doi-asserted-by":"publisher","first-page":"1765","DOI":"10.3201\/eid2809.220917","volume":"28","author":"D Norz","year":"2022","unstructured":"Norz D, Tang HT, Emmerich P, Giersch K, Fischer N, Schmiedel S, et al. Rapid adaptation of established high-throughput molecular testing infrastructure for Monkeypox virus detection. Emerg Infect Dis. 2022;28(9):1765\u20139.","journal-title":"Emerg Infect Dis"},{"key":"2049_CR19","doi-asserted-by":"publisher","first-page":"105254","DOI":"10.1016\/j.jcv.2022.105254","volume":"155","author":"D N\u00f6rz","year":"2022","unstructured":"N\u00f6rz D, Brehm TT, Tang HT, Grewe I, Hermanussen L, Matthews H, et al. Clinical characteristics and comparison of longitudinal qPCR results from different specimen types in a cohort of ambulatory and hospitalized patients infected with monkeypox virus. J Clin Virol. 2022;155:105254.","journal-title":"J Clin Virol"},{"key":"2049_CR20","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.28181","author":"L Hermanussen","year":"2022","unstructured":"Hermanussen L, Grewe I, Tang HT, N\u00f6rz D, Bal LC, Pfefferle S, et al. Tecovirimat therapy for severe monkeypox infection: longitudinal assessment of viral titers and clinical response pattern-A first case-series experience. J Med Virol. 2022. https:\/\/doi.org\/10.1002\/jmv.28181.","journal-title":"J Med Virol"},{"issue":"6","key":"2049_CR21","doi-asserted-by":"publisher","first-page":"1633","DOI":"10.1007\/s15010-022-01901-z","volume":"50","author":"C Boesecke","year":"2022","unstructured":"Boesecke C, Monin MB, van Bremen K, Schlabe S, Hoffmann C. Severe monkeypox-virus infection in undiagnosed advanced HIV infection. Infection. 2022;50(6):1633\u20134.","journal-title":"Infection"},{"issue":"29\u201330","key":"2049_CR22","first-page":"511","volume":"119","author":"S Schlabe","year":"2022","unstructured":"Schlabe S, Boesecke C, Isselstein J. Ulcer at corner of mouth as first sign of infection with Monkeypox virus. Dtsch Arztebl Int. 2022;119(29\u201330):511.","journal-title":"Dtsch Arztebl Int"},{"key":"2049_CR23","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-022-01961-1","author":"TT Brehm","year":"2022","unstructured":"Brehm TT, Hermanussen L, Schmiedel S. Orthopox simiae muscle abscess. Infection. 2022. https:\/\/doi.org\/10.1007\/s15010-022-01961-1.","journal-title":"Infection"},{"issue":"10380","key":"2049_CR24","doi-asserted-by":"publisher","first-page":"939","DOI":"10.1016\/S0140-6736(23)00273-8","volume":"401","author":"O Mitja","year":"2023","unstructured":"Mitja O, Alemany A, Marks M, Lezama Mora JI, Rodriguez-Aldama JC, Torres Silva MS, et al. Mpox in people with advanced HIV infection: a global case series. Lancet. 2023;401(10380):939\u201349.","journal-title":"Lancet"},{"issue":"7","key":"2049_CR25","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0220008","volume":"14","author":"M Wittner","year":"2019","unstructured":"Wittner M, Schlicker V, Libera J, Bockmann JH, Horvatits T, Seiz O, et al. Comparison of the integrin alpha4beta7 expression pattern of memory T cell subsets in HIV infection and ulcerative colitis. PLoS ONE. 2019;14(7): e0220008.","journal-title":"PLoS ONE"},{"issue":"10","key":"2049_CR26","doi-asserted-by":"publisher","first-page":"5587","DOI":"10.1128\/IAI.68.10.5587-5594.2000","volume":"68","author":"RA Hawkins","year":"2000","unstructured":"Hawkins RA, Rank RG, Kelly KA. Expression of mucosal homing receptor alpha4beta7 is associated with enhanced migration to the Chlamydia-infected murine genital mucosa in vivo. Infect Immun. 2000;68(10):5587\u201394.","journal-title":"Infect Immun"},{"issue":"49","key":"2049_CR27","doi-asserted-by":"publisher","first-page":"20877","DOI":"10.1073\/pnas.0911796106","volume":"106","author":"C Cicala","year":"2009","unstructured":"Cicala C, Martinelli E, McNally JP, Goode DJ, Gopaul R, Hiatt J, et al. The integrin alpha4beta7 forms a complex with cell-surface CD4 and defines a T cell subset that is highly susceptible to infection by HIV-1. Proc Natl Acad Sci U S A. 2009;106(49):20877\u201382.","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"6","key":"2049_CR28","doi-asserted-by":"publisher","first-page":"438","DOI":"10.1111\/j.1600-0897.2009.00704.x","volume":"61","author":"KA Kelly","year":"2009","unstructured":"Kelly KA, Chan AM, Butch A, Darville T. Two different homing pathways involving integrin beta7 and E-selectin significantly influence trafficking of CD4 cells to the genital tract following Chlamydia muridarum infection. Am J Reprod Immunol. 2009;61(6):438\u201345.","journal-title":"Am J Reprod Immunol"},{"issue":"11","key":"2049_CR29","doi-asserted-by":"publisher","first-page":"ofab509","DOI":"10.1093\/ofid\/ofab509","volume":"8","author":"F Heinrich","year":"2021","unstructured":"Heinrich F, Nentwich MF, Bibiza-Freiwald E, Norz D, Roedl K, Christner M, et al. SARS-CoV-2 blood RNA load predicts outcome in critically ill COVID-19 patients. Open Forum Infect Dis. 2021;8(11):ofab509.","journal-title":"Open Forum Infect Dis"},{"issue":"11","key":"2049_CR30","doi-asserted-by":"publisher","first-page":"e4020","DOI":"10.1093\/cid\/ciaa1637","volume":"73","author":"J Malsy","year":"2021","unstructured":"Malsy J, Veletzky L, Heide J, Hennigs A, Gil-Ibanez I, Stein A, et al. Sustained response after remdesivir and convalescent plasma therapy in a B cell-depleted patient with protracted coronavirus disease 2019 (COVID-19). Clin Infect Dis. 2021;73(11):e4020\u20134.","journal-title":"Clin Infect Dis"},{"key":"2049_CR31","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2022.27.26.2200477","author":"D Norz","year":"2022","unstructured":"Norz D, Pfefferle S, Brehm TT, Franke G, Grewe I, Knobling B, et al. Evidence of surface contamination in hospital rooms occupied by patients infected with monkeypox, Germany, June 2022. Euro Surveill. 2022. https:\/\/doi.org\/10.2807\/1560-7917.ES.2022.27.26.2200477.","journal-title":"Euro Surveill"}],"container-title":["Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-023-02049-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s15010-023-02049-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-023-02049-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T09:06:17Z","timestamp":1696237577000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s15010-023-02049-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,5]]},"references-count":31,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,10]]}},"alternative-id":["2049"],"URL":"https:\/\/doi.org\/10.1007\/s15010-023-02049-0","relation":{},"ISSN":["0300-8126","1439-0973"],"issn-type":[{"value":"0300-8126","type":"print"},{"value":"1439-0973","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,5]]},"assertion":[{"value":"24 March 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 May 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 June 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no conflict of interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The patients consented to participate and to have the data published.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}