{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T16:48:15Z","timestamp":1788799695793,"version":"build-2803163510"},"reference-count":37,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T00:00:00Z","timestamp":1769817600000},"content-version":"vor","delay-in-days":30,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Interdisciplinary Perspectives on Infectious Diseases"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The global monkeypox (Mpox) outbreak prompted heightened surveillance in regions with significant travel links. Fars Province, Iran, implemented a structured telemedicine response to manage patients presenting with Mpox\u2010like symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to describe and evaluate the impact of a tiered, hub\u2010and\u2010spoke telemedicine model on the triage, differential diagnosis, and cost efficiency of managing suspected Mpox cases in a setting with no confirmed Mpox.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>In this observational study conducted from August 27 to September 22, 2024, 150 patients presenting with fever and vesiculopustular rash across Fars Province were managed via a mandated protocol. Cases unresolved by local physicians were escalated via asynchronous (store\u2010and\u2010forward) WhatsApp consultations to a central specialist hub. Diagnostic testing, including Orthopoxvirus (Mpox) PCR, varicella zoster virus PCR, and herpes simplex virus testing, was performed based on telemedicine triage. A cost\u2013consequence analysis compared the implemented pathway to a hypothetical standard referral scenario.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 150 teleconsultations, 28 patients (18.7%) were triaged as high suspicion for Mpox; three had relevant international travel history. No Mpox cases were confirmed. Final diagnoses were varicella (56.7%), herpes zoster (27.3%), herpes simplex (8.0%), and other conditions (8.0%). The telemedicine model prevented 122 (81.3%) unnecessary in\u2010person specialist referrals. The median consultation response time was 95\u2009min. The cost analysis showed a 76% reduction in direct costs, saving an estimated 1,087,500,000 Iranian Rials compared to standard care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A tiered telemedicine model proved effective for outbreak preparedness, enabling rapid expert triage, accurate differential diagnosis, and significant resource savings in a high\u2010alert, zero\u2010prevalence setting. This approach might yield a scalable blueprint for managing future alerts of emerging infectious diseases with cutaneous manifestations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/ipid\/9955516","type":"journal-article","created":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T11:01:39Z","timestamp":1769857299000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Operationalizing a Hub\u2010and\u2010Spoke Telemedicine Model for Mpox Surveillance in a High\u2010Alert, Zero\u2010Prevalence Setting: An Observational Study, Real\u2010World Experience From 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