A Review of Monkeypox: The New Global Health Emergency

Abstract

Monkeypox, once a rare zoonotic disease, has been endemic to some African countries since its original identification among humans in 1970. Since then, cases in non-endemic regions have been linked to returning travelers or those who had contact with transported animals. The causative agent, Monkeypox virus, belongs to Orthopoxviruses, the same family as Variola—the causative organism for smallpox. Although most monkeypox outbreaks until recently were linked to zoonotic transmission, secondary human–human transmission in smallpox-unvaccinated individuals was observed in a small proportion of overall cases. Smallpox was declared to be eradicated in 1980, and since its eradication, Monkeypox virus has been the most significant poxvirus to cause human disease. The 2022 monkeypox outbreak marks a significant paradigm shift in the human and poxvirus association, with new modes of transmission and concerns of viral evolution and entrenchment as a sexually transmitted disease. Monkeypox clinically resembles smallpox but is far milder. At this time, there are no approved therapies for monkeypox, and antiviral agents effective against smallpox are being utilized. Additionally, preventive strategies being utilized include smallpox vaccinations such as JYNNEOS and ACAM2000. In this narrative review, we discuss the virology, epidemiology, transmission, clinical manifestations, diagnosis, management, and prevention strategies associated with monkeypox.

Recent Developments in Mpox Prevention and Treatment Options

“…Moreover, the effective public health measure adoption in these endemic regions has also limited the spread of mpox infections [ 4 , 7 ]. An additional factor that should be noted is that mpox has neither a lifelong survival nature nor has purely the characteristic nature of sexually transmitted diseases such as HIV [ 4 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ]. The disease mostly remains self-limiting and resolves within 2–4 weeks of symptoms, as the host slowly develops immunity against it.…”

“…So far, these are limited to African countries; however, some recent outbreaks have been reported in other continents as far as America, Asia, and Europe. The situation is thus alarming for scientific and healthcare networks around the world [ 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ].…”

Mpox (Monkeypox) and the Eye: Ocular Manifestation, Diagnosis, Treatment and Vaccination

“…Humans may also become infected with MPXV from direct or indirect contact with the skin lesions, body fluids, or respiratory droplets of infected animals, which facilitate human-to-human transmission [ 7 , 23 , 24 , 25 ]. In addition, vertical transmission of mpox in humans has been observed in stillborn babies born in the second trimester to mothers infected with mpox [ 26 , 27 ].…”

“…Although mpox has not been shown to be transmitted sexually, the WHO states that close contact is a likely source of transmission [ 32 ]. Notably, human-to-human transmission, especially between men who have sex with men (MSM), appears to account for most of the cases recorded during the current global mpox outbreak [ 11 , 25 , 27 , 33 ]. Thus, patients with mpox during this outbreak tend to present first to clinics because of anogenital lesions.…”

Gold-based paper for antigen detection of monkeypox virus

“…1 Unlike other previous outbreaks outside Africa, such as in the United States in 2003 and in Nigeria in 2017, no cases within this outbreak were linked to travel or exposure to areas where MPXV is endemic. 2,3 This rapid spread is a wake-up call for scientists.…”