Abstract

Mpox is a zoonotic viral illness caused by monkeypox virus which belongs to family Poxviridea and genus orthopoxvirus. Smallpox, vaccinia and cowpox are the poxvirus of this genus. Vaccination to smallpox provides some cross immunity against mpox but with cessation of smallpox vaccination, incidence of mpox has gradually increased, especially in endemic area. Mpox is usually a self limiting disease and presents with fever, myalgia, headache, lymphadenopathy and skin lesions. It spread by the body fluid, skin secretion and direct contact with the infected person or animal. Confirm diagnosis is made by detection of virus DNA by PCR. Antibodies are not useful as they do not distinguish between different poxviruses. There is no specific approved treatment for mpox at present but many are under trial. Vaccination for mpox is available and approved by FDA.usually the case fatality is <10% but can increase in high risk group Earlier mpox was endemic in West and Central Africa with sporadic cases in some other part of the world. But the outbreak in 2022 has affected non endemic area with different target population and different clinical presentation. This raised concern and mpox is now considered as disease which can cause another pandemic and therefore efforts are to be made to prevent its further outbreak.

• 1.   Walsh D. Poxviruses: Slipping and sliding through transcription and translation. PLoS Pathog. 2017 Nov; 13(11): e1006634.
• 2.   Rimoin A.W., Mulembakani P.M., Johnston S.C., et al. Major increase in human monkeypox incidence 30 years after smallpox vaccination campaigns cease in the Democratic Republic of Congo. Proc Natl Acad Sci U S A 2010; 107: 16262-16267.
• 3.   Sklenovská N., Van Ranst M. Emergence of Monkeypox as the Most Important Orthopoxvirus Infection in Humans. Front Public Health. 2018; 6:241.
• 4.   Moss B. Poxviridae: the viruses and their replication. In: Knipe D.M., Howley P.M., eds. Fields’ virology 5th Ed. New York: Lippincott Williams and Wilkins, 2007: 2905-2946.
• 5.   Chen N., Li G., Liszewski M.K., et al. Virulence differences between monkeypox virus isolates from West Africa and the Congo basin. Virology 2005; 340: 46-63.
• 6.   Centers for Disease Control and Prevention (CDC). Multistate outbreak of monkeypox-- Illinois, Indiana, and Wisconsin, 2003. MMWR Morb Mortal Wkly Rep. 2003 Jun 13; 52(23): 537-40.
• 7.   Velavan T.P., Meyer C.G. Monkeypox 2022 outbreak: An update. Trop Med Int Health. 2022 Jul; 27(7): 604-605.
• 8.   Doty J.B., Malekani J.M., Kalemba L.N., et al. Assessing monkeypox virus prevalence in small mammals at the human-animal interface in the Democratic Republic of the Congo. Viruses 2017; 9: 283-283.
• 9.   Grant R., Nguyen L.L., Breban R. Modelling human-to-human transmission of monkeypox. Bull World Health Organ. 2020 Sep 01; 98(9): 638-640.
• 10.   Hutson C.L., Carroll D.S., Gallardo-Romero N, Drew C., Zaki S.R., Nagy T., Hughes C., Olson V.A., Sanders J., Patel N., Smith S.K., Keckler M.S., Karem K., Damon I.K. Comparison of Monkeypox Virus Clade Kinetics and Pathology within the Prairie Dog Animal Model Using a Serial Sacrifice Study Design. Biomed Res Int. 2015; 2015: 965710.
• 11.   Orviz E., Negredo A., Ayerdi O., Vázquez A., Muñoz-Gomez A., Monzón S, Clavo P, Zaballos A., Vera M., Sánchez P., Cabello N., Jiménez P., Pérez-García J.A., Varona S., Del Romero J., Cuesta I., Delgado-Iribarren A, Torres M., Sagastagoitia I., Palacios G, Estrada V., Sánchez-Seco M.P., Grupo Viruela del Simio Madrid CNM/ISCIII/HCSC/Sandoval. Monkeypox outbreak in Madrid (Spain): Clinical and virological aspects. J Infect. 2022 Oct; 85(4): 412-417.
• 12.   Monkeypox. Wkly Epidemiol Rec. 2011 Oct 07; 86(41): 448-51.
• 13.   Aden T.A., Blevins P., York S.W., Rager S., Balachandran D., Hutson C.L., Lowe D., Mangal C.N., Wolford T., Matheny A., Davidson W., Wilkins K., Cook R., Roulo R.M., White M.K, Berman L., Murray J., Laurance J., Francis D., Green N.M., Berumen R.A., Gonzalez A., Evans S, Hudziec M, Noel D, Adjei M., Hovan G., Lee P., Tate L, Gose RB, Voermans R., Crew J., Adam PR, Haydel D, Lukula S., Matluk N, Shah S, Featherston J., Ware D., Pettit D., McCutchen E., Acheampong E., Buttery E., Gorzalski A., Perry M., Fowler R., Lee R.B., Nickla R., Huard R., Moore A., Jones K., Johnson R., Swaney E., Jaramillo J., Reinoso Webb C., Guin B., Yost J., Atkinson A., Griffin-Thomas L., Chenette J., Gant J., Sterkel A., Ghuman H.K., Lute J., Smole S.C., Arora V., Demontigny C.K., Bielby M., Geeter E., Newman KAM, Glazier M., Lutkemeier W., Nelson M., Martinez R., Chaitram J., Honein M.A., Villanueva J.M. Rapid Diagnostic Testing for Response to the Monkeypox Outbreak - Laboratory Response Network, United States, May 17-June 30, 2022. MMWR Morb Mortal Wkly Rep. 2022 Jul 15; 71(28): 904-907.
• 14.   Reynolds M.G., McCollum A.M., Nguete B., Shongo Lushima R., Petersen B.W. Improving the Care and Treatment of Monkeypox Patients in Low-Resource Settings: Applying Evidence from Contemporary Biomedical and Smallpox Biodefense Research. Viruses. 2017 Dec 12; 9(12).
• 15.   World Health Organization / newsroom/ fact sheets/ detail / mpox, 26 august,2024.
• 16.   Rizk J.G., Lippi G., Henry B.M., Forthal D.N., Rizk Y. Prevention and Treatment of Monkeypox. Drugs. 2022 Jun; 82(9): 957-963.
• 17.   Wittek R. Vaccinia immune globulin: current policies, preparedness, and product safety and efficacy. Int J Infect Dis 2006; 10: 193-201.
• 18.   WHO Advisory Committee on Variola Virus Research. Report of the twenty-third meeting: virtual meeting, 3–4 November 2021. Geneva: World Health Organization, 2021 (https:// apps.who.int/iris/rest/bitstreams/1423719/ retrieve).
• 19.   McCollum A.M., Damon I.K. Human monkeypox. Clin Infect Dis. 2014 Jan; 58(2): 260-7.
• 20.   Thornhill J.P., Barkati S., Walmsley S., et al. Monkeypox virus infection in humans across 16 countries — April–June 2022. N Engl J Med 2022; 387: 679-691.

Data Sharing Statement

Funding