Mpox, previously known as monkeypox, is an infectious viral disease that has garnered global attention, especially during the 2022-2023 outbreak. The disease is caused by the monkeypox virus, a member of the Orthopoxvirus genus, which also includes the smallpox virus. Although mpox is less lethal than smallpox, it remains a significant public health concern due to its potential to cause severe illness and spread rapidly through human populations.
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| Monkeypox viral structure and scale PDB-101.rcsb.org, CC BY 4.0 <https://creativecommons.org/licenses/by/4.0>, via Wikimedia Commons |
Origins and Historical Context
Mpox was first identified in 1958 in Denmark when outbreaks of a pox-like disease occurred among monkeys kept for research. The first human case was recorded in 1970 in a nine-month-old boy in the Democratic Republic of the Congo (DRC). Since then, mpox has been endemic in several Central and West African countries, with sporadic outbreaks linked to animal-to-human transmission. The eradication of smallpox in 1980 and the subsequent cessation of smallpox vaccinations have contributed to the re-emergence of mpox as a public health threat.
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| Mpox rash on the arm and leg of a four-year-old girl in 1971 |
Transmission and Spread
Mpox can spread through several routes, with person-to-person transmission being the most common during outbreaks. The virus can be transmitted through direct contact with infectious skin lesions, bodily fluids, or respiratory droplets from an infected person. Close physical contact, including skin-to-skin contact, kissing, or sexual activity, can facilitate the spread of the virus. Mpox can also be transmitted via contaminated materials such as bedding, clothing, or needles.
Animal-to-human transmission occurs when humans come into contact with infected animals, either through bites, scratches, or during activities like hunting, skinning, or cooking. The exact animal reservoir for the virus remains unknown, but small mammals such as squirrels and monkeys are considered potential hosts.
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| A global map showing the spread of Orthopoxvirus monkeypox. |
Endemic clade IEndemic clade IIBoth clades recordedClade II outbreak in 2022Suspected cases
Author: ArcMachaon, Public domain, via Wikimedia Commons
Symptoms and Clinical Presentation
Mpox typically presents with a range of symptoms that usually appear within one to three weeks after exposure. Common symptoms include fever, headache, muscle aches, back pain, low energy, swollen lymph nodes, and a characteristic rash. The rash begins as flat sores that evolve into fluid-filled blisters, which eventually crust over and fall off. These lesions can appear anywhere on the body, including the face, palms, soles, and genital areas.
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| Stages of mpox lesion development Attribution: UK government, OGL 3 <http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3>, via Wikimedia Commons |
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Stages of mpox lesion development Author: João P. Caldas, Sofia R. Valdoleiros, Sandra Rebelo, and Margarida Tavares, CC0, via Wikimedia Commons |
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| Author: Unknown,Uhooep (talk | contribs), CC BY 4.0 <https://creativecommons.org/licenses/by/4.0>, via Wikimedia Commons |
In some cases, the disease may start with a rash, while in others, symptoms like fever and muscle aches may precede the rash. The severity of the illness can vary, with most individuals recovering within two to four weeks. However, certain groups, such as children, pregnant people, and those with weakened immune systems, are at higher risk for severe illness and complications.
Diagnosis and Treatment
Diagnosing mpox can be challenging, as its symptoms can resemble those of other infections, such as chickenpox, measles, or sexually transmitted infections like herpes and syphilis. Laboratory confirmation is crucial and is typically achieved through polymerase chain reaction (PCR) testing of samples taken from skin lesions. Other testing methods, such as serology, are less effective in distinguishing mpox from other orthopoxviruses.
Treatment for mpox primarily involves supportive care aimed at alleviating symptoms and preventing complications. In some cases, antiviral medications like tecovirimat, initially developed for smallpox, have been used to treat mpox.
Vaccination with the Jynneos vaccine, which was also developed for smallpox, can provide protection against mpox. Vaccination is particularly recommended for high-risk groups, such as healthcare workers, men who have sex with men, and individuals with multiple sexual partners. Preventive Measures and Public Health Response Preventing the spread of mpox involves a combination of public health measures and individual actions. People with mpox should isolate themselves at home or in a healthcare facility until they are no longer infectious. Covering lesions, wearing masks, and practicing good hand hygiene can help reduce the risk of transmission. Avoiding contact with infected individuals and contaminated materials is essential, and those at higher risk should consider vaccination.
During the 2022-2023 outbreak, mpox primarily spread through sexual networks, particularly among men who have sex with men. The World Health Organization (WHO) declared the outbreak a Public Health Emergency of International Concern (PHEIC) in July 2022, highlighting the need for global surveillance, diagnostics, risk communication, and community engagement to control the spread of the virus.
Conclusion
Mpox is a re-emerging infectious disease that poses a significant public health challenge. While most people recover without severe complications, the disease can lead to serious health issues in vulnerable populations. Ongoing research, public health interventions, and vaccination efforts are critical to controlling mpox and preventing future outbreaks. As the global community continues to respond to the threat of mpox, it is essential to remain vigilant and proactive in mitigating the spread of this potentially dangerous virus.