Monkeypox: A Contemporary Review for Healthcare Professionals

Abstract

The ongoing 2022 multicountry outbreak of monkeypox is the largest in history to occur outside of Africa. Monkeypox is an emerging zoonotic disease that for decades has been viewed as an infectious disease with significant epidemic potential because of the increasing occurrence of human outbreaks in recent years. As public health entities work to contain the current outbreak, healthcare professionals globally are aiming to become familiar with the various clinical presentations and management of this infection. We present in this review an updated overview of monkeypox for healthcare professionals in the context of the ongoing outbreaks around the world.

Keywords: emerging infectious diseases; monkeypox; outbreak.

Figure 1.

Transmission of human monkeypox. In endemic countries, spillover events occur from zoonotic animal reservoirs into humans, potentially leading to limited outbreaks usually facilitated by close human contact. Outbreaks can also occur in nonendemic regions through introduction of the virus via human travel or importation of animals harboring the virus. Subsequent human-to-human transmission can then occur via household contacts and via other close contacts.

Figure 2.

Clinical protocols and infection control during monkeypox outbreaks. Recognizing the clinical presentation and having a high index of suspicion are crucial for identifying potential cases. Rapid confirmation through testing and isolation of individuals with suspected or confirmed disease are necessary. These actions should be taken alongside notification of public health authorities for contact tracing and other components of the public health response. Although treatment for monkeypox infection is primarily supportive, antiviral agents and immune therapies could be considered for individuals with moderate to severe symptoms or who are at high risk for progression to severe disease. Vaccinating close contacts with high-risk exposures and at-risk individuals is also important for interrupting transmission chains and containing monkeypox outbreaks. Appropriate personal protective equipment (PPE) for medical settings consists of gown, gloves, a fit-tested N-95 or equivalent, and eye protection.

Figure 3.

Stages of skin presentation and progression of monkeypox rash.