Human monkeypox disease (MPX)

Abstract

Monkeypox is a rare viral infection, endemic in many central and western African countries. The last international outbreak of monkeypox reported outside Africa occurred back in 2003. However, monkeypox has reemerged at a global scale with numerous confirmed cases across the globe in 2022. The rapid spread of cases through different countries has raised serious concerns among public health officials worldwide prompting accelerated investigations aimed to identify the origins and cause of the rapid expansion of cases. The current situation is reminiscent of the very early stages of the still ongoing COVID-19 pandemic. Overlapping features between these, two seemingly alike viral entities include the possibility for airborne transmission and the currently unexplained and rapid spread across borders. Early recognition of cases and timely intervention of potential transmission chains are necessary to contain further outbreaks. Measures should include rapid and accurate diagnosis of cases meeting case definitions, active surveillance efforts, and appropriate containment of confirmed cases. Governments and health policymakers must apply lessons learned from previous outbreaks and start taking active steps toward limiting the recent global spread of monkeypox. Herein, we discuss the status of the current monkeypox outbreaks worldwide, the epidemiological and public health situation at a global scale and what can be done to keep at bay its further expansion and future global implications.

Keywords: Monkeypox; Orthopoxvirus; global; human; infection; outbreak.

Figure 1

Poxviruses taxonomy, showing the ubication of monkeypox virus according to the International Committee on Taxonomy of Viruses (ICTV).

Figure 2

Genomic epidemiology of monkeypox virus (145 genomes sampled between 2017 and 2022). Built with nextstrain/monkeypox, maintained by Nextstrain team, and enabled by data from GenBank. Source: https://nextstrain.org/monkeypox/hmpxv1

Figure 3

Transmission routes of monkeypox.

Figure 4

Clinical evolution of MPX.

Figure 5

Cutaneous lesions in a patient with confirmed MPXV infection from Prague, Czech Republic [80]. Patient has HIV and syphilis coinfection.

Figure 6

Geographical distribution of monkeypox cases in 2022, up to June 18, 2022. From: https://ourworldindata.org/monkeypox.

Figure 7

Clinical differential diagnosis of monkeypox; Varicella (panels A and B), Herpes simplex, disseminated (panel C) and herpetic gingivostomatitis (panel D), foot-and-mouth disease due to Coxsackievirus (panels E, F, G and H), secondary syphilis (panels I, J and K), scabies (panel L), measles (panels M, N, and O), metameric Herpes zoster (panel P), and Stevens-Johnson syndrome (panel Q) (Photos took by Dr. J.A. Suárez, with consent).