Epidemiology, Virology, and Mutation Landscape of Monkeypox Virus From Past to Present

Abstract

Monkeypox (Mpox) has emerged as a significant threat to the global population. Initially identified in a rural area of Africa in 1970, after the eradication of smallpox, it spread rapidly across various African nations. The ongoing evolution of the monkeypox virus (MPXV), which causes Mpox, and its potential for cross-species transmission led to a global outbreak in 2022. Despite the control measures during the outbreak, Mpox cases continue in several African nations, posing a persistent public health threat. Global surveillance is crucial to eradicating MPXV from human populations and preventing its resurgence. Factors contributing to MPXV's increased transmissibility and immune evasion include its mutation rate, adaptability, and genetic evolution. Therefore, understanding the epidemiology and virology of Mpox is essential for developing effective prevention and control strategies. This study explores the history of human Mpox, the complexity of MPXV, how it replicates, and drug-resistant mutations. It will also stress how important it is to study how the circadian clock affects virus replication in infectious diseases in order to effectively fight this new public health threat. Understanding these aspects is crucial for developing effective strategies against Mpox as well as addressing the challenges posed by genetic mutations and resistance. The compiled information in this review underscores the critical need for continued research and monitoring to tackle the evolving dynamics of Mpox and its broader impact on global health.

Keywords: epidemiology of mpox; monkeypox; monkeypox virus; mpox; mpxv; orthopoxvirus; poxviridae infection.

Figure 1. Timeline of MPXV: The above timeline effectively elucidates the history of MPXV over the years, from its initial detection in 1958 until the global outbreak in 2022.

MPXV: monkeypox virus, DRC: Democratic Republic of the Congo, Mpox: monkeypox, UK: United Kingdom, WHO: World Health Organization Created using BioRender

Figure 2. Illustration of MPXV: The structure of MPXV appears as oval or barrel-shaped particles. The virion primarily contains genomic DNA, enzymes, and core fibrils, which are tightly packed inside a core membrane. The core membrane has lateral bodies on two sides. There are two separate infectious forms of MPXV: IMV and EEV, which are differentiated by variations in surface glycoprotein. Finally, an outer envelope composed of a single lipid bilayer shields the tightly packed core in the IMV, while the EEV has an additional external membrane in which surface tubules are embedded.

MPXV: monkeypox virus, DNA: deoxyribonucleic acid, IMV: intracellular mature virus, EEV: extracellular enveloped virus Created using BioRender

Figure 3. Brief description of variants of MPXV: The above concept map provides a brief description and comparison of two different genetic variants or clades of MPXV, namely Clade I and Clade II

MPXV: monkeypox virus, CFR: case fatality rate, WHO: World Health Organization Created using BioRender

Figure 4. Flow diagram of replication of MPXV: The above flow chart concisely explains the process of replication of MPXV by dividing the progress into five steps, starting with viral entry into the host cells, followed by transcription events, replication of viral DNA, assembly and morphogenesis of replicated viral particles, and finally the release of IEV to the neighboring cells

MPXV: monkeypox virus, DNA: deoxyribonucleic acid, IEV: intracellular enveloped viruses, Mpox: monkeypox, IMV: intracellular mature virus Created using BioRender

Figure 5. Genomic representation of mutations in MPXV: The above diagram represents the various mutations that have occurred in the F13L gene of MPXV. In the diagram, (a) indicates the early MPXV gene, (b) represents the mutated MPXV strain in 2022, and (c) demonstrates the mutation of MPXV due to tecovirimat drug resistance

MPXV: monkeypox virus Created using BioRender