Monkeypox Outbreak Global Threat and Lessons from a Reemerging Virus

Introduction

Understanding Monkeypox: Origins and Epidemiology

  • First identified in monkeys in Denmark in 1958 and later in a human in the Democratic Republic of Congo in 1970.
  • Reemerged globally in 2022 with over 48,000 reported cases, including non-endemic countries like the US, UK, and Singapore.
  • Genetically, it belongs to the Orthopoxvirus genus and is related to the smallpox virus.

Transmission and Symptoms

  • Transmission Routes:
    • Close contact with body fluids, skin lesions, and respiratory droplets.
    • Contact with contaminated clothing or surfaces.
    • Possible vertical transmission (mother to fetus).
  • Symptoms:
    • Fever, rash (including palms and soles), muscle aches, fatigue.
    • Lesions typically begin in the oropharynx and spread across the body.
    • Incubation period: 6–13 days; contagious during the rash phase.

Complications and Mortality Risks

  • Can lead to severe complications including:
    • Encephalitis
    • Sight-threatening keratitis
    • Sepsis
    • Dehydration
    • Skin scarring and death
  • Mortality rates reported between 1% to 10%, higher among children and immunocompromised individuals.

Diagnosis and Detection Methods

Current Treatment Strategies

Although no licensed treatment is currently available, the following approaches are used:

  • Supportive care remains the primary mode.
  • Antiviral drugs like Brincidofovir and Tecovirimat show promise.
  • CDC suggests smallpox vaccination within 4 days post-exposure can prevent infection.

Vaccines Available for Prevention

Several vaccines are now being considered or approved for emergency use:

  • JYNNEOS: Two-dose smallpox vaccine offering ~85% protection.
  • ACAM2000: Single dose, older generation vaccine.
  • MVA-BN and LC16: Newer, safer smallpox vaccines suitable for broader populations.

Global Outlook and Importance of Awareness

Call to Action

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