Human monkeypox: history, presentations, transmission, epidemiology, diagnosis, treatment, and prevention

Abstract

Human monkeypox is a zoonotic infection that is similar to the diseases caused by other poxviruses. It is endemic among wild rodents in the rainforests of Central and Western Africa, and can be transmitted via direct skin contact or mucosal exposure to infected animals. The initial symptoms include fever, headache, myalgia, fatigue, and lymphadenopathy, the last of which is the main symptom that distinguishes it from smallpox. In order to prevent and manage the disease, those who are infected must be rapidly diagnosed and isolated. Several vaccines have already been developed (e.g., JYNNEOS, ACAM2000 and ACAM3000) and antiviral drugs (e.g., cidofovir and tecovirimat) can also be used to treat the disease. In the present study, we reviewed the history, morphology, clinical presentations, transmission routes, diagnosis, prevention, and potential treatment strategies for monkeypox, in order to enable health authorities and physicians to better deal with this emerging crisis.

Overview of reemerging mpox infection with a focus on neurological manifestations

“…14 In the case of mpox, neurologic complications are infrequent but diverse, with headache, mood disturbances, neuropathic pain, and skin lesions causing dysphagia and rectal pain. 41 Severe complications, such as conjunctivitis leading to decreased vision and, rarely, encephalitis, have been reported. 42 Encephalitis cases in mpox outbreaks have presented with symptoms including decreased responsiveness, rigidity, dilated pupils, disc oedema, and bilateral Babinski signs.…”

“…Despite these similarities, differences emerge in the neurological complications associated with mpox compared to smallpox 14 . In the case of mpox, neurologic complications are infrequent but diverse, with headache, mood disturbances, neuropathic pain, and skin lesions causing dysphagia and rectal pain 41 . Severe complications, such as conjunctivitis leading to decreased vision and, rarely, encephalitis, have been reported 42 .…”

Transmission dynamics, complications and mitigation strategies of the current mpox outbreak: A comprehensive review with bibliometric study

“…Tecovirimat is demonstrably effective largely against orthopoxviruses including mpox. 43 It could be prescribed with caution although not widely available these days. Despite all these, supportive and symptomatic therapy is seemingly the main strategy to address the issue of mpox.…”

Enhancing diagnostic accuracy in common human poxvirus infections during mpox outbreak: A dermoscopy review

“…Since May 2022, there has been a rapid spread of human mpox cases in non‐endemic areas 19–21 . Clinical symptoms of human mpox typically include prodromal fever, fever, skin eruption, malaise, headache, and lymphadenopathy 20,22 . Diagnosis primarily relies on laboratory testing, with polymerase chain reaction (PCR) and enzyme‐linked immunosorbent assay (ELISA) being common diagnostic methods 23 .…”

“…In some cases, lesions may affect the conjunctiva, oral cavity, genitalia, perianal region, and mucosal sites. Atypical cutaneous lesions may also occur 8,22,24 . Dermoscopy plays a valuable role in recognizing mpox.…”