Monkeypox: A Contemporary Review for Healthcare Professionals

Abstract

The ongoing 2022 multi-country outbreak of monkeypox is the largest in history to occur outside of Africa. Monkeypox is an emerging zoonotic virus which 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.

Clinical features and novel presentations of human monkeypox in a central London centre during the 2022 outbreak: descriptive case series

“… 11 Skin lesions follow a typical pattern of evolution, starting as macules and progressing into papules, vesicles, and pustules, which subsequently crust over and then desquamate. 13 15 Historically, lesions have appeared simultaneously and progressed sequentially. 16 Lesions have predominantly affected the face (95% of infected people), palms and soles (75%), mucous membranes (70%), and, less commonly, genitals.…”

“…Classic descriptions of monkeypox infection depict biphasic clinical features, with a prodromal phase characterised by fever, malaise, sweats, lymphadenopathy, and headache, followed by skin eruption 2-4 days later 11. Skin lesions follow a typical pattern of evolution, starting as macules and progressing into papules, vesicles, and pustules, which subsequently crust over and then desquamate 1315. Historically, lesions have appeared simultaneously and progressed sequentially 16.…”

Monkeypox—not doing enough is not an option

“…Since the first cases were reported in the UK in early May, more than 5000 cases have been recorded in 52 countries and territories 1. MPXV is an old pathogen, which has caused human outbreaks in countries across west and central Africa for more than 50 years and has mostly been ignored by the rest of the world 2. The situation we are witnessing is unusual because of the large number of cases occurring simultaneously outside endemic locations; local human-to-human transmission in non-endemic settings; and the clustering of cases in specific social networks of primarily gay, bisexual, and other men who have sex with men 2.…”

“…MPXV is an old pathogen, which has caused human outbreaks in countries across west and central Africa for more than 50 years and has mostly been ignored by the rest of the world 2. The situation we are witnessing is unusual because of the large number of cases occurring simultaneously outside endemic locations; local human-to-human transmission in non-endemic settings; and the clustering of cases in specific social networks of primarily gay, bisexual, and other men who have sex with men 2. This has drawn global attention to the once neglected disease, leaving many wondering how big this outbreak will become and what its impact will be.…”

“…The situation with MPXV is worrying but different from what we have witnessed with covid-19. We have more existing knowledge, from historical outbreaks, about how this virus is transmitted, and vaccines and antiviral drugs are available as potential tools to contain it 2. Although this should be reassuring, the many missteps of the covid-19 pandemic response prompt valid concerns about whether the world is better prepared to respond to emerging disease threats.…”