Monkeypox virus: a neglected zoonotic pathogen spreads globally

Alakunle, Emmanuel F.; Okeke, Malachy Ifeanyi

doi:10.1038/s41579-022-00776-z

Cited by 110 publications

(108 citation statements)

References 7 publications

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“…Re-emergence of monkeypox in endemic and nonendemic areas has been attributed to changing biologic nature of the virus, climate change, waning immunity following cessation of smallpox vaccination coupled with increased international travel following the lifting of COVID-19 restrictions and high-risk sexual activity [17]. Phylogenetic analysis shows that MPX causing the current outbreak belongs to clade 3, which, in turn, is closely related to the virus causing the sporadic case in Maryland, USA in 2021, which, in turn, was related to the clade 2 viruses of Nigerian outbreak in 2017-2018 [18].…”

Section: Epidemiologymentioning

confidence: 99%

Monkeypox: A Review

2022

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Monkeypox is caused by a pox virus closely related to smallpox virus and spreads from animals to humans, and humans to humans following close contact. Prior smallpox vaccination gives partial protection against monkeypox. The steady increase in monkeypox cases in Africa over the past few decades were ignored by the global scientific community till this year, when more than 16,000 cases have been reported from nonendemic countries. Monkeypox has recently been labelled as a public health emergency of international concern by the WHO. While most of the current cases are in men who have sex with men, there is the larger threat of the disease spilling into the general population. The disease is characterized by a short febrile illness with lymphadenopathy followed by a rash which spreads centrifugally and passes through phases of macules, papules, vesicles, and pustules. Recovery occurs in most patients within 2–4 wk. Complications are more likely in children, pregnant women, and the immunocompromised. Specific diagnosis is by detection of viral DNA by PCR. Treatment is largely symptomatic. Tecorivimat is a promising antiviral drug. Vaccination with the currently available smallpox vaccines is recommended for high-risk groups, health care workers, and close contacts. Control of the monkeypox outbreak needs a multipronged effort comprising enhanced surveillance, quick diagnosis, isolation of affected people, ring immunization, and adoption of “one health” approach.

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Section: Epidemiologymentioning

confidence: 99%

Monkeypox: A Review

2022

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“…Although the precise transmission patterns of the 2022 global Monkeypox outbreak are yet to be fully understood, evidence supporting transmission as a result of sexual activity continues to accumulate [45]. Lack of or waning herd immunity from cessation of smallpox vaccination prevents cross protection offered against Monkeypox by smallpox vaccination [47]. Vertical transmission of MPV has been observed in a still-born fetus birthed through a secondtrimester loss to a monkeypox infected mother.…”

Section: Transmissionmentioning

confidence: 99%

A Review Of Monkeypox: The New Global Health Emergency

Rajsri¹,

Rao²

2022

Preprint

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Monkeypox, once a rare zoonotic disease, was endemic to some African countries since its original identification among humans in 1970. Since then, cases in non endemic regions were linked to returning travelers or those who had contact with transported animals. The causative agent, Monkeypox virus, belongs to Orthopoxviruses, the same family as Variola; the causative organism for smallpox. Although most Monkeypox outbreaks until recently were linked to zoonotic transmission, secondary human-human transmission in smallpox unvaccinated individuals was observed in a small proportion of overall cases. Smallpox was declared eradicated in 1980 and since its eradication, monkeypox virus is the most significant poxvirus to cause human disease. The 2022 monkeypox outbreak marks a significant paradigm shift in the human and poxvirus association, with new modes of transmission, concerns of viral evolution and entrenchment as a sexually transmitted disease. Monkeypox clinically resembles smallpox but is far milder. At this time there are no approved therapies for monkeypox and antiviral agents effective against smallpox are being utilized. Additionally, preventive strategies being utilized include smallpox vaccination like JYNNEOS and ACAM2000. In this narrative review, we discuss the virology, epidemiology, transmission, clinical manifestations, diagnosis, management and prevention strategies associated with monkeypox.

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“…The sudden and unexpected appearance of monkeypox simultaneously in several non-endemic countries suggests that there might have been undetected transmission for some unknown duration of time followed by recent amplifier events [ 6 ]. So far, no animal reservoir for monkeypox viruses has been identified in non-endemic regions.…”

mentioning

confidence: 99%

“…So far, no animal reservoir for monkeypox viruses has been identified in non-endemic regions. Therefore it is unlikely a zoonotic spillover from animals to humans, and instead due to multiple importations of the viruses from different endemic regions, and subsequent cryptic inter-human transmissions that were undetected [ 6 ]. However, zoonotic transmission cannot be ruled out completely.…”

mentioning

confidence: 99%