Confirmed and Suspected Cases
Monkeypox
- Monkeypox is a zoonotic disease caused by a Poxvirus known as monkeypox virus.
- Monkeypox disease results in a smallpox-like disease in humans although it is less severe than smallpox. In general, symptoms begin with fever, headache, muscle pains and feeling tired.
- Monkeypox is usually a self-limited disease with the symptoms lasting from 2 to 4 weeks.
- A rash usually appears 1–3 days after the onset of fever and lymphadenopathy, with lesions appearing simultaneously, and evolving at a similar rate. Their distribution is mainly peripheral but can cover the whole body during a severe illness.
- Human-to-human transmission is relatively inefficient, and this can result from close contact with respiratory secretions, skin lesions of an infected person or recently contaminated objects.
- In general, outbreaks occur occasionally in sub-Saharan Africa after someone comes in contact with an infected wild animal, and infected travelers sometimes carry the disease to other countries.
Monkeypox virus
The virus is closely related to smallpox and vaccinia viruses. Smallpox vaccination was approximately 85% protective against monkeypox
Two distinct genetic clades of the monkeypox virus: the West African clade and the Central African (Congo Basin) clade.
The West African clade demonstrates a case fatality rate (CFR) <1%, and no human-to-human transmission was documented previously.
The Central African clade shows a CFR up to 11% and causes more severe disease and human-to-human transmission.
Current Outbreaks of Monkeypox
Monkeypox outbreaks have been reported in over 60 countries globally.
Current global outbreaks are caused by the West African clade. It is not clear if they represent mutant strains with increased transmissibility or pathogenicity.
Most of the cases have lesions exclusively perigenital, perianal, and around the mouth.
Almost all of the cases include men aged 20–50, many of whom are gay, bisexual and have sex with men.
It is unclear whether sexual transmission is a contributing factor to current outbreak. One of the hypotheses is its transmission after close contact with lesions.
Available Vaccines
ACAM2000: similar to the vaccine used during the smallpox eradication campaign.
Jynneos: a nonreplicating form of vaccinia and explicitly approval for monkeypox.
GVN MONKEYPOX PERSPECTIVE
News
- US monkeypox deaths are rare; here’s why they can be difficult to confirm
CNN, October 3, 2022 - UK looks to be winning the fight against monkeypox
BBC, October 2, 2022 - Vietnam reports first case of monkeypox
Reuters, October 2, 2022 - Monkeypox eradication unlikely in the U.S. as virus could spread indefinitely, CDC says
CNBC, October 1, 2022 - CDC warns of severe illnesses from monkeypox as Ohio reports death of a monkeypox patient
CNN, September 30, 2022 - Should I still be worried about monkeypox?
Washington Post, September 29, 2022 - Zoonotic diseases like COVID-19 and monkeypox will become more common, experts say
NPR, September 29, 2022 - Unvaccinated individuals 14 times more likely to get monkeypox than vaccinated, new US data shows
CNN, September 28, 2022
Useful Links
Publications
- Monkeypox transmission—what we know so far
Lancet Respiratory medicine, Sep 22, 2022 - Monkeypox: Where are the racial disparities?
Lancet regional Health, Sep 22, 2022 - Monkeypox: A public health emergency in Brazil
Lancet Regional Health, Sep 23, 2022 - Monkeypox trial to begin in DR Congo
Lancet Infectious Diseases, Oct 1, 2022 - Asymptomatic Infection? Another Reason to Consider Monkeypox a Disease of Public Health Concern
Annals of Internal Medicine, August 16, 2022 - Update on the Monkeypox Outbreak
JAMA Network, August 11, 2022 - Tecovirimat and the Treatment of Monkeypox — Past, Present, and Future Considerations
NEJM, August 3, 2022
References
- Nature. Monkeypox goes global: why scientists are on alert. https://www.nature.com/articles/d41586-022-01421-8
- Shchelkunov SN, Marennikova SS, Moyer RW. Orthopovxiruses Pathogenic for Humans. Chapter: Classification of Poxviruses and Brief Characterization of the Genus. New York, NY: Springer (2005)
- Ladnyi ID, Jezek Z, Fenner F, Henderson DA, Arita I. Smallpox and its Eradication Chapter: Human Monkeypox and Other Poxvirus Infections of Man. Geneva: World Health Organization (1988).
- Fine PE, Jezek Z, Grab B, Dixon H. The transmission potential of monkeypox virus in human populations. Int J Epidemiol. 1988; 17(3):643–650.
- Bunge EM, Hoet B, Chen L, Lienert F, Weidenthaler H, Baer LR, Steffen R. The changing epidemiology of human monkeypox-A potential threat? A systematic review. PLoS Negl Trop Dis. 2022 Feb 11;16(2):e0010141. doi: 10.1371/journal.pntd.0010141. PMID: 35148313; PMCID: PMC8870502.
- Science. Monkeypox outbreak questions intensify as cases soar. https://www.science.org/content/article/monkeypox-outbreak-questions-intensify-cases-soar
- Sklenovská N, Van Ranst M. Emergence of Monkeypox as the Most Important Orthopoxvirus Infection in Humans. Front Public Health. 2018 Sep 4;6:241.
- Nature. Monkeypox goes global: why scientists are on alert. https://www.nature.com/articles/d41586-022-01421-8