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.
News
- A public health success story: How the mpox crisis was controlled within 6 months
ABC News, February 2, 2023 - FDA issues warning letters to companies selling unproven mpox treatments
ABC News, February 1, 2023 - Mpox is almost gone in the US, leaving lessons and mysteries in its wake
CNN, January 31, 2023 - Public health emergency for mpox officially ends
The Hill, January 31, 2023 - Mpox Message for 2023: Integrating Mpox Messaging Into Our HIV Response
HIV.gov, January 30, 2023 - Dimie Ogoina—Nigeria's expert in mpox
Lancet Infectious Diseases, February 2023 - The end of the mpox pandemic?
Lancet Infectious Diseases, February 2023 - The downfall of mpox
Gay City News, January 26, 2023 - Ghana: Heed Advice About Mpox!
All Africa, January 25, 2023
Useful Links
Publications
- Clinical features, antiviral treatment and patient outcomes: a systematic review and comparative analysis of the previous and the 2022 mpox outbreaks
JID, February 3, 2023 - Real-world effectiveness of a single dose of mpox vaccine in males
Nature Medicine, January 31, 2023 - Novel severe oculocutaneous manifestations of human monkeypox virus infection and their historical analogues
Lancet infectious diseases, Jan 23 2023 - MPXV Transmission at a Tattoo Parlor
NEJM, January 5, 2023 - Breakthrough Infections after Postexposure Vaccination against Mpox
NEJM, December 29, 2022 - Drug Sensitivity of Currently Circulating Mpox Viruses
NEJM, December 28, 2022 - Clinical features and management of individuals admitted to hospital with monkeypox and associated complications across the UK: a retrospective cohort study
Lancet infectious disease, December 22, 2022 - Structure of monkeypox virus DNA polymerase holoenzyme
Science, December 15, 2022 - Recombination shapes the 2022 monkeypox (mpox) outbreak
Cell Med, December 9, 2022 - Breakthrough Infections after Postexposure Vaccination against Mpox
NEJM, December 7, 2022 - Tecovirimat for Monkeypox in Central African Republic under Expanded Access
NEJM, November 30, 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