Monkeypox outbreaks: a comprehensive review of epidemiology, clinical management, and public health responses

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Abstract

Monkeypox, caused by a zoonotic virus, and has emerged as a significant public health issue, particularly with recent outbreaks extending beyond its traditional endemic areas in Central and West Africa. This virus, which belongs to the Orthopoxvirus genus, is closely related to the variola virus that causes smallpox. The resurgence of monkeypox underscores the urgent need to understand its epidemiology, clinical management, and public health responses, especially given the global spread observed in 2022. Monkeypox primarily transmits from animals to humans, with rodents and monkeys acting as the primary reservoirs. Secondary human-to-human transmission occurs through respiratory droplets or contact with contaminated materials. Clinically, monkeypox manifests with symptoms similar to smallpox, such as fever, rash, and lymphadenopathy, although it is generally less severe. Supportive treatments, including antivirals like tecovirimat, have shown efficacy in alleviating symptoms and reducing disease severity. Additionally, the development of new antiviral agents and treatment protocols remains an area of active research. Vaccination plays a crucial role in managing monkeypox outbreaks. The smallpox vaccine, which provides cross-protection against monkeypox, has been instrumental in controlling the spread of the disease. Public health strategies have emphasized targeted vaccination campaigns, thorough contact tracing, and comprehensive surveillance efforts. These measures highlight the necessity of rapid and coordinated actions to manage and prevent outbreaks effectively. Addressing the global burden of monkeypox requires strengthening healthcare infrastructure, enhancing disease surveillance systems, and fostering international collaboration. Efforts to improve diagnostics, vaccine distribution, and public health education are also vital. By focusing on these areas, the global community can improve its capacity to manage and mitigate the impact of this re-emerging infectious disease. Effective response strategies are essential for controlling current outbreaks and preventing future ones, ultimately reducing the global impact of monkeypox and improving public health outcomes.

About the authors

G. Fatima

Era University

Email: ghizalfatima8@gmail.com

PhD, FICN, Professor, Department of Biotechnology

India, Lucknow

H. B. Alhmadi

Al-Muthanna University

Email: ghizalfatima8@gmail.com

PhD, Professor, Department of Chemistry, College of Medicine

Iraq, Samawah

A. A. Mahdi

Era University

Email: ghizalfatima8@gmail.com

PhD, Vice Chancellor, Head of the Department of Biochemistry

India, Lucknow

N. Hadi

University of Kufa

Email: ghizalfatima8@gmail.com

MD, PhD, Head, Department of Pharmacology and Therapeutics, Faculty of Medicine

Iraq, Najaf

J. Fedacko

P.J. Safarik University

Email: ghizalfatima8@gmail.com

MD, PhD, Head, Department of Gerontology and Geriatric, Medipark, University Research Park

Slovakia, Kosice

A. Magomedova

Lomonosov Moscow State University

Email: ghizalfatima8@gmail.com

PhD (Economics), Department of Population, Faculty of Economics

Russian Federation, Moscow

A. M. Raza

Career Dental College and Hospital

Email: ghizalfatima8@gmail.com

MDS, PhD, Prof. Department of Pediatric Dentistry

India, Lucknow

A. Džupina

National Institute of Cardiovascular Disease

Author for correspondence.
Email: ghizalfatima8@gmail.com

MD, PhD, Head, Department of Cardiology and Angiology

Slovakia, Bratislava

References

  1. Beeson A., Styczynski A., Hutson C.L., Whitehill F., Angelo K.M., Minhaj F.S., Morgan C., Ciampaglio K., Reynolds M.G., McCollum A.M., Guagliardo S.A.J. Mpox respiratory transmission: the state of the evidence. Lancet Microbe, 2023, vol. 4, no. 4, pp. 277–283. doi: 10.1016/S2666-5247(23)00034-4
  2. Billioux B.J., Mbaya O.T., Sejvar J., Nath A. Neurologic complications of smallpox and monkeypox: a review. JAMA Neurol., 2022, vol. 79, no. 11, pp. 1180–1186. doi: 10.1001/jamaneurol.2022.3491
  3. Cheema A.Y., Ogedegbe O.J., Munir M., Alugba G., Ojo T.K. Monkeypox: a review of clinical features, diagnosis, and treatment. Cureus, 2022, vol. 14, no. 7: 26756. doi: 10.7759/cureus.26756
  4. De la Calle-Prieto F., Estébanez Muñoz M., Ramírez G., Díaz-Menéndez M., Velasco M., Azkune Galparsoro H., Salavert Lletí M., Mata Forte T., Blanco J.L., Mora-Rillo M., Arsuaga M., de Miguel Buckley R., Arribas J.R., Membrillo F.J.; Working Group of the UAAN — Grupo de Estudio de Patología Importada (GEPI) and the Working Group of the Monkeypox at the SEIMC. Treatment and prevention of monkeypox. Enferm. Infecc. Microbiol. Clin. (Engl. Ed.), 2023, vol. 41, no. 10, pp. 629–634. doi: 10.1016/j.eimce.2022.12.010
  5. Dodd L.E., Lane H.C., Muyembe-Tamfum J.J. Vaccines for Mpox — an unmet global need. NEJM Evid., 2024, vol. 3, no. 3: EVIDe2300348. doi: 10.1056/EVIDe2300348
  6. Dwivedi S., Singh V., Agrawal R., Misra R., Sadashiv, Fatima G., Abidi A., Misra S. Human monkeypox virus and host immunity: new challenges in diagnostics and treatment strategies. Adv. Exp. Med. Biol., 2024, vol. 1451, pp. 219–237. doi: 10.1007/978-3-031-57165-7_14
  7. Freckelton I., Wolf G. Responses to monkeypox: learning from previous public health emergencies. J. Law Med., 2022, vol. 29, no. 4, pp. 967–986
  8. Giovanetti M., Cella E., Moretti S., Scarpa F., Ciccozzi A., Slavov S.N., Benedetti F., Zella D., Ceccarelli G., Ciccozzi M., Borsetti A. Monitoring monkeypox: safeguarding global health through rapid response and global surveillance. Pathogens, 2023, vol. 12, no. 9: 1153. doi: 10.3390/pathogens12091153
  9. Ilic I., Zivanovic Macuzic I., Ilic M. Global outbreak of human monkeypox in 2022: update of epidemiology. Trop. Med. Infect. Dis., 2022, vol. 7, no. 10: 264. doi: 10.3390/tropicalmed7100264
  10. Jafari K., Woodward G.A. Mpox. Pediatr. Emerg. Care, 2023, vol. 39; no. 11, pp. 883–889. doi: 10.1097/PEC.0000000000003063
  11. Laurenson-Schafer H., Sklenovská N., Hoxha A., Kerr S.M., Ndumbi P., Fitzner J., Almiron M., de Sousa L.A., Briand S., Cenciarelli O., Colombe S., Doherty M., Fall I.S., García-Calavaro C., Haussig J.M., Kato M., Mahamud A.R., Morgan O.W., Nabeth P., Naiene J.D., Navegantes W.A., Ogundiran O., Okot C., Pebody R., Matsui T., Ramírez H.L., Smallwood C., Tasigchana R.F.P., Vaughan A.M., Williams G.S.; WHO mpox Surveillance and Analytics team; Mala P.O., Lewis R.F., Pavlin B.I., le Polain de Waroux O. Description of the first global outbreak of mpox: an analysis of global surveillance data. Lancet. Glob. Health, 2023, vol. 11, no. 7: e1012-e1023. doi: 10.1016/S2214-109X(23)00198-5
  12. Lu J., Xing H., Wang C., Tang M., Wu C., Ye F., Yin L., Yang Y., Tan W., Shen L. Mpox (formerly monkeypox): pathogenesis, prevention, and treatment. Signal. Transduct. Target. Ther., 2023, vol. 27, no. 8: 458. doi: 10.1038/s41392-023-01675-2
  13. Maredia H., Sartori-Valinotti J.C., Ranganath N., Tosh P.K., O’Horo J.C., Shah A.S. Supportive care management recommendations for mucocutaneous manifestations of monkeypox infection. Mayo Clin. Proc., 2023, vol. 98, no. 6, pp. 828–832. doi: 10.1016/j.mayocp.2023.01.019
  14. Poland G.A., Kennedy R.B., Tosh P.K. Prevention of monkeypox with vaccines: a rapid review. Lancet Infect. Dis., 2022, vol. 22, no. 12, pp. 349–358. doi: 10.1016/S1473-3099(22)00574-6
  15. Precious N.D., Agboola P., Oluwatimilehin O., Olakunle O.K., Olaniyi P., Adiatu A.I., Olusogo A.P., Obiwulu D.J., Adeola O.A., Ebubechukwu E.S., Oluwakayode A.M., Akano O.S., Kolawole Q.O. Re-emergence of monkeypox virus outbreak in Nigeria: epidemic preparedness and response (Review-Commentary). Ann. Med. Surg. (Lond.), 2023, vol. 85, no. 8, pp. 3990–3996. doi: 10.1097/MS9.0000000000001069.
  16. Shehryar A., Halappa Nagaraj R., Kanwal F., Reddy S.M., Grezenko H., Raut Y., Fareed M.U., Abdur Rehman, Şahin D., Bakht D., Ramteke P. Unraveling monkeypox: an emerging threat in global health. Cureus, 2023, vol. 15 no. 8: e43961. doi: 10.7759/cureus.43961
  17. Wang X., Lun W. Skin manifestation of human monkeypox. J. Clin. Med., 2023, vol. 12, no. 3: 914. doi: 10.3390/jcm12030914

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Copyright (c) 2025 Fatima G., Alhmadi H.B., Mahdi A.A., Hadi N., Fedacko J., Magomedova A., Raza A.M., Džupina A.

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