Monkeypox, now more commonly referred to as mpox, is a viral infectious disease caused by the mpox virus, a member of the Orthopoxvirus genus—the same family that includes smallpox. Although historically rare and primarily confined to parts of Central and West Africa, mpox gained significant global attention following the 2022 multi-country outbreak, which highlighted its capacity for broader human-to-human transmission.
1. Origin and History
Monkeypox was first identified in 1958 after outbreaks occurred in laboratory monkeys—hence the name. The first human case was recorded in 1970 in the Democratic Republic of Congo. For decades, mpox cases were largely associated with animal exposure in rural African regions.
Historically, two main genetic clades existed:
-
Clade I (Congo Basin clade) – more severe, higher mortality.
-
Clade II (West African clade) – milder disease, lower mortality.
Recent outbreaks have primarily involved Clade II.
2. How Mpox Spreads
Mpox is a zoonosis, meaning it can spread from animals to humans. Transmission occurs through:
Animal-to-human
-
Direct contact with infected animals (rodents are believed to be key reservoirs)
-
Bites or scratches
-
Handling bushmeat
-
Contact with body fluids or lesions of infected animals
Human-to-human
-
Close physical contact, including skin-to-skin contact with lesions
-
Respiratory droplets during prolonged face-to-face interaction
-
Contaminated materials, such as bedding or clothing
-
Intimate or sexual contact — a major driver in the 2022 outbreak
Unlike COVID-19, mpox is not primarily airborne.
3. Symptoms
Mpox symptoms typically appear 5–21 days after exposure.
Common symptoms include:
-
Fever
-
Chills
-
Headache
-
Muscle aches
-
Swollen lymph nodes (a key feature distinguishing mpox from smallpox)
-
Exhaustion
Within a few days, a characteristic rash appears, often starting on the face or genitals and spreading to the body. Lesions progress through stages:
-
Macules
-
Papules
-
Vesicles
-
Pustules
-
Scabs
The illness usually lasts 2–4 weeks.
4. Severity and Risks
Most mpox infections are mild to moderate. However, higher risk exists for:
-
Children
-
Pregnant individuals
-
Immunocompromised people
-
Those with untreated HIV
Mortality rates vary depending on the viral clade; historical rates range from 1% to 10%, though recent global outbreaks have been far lower.
5. Diagnosis
Diagnosis is confirmed through:
-
PCR testing of lesion samples (most accurate)
-
Viral culture (rarely used)
-
Serological testing (less common)
6. Treatment
Most cases resolve without specific treatment. Symptomatic care includes:
-
Pain relievers
-
Hydration
-
Skin care
In severe or high-risk cases, antiviral medications such as tecovirimat (TPOXX) may be used under medical supervision.
7. Prevention
Vaccination
Two vaccines originally developed for smallpox can help prevent mpox:
-
JYNNEOS (MVA-BN) – widely used and non-replicating
-
ACAM2000 – older, live vaccine with more side effects
Vaccination is recommended for:
-
Close contacts of confirmed cases
-
People at higher occupational risk
-
Some high-risk sexual networks
Behavioral and Hygiene Measures
-
Avoid close contact with people who have a rash consistent with mpox
-
Avoid touching bedding/clothing of infected individuals
-
Maintain good hand hygiene
8. Global Response
The 2022 outbreak marked the first widespread, sustained transmission outside Africa. Public health agencies responded with:
-
Expanded vaccination campaigns
-
Enhanced surveillance
-
Public education, especially around intimate-contact transmission
By late 2023, global cases had declined significantly, though sporadic cases continue to appear.
9. Outlook
Mpox is controllable with current medical tools, but ongoing vigilance is important. Strengthened global healthcare infrastructure, better surveillance, and broader vaccine access are key to preventing future outbreaks.