Monkeypox (MPOX): Unmasking the Lesser-known Viral Threat

Authors

  • Saksham Shah 3rd year MBBS student, RUHS College of Medical Sciences, Jaipur 302033, India.
  • Reshu Gupta Department of Physiology, RUHS College of Medical Sciences, Jaipur 302033, India.
  • Nishtha Mathur 3rd year MBBS student, RUHS College of Medical Sciences, Jaipur 302033, India.

DOI:

https://doi.org/10.31584/jhsmr.20241081

Keywords:

IMVANEX, monkeypox, orthopox, Rashes, smallpox, viral

Abstract

Monkeypox (Mpox) is caused by a viral infection and has been endemic in several African states after the last outbreak throughout the world in 2003. This disease resurfaced in the year 2022 and has since spread worldwide, even in countries where no cases had been reported in the earlier outbreak. While the world was still recovering from the menace of corona virus disease 2019 this virus; having similar features, started to spread across the world affecting thousands of people. The virus can be transmitted from human to human, and to humans from bites and scratches of infected animals. Common signs and symptoms include rashes and lymphadenopathy, accompanied with fever. Preventive measures for the Mpox virus include: using masks and alcohol-based hand sanitizers, practicing social distancing in crowded areas and practicing safe sexual activities. ACAM2000 and LC16m8 are a few vaccines available for its treatment. Early diagnosis and timely treatment of the disease have helped to curb the incidence and mortality of Mpox. Through this article, we discuss the history of infection, mode of transmission, the genomic data of the virus along with its signs and symptoms and its prevention and treatment using available vaccines. World governments and healthcare providers need to act appropriately in order to combat another such outbreak, as this disease has not been eradicated yet.

References

Farahat RA, Sah R, El-Sakka AA, Benmelouka AY, Kundu M, Labieb F, et al. Human monkeypox disease (MPX). Infez Med 2022;30:372-91.

Jahan Y. Monkeypox is an emerging threat to lowmiddle-income countries amid COVID-19. Ann Med Surg 2022;80:104344.

Centres for Disease Control and Prevention. Mpox | poxvirus. [homepage on the Internet]. Georgia: CDC; 2024 [cited 2024 Jan 8]. Avaliable from: https://www.cdc.gov/poxvirus/mpox/index.html

Akter MS, Sohan M, Islam MR. The rapid spreading of monkeypox virus is a threat for global public health: What should we do to fight this old enemy?. Health Sci Rep 2022;5:e876.

Cho CT, Wenner HA. Monkeypox virus. Bacteriol Rev 1973;37:1-8.

Ladnyj ID, Ziegler P, Kima E. A human infection caused by monkeypox virus in Basankusu Territory, Democratic Republic of the Congo. Bull World Health Organ 1972;46:593-7.

World Health Organization. Mpox (Monkeypox). [homepage on the Internet] Geneva: WHO; 2023 [cited 2024 Jan 9]. Avaliable from: https://www.who.int/news-room/fact-sheets/detail/monkeypox

Reynolds MG, Davidson WB, Curns AT, Conover CS, Huhn G, Davis JP, et al. Spectrum of infection and risk factors for human monkeypox, United States, 2003. Emerg Infect Dis 2007;13:1332-9.

Mathieu E, Spooner F, Dattani S, Arriagada P, Bachler D, Bergel M, et al. Mpox (Monkeypox). Our World in Data. [homepage on the Internet] Oxford: Global Change Data Lab;2022 [cited 2024 Jan 9]. Avaliable from: https://ourworldindata. org/monkeypox

World Health Organization. 2022-23 Mpox (Monkeypox) Outbreak: global trends. [homepage on the Internet] Geneva:WHO; 2023 [cited 2023 Jan 9]. Avaliable from: https://worldhealthorg.shinyapps.io/mpx_global/

Nuzzo JB, Borio LL, Gostin LO. The WHO declaration of monkeypox as a global public health emergency. JAMA 2022;328:615-7.

World Health Organization. Disease outbreak news; Multicountry monkeypox outbreak in non-endemic countries. [homepage on the Internet] Geneva: WHO; 2022 [cited 2023 Jan 8]. Avaliable from: https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON388

CNBC. Kopecki D. Monkeypox outbreak is primarily spreading through sex, WHO officials say. [homepage on the Internet] New York: CNBC; 2022 [cited 2024 Jan 8]. Avaliable from: https://www.cnbc.com/2022/05/23/monkeypox-outbreak-isprimarily-spreading-through-sex-who-officials-say.html

Antinori A, Mazzotta V, Vita S, Carletti F, Tacconi D, Lapini LE, et al. Epidemiological, clinical and virological characteristics of four cases of monkeypox support transmission through sexual contact, Italy, May 2022. Euro Surveill 2022;27:2200421.

Kannan S, Ali P, Sheeza A. Monkeypox: epidemiology, mode of transmission, clinical features, genetic clades and molecular properties. Eur Rev Med Pharmacol Sci 2022;26:5983-90.

European Center for Disease Prevention and Control. Monkeypox multi-country outbreak. [Monograph on the Internet] Stockholm: European Center for Disease Prevention and Control; 2022 [cited 2024 Jan 9]. Avaliable from: https://www.ecdc.europa.eu/sites/default/files/documents/Monkeypox-multi-countryoutbreak.pdf

Di Giulio DB, Eckburg PB. Human monkeypox: an emerging zoonosis. Lancet Infect Dis 2004;4:15-25.

Esposito JJ, Nakano JH, Obijeski JF. Can variola-like viruses be derived from monkeypox virus? An investigation based on DNA mapping. Bull World Health Organ 1985;63:695-703.

Rondle CJ, Sayeed KA. Studies on monkeypox virus. Bull World Health Organ 1972;46:577-83.

Seet BT, Johnston JB, Brunetti CR, Barrett JW, Everett H, Cameron C, et al. Poxviruses and immune evasion. Annu Rev Immunol 2003;21:377-423.

Resch W, Hixson KK, Moore RJ, Lipton MS, Moss B. Protein composition of the vaccinia virus mature virion. Virology 2007;358:233-47.

Manes NP, Estep RD, Mottaz HM, Moore RJ, Clauss TR, Monroe ME, et al. Comparative proteomics of human monkeypox and vaccinia intracellular mature and extracellular enveloped virions. J Proteome Res 2008;7:960-8.

Peng Q, Xie Y, Kuai L, Wang H, Qi J, Gao GF, et al. Structure of monkeypox virus DNA polymerase holoenzyme. Science 2023;379:100-5.

Andrei G, Fiten P, Krečmerová M, Opdenakker G, Topalis D, Snoeck R. Poxviruses bearing DNA polymerase mutations show complex patterns of cross-resistance. Biomedicines 2022;10:580.

Smith GL, Law M. The exit of vaccinia virus from infected cells. Virus Res 2004;106:189-97.

Pickup DJ. Extracellular virions: the advance guard of poxvirus infections. PLoS Pathog 2015;11:e1004904.

Marennikova SS, Šeluhina EM, Mal’Ceva NN, Cimiskjan KL, Macevic GR. Isolation and properties of the causal agent of a new variola-like disease (monkeypox) in man. Bull World Health Organ 1972;46:599-611.

McFadden G. Poxvirus tropism. Nat Rev Microbiol 2005;3:201-13.

Moss B. Poxvirus cell entry: how many proteins does it take? Viruses 2012;4:688-707.

Cairns J. The initiation of vaccinia infection. Virology 1960;11:603-23.

Dales S, Siminovitch L. The development of vaccinia virus in Earle’s L strain cells as examined by electron microscopy. J Biophys Biochem Cytol 1961;10:475-503.

Kmiec D, Kirchhoff F. Monkeypox: a new threat? Int J Mol Sci 2022;23:7866-80.

Gigante CM, Korber B, Seabolt MH, Wilkins K, Davidson W, Rao AK, et al. Multiple lineages of monkeypox virus detected in the United States, 2021–2022. Science 2022;378:560-5.

Delamonica B, Davalos L, Larijani M, Anthony SJ, Liu J, MacCarthy T. Evolutionary potential of the monkeypox genome arising from interactions with human APOBEC3 enzymes. Virus Evol 2023;9.

Song H, Janosko K, Johnson RF, Qin J, Josleyn N, Jett C. Poxvirus antigen staining of immune cells as a biomarker to predict disease outcome in monkeypox and cowpox virus infection in non-human primates. PLoS One 2013;8:e60533.

Rubins KH, Hensley LE, Jahrling PB, Hensley LE, Whitney AR, Geisbert TW, et al. The host response to smallpox: analysis of the gene expression program in peripheral blood cells in a nonhuman primate model. Proc Natl Acad Sci USA 2004;101:15190-5.

Lum FM, Torres-Ruesta A, Tay MZ, Lin RTP, Lye DC, Ng LFP, et al. Monkeypox: disease epidemiology, host immunity and clinical interventions. Nat Rev Immunol 2022;22:597-613.

Byrd D, Shepherd N, Lan J, Hu N, Amet T, Yang K, et al. Primary human macrophages serve as vehicles for vaccinia virus replication and dissemination. J Virol 2014;88:6819-31.

Fischer MA, Davies ML, Reider IE, Heipertz EL, Epler MR, Sei JJ, et al. CD11b+, Ly6G+ cells produce type I interferon and exhibit tissue protective properties following peripheral virus infection. PLoS Pathog 2011;7:e1002374.

Graef S, Kurth A, Auw-Haedrich C, Plange N, Kern WV, Nitsche A, et al. Clinicopathological findings in persistent corneal cowpox infection. JAMA Ophthalmol 2013;131:1089-91.

Zaucha GM, Jahrling PB, Geisbert TW, Swearengen JR, Hensley L. The pathology of experimental aerosolized monkeypox virus infection in cynomolgus monkeys (Macacafascicularis). Lab Invest 2001;81:1581-600.

Müller G, Meyer A, Gras F, Emmerich P, Kolakowski T, Esposito JJ. Monkeypox virus in liver and spleen of child in Gabon. Lancet 1988;331:769-70.

Pfeffer M, Meyer H. Poxvirus diagnostics. Birkhäuser Verlag Basel. [monograph on the Internet] Basel: Birkhäuser Verlag;2007 [cited 2024 Jan 10]. Avaliable from: https://www.researchgate.net/profile/Martin-Pfeffer/publication/226326266_Poxvirus_diagnostics/links/02bfe50ec0431b1548000000/Poxvirus-diagnostics.pdf

Medical Buyer. Transasia- ERBA Launches India’s first Monkeypox PCR Kit. [homepage on the Internet] New Delhi: Medical Buyer; 2022 [cited 2024 Jan 10]. Avaliable from: https://www.medicalbuyer.co.in/transasia-erba-launches-indias-firstmonkeypox-pcr-kit/

Peter OJ, Kumar S, Kumari N, Oguntolu FA, Oshinubi K, Musa R. Transmission dynamics of Monkeypox virus: a mathematical modelling approach. Model Earth Syst Environ 2022;8:3423-34.

Centres for Disease Control and Prevention. Signs and symptoms | Mpox | Poxvirus. [homepage on the Internet] Atlanta: CDC; 2024 [cited 2024 Jan 10]. Aveliable from: https://www.cdc.gov/poxvirus/mpox/symptoms/index.html

Weaver JR, Isaacs SN. Monkeypox virus and insights into its immunomodulatory proteins. Immunol Rev 2008;225:96-113.

Breman JG. Monkeypox: an emerging infection for humans? In: Scheld WM, Craig WA, Hughes JM, editors. Emerging infections 4 [monograph on the Internet]. Washington, DC: Amer Society for Microbiology; 2000 [cited 2023 Dec 7]. Avaliable from: https://onlinelibrary.wiley.com/doi/book/10.1128/9781555816971

Tarín-Vicente EJ, Alemany A, Agud-Dios M, Maria U, Suñer C, Arando M, et al. Clinical presentation and virological assessment of confirmed human monkeypox virus cases in Spain: a prospective observational cohort study. Lancet 2022;400:661-9.

Martins-Filho PR. Increase in interest in sexually transmitted infections on YouTube during the monkeypox outbreak in 2022: A global infodemiology study. Int J Surg 2022;107:106970.

Goff AJ, Chapman J, Foster C, Wlazlokski C, Shamblin J, Lin K, et al. A novel respiratory model of infection with monkeypox virus in cynomolgus macaques. J Virol 2011;85:4898-909.

Nalca A, Livingston VA, Garza NL, Zumbrun EE, Frick OM, Chapman JL, et al. Experimental infection of cynomolgusmacaques (Macaca fascicularis) with aerosolized monkeypox virus. PLoS one 2010;5:e12880.

Bížová B, Veselý D, Trojánek M, Rob F. Coinfection of syphilis and monkeypox in HIV positive man in Prague, Czech Republic. Travel Med Infect Dis 2022;49:102368.

Centres for Disease Control and Prevention. Clinical recognition | Mpox | Poxvirus. [homepage on the Internet] Atlanta: CDC; 2023 [cited 2024 Jan 11]. Avaliable from: https://www.cdc.gov/poxvirus/mpox/clinicians/clinical-recognition.html

Heymann DL, Szczeniowski M, Esteves K. Re-emergence of monkeypox in Africa: a review of the past six years. Br Med Bull 1998;54:693-702.

Hammarlund E, Lewis MW, Carter SV, Amanna I, Hansen SG, Strelow LI, et al. Multiple diagnostic techniques identify previously vaccinated individuals with protective immunity against monkeypox. Nat Med 2005;11:1005-11.

Grosenbach DW, Jordan R, Hruby DE. Development of the small-molecule antiviral ST-246® as a smallpox therapeutic. Future Virol 2011;6:653-71.

Centres for Disease Control and Prevention. For public health veterinarians and animal health officials | Mpox | Poxvirus. [homepage on the Internet] Atlanta: CDC; 2024 [cited 2024 Jan 11]. Avaliable: https://www.cdc.gov/poxvirus/mpox/veterinarian/animalofficials.html#:~:text=Mpox%20Transmission%20between%20Animals%20and%20People,-Infected%20animals%20can

McCollum AM, Damon IK. Human monkeypox. Clin Infect Dis 2014;58:260-7.

Sapkal A, Agrawal S. Monkeypox: the re-emerging terror. Cureus 2022;14:e28597.

Downloads

Published

2024-12-19

How to Cite

1.
Shah S, Gupta R, Mathur N. Monkeypox (MPOX): Unmasking the Lesser-known Viral Threat. J Health Sci Med Res [Internet]. 2024 Dec. 19 [cited 2024 Dec. 22];43(1):e20241081. Available from: https://he01.tci-thaijo.org/index.php/jhsmr/article/view/275975

Issue

Section

Review Article