Monkeypox is a viral disease caused by the monkeypox (MPX) virus.1 There are two clades of monkeypox: the Central African clade and the West African clade, with the Central African clade being more virulent.2

The following risk factors place a person at higher risk of getting monkeypox3-4:

• being male
• travelling abroad
• men having sexual intercourse with men
• condomless sex
• having multiple sexual partners

The MPX virus is transmitted via either animal-human or human-human contact, or when someone comes into contact with contaminated material, involving close contact with skin wounds and bodily fluids of infected organisms.5 In the 2022 monkeypox outbreak, it was noted that MPX was frequently transmitted via sexual intercourse.6 It is postulated that the MPX virus enters cells in a non-cell-receptor-specific manner.4 MPX prefers to infect epithelial cells of the stratum spinosum of the dermis of the skin.4 A macule develops on the skin which then evolves into a raised papule, which then changes into a vesicle with clear liquid inside. 2,4 The vesicle changes into a pustule, with the liquid turning yellow. 2,4 The pustule eventually bursts to release fluid with infectious virions, and forms a crust that falls off after a while.2,4

Monkeypox infection is divided into two phases, the invasion period and the skin eruption period.5

• fever
• intense headache
• lymph node swelling
• back pain
• muscle ache
• fatigue

• rash that changes from being flat, to being raised, to having clear fluid, to having yellow fluid.
• crusts that fall off

Existing vaccines (as of September 2022) approved for monkeypox have not been tested for efficacy against monkeypox.7-9 However, they are recommended by the CDC for monkeypox.8-9 Vaccine side effects include rash, headache, tiredness, fever, swelling and redness, and muscle aches.8-9

Monkeypox treatment is supportive in nature, involving addressing symptoms and complications that may arise.5 As of writing (September 2022), a possible agent exists for monkeypox treatment, tecovirimat, but its efficacy against monkeypox is unknown. 10

Cases of monkeypox in non-endemic countries were first reported in early May 2022.11 It has since spread across North America and Europe.2 The World Health Organisation declared monkeypox as a Global Health Emergency on July 23, 2022.12 The number of cases globally at the time of writing (September 2022) is 65,000, with 26 total deaths worldwide.13

• World Health Organisation
• United States Centres for Disease Control and Prevention
• European Centre for Disease Prevention and Control
• Government of the United Kingdom
• Ministry of Health Singapore
• Australian Government Department of Health and Aged Care
• New Zealand Government
• Search about monkeypox on PubMed

1. Rizk JG, Lippi G, Henry BM, Forthal DN, Rizk Y. Prevention and Treatment of Monkeypox. Drugs. 2022;82(9):957-963. doi:10.1007/s40265-022-01742-y
2. Lum FM, Torres-Ruesta A, Tay MZ, et al. Monkeypox: disease epidemiology, host immunity and clinical interventions. Nat Rev Immunol. Published online September 5, 2022. doi:10.1038/s41577-022-00775-4
3. Martins-Filho PR, Tanajura DM, Vecina-Neto G. Multi-country monkeypox outbreak: A quantitative evidence synthesis on clinical characteristics, potential transmission routes, and risk factors. Eur J Intern Med. Published online September 2022. doi:10.1016/j.ejim.2022.09.013
4. Gomez-Lucia E. Monkeypox: Some Keys to Understand This Emerging Disease. Animals. 2022;12(17):2190. doi:10.3390/ani12172190
5. Monkeypox. World Health Organisation. Published May 19, 2022. Accessed September 24, 2022. https://www.who.int/news-room/fact-sheets/detail/monkeypox
6. Thornhill JP, Barkati S, Walmsley S, et al. Monkeypox Virus Infection in Humans across 16 Countries — April-June 2022. New England Journal of Medicine. 2022;387(8):679-691. doi:10.1056/NEJMoa2207323
7. Monkeypox Vaccines. Centres for Disease Control and Prevention. Updated August 30, 2022. Accessed September 24, 2022. https://www.cdc.gov/poxvirus/monkeypox/vaccines/index.html
8. JYNNEOS Vaccine. Centres for Disease Control and Prevention. Updated August 30, 2022. Accessed September 24, 2022. https://www.cdc.gov/poxvirus/monkeypox/vaccines/jynneos.html
9. ACAM2000 Vaccine. Centres for Disease Control and Prevention. Updated August 30, 2022. Accessed September 24, 2022. https://www.cdc.gov/poxvirus/monkeypox/vaccines/acam2000.html
10. The unknown efficacy of tecovirimat against monkeypox. Nature Medicine. Published September 13, 2022. Accessed September 24, 2022. https://www.nature.com/articles/d41591-022-00094-0
11. Monkeypox outbreak 2022. World Health Organisation. Accessed September 24, 2022. https://www.who.int/emergencies/situations/monkeypox-oubreak-2022
12. WHO Director-General declares the ongoing monkeypox outbreak a Public Health Emergency of International Concern. World Health Organisation. Published July 23, 2022. Accessed September 24, 2022. https://www.who.int/europe/news/item/23-07-2022-who-director-general-declares-the-ongoing-monkeypox-outbreak-a-public-health-event-of-international-concern
13. 2022 Monkeypox Outbreak Global Map. Centres for Disease Control and Prevention. Updated September 23, 2022. Accessed September 24, 2022. https://www.cdc.gov/poxvirus/monkeypox/response/2022/world-map.html