Understanding the Mpox outbreak: Advances in epidemiology, management and prevention (Review)

Alghamdi,Abdulellah Samer; Aldajani,Basheer; Aljasim,Mohammed Ali; Alotaibi,Abdullah Hani; Alsultan,Ali Taleb; Alhussain,Abdullah Abbas; Alswedan,Abdulaziz Khalil; Motawei,Kamaluddin H.; Iqbal,Muhammad; Bashir,Shahid

doi:10.3892/wasj.2025.352

Understanding the Mpox outbreak: Advances in epidemiology, management and prevention (Review)

Authors:
- Abdulellah Samer Alghamdi
- Basheer Aldajani
- Mohammed Ali Aljasim
- Abdullah Hani Alotaibi
- Ali Taleb Alsultan
- Abdullah Abbas Alhussain
- Abdulaziz Khalil Alswedan
- Kamaluddin H. Motawei
- Muhammad Iqbal
- Shahid Bashir
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Affiliations: College of Medicine, Imam Abdulrahman Bin Faisal University, 34221 Dammam, Kingdom of Saudi Arabia, Department of Anatomy, College of Medicine, Imam Abdulrahman Bin Faisal University, 34221 Dammam, Kingdom of Saudi Arabia, Department of Physiology, College of Medicine, King Saud University, 11362 Riyadh, Kingdom of Saudi Arabia, Neuroscience Center, King Fahad Specialist Hospital Dammam, Dammam 32253, Kingdom of Saudi Arabia
Published online on: May 15, 2025 https://doi.org/10.3892/wasj.2025.352
Article Number: 64
Copyright : © Alghamdi et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].

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Abstract

Monkeypox (Mpox) is a zoonotic disease caused by the monkeypox virus (MPXV), a member of the Poxviridae family. Historically endemic to Central and West Africa, its spread beyond these regions in 2022 prompted the World Health Organization to declare it a public health emergency. Mpox is primarily transmitted through direct skin‑to‑skin contact with lesions, animal bites, or exposure to contaminated materials. The present review discusses the epidemiological, virological, immunological, clinical, diagnostic, and preventive aspects of Mpox infection. It highlights the two main viral clades (clade I and clade II), the role of APOBEC3‑driven mutations, and factors contributing to the resurgence of outbreaks, such as environmental changes, increased urbanization, air travel, and the prevalence of HIV/AIDS. Clinical manifestations range from localized rash and systemic symptoms to severe complications like encephalitis and sepsis. Diagnostic approaches including PCR, whole‑genome sequencing, and electron microscopy are explored, alongside preventive measures such as the JYNNEOS and ACAM2000 vaccines. Management primarily involves supportive care and antiviral therapy with tecovirimat, although recent clinical trials have raised concerns about its efficacy. Challenges in outbreak control include limited vaccine access, diagnostic resource gaps, stigma, particularly among high‑risk populations, and the potential emergence of antiviral resistance. The present review emphasizes the importance of the One Health approach, recognizing the interconnectedness of human, animal, and environmental health sectors, to ensure a coordinated and effective response. Furthermore, it underscores the need for ongoing research into viral evolution, novel therapeutic development, enhanced diagnostic methods, and understanding long‑term physical and psychosocial outcomes to strengthen global preparedness against Mpox outbreaks.

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July-August 2025
Volume 7 Issue 4

Print ISSN: 2632-2900
Online ISSN:2632-2919

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CiteScore: 1.5
CiteScore Rank: Q2: #291/668 General Medicine
Source Normalized Impact per Paper (SNIP): 0.339
SCImago Journal Rank (SJR): 0.228

1	Centers for Disease Control and Prevention (CDC): Monkeypox Travel. Travel. CDC, Atlanda, GA, 2022. https://www.cdc.gov/poxvirus/monkeypox/travel/index.html. Accessed on October 17, 2022.
2	Yang Z: Monkeypox: A potential global threat? J Med Virol. 94:4034–4036. 2022.PubMed/NCBI View Article : Google Scholar
3	World Health Organization (WHO): WHO Director-General declares the ongoing monkeypox outbreak a Public Health Emergency of International Concern. WHO, Geneva, 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.
4	World Health Organization (WHO): Fifth meeting of the International Health Regulations (2005) Emergency Committee on the multi-country outbreak of monkeypox (mpox). WHO, Gemeva, 2023. https://www.who.int/news/item/11-05-2023-fifth-meeting-of-the-international-health-regulations-(2005)-(ihr)-emergency-committee-on-the-multi-country-outbreak-of-monkeypox-(mpox).
5	World Health Organization (WHO): WHO Director-General declares mpox outbreak a Public Health Emergency of International Concern. WHO, Geneva, 2024. https://www.who.int/news/item/14-08-2024-who-director-general-declares-mpox-outbreak-a-public-health-emergency-of-international-concern.
6	World Health Organization (WHO): Monkeypox situation in the WHO European Region. WHO, Geneva. https://www.who.int/europe/emergencies/situations/monkeypox.
7	Centers for Disease Control and Prevention (CDC): One Health: About. CDC, Atlanta, 2024. https://www.cdc.gov/one-health/about/.
8	World Health Organization (WHO): One Health. WHO, Geneva. https://www.who.int/health-topics/one-health#tab=tab_1.
9	World Health Organization (WHO): Mpox fact sheet. WHO, Geneva, 2024. https://www.who.int/news-room/fact-sheets/detail/mpox.
10	International Committee on Taxonomy of Viruses: ICTV: Family: Poxviridae. Poxviridae. International Committee on Taxonomy of Viruses, 2009. https://ictv.global/report_9th/dsDNA/poxviridae. Accessed on October 17, 2022.
11	Realegeno S, Puschnik AS, Kumar A, Goldsmith C, Burgado J, Sambhara S, Olson VA, Carroll D, Damon I, Hirata T, et al: Monkeypox virus host factor screen using haploid cells identifies essential role of GARP complex in extracellular virus formation. J Virol. 91:e00011–17. 2017.PubMed/NCBI View Article : Google Scholar
12	Rizk JG, Lippi G, Henry BM, Forthal DN and Rizk Y: Prevention and treatment of monkeypox. Drugs. 82:957–963. 2022.PubMed/NCBI View Article : Google Scholar
13	Rheinbaben F, Gebel J, Exner M, Mercer A, Weber O and Schmidt A: Environmental resistance, disinfection, and sterilization of poxviruses. In: Poxviruses. 1st edition. Basel, Switzerland, Birkhäuser Basel, pp397-405, 2007 (Birkhäuser Advances in Infectious Diseases).
14	Essbauer S, Meyer H, Porsch-Ozcürümez M and Pfeffer M: Long-lasting stability of vaccinia virus (orthopoxvirus) in food and environmental samples. Zoonoses Public Health. 54:118–124. 2007.PubMed/NCBI View Article : Google Scholar
15	Morgan CN, Whitehill F, Doty JB, Schulte J, Matheny A, Stringer J, Delaney LJ, Esparza R, Rao AK and McCollum AM: Environmental persistence of monkeypox virus on surfaces in household of person with travel-associated infection, Dallas, Texas, USA, 2021. Emerg Infect Dis. 28:1982–1989. 2022.PubMed/NCBI View Article : Google Scholar
16	European Centre for Disease Prevention and Control: Factsheet for Health Professionals on Monkeypox, 2022. https://www.ecdc.europa.eu/en/all-topics-z/monkeypox/factsheet-health-professionals. Accessed on September 27, 2022.
17	Guarner J, Del Rio C and Malani PN: Monkeypox in 2022-What clinicians need to know. JAMA. 328:139–140. 2022.PubMed/NCBI View Article : Google Scholar
18	O'Toole Á and Rambaut A: Initial observations about putative APOBEC3 deaminase editing driving short-term evolution of MPXV since 2017. Virological. ARTIC Network, 2022. https://virological.org/t/initial-observations-about-putative-apobec3-deaminase-editing-driving-short-term-evolution-of-mpxv-since-2017/830. Accessed on October 23, 2022.
19	Likos AM, Sammons SA, Olson VA, Frace AM, Li Y, Olsen-Rasmussen M, Davidson W, Galloway R, Khristova ML, Reynolds MG, et al: A tale of two clades: Monkeypox viruses. J Gen Virol. 86:2661–2672. 2005.PubMed/NCBI View Article : Google Scholar
20	World Health Organization (WHO): Monkeypox: Experts give virus variants new names. News Release. WHO, Geneva, 2022. https://www.who.int/news/item/12-08-2022-monkeypox-experts-give-virus-variants-new-names. Accessed on October 17, 2022.
21	Chen N, Li G, Liszewski MK, Atkinson JP, Jahrling PB, Feng Z, Schriewer J, Buck C, Wang C, Lefkowitz EJ, et al: Virulence differences between monkeypox virus isolates from West Africa and the Congo basin. Virology. 340:46–63. 2005.PubMed/NCBI View Article : Google Scholar
22	Saijo M, Ami Y, Suzaki Y, Nagata N, Iwata N, Hasegawa H, Iizuka I, Shiota T, Sakai K, Ogata M, et al: Virulence and pathophysiology of the Congo Basin and West African strains of monkeypox virus in non-human primates. J Gen Virol. 90:2266–2271. 2009.PubMed/NCBI View Article : Google Scholar
23	Brown K and Leggat PA: Human monkeypox: Current state of knowledge and implications for the future. Trop Med Infect Dis. 1(8)2016.PubMed/NCBI View Article : Google Scholar
24	Yinka-Ogunleye A, Aruna O, Ogoina D, Aworabhi N, Eteng W, Badaru S, Mohammed A, Agenyi J, Etebu EN, Numbere TW, et al: Reemergence of human monkeypox in Nigeria, 2017. Emerg Infect Dis. 24:1149–1151. 2018.PubMed/NCBI View Article : Google Scholar
25	Vakaniaki EH, Kacita C, Kinganda-Lusamaki E, O'Toole Á, Wawina-Bokalanga T, Mukadi-Bamuleka D, Amuri-Aziza A, Malyamungu-Bubala N, Mweshi-Kumbana F, Mutimbwa-Mambo L, et al: Sustained human outbreak of a new MPXV clade I lineage in eastern Democratic Republic of the Congo. Nat Med. 2024;30:2791–5.
26	Karagoz A, Tombuloglu H, Alsaeed M, Tombuloglu G, AlRubaish AA, Mahmoud A, Smajlović S, Ćordić S, Rabaan AA and Alsuhaimi E: Monkeypox (mpox) virus: Classification, origin, transmission, genome organization, antiviral drugs, and molecular diagnosis. J Infect Public Health. 16:531–541. 2023.PubMed/NCBI View Article : Google Scholar
27	Curaudeau M, Besombes C, Nakouné E, Fontanet A, Gessain A and Hassanin A: Identifying the most probable mammal reservoir hosts for Monkeypox virus based on ecological niche comparisons. Viruses. 15(727)2023.PubMed/NCBI View Article : Google Scholar
28	Centers for Disease Control and Prevention (CDC): Past U.S. cases and outbreaks. CDC, Atlanda, GA. https://www.cdc.gov/mpox/outbreaks/past-us-cases/index.html. Accessed on September, 2023.
29	Pinto P, Costa MA, Gonçalves MF, Rodrigues AG and Lisboa C: Mpox person-to-person transmission-where have we got so far? A systematic review. Viruses. 15(1074)2023.PubMed/NCBI View Article : Google Scholar
30	Zebardast A, Latifi T, Shafiei-Jandaghi NZ, Gholami Barzoki M and Shatizadeh Malekshahi S: Plausible reasons for the resurgence of Mpox (formerly Monkeypox): An overview. Trop Dis Travel Med Vaccines. 9(23)2023.PubMed/NCBI View Article : Google Scholar
31	Duda R, Betoulet JM, Besombes C, Mbrenga F, Borzykh Y, Nakouné E and Giles-Vernick T: A time of decline: An eco-anthropological and ethnohistorical investigation of mpox in the Central African Republic. PLOS Glob Public Health. 4(e0002937)2024.PubMed/NCBI View Article : Google Scholar
32	McCollum AM, Shelus V, Hill A, Traore T, Onoja B, Nakazawa Y, Doty JB, Yinka-Ogunleye A, Petersen BW, Hutson CL and Lewis R: Epidemiology of human mpox-worldwide, 2018-2021. MMWR Morb Mortal Wkly Rep. 72:68–72. 2023.PubMed/NCBI View Article : Google Scholar
33	Gao S, Zeng Z, Zhai Y, Chen F, Feng X, Xu H, Kan W, Lu J, Zhou J and Chen Z: Driving effect of multiplex factors on Mpox in global high-risk region, implication for Mpox based on one health concept. One Health. 17(100597)2023.PubMed/NCBI View Article : Google Scholar
34	Lin M, Xin Y, Wang J, Nie P, Yan Q and Wang L and Wang L: Analysing monkeypox epidemic drivers: Policy simulation and multi-index modelling across 39 nations. J Glob Health. 14(04037)2024.PubMed/NCBI View Article : Google Scholar
35	Centers for Disease Control and Prevention (CDC): About one health. CDC, Atlanda, GA. https://www.cdc.gov/one-health/about/index.html. Accessed on October 1, 2023.
36	Islam M, Rahman A and Rahman MT: One health: A must-needed approach for dealing with Monkeypox. J Res Vet Sci. 3:52–55. 2024.
37	World Health Organization (WHO): Monkeypox. WHO, Geneva, 2022 https://www.who.int/en/news-room/fact-sheets/detail/monkeypox. Accessed on October 1, 2023.
38	European Centre for Disease Prevention and Control (ECDC): ECDC releases first update to its rapid risk assessment on the Monkeypox outbreak. Media Centre. ECDC, Stockholm, 2022 https://www.ecdc.europa.eu/en/news-events/ecdc-releases-first-update-its-rapid-risk-assessment-monkeypox-outbreak. Accesse on October 17, 2022.
39	Centers for Disease Control and Prevention (CDC): Monkeypox virus infection in the United States and other non-endemic countries-2022. HAN Archive-00466. CDC, Geneva, 2022 https://emergency.cdc.gov/han/2022/han00466.asp. Accessed on 17 October, 2022.
40	Antinori A, Mazzotta V, Vita S, Carletti F, Tacconi D, Lapini LE, D'Abramo A, Cicalini S, Lapa D, Pittalis S, et al: Epidemiological, clinical and virological characteristics of four cases of monkeypox support transmission through sexual contact, Italy, May 2022. Euro Surveill. 27(2200421)2022.PubMed/NCBI View Article : Google Scholar
41	Mbala PK, Huggins JW, Riu-Rovira T, Ahuka SM, Mulembakani P, Rimoin AW, Martin JW and Muyembe JT: Maternal and fetal outcomes among pregnant women with human monkeypox infection in the democratic Republic of Congo. J Infect Dis. 216:824–828. 2017.PubMed/NCBI View Article : Google Scholar
42	Nolen LD, Osadebe L, Katomba J, Likofata J, Mukadi D, Monroe B, Doty J, Kalemba L, Malekani J, Kabamba J, et al: Introduction of monkeypox into a community and household: Risk factors and zoonotic reservoirs in the democratic Republic of the Congo. Am J Trop Med Hyg. 93:410–415. 2015.PubMed/NCBI View Article : Google Scholar
43	Cases of monkeypox confirmed in England. Monkeypox case in England. GOV.UK, 2018 [cited 2022 Oct 17]. Available from: https://www.gov.uk/government/news/monkeypox-case-in-england.
44	Reynolds MG, Yorita KL, Kuehnert MJ, Davidson WB, Huhn GD, Holman RC and Damon IK: Clinical manifestations of human monkeypox influenced by route of infection. J Infect Dis. 194:773–780. 2006.PubMed/NCBI View Article : Google Scholar
45	World Health Organization (WHO): 2020 [cited 2024 Sept 30]. Available from: https://web.archive.org/web/20220605103903/https://www.who.int/emergencies/disease-outbreak-news/item/monkeypox-democratic-republic-of-the-congo.
46	World Health Organization (WHO). Mpox (Monkeypox)-Democratic Republic of the Congo. World Health Organization, WHO, Geneva, 2023. https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON493. Accessed on September 30, 2024.
47	Centers for Disease Control and Prevention (CDC): About Mpox. 2024 [cited 2024 Sept 30]. Available from: https://www.cdc.gov/mpox/about/index.html.
48	Centers for Disease Control and Prevention: Mpox virus. CDC, Atlanda, GA, 2003. https://www.cdc.gov/orr/responses/mpox-virus.html. Accessed on September 30, 2024.
49	Centers for Disease Control and Prevention (CDC): National Center for Emerging and Zoonotic Infectious Diseases (U.S.): Division of high-consequence pathogens and pathology. 2003 United States outbreak of Monkeypox. CDC, Atlanda, GA, 2018. https://stacks.cdc.gov/view/cdc/108095. Accessed on September 30, 2024.
50	Centers for disease control and prevention (CDC): CDC Archives. CDC, Atlanda, GA, 2024. https://archive.cdc.gov/#/details?q=https://www.cdc.gov/poxvirus/mpox/response/2022/index.html&start=0&rows=10&url=https://www.cdc.gov/poxvirus/mpox/response/2022/index.html. Accessed on September 30, 2024.
51	Centers for Disease Control and Prevention (CDC): Mpox in the United States and around the world: Current situation. CDC, Atlanda, GA, 2024. https://www.cdc.gov/mpox/situation-summary/index.html. Accessed on September 30, 2024.
52	Centers for Disease Control and Prevention (CDC): CDC Archives. CDC, Atlanda, GA, 2024. https://archive.cdc.gov/#/details?archive_url=https://archive.cdc.gov/www_cdc_gov/poxvirus/mpox/response/2022/us-map.htmls. Accessed on September 30, 2024.
53	World Health Organization (WHO): Multi-country outbreak of mpox. External situation report 35, published 12 August 2024. Data as received by WHO from national authorities as of 30 June 2024. WHO, Geneva, 2024. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20240812_mpox_external-sitrep_-35.pdf?sfvrsn=ee6307a_3&download=true. Accessed on September 30, 2024.
54	Centers for Disease Control and Prevention (CDC). Mpox in the United States and around the world: Current situation. Centers for Disease Control and Prevention CDC, Atlanda, GA, 2025. https://www.cdc.gov/mpox/situation-summary/index.html#:~:text=The%20first%20case%20of%20clade,country%20experiencing%20sustained%20mpox%20transmission.
55	Centers for Disease Control and Prevention (CDC): U.S. case trends: Clade II Mpox. CDC, Atlanda, GA, 2025. https://www.cdc.gov/mpox/data-research/cases/index.html.
56	European Centre for Disease Prevention and Control (ECDC): Mpox.2023. ECDC, Stockholm, 2023. https://www.ecdc.europa.eu/en/mpox#:~:text=In%202022%2C%20an%20mpox%20outbreak,humans%2C%20mainly%20through%20sexual%20contact.
57	European Centre for Disease Prevention and Control (ECDC): Communicable disease threats report week 7, 2025. European Centre For Disease Prevention And Control (ECDC). ECDC, Stockholm, 2025. https://www.ecdc.europa.eu/sites/default/files/documents/communicable-disease-threats-report-week-7-2025.pdf.
58	European Centre for Disease Prevention and Control (ECDC): Epidemiological update, 14 January 2025: Mpox due to monkeypox virus clade I. European Centre for Disease Prevention and Control. ECDC, Atlanda, GA, 2025. https://www.ecdc.europa.eu/en/news-events/epidemiological-update-14-january-2025-mpox-due-monkeypox-virus-clade-i.
59	Chinese Center For Disease Control and Prevention; 2025 [cited 2025 Apr 22]. Available from: https://www.chinacdc.cn/jksj/jksj01/202501/t20250109_303772.html.
60	Africa CDC: Outbreak report, 30 July 2024: Mpox situation in Africa. 2024 [cited 2024 Sept 30]. Available from: https://africacdc.org/disease-outbreak/mpox-situation-in-africa/.
61	Centers for Disease Control and Prevention (CDC): https://africacdc.org/wp-content/uploads/2024/08/MPox-Situation-in-Africa.pdf. Accessed on September 30, 2024.
62	Centers for Disease Control and Prevention (CDC): Fact sheet: United States response to the clade I MPOX outbreak in several African countries. CDC, ATlanda, GA, 2024. https://www.cdc.gov/media/releases/2024/s0822-mpox-outbreak.html. Accessed on September 30, 2024.
63	World Health Organization (WHO): Mpox: Multi-country externalsituation report no.47. WHO, Geneva, 2025. https://cdn.who.int/media/docs/default-source/documents/emergencies/mpox-multi-country-external-situation-report-no.-47.pdf?sfvrsn=896a25b3_2&download=true.
64	Centers for Disease Control and Prevention (CDC): Clade I MPOX outbreak originating in Central Africa. CDC, Atlanda, GA, 2023. https://www.cdc.gov/mpox/outbreaks/2023/index.html. Accessed on February 12, 2023.
65	Fenner F, Henderson DA, Arita I, Jezek Z and Ladnyi ID: Chapter 29, Human monkeypox and other poxvirus infections of man. In: Smallpox and its Eradication. Geneva, World Health Organization, pp1292-1297, 1988.
66	Ladnyj I, Ziegler P and Kima E: A human infection caused by monkeypox virus in Basankusu Territory, democratic republic of the Congo. U.S. National Library of Medicine; [cited 2024 Sept 30]. Available from: https://pubmed.ncbi.nlm.nih.gov/4340218/.
67	Rimoin AW, Kisalu N, Kebela-Ilunga B, Mukaba T, Wright LL, Formenty P, Wolfe ND, Shongo RL, Tshioko F, Okitolonda E, et al: Endemic human monkeypox, democratic republic of Congo, 2001-2004. Emerg Infect Dis. 13:934–937. 2007.PubMed/NCBI View Article : Google Scholar
68	Jezek Z and Fenner F: Human monkeypox. In: Melnick JL (eds.). Monographs in virology. Vol. 17. Basel, Karger, pp1-140, 1988.
69	CDC C for DC and P (CDC). Human Monkeypox-Kasai Oriental, Democratic Republic of Congo, February 1996-October 1997. U.S. National Library of Medicine, 1997 [cited 2024 Sept 30]. Available from: https://pubmed.ncbi.nlm.nih.gov/9408046/.
70	Hutin YJ, Williams RJ, Malfait P, Pebody R, Loparev VN, Ropp SL, Rodriguez M, Knight JC, Tshioko FK, Khan AS, et al: Outbreak of human monkeypox, Democratic Republic of Congo, 1996 to 1997. Emerg Infect Dis. 7:434–438. 2001.PubMed/NCBI View Article : Google Scholar
71	Durski KN, McCollum AM, Nakazawa Y, Petersen BW, Reynolds MG, Briand S, Djingarey MH, Olson V, Damon IK and Khalakdina A: Emergence of monkeypox-west and Central Africa, 1970-2017. MMWR Morb Mortal Wkly Rep. 67:306–310. 2018.PubMed/NCBI View Article : Google Scholar
72	Malik YS, Singh RK and Dhama K: Animal-origin viral zoonoses. Epidemiology. Singapore, Springer, pp48-52, 2.6, 2020.
73	Rimoin AW, Mulembakani PM, Johnston SC, Lloyd Smith JO, Kisalu NK, Kinkela TL, Blumberg S, Thomassen HA, Pike BL, Fair JN, et al: Major increase in human monkeypox incidence 30 years after smallpox vaccination campaigns cease in the Democratic Republic of Congo. Proc Natl Acad Sci USA. 107:16262–16267. 2010.PubMed/NCBI View Article : Google Scholar
74	Nolen LD, Osadebe L, Katomba J, Likofata J, Mukadi D, Monroe B, Doty J, Hughes CM, Kabamba J, Malekani J, et al: Extended human-to-human transmission during a monkeypox outbreak in the Democratic Republic of the Congo. Emerg Infect Dis. 22:1014–1021. 2016.PubMed/NCBI View Article : Google Scholar
75	World Helath Organization (WHO): 2020 https://web.archive.org/web/20220605103903/https://www.who.int/emergencies/disease-outbreak-news/item/monkeypox-democratic-republic-of-the-congo. Accessed on September 30, 2024.
76	World Helath Organization (WHO): Mpox (Monkeypox)-Democratic Republic of the Congo. WHO, Geneva, 2023. https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON493. Accessed on September 30, 2024.
77	World Helath Organization (WHO): Mpox-Democratic Republic of the Congo. WHO, Geneva, 2024. https://www.who.int/emergencies/disease-outbreak-news/item/2024-DON522. Accessed on September 30, 2024.
78	The Johns Hopkins University. Mpox virus: Clade I and clade II. The Center for Outbreak Response Innovation (CORI), The Johns Hopkins University, Baltimore, MD, 2024. https://publichealth.jhu.edu/sites/default/files/2024-07/mpox-su-71524.pdf.
79	Pittman PR, Martin JW, Kingebeni PM, Tamfum JM, Mwema G, Wan Q, Ewala P, Alonga J, Bilulu G, Reynolds MG, et al: Clinical characterization and placental pathology of mpox infection in hospitalized patients in the Democratic Republic of the Congo. PLoS Negl Trop Dis. 17(e0010384)2023.PubMed/NCBI View Article : Google Scholar
80	Bunge EM, Hoet B, Chen L, Lienert F, Weidenthaler H, Baer LR and Steffen R: The changing epidemiology of human monkeypox-A potential threat? A systematic review. PLoS Negl Trop Dis. 16(e0010141)2022.PubMed/NCBI View Article : Google Scholar
81	McQuiston JH, Luce R, Kazadi DM, Bwangandu CN, Mbala-Kingebeni P, Anderson M, Prasher JM, Williams IT, Phan A, Shelus V, et al: U.S. Preparedness and response to increasing clade I mpox cases in the Democratic Republic of the Congo-United States, 2024. MMWR Morb Mortal Wkly Rep. 73:435–440. 2024.PubMed/NCBI View Article : Google Scholar
82	Issacs S and Mitjà O: Epidemiology, clinical manifestations, and diagnosis of monkeypox. In: UpToDate. UpToDate Inc., Waltham MA, 2022. https://www-uptodate-com.library.iau.edu.sa/contents/epidemiology-clinical-manifestations-and-diagnosis-of-monkeypox?search=monkeypox&source=search_result&selectedTitle=2~42&usage_type=default&display_rank=2#H1136462586.
83	World Health Organization (WHO). Mpox. World Health Organization. WHO, Geneva, 2024. https://www.who.int/news-room/fact-sheets/detail/mpox.
84	The Johns Hopkins University. Mpox virus: Clade I and clade II. Center for Outbreak Response Innovation (CORI). The Johns Hopkins University, Baltimore, MA,. 2024, September 23. https://publichealth.jhu.edu/sites/default/files/2024-09/Mpox-SU-9.23.24.pdf.
85	World Health Organization (WHO): 2022-24 mpox (Monkeypox) outbreak:global trends. WHO, Geneva, 202. https://worldhealthorg.shinyapps.io/mpx_global/#3_Global_situation_update. Accessed on September 30, 2024.
86	Global Center for Health Security: Clade I MPOX outbreak originating in Central Africa. Global Center for Health Security, Omaha, NE, 2024. https://www.cdc.gov/mpox/outbreaks/2023/index.html. Accessed on September 30, 2024.
87	Centers for disease control and prevention (CDC): 2022 Monkeypox Outbreak Global Map. CDC, Atlanda, GA, 2022. https://www.cdc.gov/poxvirus/monkeypox/response/2022/world-map.html. Accessed on October 13, 2022.
88	The Johns Hopkins University: Mpox virus: Clade I and clade II. Center for Outbreak Response Innovation (CORI), The Johns Hopkins University, Baltimore, MA, 2025. https://publichealth.jhu.edu/sites/default/files/2025-01/Mpox-SU-1.8.25.pdf.
89	Africa CDC: Mpox response plan envisions support across 22 countries. Africa CDC, 2024, https://africacdc.org/news-item/mpox-response-plan-envisions-support-across-22-countries/.
90	Farahat RA, Sah R, El-Sakka AA, Benmelouka AY, Kundu M, Labieb F, Shaheen RS, Abdelaal A, Abdelazeem B, Bonilla-Aldana DK, et al: Human monkeypox disease (MPX). Infez Med. 30:372–391. 2022.PubMed/NCBI View Article : Google Scholar
91	World Health Organization (WHO): Monkeypox. WHO, Geneva, 2022 https://www.who.int/news-room/questions-and-answers/item/monkeypox?gclid=CjwKCAjwm8WZBhBUEiwA178UnDv3jof45ubTpkPHkoF4gR6kRJtZshtA_dTXpdtc0_3CD514y8FZ3hoCOOMQAvD_BwE. Accessed on October 11, 2022.
92	Lapa D, Carletti F, Mazzotta V, Matusali G, Pinnetti C, Meschi S, Gagliardini R, Colavita F, Mondi A, Minosse C, et al: Monkeypox virus isolation from a semen sample collected in the early phase of infection in a patient with prolonged seminal viral shedding. Lancet Infect Dis. 22:1267–1269. 2022.PubMed/NCBI View Article : Google Scholar
93	Jenness SM, Begier EB, Neaigus A, Murrill CS, Wendel T and Hagan H: Unprotected anal intercourse and sexually transmitted diseases in high-risk heterosexual women. Am J Public Health. 101:745–750. 2011.PubMed/NCBI View Article : Google Scholar
94	Centers for Disease Control and Prevention (CDC): Clinical considerations for treatment and prophylaxis of monkeypox virus infection in people with HIV. CDC, Geneva, 2022. https://www.cdc.gov/poxvirus/monkeypox/clinicians/people-with-HIV.html. Accessed on October 11, 2022.
95	Thornhill J, Barkati S, Walmsley S, Rockstroh J, Antinori A, Harrison L, Palich R, Nori A, Reeves I, Habibi MS, et al: Monkeypox virus infection in humans across 16 countries-April-June 2022. N Engl J Med. 387:679–691. 2022.PubMed/NCBI View Article : Google Scholar
96	Awan U, Riasat S, Naeem W, Kamran S, Khattak A and Khan S: Monkeypox: A new threat at our doorstep! J Infect. 85:e47–e48. 2022.PubMed/NCBI View Article : Google Scholar
97	Isaacs D: Monkeypox. J Paediatr Child Health. 58:1290–1292. 2022.PubMed/NCBI View Article : Google Scholar
98	Centers for Disease Control and Prevention (CDC): Key characteristics for identifying monkeypox. CDC, Geneva, 2022. https://www.cdc.gov/poxvirus/monkeypox/clinicians/clinical-recognition.html#print. Accessed on October 11, 2022.
99	Pittman PR, Martin JW, Kingebeni PM, Tamfum JJM, Wan Q, Reynolds MG, Quinn X, Norris S, Townsend MB, Satheshkumar PS, et al: Clinical characterization of human monkeypox infections in the Democratic Republic of the Congo. medRxiv, 2022. https://www.medrxiv.org/content/10.1101/2022.05.26.22273379v1.full-text.
100	Centers for Disease Control and Prevention (CDC): Epidemiologic and clinical characteristics of monkeypox cases-United States, May 17-July 22, 2022. CDC, Geneva, 2022. https://www.cdc.gov/mmwr/volumes/71/wr/mm7132e3.htm?utm_source=summari#contribAff. Accessed on October 11, 2022.
101	Centers for Disease Control and Prevention (CDC): Mpox. Mpox Case Definitions. CDC, Geneva. https://www.cdc.gov/mpox/hcp/case-definitions/?CDC_AAref_Val=https://www.cdc.gov/poxvirus/mpox/clinicians/case-definition.html#cdc_generic_section_5-epidemiologic-criteria. Accessed on October 24, 2025.
102	Petersen E, Kantele A, Koopmans M, Asogun D, Yinka-Ogunleye A, Ihekweazu C and Zumla A: Human monkeypox: Epidemiologic and clinical characteristics, diagnosis, and prevention. Infect Dis Clin North Am. 33:1027–1043. 2019.PubMed/NCBI View Article : Google Scholar
103	Branda F, Romano C, Ciccozzi M, Giovanetti M, Scarpa F, Ciccozzi A and Maruotti A: Mpox: An overview of pathogenesis, diagnosis, and public health implications. J Clin Med. 13(2234)2024.PubMed/NCBI View Article : Google Scholar
104	Alakunle E, Moens U, Nchinda G and Okeke MI: Monkeypox virus in nigeria: Infection biology, epidemiology, and evolution. Viruses. 12(1257)2020.PubMed/NCBI View Article : Google Scholar
105	Zhou Y and Chen Z: Mpox: A review of laboratory detection techniques. Arch Virol. 168(221)2023.PubMed/NCBI View Article : Google Scholar
106	Erez N, Achdout H, Milrot E, Schwartz Y, Wiener-Well Y, Paran N, Politi B, Tamir H, Israely T, Weiss S, et al: Diagnosis of imported monkeypox, Israel, 2018. Emerg Infect Dis. 25:980–983. 2019.PubMed/NCBI View Article : Google Scholar
107	Centers for Disease Control and Prevention (CDC): Mpox vaccine recommendations. Centers for disease control and prevention. CDC, Atlanda, GA, 2023. https://www.cdc.gov/poxvirus/mpox/vaccines/vaccine-recommendations.html.
108	Rizk Y, Lippi G, Henry BM, Notarte KI and Rizk JG: Update on Mpox management: Epidemiology, vaccines and therapeutics, and regulatory changes. Drugs. 85:1–9. 2025.PubMed/NCBI View Article : Google Scholar
109	NYC Health: JYNNEOS vaccine for Mpox: Frequently asked questions. https://www.nyc.gov/assets/doh/downloads/pdf/monkeypox/jynneos-vaccine-faq.pdf.
110	U.S. Food and Drug Administration (FDA): Key facts about vaccines to prevent Mpox disease. ministration (FDA): FDA approves ado-trastuzumab emtansine for early breast cancer. FDA, Silver Spring, MD. https://www.fda.gov/vaccines-blood-biologics/vaccines/key-facts-about-vaccines-prevent-mpox-disease.
111	U.S. Food and Drug Administration (FDA): ACAM2000. FDA, Silver Spring, MD. https://www.fda.gov/vaccines-blood-biologics/vaccines/acam2000.
112	UpToDate: Treatment and prevention of mpox (formerly monkeypox), 2022. https://www.uptodate.com/contents/treatment-and-prevention-of-monkeypox/print#. Accessed on October 16, 2022.
113	Centers for Disease Control and Prevention (CDC): Monitoring and risk assessment for persons exposed in the community. CDC, Atlanda, GA, 2022. https://www.cdc.gov/poxvirus/monkeypox/clinicians/monitoring.html. Accessed on October 16, 2022.
114	Centers for Disease Control and Prevention (CDC): Clinical considerations for pain management of Monkeypox. CDC, Atlanda, GA, 2022. https://www.cdc.gov/poxvirus/monkeypox/clinicians/pain-management.html. Accessed on October 16, 2022.
115	Centers for Disease Control and Prevention (CDC): Treatment information for healthcare professionals. CDC, Atlanda, GA, 2022. https://www.cdc.gov/poxvirus/monkeypox/clinicians/treatment.html. Accessed on October 16, 2022.
116	National Institutes of Health (NIH): NIH study finds tecovirimat was safe but did not improve mpox resolution or pain, 2024. https://www.nih.gov/news-events/news-releases/nih-study-finds-tecovirimat-was-safe-did-not-improve-mpox-resolution-or-pain.
117	National Institutes of Health (NIH): The antiviral tecovirimat is safe but did not improve clade I mpox resolution in Democratic Republic of the Congo, 2024. https://www.nih.gov/news-events/news-releases/antiviral-tecovirimat-safe-did-not-improve-clade-i-mpox-resolution-democratic-republic-congo.
118	Centers for Disease Control and Prevention (CDC): Clinical Treatment of Mpox. Mpox. WHO, Geneva, 2024. https://www.cdc.gov/mpox/hcp/clinical-care/index.html.
119	World Health Organization (WHO): Strategic framework for enhancing prevention and control of mpox-2024-2027. WHO, Geneva. https://www.who.int/publications/i/item/9789240092907.
120	European Centre for Disease Prevention and Control (ECDC). Monkeypox infection prevention and control guidance for primary and acute care settings. ECDC, Stockholm, 2022. https://www.ecdc.europa.eu/en/publications-data/monkeypox-infection-prevention-and-control-guidance-primary-and-acute-care.
121	Giovanetti M, Cella E, Moretti S, Scarpa F, Ciccozzi A, Slavov SN, Benedetti F, Zella D, Ceccarelli G, Ciccozzi M and Borsetti A: Monitoring monkeypox: Safeguarding global health through rapid response and global surveillance. Pathogens. 12(1153)2023.PubMed/NCBI View Article : Google Scholar
122	Lu J, Xing H, Wang C, Tang M, Wu C, Ye F, Yin L, Yang Y, Tan W and Shen L: Mpox (formerly monkeypox): Pathogenesis, prevention, and treatment. Signal Transduct Target Ther. 8(458)2023.PubMed/NCBI View Article : Google Scholar
123	Nyame J, Punniyakotti S, Khera K, Pal RS, Varadarajan N and Sharma P: Challenges in the treatment and prevention of monkeypox infection; A comprehensive review. Acta Trop. 245(106960)2023.PubMed/NCBI View Article : Google Scholar
124	Ogunkola IO, Abiodun OE, Bale BI, Elebesunu EE, Ujam SB, Umeh IC, Tom-James M, Musa SS, Manirambona E, Evardone SB and Lucero-Prisno DE III: Monkeypox vaccination in the global south: Fighting a war without a weapon. Clin Epidemiol Glob Health. 22(101313)2023.PubMed/NCBI View Article : Google Scholar
125	Khan G and Perveen N: Monkeypox: Past, present, and future. Adv Exp Med Biol. 1451:1–20. 2024.PubMed/NCBI View Article : Google Scholar
126	Nachega JB, Sam-Agudu NA, Ogoina D, Mbala-Kingebeni P, Ntoumi F, Nakouné E, Njouom R, Lewis RF, Gandhi M, Rosenthal PJ, et al: The surge of mpox in Africa: A call for action. Lancet Glob Health. 12:e1086–e1088. 2024.PubMed/NCBI View Article : Google Scholar
127	Rahim FO, Fallah M, Jain U, Richardson ET, Ndembi N, Ngongo N and Kaseya J: Challenges and ongoing actions to address the mpox emergency in Africa. Ann Glob Health. 90(68)2024.PubMed/NCBI View Article : Google Scholar
128	Rahi M, Joy S and Sharma A: Public health challenges in the context of the global spread of mpox infections. Am J Trop Med Hyg. 108:641–645. 2023.PubMed/NCBI View Article : Google Scholar
129	Acharya A, Kumar N, Singh K and Byrareddy SN: ‘Mpox in MSM: Tackling stigma, minimizing risk factors, exploring pathogenesis, and treatment approaches’. Biomed J. 48(100746)2025.PubMed/NCBI View Article : Google Scholar
130	World Health Organization (WHO): Clinical management and infection prevention and control for Monkeypox. WHO, Geneva, 2022. https://www.who.int/publications/i/item/WHO-MPX-Clinical-and-IPC-2022.1. Accessed on October 17, 2022.
131	Reynolds MG, McCollum AM, Nguete B, Shongo Lushima R and Petersen BW: Improving the care and treatment of monkeypox patients in low-resource settings: Applying evidence from contemporary biomedical and smallpox biodefense research. Viruses. 9(380)2017.PubMed/NCBI View Article : Google Scholar
132	Abdelaal A, Serhan HA, Mahmoud MA, Rodriguez-Morales A and Sah R: Ophthalmic manifestations of monkeypox virus. Eye (Lond). 37:383–385. 2022.PubMed/NCBI View Article : Google Scholar
133	Badenoch JB, Conti I, Rengasamy ER, Watson CJ, Butler M, Hussain Z, Carter B, Rooney AG, Zandi MS, Lewis G, et al: Neurological and psychiatric presentations associated with human monkeypox virus infection: A systematic review and meta-analysis. EClinicalMedicine. 52(101644)2022.PubMed/NCBI View Article : Google Scholar
134	European Centre for Disease Prevention and Control (ECDC): Factsheet for health professionals on mpox. ECDC, Stockholm. https://www.ecdc.europa.eu/en/all-topics-z/monkeypox/factsheet-health-professionals. Accessed on February, 2025.
135	DeWitt ME, Polk C, Williamson J, Shetty AK, Passaretti CL, McNeil CJ, Fairman RT, Sampson MM, Dalton C and Sanders JW: Global monkeypox case hospitalisation rates: A rapid systematic review and meta-analysis. EClinicalMedicine. 54(101710)2022.PubMed/NCBI View Article : Google Scholar
136	Zeyen C, Kinberger M, Kriedemann H, Pfäfflin F, Tober-Lau P, Huang L, Corman VM, Nast A, Sander LE, Kurth F and Werner RN: Clinical spectrum and long-term outcomes of mpox: A cohort study spanning from acute infection to six-month follow-up. BMC Infect Dis. 24(317)2024.PubMed/NCBI View Article : Google Scholar
137	Ahmed SK, Abdulqadir SO, Hussein SH, Omar RM, Ahmed NA, Essa RA, Dhama K, Lorenzo JM and Abdulla AQ: The impact of monkeypox outbreak on mental health and counteracting strategies: A call to action. Int J Surg. 106(106943)2022.PubMed/NCBI View Article : Google Scholar
138	Jaleel A, Farid G, Irfan H, Mahmood K and Baig S: A systematic review on the mental health status of patients infected with monkeypox virus. Soa Chongsonyon Chongsin Uihak. 35:107–118. 2024.PubMed/NCBI View Article : Google Scholar
139	Ogoina D, Izibewule JH, Ogunleye A, Ederiane E, Anebonam U, Neni A, Oyeyemi A, Etebu EN and Ihekweazu C: The 2017 human monkeypox outbreak in Nigeria-report of outbreak experience and response in the Niger Delta University Teaching Hospital, Bayelsa State, Nigeria. PLoS One. 14(e0214229)2019.PubMed/NCBI View Article : Google Scholar

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Understanding the Mpox outbreak: Advances in epidemiology, management and prevention (Review)

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Understanding the Mpox outbreak: Advances in epidemiology, management and prevention (Review)

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