What is Monkeypox (Monkey pox)?

From the Guidelines

Monkeypox prevention and treatment should prioritize vaccination with the JYNNEOS vaccine for high-risk individuals, as it is safe for household contacts of immunocompromised patients, according to the most recent evidence 1.

Key Considerations

• Monkeypox is a viral disease caused by the monkeypox virus, which belongs to the Orthopoxvirus genus.
• Symptoms include fever, headache, muscle aches, swollen lymph nodes, and a distinctive rash that often begins on the face and spreads to other parts of the body.
• Treatment is primarily supportive care, including pain management with acetaminophen or ibuprofen, keeping rash areas clean and dry, and avoiding touching lesions.
• For severe cases, antiviral medications like tecovirimat (TPOXX) may be prescribed by healthcare providers, typically 600mg twice daily for 14 days for adults.

Prevention and Vaccination

• Prevention includes avoiding close contact with infected individuals, practicing good hand hygiene, and vaccination for those at high risk.
• The JYNNEOS vaccine is recommended for high-risk individuals and requires two doses given 28 days apart.
• The JYNNEOS vaccine is a live replication-deficient modified vaccinia Ankara vaccine, which is safe for household contacts of immunocompromised patients 1.
• In contrast, the ACAM2000 vaccine, which contains the vaccinia virus grown in cell culture, should not be used in household members of immunocompromised patients due to the risk of unintentional vaccinia transmission 1.

Transmission and Isolation

• Monkeypox spreads through close contact with infected people or animals, particularly through direct contact with rash lesions, bodily fluids, or respiratory secretions.
• Isolation of infected individuals is important to prevent transmission, and household contacts should take precautions to avoid close contact with the infected person, especially if they are immunocompromised.

From the Research

Overview of Monkeypox

• Monkeypox (Mpox) is a zoonotic Orthopoxvirus that is commonly manifested by blisters on the skin and has a mortality rate of approximately 0-10% 2
• The clinical manifestations of Mpox, including the onset of symptoms and dermatologic characteristics, are similar to those of smallpox, but Mpox is clinically milder 2
• A key difference between smallpox and Mpox is the high prevalence of lymphadenopathy 2, 3

Transmission and Prevention

• Human-to-human, animal-to-human, and animal-to-animal transmission are the three main pathways of Mpox spread that must be considered for effective prevention 2
• Reducing contact with individuals displaying symptoms, maintaining personal safety, and adhering to practices commonly used to prevent sexually transmitted infections can help prevent Mpox 2
• The JYNNEOS and ACAM2000 vaccines are among the most commonly recommended for the prevention of Mpox 2, 3

Diagnosis and Treatment

• PCR testing is the preferred method for diagnosing Mpox infection and can enhance early detection of new cases and improve infection control measures 2
• Brincidofovir, Cidofovir, and Tecovirimat are the primary treatments for Mpox cases 2, 3
• Tecovirimat has demonstrated efficacy in animal studies and is FDA-approved for treating smallpox, and has been used to treat monkeypox under an investigational new drug protocol 4, 5

High-Risk Groups and Challenges

• People with compromised immune systems, small children, those with a history of eczema, and pregnant women may be more susceptible to serious Mpox illness 3
• The WHO should prioritize strategies that enhance early detection of the illness, careful administration of antiviral treatments, and focused vaccination initiatives for high-risk groups or wider immunization in areas where the disease is common 3