Mr. Ibrahem/Mpox
Other namesMonkeypox
Various appearances of mpox spots
Medical specialtyInfectious disease
SymptomsNone, fever, headache, muscle pains, swollen lymph nodes, blistering rash[1]
ComplicationsSecondary infections, eye infection, vision loss, scarring[2][3]
Usual onset1 to 21 days post exposure[1]
Duration2 to 4 weeks[1]
TypesClades I and II[1]
CausesMonkeypox virus[1]
Risk factorsHunters in Central and West Africa, [4]
Diagnostic methodTesting for viral DNA (PCR) from skin swab[4]
Differential diagnosisChickenpox, shingles, measles, syphilis, smallpox, scabies, bacterial skin infection, drug eruption[2]
PreventionSmallpox vaccines, hand washing, covering rash, PPE, keep away from sick people[5][6]
TreatmentSupportive, antivirals, vaccinia immune globulin[7]
MedicationCidofovir, tecovirimat[2]
PrognosisMost recover[1]
FrequencyNot as rare as previously thought[8]
Deaths<1%: West African type
Up to 11%: Central African type[2]

Mpox, previously known as monkeypox, is an infectious viral disease that can occur in both humans and some other animals.[1][9] Typical symptoms include a blistering rash associated with a fever, swollen lymph nodes, headache, and tiredness.[4] Other symptoms may include sores in the mouth, throat, or genitals, and pain on passing urine.[4] The time from exposure to onset of symptoms ranges from 1-to-21 days, and symptoms usually last around 2 to 4 weeks.[1] Symptoms are generally mild, though may be severe in people with HIV, in pregnancy, and in those with a weakened immune system.[1][10] The skin lesions can number from none to many, occur before glands swell, and can appear in one area at different stages of development.[11] The classic presentation of fever and muscle pains, followed by swollen glands, with lesions all at the same stage, has not been found to be common in all outbreaks.[12][13]

The disease is caused by monkeypox viruses, a type of Orthopoxvirus.[3] Of the 2-types in humans, the West African type causes a less severe disease than the Central African (Congo Basin) type.[14] It may spread from handling bushmeat, animal bites or scratches, body fluids, contaminated objects, or other close contact with an infected person.[15][16] Spread can occur by small droplets and possibly the airborne route.[6][12][17] People can spread the virus from the onset of symptoms until all the lesions have scabbed and fallen off; with some evidence of spread for more than a week after lesions have crusted.[14] The virus is believed to normally spread among certain rodents in Africa.[15] Diagnosis can be confirmed by swabbing and testing a lesion for the virus's DNA.[18] It can appear similar to smallpox and chickenpox.[4] Mpox should be distinguished from other infections such as measles, scabies, herpes, and syphilis, and non-infectious conditions such as a drug eruption.[4] The presence of swollen glands is more typical of mpox.[2][19]

There is no known cure.[20] The smallpox vaccine was found to be around 85% protective in preventing infection in close contacts and in lessening the severity of the disease.[3] A newer MVA-BN smallpox vaccine has been approved, but with limited availability.[2][5] Other measures include regular hand washing and avoiding sick people and other animals.[21] The antiviral medication cidofovir and tecovirimat, vaccinia immune globulin, and the smallpox vaccine may be used during outbreaks.[7][22] The risk of death has varied from 0% to 11%.[2] Most people recover.[4] The disease is more severe in the very young, malnourished people, pregnant women, and in those with weakened immune systems.[23]

The disease is no longer believed to be as rare as previously thought;[8][24] possibly as a result of waning immunity since the stopping of routine smallpox vaccination.[19] Cases have significantly increased since the 1980s.[25] Sporadic cases occur in Central and West Africa, and it is common in the Democratic Republic of Congo (DRC).[24] Hunters in the tropical forests of Central and West Africa are most at risk.[26] It was first identified as a distinct illness in 1958 among laboratory monkeys in Denmark.[27][28] The first case in humans was reported in 1970 in the DRC, during smallpox eradication efforts.[29] The first cases in humans outside of Africa presented in the United States in 2003, when the outbreak was traced to a pet store where imported rodents were sold.[18] Since 2017, a large outbreak has been occurring in Nigeria.[30] Since mid-May 2022, cases have been reported with spread between people, in several countries that do not typically see the disease, including countries in Europe, North America, South America and Australasia.[12] On 23 July 2022, the World Health Organization (WHO) declared the 2022–2023 monkeypox outbreak a Public Health Emergency of International Concern.[31] This was withdrawn in May of 2023.[32] Due to stigma associated with the term "monkeypox", the WHO renamed the disease mpox in November 2022.[33]

References

change
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  3. 3.0 3.1 3.2 Petersen, Brett W.; Damon, Inger K. (2020). "348. Smallpox, monkeypox and other poxvirus infections". In Goldman, Lee; Schafer, Andrew I. (eds.). Goldman-Cecil Medicine. Vol. 2 (26th ed.). Philadelphia: Elsevier. pp. 2180–2183. ISBN 978-0-323-53266-2. Archived from the original on 2022-05-23. Retrieved 2022-05-23.
  4. 4.0 4.1 4.2 4.3 4.4 4.5 4.6 "Mpox (monkeypox)". www.who.int. World health Organization. Archived from the original on 21 April 2022. Retrieved 14 August 2024.
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