Mpox: lessons learnt from previous viral outbreaks applicable to the ongoing outbreak

Abstract

Human monkeypox (Mpox) is a zoonotic infection caused by Mpox virus (MPXV) that was first identified in a smallpox suspect in 1970, and presents with smallpox-like symptoms but with less severe manifestations. The infection is initiated through rapid replication at the inoculation site, with early symptoms including fever, chills, and exhaustion. The advent of smallpox vaccines has significantly contributed to its prevention. Due to its zoonotic nature, individuals who consume or handle animals susceptible to the virus are at increased risk and should take appropriate precautions. Both vaccines and non-pharmacological interventions have proven potent in limiting the spread of the infection. This narrative review examines the emergence and spread of Mpox in humans, delving into the epidemiology, clinical manifestations and preventive strategies for Mpox, as well as the transmission dynamics of the two MPXV clades. It also highlights the increase in cases outside Africa, with a particular focus on a UK outbreak linked to travel from Nigeria. The importance of vaccination, especially smallpox vaccines, is underscored, noting recent advancements in vaccine development such as the Vaccinia Ankara vaccine. The review emphasizes the need for robust surveillance, diagnostics, and strategies to control and manage epidemics, drawing lessons from past experiences. It concludes by stressing the clinical similarities between Mpox and smallpox and the growing public health concern posed by Mpox, especially in areas with high human-wildlife interactions.