Mpox is an infectious disease that causes a painful rash, enlarged lymph nodes, fever, headache, muscle aches, back pain, and fatigue. Although most people recover fully, some may experience severe illness.  The disease is caused by the monkeypox virus (MPXV), an enveloped double-stranded DNA virus from the Orthopoxvirus genus, which also includes variola (smallpox), cowpox, and vaccinia viruses.  Two distinct clades exist: clade I (with subclades Ia and Ib) and clade II (with subclades IIa and IIb). The global outbreak of clade IIb, which began in 2022, continues, with additional outbreaks of clades Ia and Ib occurring in the Democratic Republic of the Congo and other African nations. As of August 2024, clade Ib has also been detected outside Africa.  While the natural reservoir of the virus is still unknown, small mammals such as squirrels and monkeys are known to be susceptible.

Transmission

  Mpox primarily spreads through close contact with an infected person, including household members. Transmission occurs through skin-to-skin contact, such as during sex, or mouth-to-skin or mouth-to-mouth contact, like kissing. Infectious respiratory particles can also spread the virus during face-to-face contact.  Those with multiple sexual partners are at a higher risk of contracting mpox.  The virus can also spread through contaminated objects like clothing, needles in healthcare settings, or communal environments such as tattoo parlors.  During pregnancy or birth, mpox can be passed to the baby, posing serious risks, including miscarriage, stillbirth, neonatal death, or complications for the parent.  Animal-to-human transmission occurs through bites, scratches, or activities like hunting, skinning, or consuming infected animals. Although the exact animal reservoir remains unknown, research is ongoing.  

Signs and Symptoms 

 Symptoms typically appear within 1–21 days after exposure and last 2–4 weeks, though they may last longer in individuals with weakened immune systems.  Common symptoms include:- Rash  - Fever  - Sore throat  - Headache  - Muscle aches  - Back pain  - Low energy  - Swollen lymph nodesFor some, the rash may be the first sign, while others experience fever or muscle aches first. The rash often begins on the face, spreading to other areas like the hands, feet, and genitals. It starts as flat sores, then forms fluid-filled blisters that may itch or hurt, eventually drying out and crusting over.  Lesions may vary in number, from one or a few to hundreds or more, and can appear on the hands, feet, face, mouth, groin, or anus. Some people may also develop painful conditions such as rectal inflammation or difficulty urinating.  People with mpox can transmit the virus until all lesions have healed and new skin has formed. Although rare, asymptomatic transmission has been reported, though the extent remains unclear.  Certain groups, including children, pregnant individuals, and those with compromised immune systems (such as people living with uncontrolled HIV), face a higher risk of severe illness and complications from mpox.  Complications can include bacterial skin infections, pneumonia, vision loss from corneal infections, difficulty swallowing, gastrointestinal symptoms, and life-threatening conditions like sepsis and encephalitis. Mpox can be fatal in some cases.

Diagnosis

Diagnosing mpox can be challenging as it may resemble other conditions, such as chickenpox, measles, bacterial skin infections, scabies, herpes, or syphilis. Testing is essential to confirm the diagnosis and begin treatment.  The preferred method for diagnosing mpox is polymerase chain reaction (PCR) testing of skin lesions, fluid, or crusts. Swabs from the throat or anus may also be used in the absence of skin lesions. Testing blood is not recommended.  HIV testing should be offered to those with mpox, and diagnostic tests for other conditions like varicella zoster virus (VZV), syphilis, and herpes should also be considered.

Treatment and Vaccination

Treatment for mpox focuses on supportive care to manage symptoms, such as pain and fever, and prevent complications.  Vaccination can help prevent infection and is recommended for high-risk individuals, such as healthcare workers, those in close contact with infected individuals, people with multiple sexual partners, and sex workers.  Post-exposure vaccination is also possible and should be given within 4 days of exposure, though it can be administered up to 14 days if symptoms have not developed.  Although no antiviral treatment has been proven effective for mpox, some antivirals have been authorized for emergency use in certain countries and are undergoing clinical trials.  People with HIV and mpox should continue their antiretroviral therapy (ART) or begin ART within 7 days of HIV diagnosis.

Self-care and Prevention

Most people with mpox recover within 2–4 weeks. To help manage symptoms and prevent spreading the virus:**Do:**- Contact a healthcare provider for advice  - Stay at home in a well-ventilated room  - Wash hands frequently  - Wear a mask and cover lesions when around others  - Keep skin dry and uncovered when alone  - Disinfect shared spaces regularly  - Use saltwater rinses for oral sores  - Take warm baths with baking soda or Epsom salts for body sores  - Take over-the-counter pain medication  **Don’t:**- Pop blisters or scratch sores, which can slow healing and cause infection  - Shave areas with sores until they have healed  People with mpox should isolate at home or in a hospital if necessary until the infectious period has ended. Covering lesions and wearing a mask can help reduce transmission. Condoms should be used during sexual activity for up to 12 weeks after recovery.  Those exposed to someone with mpox should monitor symptoms for 21 days and avoid sexual activity during this time.  Healthcare workers should follow infection prevention protocols, including the use of personal protective equipment (PPE)