Elsevier created the Monkeypox Healthcare Hub to help healthcare professionals navigate the current outbreak. Here you will find evidence-based clinical resources, including clinical overviews, patient education, and drug monographs.
Recently headlining in North America, Europe, and Oceania, this virus is endemic to western and central Africa.(1) The World Health Organization (WHO) convened a meeting of experts in May to investigate the current outbreak and provide guidance on surveillance, case investigation, and contact tracing.(2,3)
Clinically similar to smallpox, monkeypox is a zoonotic viral illness first reported in central Africa in 1970.(4) It transmits through close contact with an infected person or animal, or with contaminated material.(5) Monkeypox typically presents with fever, rash, and swollen lymph nodes; the latter is absent in smallpox. In endemic monkeypox, the rash usually begins in the mouth or on the face, and spreads to the extremities, generally sparing the trunk. In the current outbreak, which appears to disproportionately involve men who have sex with men, the distribution of the rash has often been primarily anogenital, although it may spread to other body parts as well.(6) Historically monkeypox has occasionally been complicated by invasive disease, most often involving lung tissue, as well as deaths, particularly in young children. No deaths have thus far been associated with the current outbreak. Diagnosis is made with laboratory detection of monkeypox virus in the setting of appropriate risk factors and clinical findings. Currently confirmatory testing for monkeypox is performed by the CDC.(7)
Most patients with monkeypox have mild disease and can be managed supportively. Antiviral medications originally developed for the treatment of other viral infections can be considered in certain circumstances. Additionally, although most authorities are cautiously optimistic that this outbreak will be limited in size, two vaccines are available in the United States for pre- and post-exposure prophylaxis through consultation with the CDC (Centers for Disease Control).(8)
Recently, a global research consultation was convened virtually by the WHO. Priorities set regarding future monkeypox research include improved control of monkeypox in endemic countries to decrease incidence. Experts emphasized the need to better understand disease epidemiology, modes of transmission, how to optimize clinical care, studies regarding vaccines and therapeutics, and more.(9)
1. The Lancet Infectious Diseases. Monkeypox: a neglected old foe. The Lancet Infectious Diseases. Published online June 2022. doi:10.1016/S1473-3099(22)00377-2
2. World Health Organization. Monkeypox outbreak 2022 - Global. Published online June 2022. https://www.who.int/emergencies/situations/monkeypox-oubreak-2022
3. Kraemer MUG, Tegally H, Pigott DM, et al. Tracking the 2022 monkeypox outbreak with epidemiological data in real-time. The Lancet Infectious Diseases. 2022;0(0). doi:10.1016/S1473-3099(22)00359-0
4. Adler H, Gould S, Hine P, et al. Clinical features and management of human monkeypox: a retrospective observational study in the UK. The Lancet Infectious Diseases. 2022;0(0). doi:10.1016/S1473-3099(22)00228-6/ATTACHMENT/D0AB7E0A-26D1-4573-AB01-E977F3CBBCCF/MMC1.PDF
5. Actor JK. Clinical Virology. Elsevier’s Integrated Review Immunology and Microbiology. Published online 2012:129-138. doi:10.1016/B978-0-323-07447-6.00014-4
9. World Health Organization. WHO consultation sets research priorities for monkeypox. https://www.who.int/news/item/03-06-2022-who-consultations-sets-research-priorities-for-monkeypox
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