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MPOX: Symptoms, Causes and Treatment

MPOX (formerly monkeypox) is a viral infectious disease caused by the Mpox virus, characterized by skin rash, fever, and swollen lymph nodes.

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MPOX (formerly monkeypox) is a viral infectious disease caused by the Mpox virus, characterized by skin rash, fever, and swollen lymph nodes.

What is MPOX?

MPOX, formerly known as monkeypox, is an infectious disease caused by the Mpox virus (MPXV). The virus belongs to the Poxviridae family and is related to the virus that causes smallpox. The disease was first identified in laboratory monkeys in 1958 and was detected in humans for the first time in 1970. Since 2022, cases have increased significantly worldwide, leading the WHO to declare a public health emergency of international concern.

Causes and Transmission

The Mpox virus is primarily spread through close physical contact. The main routes of transmission include:

Direct skin contact with lesions or mucous membranes of an infected person
Sexual contact, particularly among individuals with multiple partners
Respiratory droplets during prolonged, close face-to-face contact
Contact with contaminated objects such as bedding or clothing
Animal-to-human transmission through contact with infected rodents or primates in endemic regions

Two main genetic variants (clades) are recognized: Clade I (Central African, associated with more severe illness) and Clade II (West African, generally milder course).

Symptoms

The incubation period is typically 5 to 21 days. Common symptoms include:

Fever, chills, and general malaise
Swollen lymph nodes (lymphadenopathy) – a hallmark feature that distinguishes MPOX from other poxvirus infections
Headache, muscle aches, and back pain
Characteristic skin rash: often beginning on the face before spreading to the body; lesions progress from flat spots to blisters, pustules, and eventually scabs
In sexually transmitted cases, lesions may appear on the genitals, anus, or mouth

The illness typically lasts 2 to 4 weeks. Immunocompromised individuals, pregnant women, children, and older adults are at higher risk of severe disease.

Diagnosis

MPOX is diagnosed using the following approaches:

PCR testing (polymerase chain reaction): A swab taken from a skin lesion or mucous membrane; this is the gold standard for diagnosis
Clinical assessment: Evaluation of the characteristic appearance of skin lesions and lymphadenopathy
Serology: Detection of specific antibodies in the blood (less commonly used)

Anyone suspecting an MPOX infection should seek medical attention promptly and inform healthcare providers about potential contacts to help prevent further spread.

Treatment

There is no universally approved specific treatment for MPOX. Management is primarily supportive:

Symptomatic treatment: Fever reducers, pain relief, and wound care for skin lesions
Tecovirimat (TPOXX): An antiviral medication that may be used in severe cases or for high-risk groups
Isolation: Infected individuals should isolate until all scabs have fallen off and the skin has fully healed

Prevention and Vaccination

The most effective way to prevent MPOX is vaccination. The smallpox vaccine Imvanex (Jynneos) is recommended for at-risk groups in many countries. Additional preventive measures include:

Avoiding close contact with infected individuals or animals
Regular handwashing and good hygiene practices
Use of personal protective equipment in healthcare settings
Education about sexual transmission routes

References

World Health Organization (WHO): Mpox (monkeypox) Fact Sheet, 2024. Available at: https://www.who.int/news-room/fact-sheets/detail/monkeypox
Centers for Disease Control and Prevention (CDC): Mpox in the U.S., 2024. Available at: https://www.cdc.gov/mpox
Petersen E. et al.: Mpox: A Global Public Health Emergency. International Journal of Infectious Diseases, 2022.

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