Monkeypox

Monkeypox is a viral zoonosis caused by monkeypox virus, which belongs to the Orthopoxvirus genus alongside variola, vaccinia, and cowpox viruses ^[1]. It was first detected in a human case in the Democratic Republic of the Congo in 1970 and was long described as endemic in West and Central Africa, although more recent reports document cases in many nonendemic countries ^[1][2][3]. One source also notes two viral clades, referred to as West African and Congo Basin/Central African clades ^[4].

The hallmark clinical pattern described in the sources is a flu-like prodrome followed by a smallpox-like rash or exanthem ^[3][1]. In the 2022 outbreak, one review reports a typical incubation period of 7 to 10 days and a syndrome including fever, myalgia, and a characteristic rash that progresses from papules to vesicles, pustules, and crusts ^[1]. The rash was often noted in genital, anal, or oral regions and frequently involved mucosal surfaces ^[1]. Complications requiring medical treatment were reported in up to 40% of patients and included rectal pain, odynophagia, penile oedema, and skin or anorectal abscesses ^[1]. Most cases were self-limited, although some required hospital admission ^[1].

The disease has been described as a zoonosis endemic to West and Central Africa, with sporadic infections and outbreaks reported since the first recognized human case in 1970 ^[1][3]. More recent sources emphasize confirmed cases in many nonendemic countries outside Africa and describe the 2022 outbreak as unprecedented in its global spread ^[2][1]. One source states that the disease circulated naturally in mammals such as field rats, squirrels, and other rodents, while also noting that the natural reservoir remains uncertain ^[4]. The 2022 outbreak produced substantial international concern and was associated with transmission among residents of many nonendemic countries, including reports from 100 countries in one review ^[3].

The available sources describe monkeypox transmission as predominantly zoonotic in origin, with close contact implicated in human infection ^[1][3]. In the 2022 outbreak, close intimate contact, including sexual activity, was the principal association reported, and person-to-person transmission was emphasized as an important driver of spread ^[1][3]. The sources in this payload do not provide a fuller route-specific transmission account, so additional mechanism detail is not yet source-backed here ^[1][3].

The strongest source-backed outbreak association in this payload is with men who have sex with men, who were frequently affected in the 2022 outbreak and often presented with novel epidemiological and clinical characteristics ^[2][1]. The sources also indicate heightened relevance for people in settings with close intimate contact, including sexual activity, during the recent outbreak ^[1]. Beyond these groups, additional high-risk populations are not clearly specified in the supplied snippets and are therefore not claimed here ^[2][1].

Source-backed prevention information in this payload is limited, but one review explicitly includes vaccination with smallpox vaccine among prevention strategies ^[2]. The sources also indicate that public health countermeasures were implemented rapidly and widely in response to person-to-person spread across nonendemic countries ^[3]. More specific exposure-control measures, vaccination schedules, or community guidance are not provided in the supplied snippets and are therefore not stated here ^[2][3].

For surveillance purposes, monkeypox should be interpreted as a zoonotic orthopoxviral disease that has shifted from a historically restricted African endemic pattern to a broader multinational outbreak context ^[1][2]. Recent monitoring should pay attention to close-contact transmission networks and to cases occurring in nonendemic settings, as these features were prominent in the 2022 event ^[1][3]. The supplied sources support heightened situational awareness, but they do not provide a complete surveillance case definition or standardized reporting framework in this payload ^[2][1].

1. 1 Mitjà O et al. Monkeypox. Lancet. 2023 Jan 7. PMID: 36403582. doi: 10.1016/S0140-6736(22)02075-X. PubMed: https://pubmed.ncbi.nlm.nih.gov/36403582/
2. 2 Huang Y et al. Monkeypox: epidemiology, pathogenesis, treatment and prevention. Signal Transduct Target Ther. 2022 Nov 2. PMID: 36319633. doi: 10.1038/s41392-022-01215-4. PubMed: https://pubmed.ncbi.nlm.nih.gov/36319633/
3. 3 Elsayed S et al. Monkeypox Virus Infections in Humans. Clin Microbiol Rev. 2022 Dec 21. PMID: 36374082. doi: 10.1128/cmr.00092-22. PubMed: https://pubmed.ncbi.nlm.nih.gov/36374082/
4. 4 Monkeypox:. Biología y Sociedad. 2022. doi: 10.29105/bys5.10-68. DOI: https://doi.org/10.29105/bys5.10-68
5. 5 Monkeypox. Scholarly DOI record. 2022. doi: 10.14293/s2199-1006.1.sor-med.clm7ryn.v1. DOI: https://doi.org/10.14293/s2199-1006.1.sor-med.clm7ryn.v1
6. 6 Monkeypox. Journal of Paediatrics and Child Health. 2022. doi: 10.1111/jpc.16121. DOI: https://doi.org/10.1111/jpc.16121

ICD-10

B04

ICD-11

1E71

Total cases

7K

Peak month

2022-01

Coverage

9 reporting countries · 2000-01-01 → 2026-06-20