The 2022 global mpox virus (MPXV) outbreak highlights the urgent need for safer, next-generation vaccines. We compared the immunogenicity and protective efficacy of individual and multicomponent membrane proteins of MPXV virions in mice to inform the development of a recombinant subunit vaccine against mpox. BALB/c mice were immunized with eukaryotically expressed A35R, A29L, B6R, and M1R proteins, administered individually or in multicomponent combinations with an Al(OH)3 + CpG oligodeoxynucleotide adjuvant. Three multicomponent protein vaccines (A29/B6, A29/B6/M1, and A29/B6/M1/A35) provided complete protection, but others (individual protein and A35/M1 combinations) provided partial protection against challenge with high-lethal doses of vaccinia virus Western Reserve (VACV-WR). Additionally, A29/B6 conferred partial protection, whereas A29/B6/M1 and A29/B6/M1/A35 provided complete protection against ectromelia virus (ECTV), with A29/B6/M1 being most effective. All vaccines induced strong antigen-specific immunoglobulin G (IgG) and cellular immunity, whereas only four (M1, A35/M1, A29/B6/M1, A29/B6/M1/A35) exhibited significant neutralizing activity against MPXV, VACV-Tiantan, and ECTV. Correlation analysis suggested that neutralizing antibodies and A35-/A29-/B6-specific cellular immunity act as complementary defense mechanisms, potentially providing first- and second-line protection against MPXV and related orthopoxviruses. Collectively, A29/B6/M1 demonstrated the best protective efficacy. This study provides novel insights into immunogen optimization and potential mechanisms for the development of vaccines against MPXV and other orthopoxviruses.

Mpox is a zoonotic viral infection caused by the monkeypox virus (MPXV) genus Orthopoxvirus. The MPXV, possesses a large and complex double-stranded DNA genome, encoding approximately 190 genes. The virus has gained attention due to recent outbreaks and the emergence of resistant variants. MPXV exists in two distinct clades: Central African (Clade I) and West African (Clade II), with Clade I being more virulent. Genomic surveillance has revealed significant mutations across MPXV lineages, with Clade IIb, responsible for the 2022 outbreak, exhibiting rapid adaptation through APOBEC3-mediated deamination associated with sustained human-to-human transmission. The recent outbreak of highly mutated Clade 1b MPXV (hMpox-1) strain was associated with increased human-to-human transmission, underscoring the importance of monitoring viral mutations to track diversity and identify resistance to antiviral therapies. Tecovirimat, an antiviral drug authorized for treating Mpox, targets the F13L protein involved in viral egress. However, the rise of MPXV variants resistant to tecovirimat, linked to mutations in the F13L gene, presents a growing challenge. Mutations in the F13L gene, such as H238Q, A288P, A290V, D294V, P243S, N267D, A295E, I372N, and A184T, have been linked to resistance, reducing tecovirimat's efficacy. Therefore, understanding the Clade-specific mutation patterns and genomic adaptations offers crucial insights into the mechanisms driving resistant variant emergence to inform targeted therapeutic and vaccine development strategies, ensuring effective containment of future Mpox outbreaks. This review highlights the genomic diversity of MPXV, its implications for antiviral resistance, and strategies to enhance treatment effectiveness, particularly in vulnerable populations.

The mpox virus, a member of the orthopoxvirus genus of the Poxviridae family, is the source of this newly recognized viral zoonotic illness. Before October 2023, no mpox cases were reported in Oman. This study describes the first confirmed case of mpox and a related family cluster from North Batinah Governorate. This study aimed to describe the clinical and epidemiologic investigations of the first mpox case and cluster in Oman, including the identification of infection sources; assessing the transmission prevention measures in place for health care settings and the community; and providing recommendations for improving public health measures for the prevention, detection, and response to the emerging threat of mpox.

An outbreak investigation study was conducted involving all three confirmed cases of mpox in October 2023 in North Batinah Governorate, using a previously prepared form for epidemiological investigation of the cases and another form for detailed contact tracing.

The results showed that all three cases were from the same family from Sohar Willayat infected with mpox clade IIb. The possible source of infection for the index case was not declared but was potentially travel-related. Transmission to secondary cases occurs through droplets, direct contact, and bedding within households. All contacts were identified and followed up for 21 days, and no secondary cases occurred outside the household.

Travel-related exposure appeared to be a significant factor in the outbreak of clade IIb in Oman. This investigation serves as a practical exercise for public health preparedness, emphasizing the importance of an adaptive health system. Ensuring robust detection and response measures while accounting for patient privacy, cultural contexts, and available resources, such as institutional quarantine for contacts, is crucial for effectively managing emerging infectious diseases.

The increasing number of Monkeypox (Mpox) cases in non-endemic countries resulted in the WHO declaring a public health emergency of international concern. Accurate and timely diagnosis of Mpox has a critical role in containing the spread of infection. Diagnosis currently relies on PCR, which requires trained personnel and complex laboratory infrastructure. Thus, the development of point-of-care (POC) tools are essential to facilitate rapid, accurate, and user-friendly diagnosis. Here, we review POC diagnostic tools available for Mpox. We also discuss bottlenecks preventing the widespread implementation of POC platforms for Mpox diagnosis and potential strategies to address these limitations. Furthermore, we describe future directions, including the role of machine learning (ML) and deep learning (DL)-based models and the integration of integrated field-deployable platforms for Mpox diagnosis.

In 2022, a global mpox outbreak occurred, and remains a concern today. The T cell memory response to MPXV (monkeypox virus) infection has not been fully investigated. In this study, we evaluate this response in convalescent and MVA-BN (Modified Vaccinia Ankara - Bavarian Nordic) vaccinated individuals using VACV-infected cells. Strong CD8+ and CD4+ T cell responses are observed, and T cell responses are biased towards viral early expressed proteins. We identify seven immunodominant HLA-A*02:01 restricted MPXV-specific epitopes and focus our detailed phenotypic and scRNAseq analysis on the immunodominant HLA-A*02:01-G5R18-26-specific CD8+ T cell response. While tetramer+CD8+ T cells share similar differentiation and activation phenotypes, T cells from convalescent individuals show greater cytotoxicity, migratory potential to site of infection and TCR clonal expansion. Our data suggest that effective functional profiles of MPXV-specific memory T cells induced by Mpox infection may have an implication on the long-term protective responses to future infection.

Monkeypox is a viral zoonosis caused by the monkeypox virus (MPXV). Although the virus was identified decades ago, human immunity to MPXV infection has not been widely characterized. During MPXV infection, macrophages are recruited at the site of infection and are thought to contribute to the spread of the virus. Cases of MPXV vertical transmission were reported in infected pregnant women to the developing fetuses in utero resulting to high viral burden in placenta tissue and abortion. We aim to understand the impact of MPXV infection at the foeto-maternal interface by focusing on macrophages functions. Using full-term placental explant model, macrophages were recruited at site of infection. Isolated naive macrophages are permissive to MPXV infection and secrete high levels of pro-inflammatory cytokines associated with a strong M1 polarization profile. Analysis of antiviral gene expression reveals upregulation of IFNA and IFN-associated genes suggesting that MPXV induces the expression of some component of antiviral response from macrophages that are unable to clear the virus. Our study shows that macrophages are permissive to MPXV that subverts inflammatory and antiviral machinery without virus clearance. Such findings contribute to better knowledge of MPXV vertical transmission pathogenesis.

Monkeypox was re-emerging in 2022 and spread to more than 100 countries. Two clades of Monkeypox virus (MPXV) result in different lethality rates and varying transmission capabilities. Rapid identification of MPXV and differentiation of its clades and subclades are crucial for effective control of the disease. In this study, we developed an ARMS-Quadruplex-qPCR method to detect MPXV and distinguish clades (Ia, Ib, IIa and IIb). F3L gene was used to detect all clades of MPXV from other orthopoxviruses. A 1953 bp fragment containing the C3L gene was found to be completely absent in clade II. Additionally, a sequence spanning from the 177th to the 1318th position (1142 bp) within the 1953 bp fragment was missing in Ib. Therefore, the 1142 bp sequence was used to distinguish Ia from other subclades, and the sequence with the 1142 bp region missing in Ib was used to discriminate Ib from other subclades. Since subclades IIa and IIb are too close to have large deletions and insertions, a unique single nucleotide polymorphism (SNP) was used to design a primer/probe set for ARMS-qPCR to differentiate clade IIa from IIb. The ARMS-Quadruplex-qPCR system can detect down to 2 copies per reaction of MPXV and effectively differentiate all the four subclades. Altogether, four qPCR primer/probe sets in one tube were deployed to recognize MPXV and differentiate MPXV subclades. The high sensitivity, rapidity and specificity of the developed system make it a promising alternative for the diagnosis of MPXV and the determination of the subclades of the infected MPXV.

This review explores the intersection of Mpox and HIV, highlighting clinical manifestations, immune evasion mechanisms, epidemiological challenges, and prevention strategies. People with HIV (PWH), particularly those with low CD4 + cell count, face severe Mpox outcomes. Prevention relies on education, vaccination, and early detection. Integrating Mpox management into HIV care systems is vital.

Since May 2022, Mpox caused by Orthopoxvirus monkeypox (MPV) Clade IIb, has affected 126 countries. In 2024, Clade Ib emerged in the Democratic Republic of Congo, leading to its declaration as a Public Health Emergency of International Concern (PHEIC). Research on MPV-HIV co-infections has provided genomic insights and protective strategies for PWH. Antivirals like tecovirimat show promise despite emerging resistance concerns.

The global Mpox outbreak caused by Clade IIb and the emergence of Clade Ib underscores its growing threat. Mpox disproportionately impacts PWH, leading to severe outcomes and higher fatality rates. This review emphasizes clinical challenges, genomic advances, and prevention strategies. Enhanced surveillance, vaccination, and tailored therapies are essential to addressing this evolving health crisis.

During the global Mpox epidemic of 2022/2023, the first cases in France were identified on 20 May 2022 among gay men. Scientific data on the experience of individuals concerned during the peak of the epidemic in France are scarce. This paper describes the results of the qualitative phase of the French ad hoc ANRS Mpox-SHS study, which was conducted in September/October 2022 among gay men diagnosed with Mpox.Study participants highlighted that they were not surprised at being diagnosed with Mpox, given that they were more exposed to sexually transmitted diseases in general because they had several partners and they were a target group of prevention campaigns.In contrast, the rapidity and extent of the disease's symptoms (pain, rashes, scabs, etc.) surprised many of them. All participants mentioned strong barriers to accessing appropriate care, the most-cited being stigma. Participants felt they were treated like "plague victims". Furthermore, most reported serious social and psychological consequences of being diagnosed with Mpox, arising from their fear that their sexual orientation and/or their sexual practices would be exposed. Moreover, respondents highlighted having an erratic Mpox care pathway, being sent from one health provider to another to receive care. Finally, participants explained that they implemented various negotiation strategies with their healthcare providers, sexual partners, and their employers during their illness.This study highlights the importance of using community health to better understand the development of an epidemic and its impact on affected individuals.

Vaccinia virus (VACV) and mpox virus (MPXV) belong to the orthopoxvirus genus and share high genetic similarity, making VACV widely used in the mpox pandemic. CAST/EiJ mice have been widely used for studying orthopoxvirus infection. However, the histopathological features of CAST/EiJ mice with mpox virus (MPXV) and vaccinia virus (VACV) infections have not been fully elucidated.

Four group of CAST/EiJ mice were challenged with low-dose VACV (103 PFU, VACV-L), high-dose VACV (106 PFU, VACV-H), MPXV (106 PFU) or PBS via intraperitoneal route, and the disease signs and body weight were monitored daily. Subsequently, viral loads and titers in the blood and spleen of CAST/EiJ mice were analyzed via qPCR and TCID50 assay. Finally, the spleen samples were analyzed for histopathological, immunohistochemical and RNA-seq.

Herein, we found that VACV-L and MPXV caused splenomegaly via the intraperitoneal route, whereas VACV-H caused rapid lethality with limited splenomegaly. Transcriptome analysis from spleen revealed significant differences in gene expression between VACV-L and VACV-H groups, but the differentially expressed genes induced by splenomegaly between VACV-L and MPXV groups were highly similar. Furthermore, pathway enrichment analysis demonstrated that the VACV-L, VACV-H, and MPXV groups were all associated with the calcium, MAPK, and PI3K-Akt signaling pathway. Compared to the lethal infection observed in VACV-H group, the splenomegaly in the VACV-L and MPXV groups was characterized by extramedullary hematopoiesis and increased macrophages infiltration in the red pulp. Transcriptome analysis of the spleen demonstrated that the Wnt, tumor necrosis factor (TNF), and transforming growth factor β (TGF-β) signaling pathways may promote splenomegaly by modulating granulocyte infiltration and inflammatory responses. Compared to VACV-L group, the limited splenomegaly but lethality in VACV-H-infected mice might be associated with extensive splenic necrosis, diffuse congestion, and hemorrhage in the red pulp, as well as changes in the cGMP-PKG, Ras signaling, and Fc gamma R-mediated phagocytosis pathways.

Our findings systematically compared the pathogenicity of VACV and MPXV in CAST/EiJ mice, incorporating splenic transcriptome analysis to provide insights into the potential molecular mechanism behind orthopoxvirus-induced splenomegaly in CAST/EiJ mice.

Saudi Arabia has witnessed the first confirmed case of Mpox on July 14th, 2022. Currently, there is no approved medication for the treatment of this infection. Therefore, prevention of this infection is crucial. This study aimed to assess knowledge and attitude toward the monkeypox viral infection among pharmacy students of Jazan University in Saudi Arabia.

This is a cross-sectional, self-administered web-based study between the periods from April 2024 to June 2024. Descriptive statistics for all variables used chi-square statistics, and multivariate analysis to establish the association between participant's demographic characteristics and knowledge of monkeypox disease.

The overall level of knowledge and attitude found 32 and 44.5%, respectively among pharmacy students. The source of information was commonly social media (55.5%), and only 38% reported receiving information during medical education. The factors associated with knowledge level included gender (p = 0.02), obesity (p = 0.03), receiving information from family or friends (p = 0.03), and during medical education (p = 0.016). The factors that were associated with attitude included age (p = 0.03), chronic disease (p = 0.0001), social media (p = 0.007), and medical education (p = 0.004) as sources of information.

This study found the participants had a low level of knowledge and attitude toward Mpox infection. There is a need for the implementation of educational programs to know about this kind of outbreak and increase the knowledge and attitude of the students.

Monkeypox has recently garnered global attention, particularly in 2022, due to a worldwide outbreak. It is a viral infection that begins as a rash on the face and then spreads to other parts of the body. In recent times, cases presenting as genital lesions have been reported, particularly among men who have sex with men (MSM). We present a unique case of a 20-year-old male from Riyadh, Saudi Arabia, who developed an isolated genital rash after engaging in heterosexual contact. This case represents one of the rare local monkeypox infections in Saudi Arabia and emphasizes the significance of considering sexual transmission outside of MSM populations. The patient initially presented with fever and a localized vesicular rash in the pubic area, which evolved into erythematous plaques on other parts of the body. Laboratory confirmation of monkeypox was attained, and supportive treatment was provided. Therefore, physicians should consider monkeypox when diagnosing sexually transmitted diseases that present as genital lesions and reinforce the importance of health education on safe sexual practices to decrease viral spread.

Mpox is a globally prevalent disease that has triggered multiple epidemics over the past few decades, leading to moderate rates of hospitalisation and mortality. Recently, it has re-emerged in several countries, including the Democratic Republic of Congo, and appears to be spreading at an unprecedented pace. The disease is caused by zoonotic double-stranded DNA viruses. Due to its similarities with smallpox, distinguishing between the two can be challenging, though the smallpox vaccine typically provides immunity against Mpox. At the time of writing, no approved treatment for Mpox exists; however, several promising candidates have demonstrated the ability to inhibit viral replication, including resveratrol-a polyphenolic compound found in red wine. This study employs molecular docking and molecular dynamics simulations to assess the effectiveness and stability of nine resveratrol analogues. Additionally, 2D and 3D pharmacophore models were developed for the highest-ranked docked compounds, leading to a composite pharmacophore. A structure-activity relationship analysis was also conducted using these top-performing compounds. The findings suggest that two compounds- (9) [1,1'-biphenyl]-3,4',5-triol and (11) {3-hydroxy-5-[2-(4-hydroxyphenyl)ethenyl]phenyl}oxidanesulfonic acid-exhibit strong binding affinity, with compound 11 potentially forming a stable complex with the thymidylate kinase of the vaccinia virus.

The online version contains supplementary material available at 10.1007/s40203-025-00345-1.

As the COVID-19 pandemic situation was on an end, a new monkeypox menace has been discovered in several places of the world. The most comforting thing is that the fatality rate of monkeypox is unlike Covid-19. But the recent global outbreaks and the rise in the number of cases has drawn attention of world towards it. The number of cases in multiple countries have already surpassed 25,000, according to the WHO report released on July 25, 2022. The zoonotic disease monkey-pox virus causes a feverish sickness in humans, with characteristic skin rashes and is similar to smallpox in structure, clinical presentation, and response to antiviral medicine. This review offers important insights on the evolution of the monkeypox virus and its different modes of transmission. It also discusses epidemiology, clinical findings, management, challenges, and current strategies for the disease, as well as the implications of the current epidemic on public health. Comprehensive research on the pathophysiology and management of monkeypox is still lacking. In order to solve this problem, we reviewed the pathology and virology of monkeypox infection and provided an overview of the most recent developments in anti-monkeypox medications.

Mpox, previously known as monkeypox, is a zoonotic viral disease caused by the Mpox virus (MPXV), a member of the Orthopoxvirus genus. This disease is of significant concern due to its zoonotic transmission, which can be challenging to control, its ability to spread easily from person to person, the potential for severe symptoms or even fatality, and its history of frequent global outbreaks. Despite the growing threat, there is still limited research on the pathophysiology of the disease and available disease-modifying treatments. To address this gap, the latest developments in Mpox epidemiology, viral variant detection, and advanced diagnostic tools for accurate MPXV detection have been reviewed. Ongoing preventive measures, including vaccination strategies, have also been examined. Additionally, the genomic and proteomic characteristics of MPXV have been explored, and network and pathway enrichment analyses have been performed to identify potential therapeutic targets. The findings presented in this manuscript suggest the potential for novel disease-modifying treatments. Moreover, emerging technologies, such as artificial intelligence and "big data," are playing a crucial role in advancing disease management and enhancing prevention strategies. This review emphasizes the evolving understanding of Mpox and MPXV variants and underscores the importance of continued research and public health initiatives to combat the disease and prevent future global outbreaks.

Effective control of any disease, including Monkey pox (mpox), is highly dependent on public knowledge and adherence to preventive measures. This cross-sectional study was conducted with the aim of investigating the knowledge of students and staff of Baqiyatallah University about the origin of mpox and its symptoms, transmission, prevention, and management.

In the current cross-sectional study, the data was collected from Aug 5, 2024 to Sep 5, 2024. The target population consisted of students, teachers, and the staff of Baqiyatallah University, aged 18 or above. Multiple Logistic regressions were employed to assess the association between participants' overall knowledge about human mpox as well as their attitude and their demographic data. Data was analyzed using IBM SPSS statistics version 23.0 (IBM Corp., Armonk, NY, USA) and subsequently coded and labeled. The statistical significance level was set at 5%.

The overall mean score of participants' knowledge and attitude was 6.37 ± 2.20 and 4.24 ± 1.71, respectively. Based on Bloom's cut-off points, 458 (84.3%), 78 (14.4%), and 7 (1.3%) of the participants had low, moderate, and high knowledge levels, respectively and, 279 (51.4%), 221 (40.7%), and 43 (7.9%) of the participants had low, moderate, and high attitude levels, respectively. Logistic regression analysis showed that job status(OR: 9.6, 95% CI: 1.3-66.4), major(OR: 4.3, 95% CI: 1.3-14), and higher educational level (OR: 7.6, 95% CI: 1.03-61.8), was significantly associated with participants' knowledge about mpox.

This study showed that university students and staff in Iran do not have enough knowledge about mpox, including its symptoms, preventive measures, and treatment, with a good understanding of local and international health authorities in the control of emerging mpox. People with higher education tend to have better knowledge, which indicates that access to reliable information sources is necessary to acquire accurate knowledge.

Monkeypox (Mpox) is an  emerging infectious disease caused by the Mpox virus (MPX Virus). The outbreak of Mpox epidemic has caused global panic and is now a public health incident. Various approaches have been proposed in the recent literature to study and analyze the epidemiological dynamics of this infection and effective prevention and control measures. Using mathematical model to understand the transmission dynamics and control strategy is a useful way to understand the prevention of Mpox.

A new compartment model is established to examine the effectiveness of vaccine on Mpox based on previous studies. Nonlinear least squares fitting is used for model's parameter estimation. The impact of a series of preventive and control measures on the epidemic control is explored with optimal control theory in conjunction with the official data released by the authorities.

Firstly, a stability analysis of the developed model was carried out to show that, under certain circumstances, its equilibrium is both locally and globally stable. Secondly, based on the reported cases of Mpox infection in the United States between 2022 and 2023, the model's optimal parameter values were obtained. A sensitivity analysis of the model parameters was then conducted to identify the key parameters that affect the development of Mpox epidemics in the United States. Lastly, the comparison of control effects under various control strategies showed that implementing the all suggested four control measures at the same time was the most effective way to curb the development of monkeypox epidemic in the United States.

This study has theoretical significance for understanding and controlling Mpox virus transmission.

Mpox (formerly known as monkeypox) is a neglected tropical disease that became notorious during its 2022-2023 worldwide outbreak. The vaccination was available, but there were inequities in vaccine access. In this paper, we extend existing game-theoretic models to study a population that is heterogeneous in the relative vaccination costs. We consider a population with two groups. We determine the Nash equilibria (NE), i.e., optimal vaccination rates, for each of the groups. We show that the NE always exists and that, for a narrow range of parameter values, there can be multiple NEs. We focus on comparing the mean optimal vaccination rate in the heterogeneous population with the optimal vaccination rate in the corresponding homogeneous population. We show that there is a critical size for the group with lower relative costs and the mean optimal vaccination in the heterogeneous population is more than in the homogeneous population if and only if the group is larger than the critical size.

Individual tissues have distinct antiviral properties garnered through various mechanisms, including physical characteristics, tissue-resident immune cells and commensal organisms. Although the oral mucosa has long been appreciated as a critical barrier tissue that is exposed to a continuous barrage of pathogens, many fundamental aspects of the antiviral immune response in this tissue remain unknown. Several viral pathogens, such as herpesviruses and human papillomaviruses, have been acknowledged both historically and at present for infections in the oral cavity that result in substantial clinical burden. However, recent viral outbreaks, including those with SARS-CoV-2 and mpox, featured oral symptoms even though these viruses are not generally considered oral pathogens. Ensuing studies have shown that the oral cavity is an important locale for viral infection and potential transmission of newly emergent or re-emergent pathogens, highlighting the need for an increased understanding of the mechanisms of antiviral immunity at this site. In this Review, we provide a broad overview of antiviral immune responses in the oral cavity and discuss common viral infections and their manifestations in the oral mucosa. In addition, we present current mouse models for the study of oral viral infections.

Human monkeypox (Mpox) is a zoonotic disease caused by monkeypox virus (MPXV) present in western Africa and exported sporadically worldwide. MPXV causes illness in individuals and pregnant women which constitute a population at risk with obstetrical and fetal complications including miscarriage, stillbirth and premature delivery. There are accumulated data suggesting a vertical transmission of MPXV from mother to fetus. This review provides an overview of the literature on MPXV infection in pregnant women with a specific focus on vertical transmission.

Infection with clade I Mpox virus (MPXV) results in adverse pregnancy outcomes, yet the potential for vertical transmission resulting in fetal harm with clade IIb MPXV, the clade that is currently circulating in the Western Hemisphere, remains unknown. We sought to establish a pregnant rhesus macaque model of clade IIb MPXV infection with early gestation inoculation to understand if infection results in vertical transmission and adverse pregnancy outcomes. Three pregnant rhesus macaques were inoculated intradermally with 1.5 x 105 plaque forming units (PFU) of clade IIb MPXV near gestational day (GD) 30 and animals were monitored for viremia and maternal and fetal well-being. Animals were euthanized to collect tissues at 5, 14, or 25 days post-inoculation (dpi). Tissues were evaluated for viral DNA (vDNA) loads, infectious virus titers, histopathology, MPXV mRNA and protein localization, as well as MPXV protein co-localization with placental cells including, Hofbauer cells, mesenchymal stromal cells, endothelial cells, and trophoblasts. vDNA was detected in maternal blood and skin lesions by 5 dpi. Lack of fetal heartbeat was observed at 14 or 25 dpi for two dams indicating fetal demise; the third dam developed significant vaginal bleeding at 5 dpi and was deemed an impending miscarriage. vDNA was detected in placental and fetal tissue in both fetal demise cases. MPXV localized to placental villi by ISH and IHC. Clade IIb MPXV infection in pregnant rhesus macaques results in vertical transmission to the fetus and adverse pregnancy outcomes, like clade I MPXV. This suggests that clade IIb MPXV infection in human pregnancy poses a danger to maternal and fetal health as well. Further studies are needed to determine whether antiviral therapy with tecovirimat will prevent vertical transmission and improve pregnancy outcomes.

The mpox virus, sometimes known as MPXV, is the cause of the disease mpox. The Monkeypox virus is a different Poxviridae family member from the orthopoxvirus (OPXV) group. Clades I and II are the two varieties of the Monkeypox virus. The mpox can spread from person to person through direct contact with infectious skin or other lesions, such as those on the mouth or genitalia. The mpox virus is spread from animal to people by bites or scratches, as well as through tasks including skinning, trapping, cooking, playing with carcasses, and eating animals. People with compromised immune systems, small children, those with a history of eczema, and pregnant women may be more susceptible to serious mpox illness. This review aimed to identify the challenges of mpox, treatment alternatives, and prevention modalities.

This review addressed mpox virus etiology, epidemiology, risk factors, clinical presentations, clinical evaluation techniques, currently available treatments, and preventative measures. An analysis of the narrative data was conducted instead of a pooled analysis. Complete data published in English was included in a comprehensive literature search conducted across relevant databases pertaining to the mpox.

The recommended laboratory test for mpox is polymerase chain reaction detection of viral DNA. It is crucial to differentiate measles, scabies, herpes, syphilis, chickenpox, measles, bacterial skin infections, and allergies related to medications from mpox. The ability to distinguish between chickenpox and mpox is made by lymphadenopathy. The JYNNEOS vaccine, ACAM2000 vaccine, and MVABN also known as Imvamune vaccinations have now been investigated and authorized for usage during mpox epidemics in different locations. Tecovirimat, brincidofovir, and cidofovir which had previously shown promise against OPXV were used as antivirals during the 2022 outbreak.

This review provides a brief overview of current vaccinations and antiviral medications that have been assessed for their potential as treatments since the mpox threat came into existence will be provided. It is useful to increase awareness and recognize the common clinical manifestations of mpox, diagnose, and its prevention methods. To effectively reduce the global transmission of mpox, the WHO should prioritize strategies that enhance early detection of the illness, careful administration of antiviral treatments, and focused vaccination initiatives for high-risk groups or wider immunization in areas where the disease is common. Furthermore, it is crucial to establish preventive measures, conduct educational outreach, and implement robust healthcare policies.

Recent emergence of zoonotic monkeypox virus (Mpox) in human has triggered the virologists to develop plausible preventive measures. Hitherto, our understanding on the mechanism of immunopathogenesis of Mpox infection is elusive. However, available experimental evidences suggest induction of inflammation as the main cause of pathogenesis. Toll-like receptors (TLRs) are critical in initiating and modulating the host immune response to pathogens. Inflammatory responses observed in various poxvirus infections have, in fact, been shown to be mediated through TLR activation. Therefore, by in silico approaches, this study seeks to identify the Mpox antigen(s) (MAg) that are most likely to interact with human cell-surface TLRs. The Mpox proteomics data available in UniProt database contain 174 protein sequences, among which 105 immunoreactive proteins were modeled for 3D structure and examined for comparative protein-protein interactions with the TLRs through molecular docking and molecular dynamics simulation. F14, an 8.28 kDa infective protein of Mpox, was found to exhibit strong binding affinity (ΔG=-12.5 Kcal mol-1) to TLR1/2 dimer to form a compact thermodynamically stable protein complex. Interestingly, a significant level of conformational change was also observed in both F14 and TLR6 while forming F14-TLR1/2 complex. Based on these data we propose F14 as a putative ligand of human TLR1/2 to initiate proinflammatory signaling in the Mpox-infected host.

Monkeypox (Mpox), a zoonotic viral disease caused by the Mpox virus (MPOXV), was first identified in 1958 and remained largely confined to Central and West Africa for decades. While it usually exhibited limited international transmission, recent outbreaks, including in the USA in 2003 and globally in 2024, highlight significant epidemiological shifts. We aimed to systematically evaluate the evolution of Mpox from 1958 to 2024, focussing on its epidemiology, viral evolution, and public health responses.

We conducted a systematic review using data from global health reports, surveillance databases, and published literature. The analysis covered key outbreaks, transmission patterns, geographic distribution, public health responses, and the roles of viral mutations and vaccination in disease management.

The 2022 Mpox outbreak, declared a Public Health Emergency of International Concern by the World Health Organization (WHO), was characterised by an unprecedented international spread of the virus. By July 2024, a total of 102 997 confirmed cases and 223 deaths were reported across 121 countries. Two distinct viral clades were identified: Central African (clade I) and West African (clade II), with the latter being the primary agent of global transmission. Research on Mpox has highlighted the protective effects of smallpox vaccination and emerging risk factors such as human-animal interactions and international travel.

Mpox has evolved from a regionally contained zoonotic disease to a global public health challenge. Enhanced surveillance, international collaboration, and targeted interventions in non-endemic regions are critical for mitigating future outbreaks and managing ongoing epidemiological changes.

This study aimed to describe the clinical and epidemiologic characteristics of suspected cases of human mpox in one of the most affected health zones, Katako-Kombe, Sankuru Province, in the Democratic Republic of the Congo. Also, to identify key challenges to prevent and improve the health of the affected community.

Between January 26, 2023 and November 30, 2023, the DRC reported its highest incidence of mpox cases,with a total of 12,569 suspected cases in 156 health zones from 22 of the 26 country's provinces. The Katako-Kombe Health Zone registered 369 suspected cases and 17 deaths, making it one of the hotspots of the outbreak.

Ten villages and centres were affected, with an attack rate (AT) of 2.15‰ and a case fatality rate (CFR) of 4.6%. Epi-curves showed an increase in clinical cases from January to May 2023, followed by a decrease until August 2023 and a resurgence of cases in September 2023, with a reproduction rate of 1.29. Furthermore, the occurrence of complications appeared to increase the CFR with 7 (14%), 11 (18.03%), and 9 (23.68%) for encephalitis, anemia, and pulmonary complications, respectively.

AT, CFR, and transmission rate appeared to be lower in the current epidemic than in previous outbreaks and in Clade I. Critically, delayed medical care increases the incidence of complications and CFR. Therefore, mpox requires early diagnosis and prompt public health response. Including the possibility of mpox in the differential diagnosis of patients presenting with a vesicular or pustular rash is suggested.

Mpox is a zoonotic illness caused by the Mpox virus (MPXV), a member of the Orthopoxvirus family. Although a few cases have been reported outside Africa, it was originally regarded as an endemic disease limited to African countries. However, the Mpox outbreak of 2022 was remarkable in that the infection spread to more than 123 countries worldwide, causing thousands of infections and deaths. The ongoing Mpox outbreak has been declared as a public health emergency of international concern by the World Health Organization. For a better management and control of the epidemic, this review summarizes the research advances and important scientific findings on MPXV by reviewing the current literature on epidemiology, clinical characteristics, diagnostic methods, prevention and treatment measures, and animal models of MPXV. This review provides useful information to raise awareness about the transmission, symptoms, and protective measures of MPXV, serving as a theoretical guide for relevant institutions to control MPXV.

Mpox (previously known as monkeypox) is receiving attention worldwide due to outbreaks in various countries since May 2022. On August 14, 2024, based on the increase Mpox infections, the World Health Organization (WHO) declared a public health emergency. The zoonotic disease is caused by the Mpox virus, an Orthopoxvirus related to other Poxviridae. The virus is transmitted via direct contact with infected bodily fluids, respiratory droplets, or contaminated objects and has an incubation time of 5-21 days. Symptoms include fever, headache, muscle pain, and a characteristic skin rash which progresses from macules, to papules, to vesicles, and to pustules before scabbing over. There are two main genetic clades of Mpox: clade I (Central Africa) and clade II (West Africa), whereby clade IIb was responsible for the 2022 outbreak. Diagnosis is based on PCR testing of skin lesions. Although Mpox may mimic other diseases such as chickenpox or syphilis, lymphadenopathy is a distinguishing feature. Treatment is primarily supportive, although antiviral agents such as tecovirimat and cidofovir have shown a certain efficacy. Vaccination is an important protective measure; MVA-BN and ACAM2000 are among the available vaccines. Prognosis depends on the clade, the access to medical care, and the underlying health status. Immunocompromised persons and children are at a higher risk of a severe course.

Human monkeypox (Mpox) is an emerging zoonotic disease. Its clinical features are similar to but less severe than those of smallpox. The etiology of this disease is the monkeypox virus. This virus is a double-stranded DNA virus that is classified into the genus Orthopoxvirus and the family Poxviridae. Human monkeypox was first identified in 1970 and mainly occurred in Central and Western Africa. In 2022, outbreaks of Mpox virus infection occurred in several non-endemic countries and caused a potential threat to humans. It is urgent to take immediate action to control and prevent the outbreak of the Mpox virus infection. This paper summarizes the current status of Mpox and generated strategies for managing the Mpox epidemic. Although progress in the diagnostic methods and treatment of Mpox produces better knowledge, we argue that the sensitive surveillance for animal and human Mpox virus infection and evidence-based response and management of Mpox outbreaks is critical. This study highlights the need for further research on preventive and control strategies for Mpox disease approached through the One Health concept.

The current outbreak of mpox has been declared a public health emergency of international concern by the World Health Organization. However, distinguishing symptoms of mpox virus (MPXV) infection from other orthopoxviruses is atypical, necessitating laboratory confirmatory tests to aid in clinical diagnosis. Therefore, rapid and accurate detection and differentiation of various clades of MPXV are imperative.

A multiplex droplet digital PCR (ddPCR) method was developed to detect and differentiate various clades of MPXV with subsequent evaluation of its sensitivity and accessibility through the analysis of 17 clinical samples.

Primers and probes for multiple ddPCR were designed by comparing multiple complete genomes of orthopoxviruses. Primer and probe concentrations, reaction conditions were tentatively optimized on the Biorad QX200 platform. Seventeen clinical samples of MPXV were detected and verified by Sanger sequencing.

The established ddPCR method could detect and differentiate MPXV, and the results were consistent with those of Sanger sequencing.

Multiplex ddPCR could be used to detect and distinguish different clades of MPXV rapidly and accurately.

Mpox is a zoonotic disease caused by the monkeypox virus (MPV), primarily found in Central and West African countries. The typical presentation of the disease before the 2022 mpox outbreak includes a febrile prodrome 5-13 days post-exposure, accompanied by lymphadenopathy, malaise, headache, and muscle aches. Unexpectedly, during the 2022 outbreak, several cases of atypical presentations of the disease were reported, such as the absence of prodromal symptoms and the presence of genital skin lesions suggestive of sexual transmission. As per the World Health Organization (WHO), as of March 20, 2024, 94,707 cases of mpox were reported worldwide, resulting in 181 deaths (22 in African endemic regions and 159 in non-endemic countries). The United States Centers for Disease Control and Prevention (CDC) reports a total of 32,063 cases (33.85% of total cases globally), with 58 deaths (32.04% of global deaths) due to mpox. Person-to-person transmission of mpox can occur through respiratory droplets and sustained close contact. However, during the 2022 outbreak of mpox, a high incidence of anal and perianal lesions among MSMs indicated sexual transmission of MPV as a major route of transmission. Since MSMs are disproportionately at risk for HIV transmission. In this review, we discusses the risk factors, transmission patterns, pathogenesis, vaccine, and treatment options for mpox among MSM and people living with HIV (PLWH). Furthermore, we provide a brief perspective on the evolution of the MPV in immunocompromised people like PLWH.

The Mpox, a zoonotic viral disease that has historically affected Central and West Africa, has been declared a Public Health Emergency of International Concern by the World Health Organization. Rapid transmission and recent dissemination in Africa may imply significant challenges to global health, including mental health.

We reviewed the mental health implications of the Mpox outbreak according to the published literature. We also discussed the psychological effects of the global spreading of this infection and public health preparedness strategies. Key areas of intervention may include the epidemiological surveillance, vaccine development, and mental health strategies.

The Mpox outbreak calls for a robust global preparedness to address potential health emergencies. Strengthening epidemiological surveillance, ensuring equitable vaccine distribution, and building resilient public health infrastructure are crucial. Additionally, addressing mental health consequences may require immediate, intermediate, and long-term strategies, including telepsychiatry, stress management training, and the integration of mental health into primary care.

Evaluation of diagnostic accuracy of two point-of-care (POC) molecular diagnostic tests for the detection of monkeypox virus (MPXV): Xpert® Mpox (Cepheid, Inc., USA) and STANDARD™ M10 MPX/OPX (SD Biosensor, Inc., Korea).

Diagnostic accuracy of both POC platforms was evaluated using 53 upper-respiratory swabs (URS) and 32 skin lesions swabs (SS) collected from mpox and COVID-19 patients in the UK against the Sansure (Sansure Biotech Inc.) and CDC reference qPCR tests. The analytical sensitivity of both platforms was assessed using a viral isolate from II, B.1 lineage.

The overall sensitivity and specificity of the Xpert® Mpox was 97.67% [95% CI 87.71-99.94%] and 88.57% [95% CI 73.26-96.80%] and 97.44% [95% CI 86.52-99.94%] and 74.42% [95% CI 58.83-86.48%] comparing the Sansure and CDC qPCR, respectively and for the M10 MPX/OPX was 87.80% [95% CI 73.80-95.92%] and 76.60% [95% CI 61.97-87.70%] and 94.29% [95% CI 80.84-99.30%] and 86.67% [95% CI 73.21-94.95%] with the Sansure and CDC qPCR.

The Xpert® Mpox had good diagnostic accuracy for both sample types while the M10 MPX/OPX clinical accuracy was deficient with URS. Our data supports the use of URS during the first 3 days of symptoms onset for mpox diagnosis.

Unlike classical smallpox and other orthopoxviruses, primary genital lesions may be the initial presentation of monkeypox, particularly in sexually active or immunocompromised individuals, with a rising incidence in certain populations. We report a case of monkeypox with an unusual presentation of penile edema and phimosis in an uncircumcised male complicated by bacterial superinfection and necrotizing fasciitis. The patient presented with fever, painful genital swelling, and a vesiculopapular rash that progressed to involve the peripheries. Prompt diagnosis and surgical intervention, including circumcision, debridement, and appropriate antibiotic coverage, effectively managed the necrotizing fasciitis and improved the patient's outcome. This case highlights the need for heightened clinical suspicion of monkeypox in patients presenting with genital lesions, as early diagnosis and management are critical in preventing severe complications.

In response to the pressing need for the detection of Monkeypox caused by the Monkeypox virus (MPXV), this study introduces the Enhanced Spatial-Awareness Capsule Network (ESACN), a Capsule Network architecture designed for the precise multi-class classification of dermatological images. Addressing the shortcomings of traditional Machine Learning and Deep Learning models, our ESACN model utilizes the dynamic routing and spatial hierarchy capabilities of CapsNets to differentiate complex patterns such as those seen in monkeypox, chickenpox, measles, and normal skin presentations. CapsNets' inherent ability to recognize and process crucial spatial relationships within images outperforms conventional CNNs, particularly in tasks that require the distinction of visually similar classes. Our model's superior performance, demonstrated through rigorous evaluation, exhibits significant improvements in accuracy, precision, recall, and F1 score, even with limited data. The results highlight the potential of ESACN as a reliable tool for enhancing diagnostic accuracy in medical settings. In our case study, the ESACN model was applied to a dataset comprising 659 images across four classes: 178 images of Monkeypox, 171 of Chickenpox, 80 of Measles, and 230 of Normal skin conditions. This case study underscores the model's effectiveness in real-world applications, providing robust and accurate classification that could greatly aid in early diagnosis and treatment planning in clinical environments.

Viruses frequently exploit the host's nucleocytoplasmic trafficking machinery to facilitate their replication and evade immune defenses. By encoding specialized proteins and other components, they strategically target host nuclear transport receptors (NTRs) and nucleoporins within the spiderweb-like inner channel of the nuclear pore complex (NPC), enabling efficient access to the host nucleus. This review explores the intricate mechanisms governing the nuclear import and export of viral components, with a focus on the interplay between viral factors and host determinants that are essential for these processes. Given the pivotal role of nucleocytoplasmic shuttling in the viral life cycle, we also examine therapeutic strategies aimed at disrupting the host's nuclear transport pathways. This includes evaluating the efficacy of pharmacological inhibitors in impairing viral replication and assessing their potential as antiviral treatments. Furthermore, we emphasize the need for continued research to develop targeted therapies that leverage vulnerabilities in nucleocytoplasmic trafficking. Emerging high-resolution techniques, such as advanced imaging and computational modeling, are transforming our understanding of the dynamic interactions between viruses and the NPC. These cutting-edge tools are driving progress in identifying novel therapeutic opportunities and uncovering deeper insights into viral pathogenesis. This review highlights the importance of these advancements in paving the way for innovative antiviral strategies.

Mpox, a zoonotic disease caused by the mpox virus (MPXV), has seen a significant shift in its epidemiological status since 2022, evolving from an initial local outbreak to a global epidemic. This recent outbreak of MPXV mainly emerged in several European and American countries and subsequently spread to over 100 countries and regions worldwide. The rapid evolution of MPXV, coupled with increased international interactions, has led to a gradual rise in mpox cases in certain regions of Asia, mostly involving MPXV clade II and its branch strains. In contrast, the more pathogenic and clinically severe MPXV clade Ib has been relatively rare, with no reports in China to date. Here, we analyzed the whole gene sequence of imported MPXV clade Ib variant from the first infection case detected in China. Through whole genome sequencing, we successfully obtained a full-length MPXV genome of 195,405 base pairs (bp). Phylogenetic analysis revealed that the genetic sequence of the MPXV in this case was predominantly clustered with MPXV clade Ib sequences previously reported from multiple African and European countries. Compared with the MPXV clade Ib reference strain DQ011155.1, there are 127 nucleotide alterations and 57 amino acid mutations in the MPXV genome of this case. Given that the MPXV clade Ib has started to appear in China, we must pay more attention to the prevention of and control measures for the spread of mpox.

MPOX (Monkeypox) is a zoonotic disease of increasing global concern due to its re-emergence and potential for human-to-human transmission. Effective public health interventions rely on understanding socio-demographic determinants of knowledge and perceptions of the disease. This study aimed to investigate MPOX-related knowledge and concerns among a diverse sample in Türkiye, identifying key factors influencing knowledge levels.

A cross-sectional study was conducted with 509 participants aged 18-73 years (mean age: 33.8 ± 15.6) in all settlements of Türkiye. Socio-demographic data were collected, and MPOX knowledge and concerns were assessed using a structured data form. To assess knowledge levels regarding MPOX, 15 questions were defined with 1 point given for each correct answer, and these questions were then categorized as high knowledge (≥ 10 correct answers) and low knowledge (< 10 correct answers). Univariable and multivariable binary logistic regression analyses were conducted to identify factors associated with knowledge levels. Trust and reliance on information sources were also evaluated. The data form was distributed to participants via social media platforms.

The majority of participants (97.1%) were aware of MPOX, but only 6.5% believed adequate precautions were in place. The mean knowledge score was 7.6 ± 3.7, with 37.7% demonstrating high knowledge. In terms of concerns about MPOX, only 31.6% of participants were identified as concerned, whereas the majority (68.4%) of the participants reported no significant concerns. The most trusted source of information about MPOX among the participants was medical doctors and healthcare professionals, as indicated by 53.63% of respondents. Low knowledge was significantly associated with older age (p = 0.015), female gender (p = 0.002), lower education levels (p < 0.001), non-medical fields (p < 0.001), and lower income (p < 0.001). Social media (53.11%) was the most common information source, yet healthcare professionals (53.63%) were the most trusted. Multivariable logistic regression confirmed that being in non-medical fields (OR = 2.858, 95% CI: 1.809-4.515, p < 0.001), lower income (OR = 3.141, 95% CI: 2.015-4.896, p < 0.001), and perceived low immunity (OR = 2.264, 95% CI: 1.350-3.797, p = 0.002) independently predicted lower knowledge.

Despite high awareness, significant gaps in MPOX knowledge exist, particularly among older adults, females, non-medical professionals, and those with low income. Public health strategies should prioritize these groups, leveraging trusted sources like healthcare professionals while improving the reliability of digital information platforms.

Monkeypox virus (MPXV) is an enclosed, double-stranded DNA virus from the Orthopoxvirus genus, which also contains variola, vaccinia, and cowpox. MPXV, which was once confined to West and Central Africa, has recently had a rebound, spreading beyond its original range since 2017. The virus is distinguished by its unique morphology, which includes an oval or brick-shaped structure and a complex lipid and protein makeup. The current multi-country outbreak designated a public health emergency in 2022, has highlighted MPXV's shifting epidemiology and ability to spread rapidly over the globe. 'No one is safe until everyone is safe' is a slogan we often heard during the COVID-19 pandemic, which is now also required for the growing global and regional mpox outbreaks. The epidemic is divided into two clades: Clade I and Clade II, which have distinct pathogenic characteristics. Diagnostic approaches have developed with advances in molecular techniques, yet problems persist in resource-constrained situations. This overview summarizes the virus's history, epidemiology, morphology, and clinical characteristics, offering insights into its recent comeback and current global response efforts.

Due to the lack of efficient mpox diagnostic technology, mpox cases continue to increase. Recently, the great potential of deep learning models in detecting mpox and non-mpox has been proven. However, existing methods are susceptible to interference from various noises in real-world settings, require diverse non-mpox images, and fail to detect abnormal input, which makes them unsuitable for practical deployment and application. To address these challenges, we proposed a novel strategy based on image inpainting called "Mask, Inpainting, and Measure" (MIM). In MIM's pipeline, a generative adversarial network learns feature representations of mpox images by inpainting the masked mpox images. On this basis, MIM measure the similarity between the inpainted image and the original image to detect mpox and non-mpox. Compared with multi-class classification models, MIM can handle unknown categories and abnormal inputs more effectively. We used the recognized mpox dataset (MSLD) and a dataset containing 18 categories of non-mpox skin diseases to verify the effectiveness and robustness of MIM. Experimental results show that the average AUROC of MIM achieves 0.8237. In addition, external clinical testing further demonstrates the robustness of MIM. Importantly, we developed a free smartphone app to help the public and healthcare professionals detect mpox more conveniently.

Human monkeypox (Mpox) is a zoonotic disease caused by the Monkeypox virus (MPXV). As of 14 August 2024, the World Health Organization (WHO) has declared it a global health emergency. For Mpox, this was the second public health emergency of global significance in the past two years. MPXV belongs to the Poxviridae family and is phylogenetically and epidemically divided into two clades: the Congo Basin (Clade-I) and the West African (Clade-II) clades. Clade-I has been associated with more severe disease progression and higher mortality compared to Clade-II, and thus the differentiation between clades can play an important role in predicting disease prognosis. The LAMP technique has the advantages of not requiring thermal cycling and achieving higher amplification in a shorter time compared to qPCR. Different types of LAMP assays were developed in this study to benefit from these advantages. We report the development of LAMP-1 and LAMP-2 assays using the LAMP method to detect MPXV Clade-I and Clade-II, respectively. The LAMP-1 assay includes both fluorescence and visible colorimetric readout tests developed with sensitivities of 103 and 107 copies, respectively. For the LAMP-2 assay, a probe-based test utilizing the Novel R-Duplex DARQ probe was developed, offering fluorescence detection at a sensitivity of 103 copies. As a result, we successfully developed three highly specific molecular diagnostic tests that distinctly differentiate between MPXV clades, delivering essential tools for the precise diagnosis and effective control of Mpox.