Mpox (monkeypox)

At a Glance

Monkeypox is an infectious disease caused by monkeypox virus infection. It was previously known as monkeypox and belongs to the same family as the variola virus (smallpox).

The representative manifestations are rashes and lesions that look like acne or blisters. Fever, chills, lymphadenopathy, fatigue, headache, myalgia, and respiratory symptoms may accompany them.

How the disease works

The main factors related to transmission include close skin contact with lesions, scabs, or bodily fluids of an infected person, prolonged face-to-face contact, and sexual or intimate contact. Contact with infected animals or contaminated items may also be involved.

After the virus enters through mucous membranes or damaged skin, it multiplies, and the resulting innate and adaptive immune responses cause systemic symptoms and skin lesions.

Variations in presentation among individuals

The risk of severe disease may be higher in cases of immunosuppression, pregnancy, infants, and active skin diseases such as eczema, impetigo, or psoriasis. The course of the disease varies depending on the viral lineage and the individual's immune status.

The broad framework of diagnosis and management

Symptoms usually begin within 3 weeks after exposure. The rash may appear first or follow flu-like symptoms. The rash typically heals over a period of 2 to 4 weeks through the scabbing stage.

Diagnosis primarily involves confirming symptoms, exposure history, and medical history, followed by observing lesions and testing lesion specimens; blood tests may be used as a supplement if necessary.

Current status of treatment

Since rashes can resemble other infectious and non-infectious diseases, a diagnosis is not confirmed by appearance alone; test results must be interpreted alongside the timing and site of specimen collection, the testing method, and the clinical context.

Management includes controlling moisture, pain, and itching, managing skin lesions, preventing transmission, and assessing the risk of severe disease; it is important to reduce close contact while symptoms are present and until the rash has healed.

Many patients improve with conservative treatment, but in cases of severe disease or high risk of severity, antivirals used for the treatment of smallpox may be considered.

How to read clinical trials

There are registrations for mpox-related observational cohort studies on ClinicalTrials.gov, but the fact of registration alone does not imply treatment efficacy, safety, approval, or standard of care, and the study status and whether results are disclosed must be verified separately.

Points to verify during clinical consultations

In clinical practice, the onset and changes in rash, exposure and close contact, possibility of pregnancy, immunocompromised state/skin disease, pain and dehydration, co-infections, and the risk to family/household members can be verified with medical staff.