{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T10:18:37Z","timestamp":1788344317000,"version":"build-2803163510"},"reference-count":47,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>With the re\u2010emergence of monkeypox (Mpox), it is vital for communities to assess and effectively respond to emerging outbreaks. This paper aims to review the potential of clade I Mpox to result in a widespread outbreak by assessing genetically enhanced virulence, transmission, and clinical manifestations. It highlights antiviral therapies, vaccine strategies, and public health initiatives that offer adaptive guidance for policy and management strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive literature search written in English was conducted using the PubMed, Scopus, Web of Science, World Health Organization, and the Center for Disease Control and Prevention sources to compile the most up\u2010to\u2010date information on Mpox.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The Mpox virus has evolved into two genetically and clinically distinct clades: clade I (Central African) and clade II (West African). Previously, Clade II strains caused a 2022\u20132023 global outbreak. Genetic mutations in clade I strains have resulted in higher virulence, immune evasion capabilities, and case\u2010fatality rates, causing concern for a future pandemic. To effectively protect against, treat, and contain clade I Mpox, a substantial understanding of its virological, clinical, and epidemiological characteristics is essential. Given the recent history of pandemics, there is much reason to be forward\u2010looking to elicit a more effective response to the next one. Clade I Mpox is better adapted to evade and suppress the human immune response, rendering it more lethal. The similarities to smallpox allow for vaccines tailored for smallpox to be used to prevent Mpox, with good efficacy. Furthermore, some drugs can be used to treat active infections, targeting various components of the Mpox life cycle.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among Mpox clades, clade I is more of a concern as it is more lethal. A solid understanding of the clinical presentation and routes of transmission, measures could be better taken to identify cases and take the proper steps to avoid the spread.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.72534","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T06:40:42Z","timestamp":1778827242000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Trends of Pathogenicity and Potential Risk Evaluation of Central African Mpox Variant to Cause Global Public Health Emergency: A Cross\u2010Sectional Analysis"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0146-5312","authenticated-orcid":false,"given":"Md. Ashrafur","family":"Rahman","sequence":"first","affiliation":[{"name":"Nesbitt School of Pharmacy Wilkes University Wilkes\u2010Barre Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlie","family":"Kozlowich","sequence":"additional","affiliation":[{"name":"Nesbitt School of Pharmacy Wilkes University Wilkes\u2010Barre Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Katulka","sequence":"additional","affiliation":[{"name":"Nesbitt School of Pharmacy Wilkes University Wilkes\u2010Barre Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie Roke","family":"Thomas","sequence":"additional","affiliation":[{"name":"Nesbitt School of Pharmacy Wilkes University Wilkes\u2010Barre Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeasna","family":"Shanjana","sequence":"additional","affiliation":[{"name":"Department of Education Wilkes University Wilkes Barre Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2820-3144","authenticated-orcid":false,"given":"Md. Rabiul","family":"Islam","sequence":"additional","affiliation":[{"name":"School of Pharmacy BRAC University Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,14]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.4103\/jfmpc.jfmpc_2071_20"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)02796-3"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1250343"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-025-11784-8"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41392-023-01540-2"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.meegid.2022.105372"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.isci.2023.108601"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1128\/msphere.00062-23"},{"key":"e_1_2_11_10_1","unstructured":"Centers for Disease Control and Prevention. \u201cMpox in the United States and Around the World: Current Situation.\u201dMpox U.S. Centers for Disease Control and Prevention 16 July2025 accessed 18 July 2025 www.cdc.gov\/mpox\/situation-summary\/index.html."},{"key":"e_1_2_11_11_1","unstructured":"F. S.Minhaj R. L.Ogale Whitehill et al. Monkeypox Outbreak\u2014Nine States May 2022 20 no.72 Morbidity and Mortality Weekly Report2023619\u2013622. Centers for Disease Control and Prevention accessed 18 July 2025 www.cdc.gov\/mmwr\/volumes\/72\/wr\/mm7220a2.htm."},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiad414"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciac960"},{"key":"e_1_2_11_14_1","unstructured":"More Than 600 Dead in Spreading DR Congo mpox Outbreak as Republic of Congo reports Its First Cases | CIDRAP. March 15 2024 accessed June 17 2025 https:\/\/www.cidrap.umn.edu\/mpox\/more-600-dead-spreading-dr-congo-mpox-outbreak-republic-congo-reports-its-first-cases."},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bj.2024.100746"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-025-12150-4"},{"key":"e_1_2_11_17_1","unstructured":"Mpox. accessed May 21 2025 https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/mpox."},{"key":"e_1_2_11_18_1","unstructured":"Epidemiological update \u2013 Week 35\/2024: Mpox Due to Monkeypox Virus Clade I. September 2 2024 accessed May 21 2025 https:\/\/www.ecdc.europa.eu\/en\/news-events\/mpox-epidemiological-update-monkeypox-2-september-2024."},{"key":"e_1_2_11_19_1","unstructured":"CDC. Clinical Considerations for Pain Management. Mpox. September 13 2024 accessed May 21 2025 https:\/\/www.cdc.gov\/mpox\/hcp\/clinical-care\/pain-management.html."},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1128\/aac.01226-22"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines11020278"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-022-01742-y"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2025.127598"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/v14091960"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(22)00574-6"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1005769107"},{"key":"e_1_2_11_27_1","unstructured":"CDC. How Mpox Spreads. Mpox. January 30 2025 accessed May 21 2025 https:\/\/www.cdc.gov\/mpox\/causes\/index.html."},{"key":"e_1_2_11_28_1","unstructured":"\u201cOperational Tool on Rapid Risk Assessment Methodology \u2010 ECDC.\u201dEuropean Centre for Disease Prevention and Control Mar.2019 www.ecdc.europa.eu\/sites\/default\/files\/documents\/operational-tool-rapid-risk-assessment-methodolgy-ecdc-2019.pdf."},{"key":"e_1_2_11_29_1","unstructured":"\u201cMonkeypox Multi\u2010Country Outbreak \u2010 First Update.\u201dEuropean Centre for Disease Prevention and Control 8 July2022 www.ecdc.europa.eu\/sites\/default\/files\/documents\/Monkeypox-multi-country-outbreak-first-update-8-July-FINAL3.pdf."},{"key":"e_1_2_11_30_1","unstructured":"\u201cRisk Assessment for the EU\/EEA of the MPOX Epidemic Caused by Monkeypox Virus Clade I in Affected African Countries.\u201dEuropean Centre for Disease Prevention and Control 16 August2024 www.ecdc.europa.eu\/en\/publications-data\/risk-assessment-mpox-epidemic-monkeypox-virus-clade-i-africa."},{"key":"e_1_2_11_31_1","unstructured":"\u201cRisk to United States From Clade I MPOX Outbreak in Central and Eastern Africa.\u201dCenters for Disease Control and Prevention Centers for Disease Control and Prevention 14 November2024 www.cdc.gov\/cfa-qualitative-assessments\/php\/data-research\/mpox-risk-assessment-november-update.html."},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiph.2023.04.001"},{"key":"e_1_2_11_33_1","unstructured":"\u201cClinical Management and Infection Prevention and Control for Monkeypox: Interim Rapid Response Guidance 10 June2022.\u201dWorld Health Organization World Health Organization 10 June 2022 www.who.int\/publications\/i\/item\/WHO-MPX-Clinical-and-IPC-2022.1."},{"key":"e_1_2_11_34_1","unstructured":"\u201cStrategic Framework for Enhancing Prevention and Control of Mpox: 2024\u20132027.\u201dWorld Health Organization World Health Organization 24 May2024 www.who.int\/publications\/i\/item\/9789240092907."},{"key":"e_1_2_11_35_1","unstructured":"\u201cPreventing Mpox.\u201dCenters for Disease Control and Prevention Centers for Disease Control and Prevention 11 December2024 www.cdc.gov\/mpox\/prevention\/index.html."},{"key":"e_1_2_11_36_1","unstructured":"\u201cIsolation and Infection Control at Home.\u201dCenters for Disease Control and Prevention Centers for Disease Control and Prevention 13 September2024 www.cdc.gov\/mpox\/hcp\/infection-control\/at-home.html."},{"key":"e_1_2_11_37_1","unstructured":"\u201cCleaning and Disinfecting.\u201dCenters for Disease Control and Prevention Centers for Disease Control and Prevention 20 November2024 www.cdc.gov\/mpox\/caring\/cleaning-and-disinfecting.html."},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2023.307409"},{"key":"e_1_2_11_39_1","unstructured":"Addressing Disproportionality in Communities Most Impacted by Mpox.\u201dLA County Department of Public Health accessed July 18 2025 publichealth.lacounty.gov\/media\/monkeypox\/addressing-disproportionality.htm."},{"key":"e_1_2_11_40_1","unstructured":"The White House. \u201cFact Sheet: Biden Administration Announces Key Actions and Implementation Plan to Increase Vaccine Supply.\u201dThe White House 9 August2022 web.archive.org\/web\/20250118094812\/https:\/\/www.whitehouse.gov\/briefing-room\/statements-releases\/2022\/08\/09\/fact-sheet-biden-administration-announces-key-actions-and-implementation-plan-to-increase-vaccine-supply\/."},{"key":"e_1_2_11_41_1","unstructured":"\u201cHHS Facilitates Agreement to Accelerate Delivery of Additional Smallpox and Monkeypox Vaccines Using New U.S. Production Line.\u201dU.S. Department of Health and Human Services 8 August2022 www.hhs.gov\/about\/news\/2022\/08\/18\/hhs-facilitates-agreement-accelerate-delivery-additional-smallpox-monkeypox-vaccines-using-new-us-production-line.html."},{"key":"e_1_2_11_42_1","unstructured":"Distribution from the Strategic National Stockpile. Pre\u2010Positioning and Contingency Supplies.\u201d Administration for Strategic Preparedness and Response (ASPR) aspr hhs.gov\/Mpox\/TPOXXOperationalGuidance\/Pages\/Distribution.aspx."},{"key":"e_1_2_11_43_1","unstructured":"\u201cTPOXX (Tecovirimat) Operational Planning Guide \u2014 Information for Providing Therapeutics for Persons with Mpox.\u201d Administration for Strategic Preparedness and Response (ASPR) web.archive.org\/web\/20240718160632\/https:\/\/aspr.hhs.gov\/mpox\/TPOXXOperationalGuidance\/Pages\/default.aspx."},{"key":"e_1_2_11_44_1","unstructured":"\u201cJoint Press Release: The Democratic Republic of Congo Receives First Mpox Vaccines.\u201d Africa CDC 5 September2024 africacdc.org\/news-item\/joint-press-release-the-democratic-republic-of-congo-receives-first-mpox-vaccines\/."},{"key":"e_1_2_11_45_1","unstructured":"Congo Launches Its First Mpox Vaccination Drive.\u201dDW.com Deutsche Welle 5 Oct.2024 accessed May 22 2025 www.dw.com\/en\/congo-launches-its-first-mpox-vaccination-drive\/a-70414094."},{"key":"e_1_2_11_46_1","unstructured":"SSHP.\u201dKemenkes 2025 sshp.kemkes.go.id\/."},{"key":"e_1_2_11_47_1","unstructured":"Ministry of Health of the Republic of Indonesia. \u201cSATUSEHAT Health Pass.\u201dhttps:\/\/www.kemkes.go.id\/id\/antisipasi-mpox-pendatang-dari-luar-negeri-wajib-isi-satusehat-health-pass."},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.4103\/apjtm.apjtm_527_24"}],"container-title":["Health Science Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hsr2.72534","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hsr2.72534","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hsr2.72534","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T09:56:53Z","timestamp":1788343013000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hsr2.72534"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":47,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1002\/hsr2.72534"],"URL":"https:\/\/doi.org\/10.1002\/hsr2.72534","archive":["Portico"],"relation":{},"ISSN":["2398-8835","2398-8835"],"issn-type":[{"value":"2398-8835","type":"print"},{"value":"2398-8835","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"2025-09-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e72534"}}