{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:02:24Z","timestamp":1789689744286,"version":"4.0.1"},"reference-count":92,"publisher":"Microbiology Society","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,6,28]]},"abstract":"<jats:p>Human monkeypox virus (hMpoxV) is of zoonotic origin and is closely related to the once-dreaded smallpox virus. It is largely endemic to the African continent but has moved out of the endemic regions as sporadic clusters in the past 20 years, raising concerns worldwide. Human Mpox is characterized by a mild to severe, self-limiting infection, with mortality ranging from less than 1% to up to 10% during different outbreaks caused by different clades of MpoxV. Bushmeat hunting is one of the primary reasons for its transmission from animals to humans. Various international and national health regulatory bodies are closely monitoring the disease and have laid down guidelines to manage and prevent hMpox cases. Emergency Use Status has been granted to Tecovirimat and Brincidofovir to treat severe cases and vaccination with the smallpox vaccine is recommended for high-risk group individuals. Strategies to repurpose and discover novel therapeutics and vaccines to control the outbreak are being researched. The current Mpox outbreak that has mainly affected men as approximately 96% of all cases are reported in men, is probably the result of a complex intersection of various factors. This necessitates a strong One Health response coordination involving human, animal and environmental health institutions. This review is an attempt to provide an all-inclusive overview of the biology, history, epidemiology, pathophysiology, diagnosis and management of hMpox in context to the recent 2022\u20132023 multi-country outbreak which is termed by WHO a \u2018Public Health Emergency of International Concern (PHEIC)\u2019.<\/jats:p>","DOI":"10.1099\/jmm.0.001725","type":"journal-article","created":{"date-parts":[[2023,6,28]],"date-time":"2023-06-28T14:16:59Z","timestamp":1687961819000},"source":"Crossref","is-referenced-by-count":15,"title":["Insights into the challenging multi-country outbreak of Mpox: a comprehensive review"],"prefix":"10.1099","volume":"72","author":[{"given":"Shreyas","family":"Bhat","sequence":"first","affiliation":[{"name":"Department of Microbiology, Ram Lal Anand College, University of Delhi, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumana","family":"Saha","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Ram Lal Anand College, University of Delhi, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanisha","family":"Garg","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Ram Lal Anand College, University of Delhi, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Himanshu","family":"Sehrawat","sequence":"additional","affiliation":[{"name":"Department of Biotechnology, Jamia Millia Islamia, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Balu Ananda","family":"Chopade","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Savitribai Phule Pune University, Pune 411007, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4785-5615","authenticated-orcid":false,"given":"Vandana","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Ram Lal Anand College, University of Delhi, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"345","reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-022-02004-w"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-022-01742-y"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0010141"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.10802"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2022.27.22.2200422"},{"key":"R6","volume-title":"StatPearls","author":"Moore","year":"2022"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(22)00228-6"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiph.2023.02.003"},{"key":"R9","doi-asserted-by":"publisher","DOI":"10.3390\/ijms23147866"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro1099"},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.3201\/eid2505.190076"},{"key":"R12","doi-asserted-by":"publisher","DOI":"10.1006\/viro.2002.1446"},{"key":"R13","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-022-02036-2"},{"key":"R14","doi-asserted-by":"publisher","DOI":"10.1126\/science.add4153"},{"key":"R15","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.28036"},{"key":"R16","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11216388"},{"key":"R17","article-title":"Highly accurate protein structure prediction and drug screen of monkeypox virus proteome - PMC","author":"Yang","year":"2022"},{"key":"R18","doi-asserted-by":"publisher","DOI":"10.15212\/AMM-2022-0017"},{"key":"R19","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0015547"},{"key":"R20","article-title":"Monkeypox","year":"2022"},{"key":"R21","article-title":"Multi-country Outbreak of Mpox. External Situation Report 13, (05 Jan 2023)","year":"2023"},{"key":"R22","article-title":"Multi-country Outbreak of Mpox. External Situation Report 22, (11May 2023)","year":"2023"},{"key":"R23","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7114a1"},{"key":"R24","doi-asserted-by":"publisher","DOI":"10.2217\/fvl.12.130"},{"key":"R25","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2019.03.001"},{"key":"R26","doi-asserted-by":"publisher","DOI":"10.1038\/d44148-022-00087-8"},{"key":"R27","doi-asserted-by":"publisher","DOI":"10.1038\/s41392-022-01215-4"},{"key":"R28","article-title":"Mpox (Monkeypox) and Animals - Canada.ca","year":"2023"},{"key":"R29","article-title":"Center for Food Security and Public Health factsheet on Monkeypox","year":"2022"},{"key":"R30","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.28513"},{"key":"R31","doi-asserted-by":"publisher","DOI":"10.3201\/eid1009.040310"},{"key":"R32","doi-asserted-by":"publisher","DOI":"10.7326\/M22-1581"},{"key":"R33","article-title":"Monkeypox: experts give virus variants new names (2022, August12)","year":"2022"},{"key":"R34","article-title":"WHO recommends new name for monkeypox disease (2022,November 28). WHO Recommends New Name for Monkeypox Disease","year":"2022"},{"key":"R35","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.bmb.a011720"},{"key":"R36","doi-asserted-by":"publisher","DOI":"10.9734\/IJTDH\/2017\/35885"},{"key":"R37","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0007791"},{"key":"R38","article-title":"History of Smallpox | Smallpox | CDC","year":"2021"},{"key":"R39","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-5247(22)00257-9"},{"key":"R40","article-title":"Signs and Symptoms | Mpox | CDC (October 18,2022)","year":"2022"},{"key":"R41","article-title":"Exportation of Monkeypox Virus From the African Continent | The Journal of Infectious Diseases | Oxford Academic","author":"Mauldin","year":"2022"},{"key":"R42","article-title":"Multi-country Outbreak of Mpox. External Situation Report 12, (14Dec 2022)","year":"2022"},{"key":"R43","article-title":"Fear of social stigma preventing Asians from monkeypox testing","author":"Times","year":"2022"},{"key":"R44","article-title":"UNAIDS warns that stigmatizing language on Monkeypox jeopardises public health.UNAIDS Warns That Stigmatizing Language on Monkeypox Jeopardises Public Health | UNAIDS","year":"2022"},{"key":"R45","article-title":"Perceptions of monkeypox from those most at risk: men who have sex with men having multiple sexual partners","year":"2022"},{"key":"R46","article-title":"Monkeypox messaging matters to reduce stigma: NPR","author":"Kim","year":"2022"},{"key":"R47","doi-asserted-by":"publisher","DOI":"10.1080\/14760584.2022.2113515"},{"key":"R48","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2022-073153"},{"key":"R49","doi-asserted-by":"publisher","DOI":"10.4314\/ajcem.v19i4.9"},{"key":"R50","doi-asserted-by":"publisher","DOI":"10.3201\/eid2608.191387"},{"key":"R51","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7135e1"},{"key":"R52","doi-asserted-by":"publisher","DOI":"10.3390\/v14091870"},{"key":"R53","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.16669"},{"key":"R54","article-title":"Guidelines for Management of Monkeypox Disease (2022, May 31)","year":"2022"},{"key":"R55","article-title":"Monkeypox in the U.S (2022, October 31)","year":"2022"},{"key":"R56","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(18)30788-6"},{"key":"R57","article-title":"FDA approves the first drug with an indication fortreatment of smallpox. (2018, July 13","year":"2018"},{"key":"R58","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1705688"},{"key":"R59","doi-asserted-by":"publisher","DOI":"10.1080\/14787210.2020.1819791"},{"key":"R60","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp2210125"},{"key":"R61","doi-asserted-by":"publisher","DOI":"10.1038\/s41564-022-01269-8"},{"key":"R62","article-title":"Tecovirimat SIGA","year":"2021"},{"key":"R63","doi-asserted-by":"publisher","DOI":"10.1097\/FTD.0000000000000353"},{"key":"R64","doi-asserted-by":"publisher","DOI":"10.1016\/j.antiviral.2017.04.002"},{"key":"R65","doi-asserted-by":"publisher","DOI":"10.1128\/mSphere.00126-21"},{"key":"R66","doi-asserted-by":"publisher","DOI":"10.1016\/j.antiviral.2015.02.007"},{"key":"R67","doi-asserted-by":"publisher","DOI":"10.1016\/j.antiviral.2021.105182"},{"key":"R68","article-title":"FDA approves drug to treat smallpox. (2021, June 4)","year":"2021"},{"key":"R69","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jis510"},{"key":"R70","doi-asserted-by":"publisher","DOI":"10.1086\/587668"},{"key":"R71","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00762-07"},{"key":"R72","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2005.12.001"},{"key":"R73","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(22)00574-6"},{"key":"R74","article-title":"Interim Clinical Considerations for Use of JYNNEOS and ACAM2000 Vaccines during the 2022 U.S Monkeypox Outbreak (2022, October 19)","year":"2022"},{"key":"R75","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.9499"},{"key":"R76","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2022.102855"},{"key":"R77","article-title":"Vaccines | Smallpox | CDC. (2022, August 8).Vaccines | Smallpox | CDC","year":"2022"},{"key":"R78","article-title":"Notes from the field: responding to an outbreak of monkeypox","author":"Eteng","year":"2018"},{"key":"R79","article-title":"How WHO\u00e2s \u00e2One Health\u00e2 Program Can Help India Tackle Monkeypox-","author":"Sharma","year":"2022"},{"key":"R80","doi-asserted-by":"publisher","DOI":"10.1016\/j.lansea.2022.100063"},{"key":"R81","article-title":"Cureus | Monkeypox: A Comprehensive Review of Transmission, Pathogenesis, and Manifestation. Monkeypox: AComprehensive Review of Transmission, Pathogenesis, and Manifestation","author":"Kaler","year":"2022"},{"key":"R82","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2022.27.22.2200424"},{"key":"R83","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms10081633"},{"key":"R84","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-022-01874-z"},{"key":"R85","doi-asserted-by":"publisher","DOI":"10.7883\/yoken.JJID.2008.140"},{"key":"R86","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1005769107"},{"key":"R87","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2022.08.007"},{"key":"R88","doi-asserted-by":"publisher","DOI":"10.3201\/eid2805.220292"},{"key":"R89","article-title":"Reaching the vulnerable without stigma. Reaching the Vulnerable Without Stigma - ScienceDirect","author":"Girometti","year":"2022"},{"key":"R90","article-title":"There\u2019s Lots of Confusion and Stigma Around Monkeypox\u2014Let\u2019s Clear It Up SELF","author":"Wallace","year":"2022"},{"key":"R91","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2018.00241"},{"key":"R92","article-title":"SymBio announces exclusive global license agreement with chimerix for antiviral drug, brincidofovir","author":"Yoshida","year":"2019"}],"container-title":["Journal of Medical Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.microbiologyresearch.org\/content\/journal\/jmm\/10.1099\/jmm.0.001725?crawler=true&mimetype=application\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,28]],"date-time":"2023-06-28T14:17:03Z","timestamp":1687961823000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.microbiologyresearch.org\/content\/journal\/jmm\/10.1099\/jmm.0.001725"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,28]]},"references-count":92,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,6,28]]}},"URL":"https:\/\/doi.org\/10.1099\/jmm.0.001725","relation":{},"ISSN":["0022-2615","1473-5644"],"issn-type":[{"value":"0022-2615","type":"print"},{"value":"1473-5644","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,28]]}}}