The 2022 outbreak and the pathobiology of the monkeypox virus

• Published in: Journal of autoimmunity Vol. 131; p. 102855
• Main Authors: Kumar, Narendra, Acharya, Arpan, Gendelman, Howard E., Byrareddy, Siddappa N.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.07.2022
• Subjects: Animals; Antiviral therapies; COVID-19; Disease Outbreaks; Humans; Monkeypox outbreak 2022; Monkeypox virus; Mpox (monkeypox) - epidemiology; Pandemics; Prevention; Transmission; Viral pathogenesis; FDA; TCR; CDC; PPE; RNA; Transmission; Prevention; COVID-19; MPV; SARS-CoV-2; RT-PCR; EMA; WHO; Monkeypox outbreak 2022; MSM; PLWH; AIDS; EA-IND; cART; Viral pathogenesis; DRC; HIV; DNA; STDs; MVA; MTCT; Antiviral therapies; PCR; ELISA; VIGIV
• ISSN: 0896-8411; 1095-9157; 1095-9157
• DOI: 10.1016/j.jaut.2022.102855

Following two reports of monkeypox virus infection in individuals who returned from Nigeria to the USA, one who returned to Texas (July 2021) and the other to the Washington, DC area (November 2021), the number of monkeypox infection have dramatically increased. This sounded an alarm of potential for spreading of the virus throughout the USA. During 2022, there was a report of monkeypox virus infection (May 6, 2022) in a British national following a visit to Nigeria who developed readily recognizable signs and symptoms of monkeypox virus infection. Soon following this report, case numbers climbed. By June 10, 2022, more than 1,500 cases were reported in 43 countries, including Europe and North America. While the prevalence of the monkeypox virus is well known in central and western Africa, its presence in the developed world has raised disturbing signs for worldwide spread. While infection was reported during the past half-century, starting in the Democratic Republic of Congo in 1970, in the United States, only sporadic monkeypox cases have been reported. All cases have been linked to international travel or through African animal imports. The monkeypox virus is transmitted through contact with infected skin, body fluids, or respiratory droplets. The virus spreads from oral and nasopharyngeal fluid exchanges or by intradermal injection; then rapidly replicates at the inoculation site with spreads to adjacent lymph nodes. Monkeypox disease begins with constitutional symptoms that include fever, chills, headache, muscle aches, backache, and fatigue. Phylogenetically the virus has two clades. One clade emerged from West Africa and the other in the Congo Basin of Central Africa. During the most recent outbreak, the identity of the reservoir host or the primary carriage remains unknown. African rodents are the suspected intermediate hosts. At the same time, the Centers for Disease Control (CDC) affirmed that there are no specific treatments for the 2022 monkeypox virus infection; existing antivirals shown to be effective against smallpox may slow monkeypox spread. A smallpox vaccine JYNNEOS (Imvamune or Imvanex) may also be used to prevent infection. The World Health Organization (WHO), has warned that the world could be facing a formidable infectious disease challenge in light of the current status of worldwide affairs. These affairs include the SARS-COVID-19 pandemic and the Ukraine-Russia war. In addition, the recent rise in case of numbers worldwide could continue to pose an international threat. With this in mind, strategies to mitigate the spread of monkeypox virus are warranted. •Monkeypox virus (MPV) outbreak 2022 is occurring due to new mutations in the virus, and multiple monkeypox outbreaks.•In the 2022 MPV outbreak, most of the cases were detected in the Men who have Sex with Men (MSM) population.•MPV has two clades, West African and Central African, but the 2022 outbreak is different from both clades.•MPV transmission occurs through contact with infected animals skin lesions, body fluids, or respiratory droplets.•Currently, FDA approved vaccine for smallpox (JYNNEOS vaccine) may be effective for the MPV.