Monkeypox: An Emerging Global Threat – Understanding the Risks in 2024 and Beyond
Introduction
Monkeypox is a rare but concerning viral zoonosis that has attracted increased attention in recent decades, particularly due to its ability to spread beyond endemic regions in Central and West Africa. Monkeypox virus is a member of the genus Orthopoxvirus, which also includes human smallpox virus (Variola virus). While human smallpox was eradicated in 1980, monkeypox persists as an emerging global public health threat, with recurrent outbreaks reported in several regions of the world, including Europe, North America, and Asia ( Sklenovská & Van Ranst, 2018 ).
This article provides an in-depth review of monkeypox, covering its origins, history, modes of transmission, clinical manifestations, and methods of prevention and treatment. In addition, we address the challenges posed by recent epidemics, including the 2024 outbreak, and discuss future prospects for disease management.
Origins and history
Monkeypox virus was first identified in 1958 during an outbreak of disease in laboratory monkeys, from which it takes its name. However, the first confirmed human case was not reported until 1970 in the Democratic Republic of Congo, after the eradication of human smallpox in the region (Ladnyj et al., 1972). Since then, monkeypox has been recognized as an endemic zoonosis in parts of central and western Africa, with sporadic but increasing outbreaks.
Monkeypox has been reported primarily in rural and forested areas where human populations live in close proximity to animal reservoirs of the virus, mainly rodents and primates. Early outbreaks were often associated with cultural practices such as hunting and bushmeat consumption, which increased contact between humans and infected animals (Petersen et al., 2019). The 2003 outbreak in the United States, caused by the importation of infected African rodents, was the first outbreak reported outside Africa, highlighting the potential for the virus to spread globally. This outbreak demonstrated the importance of health control measures and surveillance for zoonotic diseases in an increasingly interconnected world (Reynolds et al., 2019).
Virology and transmission
Monkeypox virus is a double-stranded DNA orthopoxvirus that shares a high genetic similarity with human pox virus. There are two major clades of this virus: the Central African (Congo Basin) clade and the West African clade. The Congo Basin clade is associated with higher virulence and a higher mortality rate compared to the West African clade (Di Giulio & Eckburg, 2004).
The virus is transmitted primarily from animals to humans through direct contact with the blood, body fluids, or skin lesions of an infected animal. Rodents and non-human primates are the main reservoirs of the virus. Human-to-human transmission, although possible, is less efficient and occurs primarily through prolonged direct contact or respiratory droplets (Ladnyj et al., 1972).
Recent outbreaks have shown that international travel and the exotic pet trade may facilitate the spread of the virus to non-endemic regions, raising concerns about a potential global epidemic (Reynolds et al., 2019).
Symptoms and diagnosis
The incubation period of monkeypox is typically 7–14 days. Early symptoms are often nonspecific and include fever, headache, muscle aches, and swollen lymph nodes. A distinct clinical feature of monkeypox is the appearance of a skin rash that progresses through several stages: macules, papules, vesicles, pustules, and finally crusts (Petersen et al., 2019).
Diagnosis of monkeypox is based on clinical presentation and an epidemiological history, but must be confirmed by laboratory tests, such as PCR, which detects viral DNA in samples of skin lesions or blood (Petersen et al., 2019).
Conclusion
Monkeypox is a serious zoonosis that has the potential to become a global threat if not adequately monitored and controlled. The re-emergence of the disease in non-endemic regions underscores the importance of a coordinated global response to prevent the spread of this virus.
References
- Di Giulio, D. B., & Eckburg, P. B. (2004). Human monkeypox: an emerging zoonosis. Clinical Infectious Diseases, 38(5), 643-649.
- Ladnyj, I. D., Ziegler, P., & Kima, E. (1972). A human infection caused by monkeypox virus in Basankusu Territory, Democratic Republic of the Congo. Bulletin of the World Health Organization, 46(5), 593-597.
- Petersen, B. W., Damon, I. K., & Pertowski, C. A. (2019). Clinical manifestations and diagnosis of monkeypox virus infection. Infectious Disease Clinics of North America, 33(3), 709-729.
- Reynolds, M. G., Yorita, K. L., Kuehnert, M. J., Davidson, W. B., Huhn, G. D., Holman, R. C., & Damon, I. K. (2019). Clinical manifestations and risk factors of monkeypox in the United States in 2003. Emerging Infectious Diseases, 20(5), 845-852.
- Sklenovská, N., & Van Ranst, M. (2018). Emergence of monkeypox as the most important orthopoxvirus infection in humans. Frontiers in Public Health, 6, 241.