Mpox, previously referred to as monkeypox, is a viral illness that can affect both humans and different animal species. The current outbreak is linked to Clade I, a variant known for its potential for sexual transmission, which could lead to more serious health issues and has a mortality rate of up to 10% among infected individuals.
Common symptoms consist of a rash that transforms into blisters before forming crusts, along with fever and swollen lymph nodes. The skin rash or mucosal lesions can persist for 2 to 4 weeks and may be accompanied by fever, headaches, muscle pain, back discomfort, fatigue, and enlarged lymph nodes.
- Monkeypox can be transmitted between individuals via touch, kissing, or sexual activity, as well as through animals during hunting, skinning, or cooking. It can also be spread through materials, such as contaminated sheets, clothes or needles or
- through pregnant persons, who may pass the virus on to their unborn baby.Â
According to WHO, Person-to-person transmission of mpox can occur through direct contact with infectious skin or other lesions such as in the mouth or on genitals; this includes contact which is
- face-to-face (talking or breathing)
- skin-to-skin (touching or vaginal/anal sex)
- mouth-to-mouth (kissing)
- mouth-to-skin contact (oral sex or kissing the skin)
- respiratory droplets or short-range aerosols from prolonged close contact
The virus then enters the body through broken skin, mucosal surfaces (e g oral, pharyngeal, ocular, genital, anorectal), or via the respiratory tract. Mpox can spread to other members of the household and to sex partners. People with multiple sexual partners are at higher risk.
Animal to human transmission of mpox occurs from infected animals to humans from bites or scratches, or during activities such as hunting, skinning, trapping, cooking, playing with carcasses, or eating animals. The extent of viral circulation in animal populations is not entirely known and further studies are underway.
People can contract mpox from contaminated objects such as clothing or linens, through sharps injuries in health care, or in community setting such as tattoo parlours.
For some people, the first symptom of mpox is a rash, while others may have different symptoms first.
The rash begins as a flat sore which develops into a blister filled with liquid and may be itchy or painful. As the rash heals, the lesions dry up, crust over and fall off.
Some people may have one or a few skin lesions and others have hundreds or more. These can appear anywhere on the body such as the:
- palms of hands and soles of feet
- face, mouth and throat
- groin and genital areas
- anus.
Some people also have painful swelling of their rectum or pain and difficulty when peeing.
People with mpox are infectious and can pass the disease on to others until all sores have healed and a new layer of skin has formed.
Children, pregnant people and people with weak immune systems are at risk for complications from mpox.
Typically for mpox, fever, muscle aches and sore throat appear first. The mpox rash begins on the face and spreads over the body, extending to the palms of the hands and soles of the feet and evolves over 2-4 weeks in stages – macules, papules, vesicles, pustules. Lesions dip in the centre before crusting over. Scabs then fall off. Lymphadenopathy (swollen lymph nodes) is a classic feature of mpox. Some people can be infected without developing any symptoms.
Identifying mpox can be difficult as other infections and conditions can look similar. It is important to distinguish mpox from chickenpox, measles, bacterial skin infections, scabies, herpes, syphilis, other sexually transmissible infections, and medication-associated allergies. Someone with mpox may also have another sexually transmissible infection such as herpes. Alternatively, a child with suspected mpox may also have chickenpox. For these reasons, testing is key for people to get treatment as early as possible and prevent further spread.
