Mpox: transmission dynamics, treatment, and innovations.

Abstract

The resurgence of monkeypox (mpox), driven by Clade IIb of the monkeypox virus (MPXV), has intensified global concerns about its transmission, treatment, and prevention. Mpox, a zoonotic orthopoxvirus and is primarily transmitted through close contact with infected individuals, contaminated surfaces, or respiratory droplets. Historically, the virus has been divided into two clades: Clade I, endemic to Central Africa and characterized by higher fatality rates, and Clade II, linked to milder disease in West Africa. The unprecedented global spread of Clade IIb Mpox in 2022, affecting over 99,000 individuals across 118 countries, underscored the potential for widespread transmission beyond endemic regions. This review provides a detailed examination of the transmission dynamics of mpox, current treatments, innovations, and global health challenges. Current treatment strategies primarily involve supportive care, with advanced therapeutics such as tecovirimat, cidofovir, and brincidofovir reserved for severe cases. While these antivirals show promise, their clinical efficacy and safety remain inadequately substantiated, creating a pressing need for rigorous trials. Preventive measures, including vaccination and postexposure prophylaxis, remain pivotal in mitigating disease spread, yet face barriers such as limited supply, accessibility, and vaccine hesitancy. Emerging therapeutic innovations, such as monoclonal antibodies, gene-editing technologies, and RNA-based therapies, offer hope for addressing these gaps. These novel approaches aim to enhance treatment specificity, minimize off-target effects, and reduce the risk of resistance. However, their successful integration into clinical practice demands robust validation through preclinical and clinical research. In addressing the challenges ahead, this review underscores the critical importance of global collaboration to strengthen epidemiological surveillance, accelerate drug development, and optimize prevention strategies. The emergence of drug-resistant strains, the persistence of mpox in vulnerable populations, and the potential for future outbreaks necessitate sustained investment in research and public health infrastructure. By integrating innovative therapeutic approaches, effective preventive measures, and comprehensive outbreak management strategies, the global health community can better address the ongoing threat of mpox and prepare for future public health challenges.