Mpox: Transmission, clinical manifestations, prevention, and treatment – a narrative review
DOI:
https://doi.org/10.62486/agsalud2025182Keywords:
Virus, Mpox, transmission, symptoms, prevention, treatmentAbstract
Objective:To identify the transmission methods, symptoms, complications, prevention, and treatment associated with Mpox. Design:Literature review based on a narrative synthesis. Data Sources:Web of Science, Google Scholar, Scielo, ScienceDirect, Redalyc, and Scopus. Study Selection:Documents were selected and analyzed through a critical literature review, considering inclusion and exclusion criteria. Results:A literature review was conducted with a corpus of 17 articles, including 11 narrative reviews, 2 systematic reviews, and 4 statistical analyses. Mpox is more prevalent among children, adults, pregnant women, and homosexual and bisexual individuals. The regions with the highest outbreak incidence are Asia, South America, Europe, the United States, and especially West and Central Africa, where it is endemic. Clinical conditions associated with Mpox include fever, skin rashes, abdominal pain, and meningitis, and it is strongly linked to HIV. Most reported cases have been among lower-class individuals, with some from the middle class. Conclusions: The Mpox virus is transmitted through various means, primarily contact, bodily fluids, and sexual relations between men. It significantly affects children and pregnant women and presents a range of symptoms, with skin lesions being the most frequent, followed by fever, headaches, oral lesions, and others. If left untreated or inadequately managed, it can lead to severe complications, with HIV-positive individuals and immunocompromised patients at the highest risk. Pneumonia can be fatal in severe cases. Good personal hygiene is recommended, and although there are no approved vaccines for Mpox, Tecovirimat and Brincidofovir show potential for approval in case of future outbreaks.
References
Abarzúa, F., Nuñez, F., Hubinont, C., Bernard, P., Yombi, J. C., & Vandercam, B. (2005). Infección por virus de inmunodeficiencia humana en el embarazo: Tratamiento anti-retroviral y vía de parto Human immunodeficiency virus (HIV) infection in pregnancy: Antiretroviral treatment (ART) and mode of delivery. In Rev Chil Infect (Vol. 22, Issue 4).
Abdelghany, A. M., Ghaly, F. F., & Allam, M. F. (2024). Antiviral Drugs for Treatment of Human Monkeypox: A Systematic Review/Meta-analysis. Microbes, Infection and Chemotherapy, 4(1–7), e1963. https://doi.org/10.54034/mic.e1963
Arranz Izquierdo, J., Molero García, J. M., & Gutiérrez Pérez, M. I. (2023). Manejo desde atención primaria de la infección por la viruela del mono (MPOX) en humanos. Atencion Primaria, 55(10), 102680. https://doi.org/10.1016/j.aprim.2023.102680
Beeson, A., Styczynski, A., Hutson, C. L., Whitehill, F., Angelo, K. M., Minhaj, F. S., Morgan, C., Ciampaglio, K., Reynolds, M. G., McCollum, A. M., & Guagliardo, S. A. J. (2023). Mpox respiratory transmission: the state of the evidence. In The Lancet Microbe (Vol. 4, Issue 4, pp. e277–e283). Elsevier Ltd. https://doi.org/10.1016/S2666-5247(23)00034-4
Bellido-Blasco, J. B., Mahiques-Santos, L., Bejarano-Velásquez, M. L., Gómez-Alfaro, I., Pitarch-Bort, G., Gascó-Laborda, J. C., Arias-López, J. A., Silvestre-Silvestre, E., Meseguer-Ferrer, N., Deaconescu, G.
D., Lluch-Bacas, L., Rusen, V., & Sabater-Vidal, S. (2023). Brote familiar de viruela del mono con transmisión domiciliaria de un adulto a una lactante de 10 meses. Enf Emerg, 22(2), 99–103.
Català, A., Riera, J., & Fuertes. (2023). MPOX (antes viruela del mono): revisión de los aspectos clínicos, epidemiológicos, diagnósticos y terapéuticos más relevantes para el dermatólogo. Actas Dermo- Sifiliográficas, 114(4), 318–326. https://doi.org/10.1016/j.ad.2023.01.002
Chakravarty, N., Hemani, D., Paravastu, R., Ahmad, Z., Palani, S. N., Arumugaswami, V., & Kumar, A. (2024). Mpox Virus and its ocular surface manifestations. The Ocular Surface, 34, 108–121. https://doi.org/10.1016/j.jtos.2024.07.001
Colon, J., McNamara, S. A., Grubbs, H., Gupta, A., Henehan, M., Brazen, B., Rajabi-Estarabadi, A., & Nousari, C. H. (2024). An atypical presentation of human monkeypox infection with clinicopathologic correlation. Dermatology Online Journal, 30(2). https://doi.org/10.5070/D330263584
Croasdale, C. R., Weinlander, E., & Boyce, T. G. (2024). Mpox Keratitis: A Case Report and Review. Wolters Kluwer Health, Inc., 43(10), 1319–1331. www.corneajrnl.com
de la Calle-Prieto, F., Estébanez Muñoz, M., Ramírez, G., Díaz-Menéndez, M., Velasco, M., Azkune Galparsoro, H., Salavert Lletí, M., Mata Forte, T., Blanco, J. L., Mora-Rillo, M., Arsuaga, M., de Miguel Buckley, R., Arribas, J. R., & Membrillo, F. J. (2023). Treatment and prevention of monkeypox. In Enfermedades Infecciosas y Microbiologia Clinica (Vol. 41, Issue 10, pp. 629–634). Sociedad Espanola de Enfermedades Infecciosas y Microbiologia Clinica. https://doi.org/10.1016/j.eimc.2022.08.001
de Sousa, D., Frade, J., Patrocínio, J., Borges-Costa, J., & Filipe, P. (2022). Monkeypox infection and bacterial cellulitis: a complication to look for. International Journal of Infectious Diseases, 123, 180–182. https://doi.org/10.1016/j.ijid.2022.08.024
Duarte, P. M., Adesola, R. O., Priyadarsini, S., Singh, R., Shaheen, M. N. F., Ogundijo, O. A., Gulumbe, B. H., Lounis, M., Samir, M., Govindan, K., Adebiyi, O. S., Scott, G. Y., Ahmadi, P., Mahmoodi, V.,
Chogan, H., Gholami, S., Shirazi, O., Moghadam, S. K., Jafari, N., … Tazerji, S. S. (2024). Unveiling the Global Surge of Mpox (Monkeypox): A comprehensive review of current evidence. The Microbe, 4, 100141. https://doi.org/10.1016/j.microb.2024.100141
Elsayed, S., Bondy, L., & Hanage, W. P. (2022). Monkeypox Virus Infections in Humans. In Clinical Microbiology Reviews (Vol. 35, Issue 4). American Society for Microbiology. https://doi.org/10.1128/cmr.00092-22
Elsheikh, R., Makram, A. M., Vasanthakumaran, T., Tomar, S., Shamim, K., Tranh, N. D., Elsheikh, S. S., Van, N. T., & Huy, N. T. (2023). Monkeypox: A comprehensive review of a multifaceted virus.
Infectious Medicine, 2(2), 74–88. https://doi.org/10.1016/j.imj.2023.04.009
Garcia-Junior, M. A., Andrade, B. S., Guevara-Vega, M., de Melo, I. S., Cunha, T. M., Jardim, A. C. G., & Sabino-Silva, R. (2023). Oral Infection, Oral Pathology and Salivary Diagnostics of Mpox Disease: Relevance in Dentistry and OMICs Perspectives. International Journal of Molecular Sciences, 24(18), 14362. https://doi.org/10.3390/ijms241814362
Gemelli, S., Tilve, C., Frantchez, V., & Guirado, M. (2022). Viruela símica: aspectos generales y particularidades en el embarazo y lactancia. Cátedra de Enfermedades Infecciosas.
Gupta, A. K., Talukder, M., Rosen, T., & Piguet, V. (2023). Differential Diagnosis, Prevention, and Treatment of mpox (Monkeypox): A Review for Dermatologists. In American Journal of Clinical
Dermatology (Vol. 24, Issue 4, pp. 541–556). Adis. https://doi.org/10.1007/s40257-023-00778-4
Gurnani, B., Kaur, K., Chaudhary, S., & Balakrishnan, H. (2023). Ophthalmic manifestations of monkeypox infection. In Indian Journal of Ophthalmology (Vol. 71, Issue 5, pp. 1687–1697). Wolters Kluwer
Medknow Publications. https://doi.org/10.4103/ijo.IJO_2032_22
Gutiérrez-Chablé, L. E., Ochoa-Fuentes, D. A., Lezama-Ávila, F. I., García-Flores, M. A., Santos-López, G., & Méndez-Martínez, S. (2024). Mpox en humanos: un panorama de la epidemia de 2022-2023. Rev Med Inst Mex Seguro Soc, 62(2), e5756. https://doi.org/10.5281/zenodo.10713144
Hassan, R., Meehan, A. A., Hughes, S., Beeson, A., Spencer, H., Howard, J., Tietje, L., Richardson, M., Schultz, A., Zawitz, C., Ghinai, I., & Hagan, L. M. (2024). Health Belief Model to Assess Mpox Knowledge, Attitudes, and Practices among Residents and Staff, Cook County Jail, Illinois, USA, July–August 2022. Emerging Infectious Diseases, 30(13), S49–S55. https://doi.org/10.3201/eid3013.230643
Hens, M., Brosius, I., Berens-Riha, N., Coppens, J., Van Gestel, L., Rutgers, J., Kenyon, C., Soentjens, P., van Henten, S., Bracke, S., Vanbaelen, T., Vandenhoven, L., Bottieau, E., Vercauteren, K., Van Esbroeck, M., Liesenborghs, L., Van Dijck, C., De Baetselier, I., Van den Bossche, D., … Ariën, K.
(2023). Characteristics of confirmed mpox cases among clinical suspects: A prospective single-
centre study in Belgium during the 2022 outbreak. New Microbes and New Infections, 52, 101093. https://doi.org/10.1016/j.nmni.2023.101093
Hoffmann, C., Jessen, H., Wyen, C., Grunwald, S., Noe, S., Teichmann, J., Krauss, A. S., Kolarikal, H., Scholten, S., Schuler, C., Bickel, M., Roll, C., Kreckel, P., Köppe, S., Straub, M., Klausen, G., Lenz, J.,
Esser, S., Jensen, B., … Boesecke, C. (2023). Clinical characteristics of monkeypox virus infections among men with and without HIV: A large outbreak cohort in Germany. HIV Medicine, 24(4), 389–397. https://doi.org/10.1111/hiv.13378
Joseph, B., & Anil, S. (2023). Oral lesions in human monkeypox disease and their management—a scoping review. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 135(4), 510–517. https://doi.org/10.1016/j.oooo.2022.11.012
Laiton-Donato, K., Álvarez-Díaz, D. A., Franco-Muñoz, C., Ruiz-Moreno, H. A., Rojas-Estévez, P., Prada, A., Rosales, A., Ospina, M. L., & Mercado-Reyes, M. (2022). Monkeypox virus genome sequence from an imported human case in Colombia. Biomedica, 42(3), 541–545. https://doi.org/10.7705/biomedica.6647
Liu, Q., Fu, L., Wang, B., Sun, Y., Wu, X., Peng, X., Li, Y., Lin, Y. F., Fitzpatrick, T., Vermund, S. H., & Zou, H. (2023). Clinical Characteristics of Human Mpox (Monkeypox) in 2022: A Systematic Review and
Meta-Analysis. In Pathogens (Vol. 12, Issue 1). MDPI. https://doi.org/10.3390/pathogens12010146
Lucena-Neto, F. D., Falcão, L. F. M., Vieira-Junior, A. S., Moraes, E. C. S., David, J. P. F., Silva, C. C., Sousa, J. R., Duarte, M. I. S., Vasconcelos, P. F. C., & Quaresma, J. A. S. (2023). Monkeypox Virus Immune Evasion and Eye Manifestation: Beyond Eyelid Implications. In Viruses (Vol. 15, Issue 12).
Multidisciplinary Digital Publishing Institute (MDPI). https://doi.org/10.3390/v15122301
Mailhe, M., Beaumont, A. L., Thy, M., Le Pluart, D., Perrineau, S., Houhou-Fidouh, N., Deconinck, L., Bertin, C., Ferré, V. M., Cortier, M., De La Porte Des Vaux, C., Phung, B. C., Mollo, B., Cresta, M., Bouscarat, F., Choquet, C., Descamps, D., Ghosn, J., Lescure, F. X., … Peiffer-Smadja, N. (2023).
Clinical characteristics of ambulatory and hospitalized patients with monkeypox virus infection: an observational cohort study. Clinical Microbiology and Infection, 29(2), 233–239. https://doi.org/10.1016/j.cmi.2022.08.012
Mansoor, A., Mansoor, E., Waheed, Y., Palma, P. J., & Chaves, C. (2024). Update on the M-pox virus and safety measures taken against it globally. Journal of the Formosan Medical Association, 123(10), 1030–1036. https://doi.org/10.1016/j.jfma.2023.10.019
Nakamura, H., & Yamamoto, K. (2024). Mpox in people with HIV: A narrative review. HIV Medicine, 25(8), 910–918. https://doi.org/10.1111/hiv.13661
Pitcock, C. T., Van Sickels, N., & Romanelli, F. (2024). Advances in recognizing, treating, and preventing mpox infection. Journal of the American Pharmacotherapy, 1(2), 100004. https://doi.org/10.1016/j.japhar.2023.100004
Polidoro, M., Oliveira, D. C. de, & Nogueira, P. R. R. (2023). Spatial and Epidemiological Aspects of Monkeypox (Mpx) in Rio Grande do Sul. Sociedade & Natureza, 35, 68188. https://doi.org/10.14393/sn-v35-2023-68188x
Protopapas, K., Dimopoulou, D., Kalesis, N., Akinosoglou, K., & Moschopoulos, C. D. (2024). Mpox and Lessons Learned in the Light of the Recent Outbreak: A Narrative Review. In Viruses (Vol. 16, Issue 10). Multidisciplinary Digital Publishing Institute (MDPI). https://doi.org/10.3390/v16101620
Reynolds, M. G., McCollum, A. M., Nguete, B., Lushima, R. S., & Petersen, B. W. (2017). Improving the care and treatment of monkeypox patients in low-resource settings: Applying evidence from
contemporary biomedical and smallpox biodefense research. In Viruses (Vol. 9, Issue 12). MDPI AG. https://doi.org/10.3390/v9120380
Ritter, J. M., Martines, R. B., Bhatnagar, J., Rao, A. K., Villalba, J. A., Silva-Flannery, L., Lee, E., Bullock, H. A., Hutson, C. L., Cederroth, T., Harris, C. K., Hord, K., Xu, Y., Brown, C. A., Guccione, J. P., Miller, M., Paddock, C. D., & Reagan-Steiner, S. (2024). Pathology and Monkeypox virus Localization in Tissues from Immunocompromised Patients With Severe or Fatal Mpox. Journal of Infectious Diseases, 229(2), S219–S228. https://doi.org/10.1093/infdis/jiad574
Rizk, J. G., Lippi, G., Henry, B. M., Forthal, D. N., & Rizk, Y. (2022). Prevention and Treatment of Monkeypox. Drugs, 82(9), 957–963. https://doi.org/10.1007/s40265-022-01742-y
Romo López, A., Arteaga Pérez, R., Vega Memije, M., & Fonte Ávalos, V. (2022). Viruela símica, revisión de la literatura: antecedentes históricos, epidemiología, formas de contagio, cuadro clínico, síntomas, mortalidad y grupos vulnerables, tratamiento y vacunación. Dermatología Cosmética, Médica y Quirúrgica, 20(4), 459–467.
Schwartz, D. A., & Pittman, P. R. (2023). Mpox (Monkeypox) in Pregnancy: Viral Clade Differences and Their Associations with Varying Obstetrical and Fetal Outcomes. Viruses, 15(8), 1649. https://doi.org/10.3390/v15081649
Shamim, M. A., Satapathy, P., Padhi, B. K., Veeramachaneni, S. D., Akhtar, N., Pradhan, A., Agrawal, A., Dwivedi, P., Mohanty, A., Pradhan, K. B., Kabir, R., Rabaan, A. A., Alotaibi, J., Al Ismail, Z. A., Alsoliabi, Z. A., Al Fraij, A., Sah, R., & Rodriguez-Morales, A. J. (2023). Pharmacological treatment and vaccines in monkeypox virus: a narrative review and bibliometric analysis. In Frontiers in Pharmacology (Vol. 14). Frontiers Media S.A. https://doi.org/10.3389/fphar.2023.1149909
Singh, P., Sridhar, S. B., Shareef, J., Talath, S., Mohapatra, P., Khatib, M. N., Ballal, S., Kaur, M., Nathiya, D., Sharma, S., Siva Prasad, G. V., Sinha, A., Varma, A., Bushi, G., Gaidhane, A. M., Satapathy, P., Shabil, M., Sah, R., Al-Tawfiq, J. A., … Rodriguez-Morales, A. J. (2024). The resurgence of monkeypox: Epidemiology, clinical features, and public health implications in the post-smallpox eradication era. New Microbes and New Infections, 62, 101487. https://doi.org/10.1016/j.nmni.2024.101487
Soheili, M., Nasseri, S., Afraie, M., Khateri, S., Moradi, Y., Maryam Mahdavi Mortazavi, S., Gilzad Kohan, H., Gastroenterology Fellowship, P., & Kohan, G. (2022). Monkeypox: Virology, Pathophysiology, Clinical Characteristics, Epidemiology, Vaccines, Diagnosis, and Treatments. In J Pharm Pharm Sci (www.cspsCanada.org) (Vol. 25). www.cspsCanada.org
Speiser, L. J., Wonnaparhown, A. M., Blair, J., Shah, A., Patel, D. R., McCullough, A. E., Nicolasora, N., Khalsa, A. M., Orenstein, R., Vikram, H. R., Huang, V., & Seville, M. T. (2024). A case of sustained viral shedding of mpox with ocular involvement resulting in vision loss. Open Forum Infectious Diseases, 11(1). https://doi.org/10.1093/ofid/ofad632
Upadhayay, S., Arthur, R., Soni, D., Yadav, P., Navik, U. S., Singh, R., Gurjeet Singh, T., & Kumar, P. (2022). Monkeypox infection: The past, present, and future. In International Immunopharmacology (Vol. 113, p. 109382). Elsevier B.V. https://doi.org/10.1016/j.intimp.2022.109382
Velázquez-Cervantes, M. A., Ulloa-Aguilar, J. M., & León-Juárez, M. (2023). La viruela del mono y el embarazo: una enfermedad olvidada y su impacto en la salud perinatal. In Revista Clinica Espanola (Vol. 223, Issue 1, pp. 32–39). Sociedad Espanola de Medicina Interna (SEMI). https://doi.org/10.1016/j.rce.2022.09.002
Wang, X., & Lun, W. (2023a). Skin Manifestation of Human Monkeypox. In Journal of Clinical Medicine (Vol. 12, Issue 3, p. 914). MDPI. https://doi.org/10.3390/jcm12030914
Yang, S., Xia, C., Zhang, Y., Shen, Y., Xia, C., Lu, Y., Su, S., Deng, C., Harypursat, V., Wang, J., Yuan, J., & Chen, Y. (2024). Clinical features and viral load variations of Mpox: a retrospective study in Chongqing, China. BMC Infectious Diseases, 24(1). https://doi.org/10.1186/s12879-024-09537-0
Zacur, M., Barrientos, V., Carreño, P., & Segovia, J. (2023). Primer caso de transmisión de mpox mediante toma de muestra por desteche en Chile. Rev Chilena Infectol, 40(5), 564–568.
www.revinf.clCasoClínicoPrimercasodetransmisióndempoxmediantetomademuestrapordestechee nChile
Zevallos, J., Aurich, J., & Quiroz, J. (2023). A case of monkeypox and cytomegalovirus coinfection manifesting with crusted lesions mimicking rupiod syphilis. Dermatology Online Journal, 29(5). https://doi.org/10.5070/D329562406
Zong, Y., Kamoi, K., Zhang, J., Yang, M., & Ohno-Matsui, K. (2023). Mpox (Monkeypox) and the Eye: Ocular Manifestation, Diagnosis, Treatment and Vaccination. In Viruses (Vol. 15, Issue 3). MDPI. https://doi.org/10.3390/v15030616.
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Copyright (c) 2025 Erica Sandoval-Urbano, Jhonny E. Pimentel-Betancourt, Kelita M. Lozano-Gutierres, Mirian Julca-Cano, Víctor Álvarez-Manrique, Mardel Morales-García , Wilter C. Morales-García (Author)

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