Mpox, formerly known as monkeypox, is a rare illness caused by a Orthopoxvirus type virus that is typically found in rodents. Although it is not common, mpox can affect humans and cause symptoms like chills, muscular and back pain, fatigue and the appearance of blisters or lesions on the skin.

The first cases of mpox were first identified in 1958 in a group of monkeys, which gave this condition its former name (even though it is more common in rodents). The first case of mpox in humans was identified in 1970.

If you notice any signs or symptoms of mpox, you should proceed to the hospital for a diagnosis, as this will help to prevent further transmission to other people and allow for the initiation of treatment. Treatment is usually at managing symptoms with medication.

Imagem ilustrativa número 1 — Vírus da varíola

Common symptoms

The first symptoms of mpox are:

Blisters and skin wounds
Fever
Chills
Headache
Muscular pain
Fatigue
Back pain

These symptoms usually appear around 5 to 21 days after initial contact with the virus, and can last for 14 to 21 days. The blisters usually appear first on the face and oral mucosa, then spread to the rest of the body and mainly affect the extremities, such as the palms of the hands. In some cases, blisters and sores may also appear in the genital area, and cause penile swelling of the penis and anal pain.

It is rare for mpox to develop into a more serious condition, however this may depend on the form of transmission, the person's immune status and the amount of virus that was inoculated. In these cases, there may be lung damage or inflammation of the brain.

Transmission of mpox

Mpox is transmitted from person to person through respiratory secretions that are released in the air from coughing or talking. However, for the virus to be transmitted to another person, two people must be close to each other for a prolonged period of time.

In addition, transmission can also occur through direct contact of the discharge released by the mpox lesions, or through contaminated objects. Lesions in the genital area can also increase the risk of transmission through sexual contact.

Mpox is contagious once the person presents with symptoms, and up until the lesions heal and new skin forms. It is also possible for pregnant women to transmit mpox to the baby through the placenta

Is it possible to catch mpox from animals?

Mpox can also be transmitted from animals to people, and is most commonly transmitted through bites from infected rodents. It can also be transmitted through contaminated, undercooked meat, or through contact with infected bodily fluids.

Confirming a diagnosis

Mpox can be diagnosed by an infectious disease specialist or general practitioner based on the patient's health history and symptoms. However, confirmation of Monkeypox can only be done through an PCR test, which involves collecting a sample of discharge from a wound or scab using a swab, and sending it to a lab.

Mpox can be suspected when the patient presents with symptoms and has had close contact with another infected person infected with monkeypox.

If a person presents symptoms suggestive of monkeypox, but the test result is negative, other complementary tests can be ordered to rule out other possible causes.

Mpox vs another skin disease

The following table outlines some characteristics that help to differentiate mpox blisters and lesions from other skin problems:

	Characteristics	Itching?	Color of discharge	Area affected
Mpox	Red blisters that increase in size, then dry and become scabs	Yes	White, pus-like	Face and mouth, but can spread to the whole whole, particularly the extremities
Shingles	Red blisters of varying sizes	Yes	Transparent	Chest and abdomen, on just one side of the body
Syphilis	Small wounds or bumps	No	Transparent	Genital area, anus and mouth
Chickenpox	Red bumps that become small, fluid-filled blisters. Once they rupture, they form wounds that scab	Yes	Transparent, and gradually becomes darker	Chest, back and face, but it can spread to the body
Lymphogranuloma venereum	Small blister that can increase in size, and wound in some cases	No	White, pus-like	Genital area
Molluscum contagiosum	Small blisters, isolated or in clusters	Yes	None	Anywhere on the body, except for the palms of the hands and bottom of foot
Skin irritation	Small white or red bumps	Yes	Transparent, may not have discharge in some cases	Anywhere on the body
Impetigo	Similar to pimples. Once they rupture, they form a scab	Yes	White, pus-like	Nose, mouth, legs, feet, chest and abdomen

Treatment options

Normally a specific treatment is not necessary to treat mpox, as the symptoms usually disappear within a few weeks. In some cases, however, the doctor may prescribe medications to treat symptoms more quickly.

Even though it is a rare disease, it is important to go to the hospital for monitoring and to prevent further transmission if you have symptoms of mpox.

Medications that have been approved for the treatment of smallpox may be prescribed for mpox. Some examples include Tecovirimat e o Brincidofovir. Nonetheless, these medications have not been tested in infected patients, and therefore are only used to control a potential outbreak.

Is mpox curable?

Mpox can be cured and, in general, no specific treatment is necessary, since the virus is usually eliminated by the immune system itself after about 4 weeks.

However, to speed up the healing process, the doctor may prescribe specific medications to combat the virus.

How to prevent it

Some recommended prevention tips include:

Avoiding close proximity with people diagnosed with monkey pox
Avoid touching mpox lesions or coming in contact with the clothes or personal objects of those with signs and symptoms of mpox
Thorough hand hygiene with soap and water
Using masks

In addition, this illness can also be transmitted from animals to people, although this is rare. You are advised to consume meat that is well-cooked and to avoid contact with wild animals, particularly rodents, as they can be infected with mpox or other infectious agents.

Vaccine information

Vaccines are also a useful tool for protecting yourself against mpox. According to the World Health Organization, mass vaccination against mpox is not possible, as there are not enough vaccines for the total global population.

Currently, the vaccines that are approved for use in the USA, Canada, UK and/or Europe are:

Jynneos/ Imvamune/ Imvanex, which is given in 2 doses, 4 weeks apart. This vaccine can also be administered up to 4 days after contact with the virus (in these cases, only 1 dose is recommended). Vaccines that are administered 5 to 14 days after initial que exposure can still reduce symptoms, but they may not stop the development of the disease in the body.
ACAM2000, which is given as a single dose. It is not recommended for those with a history of a weakened immune system, atopic dermatitis, eczema, cardiac disease, or ocular diseases. It should also not be administered to pregnant women.

These vaccines are not recommended for all people, and instead, should be administered to those who are at higher risk for exposure to mpox, including healthcare workers and people who work in laboratories or are researching Orthopoxvirus.

The vaccine efficacy against the current outbreak is still not totally known, although it is still recommended as an important prevention measure.