Understanding Monkeypox Virus Evolution, Host-Pathogen Interactions, and Therapeutic Advances.

Area of Science:

• Virology
• Epidemiology
• Public Health

Background:

• Monkeypox virus (MPXV), an Orthopoxvirus, is a zoonotic disease with two clades (West African and Central African) exhibiting varying mortality rates.
• Global outbreaks, including the 2022 'International Public Health Emergency Concern' declared by WHO, underscore the need for effective control strategies.
• Recent clade Ib outbreaks in Central Africa highlight ongoing public health challenges, with significant reported deaths and a notable case-fatality rate.

Purpose of the Study:

• To outline Mpox transmission routes and clinical manifestations, from early to chronic stages.
• To detail the viral mechanisms of immune evasion and immune suppression.
• To review current and emerging Mpox therapeutics, including antiviral medications and prophylactic vaccines.

Main Methods:

• Literature review of Mpox transmission, pathogenesis, clinical presentation, and treatment modalities.
• Analysis of recent outbreak data and reported case-fatality rates.
• Examination of advancements in vaccine development and future research directions.

Main Results:

• Mpox is transmitted via animal contact, respiratory droplets, contaminated materials, and vertically from mother to child.
• The virus employs immune evasion strategies to ensure survival within the host.
• Current treatments include antivirals and supportive care, with ongoing development of prophylactic vaccines like JYNNEOS (MVA).

Conclusions:

• Effective Mpox control requires robust strategies, including accessible prophylactic therapies in endemic regions.
• Further research into conserved Mpox antigens is crucial for developing broader-spectrum vaccines.
• International collaboration in surveillance, rapid response, and OMICS studies is essential for understanding viral evolution and informing future vaccine and therapeutic designs.