While the world population is focused on coping with SARS-CoV-2, a threatening zoonotic pathogen is likewise spreading globally. Monkeypox is caused by the monkeypox virus (MPXV), a DNA virus that belongs to the Orthopoxvirus genus which includes variola virus (smallpox) and cowpox virus. The MPXV can be classified into two major groups: Congo Basin Clade and West African Clade; the former clade has a case fatality rate of up to 10%, whereas the latter clade has a case fatality rate of approximately 1%. Monkeypox appeared in non-endemic regions in May of this year, and this global outbreak prompted the WHO to declare it a Public Health Emergency of International Concern (PHEIC) on June 23, 2022. As of July 22, 2022, at least 16,836 confirmed cases have been reported in 74 countries worldwide. The genomic sequence analyses of MPXV isolated from confirmed cases suggest that the virus from this outbreak belongs to the mild West African Clade.
Although the mortality rate of monkeypox is not as severe as that of smallpox, the symptoms and complications that arise should not be overlooked as there may be potential risks associated, especially those occurring in young children and immunocompromised individuals. The potential reservoir hosts of MPXV are rodents, and non-human primates, which can accidentally be transmitted to humans, facilitating person-to-person transmission. MPVX is usually transmitted through respiratory droplets as well as close or direct contact with skin lesions of infected animals. Transmission through sexual activity is another probable cause. The clinical syndrome is characterized by fever, headache, muscle aches, rash, exhaustion, and lymphadenopathy. Moreover, the disease may progress, followed by complications of MPXV, including pneumonitis, encephalitis, sight-threatening keratitis, and secondary bacterial infections.
Currently, specific vaccines against MPXV infection do not exist. Luckily, it has been reported that vaccination against smallpox provides 85% protection against MPXV, and therefore, could be used as an alternative prevention against MPXV. For instance, the third-generation vaccine IMVAMUNE, which contains modified attenuated vaccinia virus (Ankara strain), has been approved by the Food and Drug Administration (FDA) under emergency use authorization (EUA) for individuals 18 years of age and older who are at high risk for monkeypox infection. On the other hand, there are no FDA-approved therapeutics for monkeypox.
Developing the safety and efficacy of the antiviral medication is of urgent importance. Recently, Gong et al. comprehensively reviewed the candidate of vaccines and antiviral drugs for the prevention and treatment of MPXV. We are anticipating the therapeutic value of these prospective anti-MPXV drugs. To contain further community spreading, our global community should remain alert to the zoonotic disease and raise public awareness on this issue.
Table 1. Candidates of vaccines for prevention and treatment of human poxvirus
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Table 1. Candidates of vaccines for prevention and treatment of human poxvirus
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