Monkeypox, now often referred to as mpox, has become a global public health concern due to recent widespread outbreaks. Once primarily confined to specific regions, this viral disease has demonstrated its capacity for broader transmission, prompting increased vigilance worldwide.
Understanding the Virus
The monkeypox virus (MPXV) is a double-stranded DNA virus that causes mpox in humans and other mammals. It is classified within the Orthopoxvirus genus, which includes the variola virus (smallpox), cowpox, and vaccinia viruses. This classification highlights its genetic relationship to smallpox, though mpox typically presents as a milder illness. The virus is oval-shaped and possesses a lipoprotein outer membrane, with a genome approximately 190 kilobases in size.
Mpox is a zoonotic disease, meaning it can transmit from animals to humans. While first identified in monkeys in 1958, various smaller mammals, particularly rodents, are suspected to be its natural reservoirs. The virus is endemic in Central and West Africa, where human infections have historically been more frequent.
Current Global Picture
The global landscape of mpox has shifted significantly since the widespread outbreak began in May 2022, primarily driven by the clade IIb strain. This outbreak resulted in over 100,000 cases across 122 countries, including 115 where mpox was not previously reported. While global case numbers have decreased since the 2022 peak, the virus continues to circulate with ongoing outbreaks.
As of July 2025, the Democratic Republic of the Congo (DRC) is experiencing an upsurge in cases, primarily due to clade I, including a new offshoot called clade Ib, which has spread to neighboring countries and beyond Africa. Several countries in Central and East Africa, including Burundi, Ethiopia, Kenya, Malawi, Rwanda, South Sudan, Tanzania, Uganda, and Zambia, are experiencing sustained human-to-human transmission of clade I mpox. The World Health Organization (WHO) and the Centers for Disease Prevention and Control (CDC) monitor these trends, noting all MPXV clades circulate in Africa, with an upward trend in West Africa.
How it Spreads and What to Look For
Mpox primarily spreads through close, prolonged contact with an infected person. This includes direct skin-to-skin contact, such as touching, kissing, or sexual activity, especially with a person who has visible lesions. The virus can also transmit through respiratory droplets during extended face-to-face interactions or contact with contaminated materials like bedding, towels, or clothing. Pregnant individuals can also pass the virus to their unborn child.
Symptoms of mpox typically appear within one to two weeks after exposure, though the incubation period can range from five days to three weeks. Initial symptoms often resemble the flu, including fever, headache, muscle aches, fatigue, and swollen lymph nodes in the neck, armpits, or groin. A characteristic rash usually follows these symptoms, appearing within one to three days of fever onset.
The rash progresses through several stages: flat, discolored spots (macules), raised bumps (papules), fluid-filled blisters (vesicles), and pus-filled sores (pustules), before scabbing over and healing. Lesions can appear anywhere on the body, including the face, palms, soles, genitals, and mouth. In some recent outbreaks, lesions have appeared in the genital or anal area, sometimes without other systemic symptoms, making diagnosis challenging as they can be mistaken for sexually transmitted infections. An infected person is contagious from the onset of flu-like symptoms until all scabs have fallen off and new skin has formed.
Protecting Yourself and Others
Preventing mpox spread involves several measures, especially avoiding close contact with symptomatic individuals. This includes refraining from intimate physical contact, such as sexual activity, and minimizing face-to-face interactions with those showing signs of illness. Practicing good hand hygiene, by regularly washing hands with soap and water or using an alcohol-based hand rub, is recommended, particularly after touching contaminated surfaces or materials.
Avoid sharing contaminated items like bedding, towels, or eating utensils with an infected person. If a person suspects mpox or exposure, seeking prompt medical attention is important for diagnosis and guidance. Individuals diagnosed with mpox should isolate themselves from others, including pets, until all lesions have healed and new skin has formed, to prevent further transmission. Vaccination is a protective measure for those at high risk of exposure, based on healthcare provider recommendations.