Monkeypox (Mpox): a comprehensive review of epidemiology, therapeutic advances, and public health implications.

BACKGROUND

Monkeypox, a zoonotic viral disease caused by the monkeypox virus (MPXV), was first identified in captive monkeys in 1958 and in humans in 1970. Although historically limited to Central and West Africa, the unprecedented 2022–2025 multi-country outbreaks exposed its ability for sustained human-to-human transmission, raising urgent global health concerns.

OBJECTIVES

This review aims to provide a comprehensive overview of the epidemiology, genomic structure, evolutionary patterns, transmission routes, clinical features, and treatment options related to MPXV.

METHODS

Evidence was collected through systematic searches of established scientific databases (PubMed, Scopus, Web of Science, ScienceDirect, Cochrane Library, and Google Scholar) using specific keywords (monkeypox, MPXV, outbreak, transmission, diagnosis, therapeutics, vaccination, public health). Data were carefully analyzed to compare historical and current outbreaks, evaluate diagnostic methods, explore developments in therapeutics and vaccines, and assess public health responses. The review highlights advances in molecular diagnostics (PCR-based platforms, CRISPR-integrated assays, and point-of-care systems), emerging therapeutic options (tecovirimat, brincidofovir, cidofovir), and novel vaccine strategies (MVA-BN/JYNNEOS and ACAM2000). However, barriers such as asymptomatic infections, under-resourced healthcare infrastructure in endemic areas, viral genomic plasticity, and inequitable vaccine access continue to limit effective containment.

CONCLUSIONS

By integrating clinical, molecular, and epidemiological perspectives, this review underscores the urgent need for global surveillance networks, targeted vaccination policies, and host-pathogen-driven therapeutic innovations. Addressing these priorities is critical to mitigating future outbreaks and establishing long-term resilience against MPXV and related orthopoxviruses.