A. Causes:

A member of the Orthopoxvirus genus, the Monkeypox or Mpox virus is the causative agent of the disease known as monkeypox. The majority of the time, it is a zoonotic virus, which means that it is transported from animals to humans individuals.

B. Transmission:

a) Animal-to-Human Transmission:

Direct contact with the blood, body fluids, or cutaneous or mucosal lesions of infected animals (particularly rodents and primates) is the most common method of transmission from animals to humans.
Ingestion of meat from sick animals that has been inadequately handled or that has not been properly cooked.

b) Human-to-Human Transmission:

• Coming into close contact with respiratory secretions, wounds on the skin caused on by an infected person, or objects that have been recently contaminated.
• Face-to-face contact that lasts for an extended period of time or personal physical contact such as kissing, embracing, or sexual intercourse.

Updated Insights on Transmission (2024):

Studies that were conducted recently indicate that respiratory transmission plays a more significant role than was previously believed. As a result, social distancing measures and respiratory protection are becoming increasingly important, particularly in healthcare settings.

The onset of symptoms of monkeypox normally occurs between 07 and 14-days following exposure; but, in certain instances, it may take up to twenty-one days. It is possible to separate the disease into two distinct phases:

A. Invasion Period (Lasts 1-5 days):

• Fever
• Intense headache
• Lymphadenopathy (swollen lymph nodes)
• Muscle aches (myalgia)
• Back pain
• Intense fatigue

B. Eruptive Stage (1-3 days after fever onset):

Skin Rash: Begins on the face and then spreads to other parts of the body.
The rash progresses through stages: macules (flat lesions), papules (raised lesions), vesicles (fluid-filled lesions), pustules, and crusts.

C. Severity:

In most cases, symptoms are mild to moderate, with the rash lasting 2-4 weeks.
Severe cases can occur, especially in children or those with weakened immune systems.

2024 Updates on Symptoms:

Recent reports indicate that the rash might start simultaneously in multiple body areas rather than the traditional progression, potentially complicating early diagnosis.

A. Medical Diagnosis:

• Physical Examination: The doctor will check for a distinctive rash and swollen lymph nodes.

• Laboratory Tests:
  • PCR Testing: Polymerase Chain Reaction (PCR) tests on fluid specimens taken from lesions or scabs are confirmatory tests for the diagnosis of Monkeypox.
  • Blood Tests: Serological tests to detect Monkeypox antibodies.
  • Viral Culture: For research purposes and in some cases, virus culture from lesion samples can be done.

B. Differential Diagnosis:

• Chickenpox
• Measles
• Bacterial skin infections

C. Epidemiological Link:

This would be helpful in the diagnosing process if there is a history of contacts with animals or infected people, as well as travel to places where the disease is spread.

At present, there is no specific treatment approved for Monkeypox, but supportive care is the mainstay of management. However, treatment strategies have evolved at times. Some of these are explained as:

A. Antiviral Treatment:

• Tecovirimat (TPOXX): Tecovirimat is an antiviral medicine that has activity against orthopoxviruses including smallpox and mpox. It is available under a variety of trade names, including Tpoxx, among others. 2018 marked the year that it was granted approval as the first antipoxviral medication in the United States. The medicine is effective because it interrupts the transmission of the virus from cell to cell, so avoiding the illness from occurring.
• Cidofovir and Brincidofovir: On the other hand, these antivirals are often reserved for life-threatening diseases that are associated with inhibitory activity against the monkeypox virus and other orthopoxviruses. However, they are currently being investigated for usage in severe cases.

B. Symptomatic Management:

• Fever & Pain Relief: Use of acetaminophen or ibuprofen to relieve fever and discomfort.
• Fluid Management: Rehydration is crucial in severe cases, especially when oral intake is affected.

C. Isolation:

Infected individuals should be isolated until the scabs have fully healed to prevent further transmission.

D. Monitoring:

Regular monitoring of vitals, fluid balance, and secondary infections, especially in immunocompromised individuals, is essential. 

2024 Treatment Updates:

Research in 2024 has emphasized early use of antivirals in high-risk populations, such as those with underlying conditions, which may improve outcomes significantly. 

A. Vaccination:

• JYNNEOS Vaccine: When it comes to the protection of monkeypox, the JYNNEOS vaccine, which is an improved version of the smallpox vaccination, has been given approval. In order to create immunity, it is necessary to take two doses, and the process takes several weeks to complete.
• ACAM2000: An additional vaccine option, despite the fact that it is associated with more severe adverse effects, particularly in immunocompromised persons.

B. Public Health Measures:

• Avoid from coming into contact with animals that are belongs to Endemic area, particularly primates and rats.
  Ensure that the meat is cooked properly: Make sure that all animal products are cooked thoroughly.
• Practice proper hand hygiene by often washing your hands with soap and water or by using a hand sanitizer that contains alcohol.
• Use of Personal Protective Equipment (PPE): Individuals working in the healthcare industry are required to wear the necessary PPE, which may include masks, gloves, and gowns.

C. Travel Advisories:

Individuals who are traveling to regions where cases have been reported should take additional precautions, such as avoiding direct contact with animals, avoiding items made from raw or undercooked animal products, and adhering to public health guidelines before visiting.