Q: Why did mpox spread globally in 2022?

Waning smallpox cross-protective immunity globally (routine vaccination ended 1980), amplification of clade IIb through sexual networks at social gatherings, and absence of widespread recognition outside Africa contributed to the 2022 global spread.

Q: Is there a vaccine?

Yes — JYNNEOS (Imvanex/Imvamune) is approximately 85% effective. It is non-replicating (safe for immunocompromised people) — given as 2 subcutaneous doses or 1 intradermal dose (dose-sparing strategy). Ring vaccination of contacts is the recommended strategy in outbreaks.

Q: How is mpox treated?

Most cases in healthy adults are self-limiting with supportive care. Tecovirimat (TPOXX) is used for severe disease, immunocompromised patients and certain anatomical locations under expanded access. Ongoing trials (PALM007, STOMP) clarify optimal use.

Q: Why was monkeypox renamed?

WHO renamed "monkeypox" to "mpox" in November 2022 to avoid stigmatising associations with Africa and primates, and to standardise nomenclature for the two clades.

Q: What was the August 2024 PHEIC?

On 14 August 2024, WHO declared mpox a PHEIC for the second time — triggered by rapid clade I spread (clade Ib) from DRC to Burundi, Kenya, Rwanda and Uganda with evidence of efficient sexual transmission and higher severity than clade IIb.

Q: What is the history of mpox?

Monkeypox virus was identified in 1958 in laboratory monkeys in Denmark, then in humans in 1970 in DRC. It remained a rare zoonosis confined to Central and West Africa for decades. A 2003 US outbreak (47 cases) occurred via pet prairie dogs. The 2022 global outbreak was the first multi-country sustained community transmission outside Africa.

Q: What is the role of waning smallpox immunity?

Smallpox vaccination provides ~85% cross-protection against mpox. Routine vaccination ended in 1980 — leaving growing proportions of the global population without cross-protective immunity, substantially contributing to the expanded 2022 outbreak and ongoing spread.

Question 1

What is mpox?

Accepted Answer

Mpox is caused by monkeypox virus — an orthopoxvirus related to smallpox. It causes fever, severe headache, muscle aches and fatigue, followed by a pustular rash progressing through macules, papules, vesicles and scabs. Lymph node swelling distinguishes it from smallpox and chickenpox. Most cases resolve within 2-4 weeks in healthy adults.

Question 2

How is mpox transmitted?

Accepted Answer

Mpox spreads through: direct contact with an infected person's rash, scabs or body fluids; contaminated objects (bedding, towels); prolonged respiratory contact; and from infected animals (rodents are the primary reservoir). During the 2022 outbreak, sexual contact was the predominant transmission route for clade IIb. Clade I also demonstrates sexual transmission in the 2024 outbreak.

Question 3

What is the difference between clade I and clade IIb?

Accepted Answer

Clade I is more severe (CFR 1-10% unvaccinated) and has been endemic in Central Africa for decades. Clade IIb caused the 2022 global outbreak — less severe (CFR <0.1% in high-income countries) and spreading predominantly through sexual networks among gay and bisexual men. The 2024 PHEIC involves clade I spreading from DRC to neighbouring countries with evidence of sexual transmission.

Question 4

Why did mpox spread globally in 2022?

Accepted Answer

Waning smallpox cross-protective immunity globally (routine vaccination ended 1980), amplification of clade IIb through sexual networks at social gatherings, and absence of widespread recognition outside Africa contributed to the 2022 global spread.

Question 5

Is there a vaccine?

Accepted Answer

Yes — JYNNEOS (Imvanex/Imvamune) is approximately 85% effective. It is non-replicating (safe for immunocompromised people) — given as 2 subcutaneous doses or 1 intradermal dose (dose-sparing strategy). Ring vaccination of contacts is the recommended strategy in outbreaks.

Question 6

How is mpox treated?

Accepted Answer

Most cases in healthy adults are self-limiting with supportive care. Tecovirimat (TPOXX) is used for severe disease, immunocompromised patients and certain anatomical locations under expanded access. Ongoing trials (PALM007, STOMP) clarify optimal use.

Question 7

Why was monkeypox renamed?

Accepted Answer

WHO renamed "monkeypox" to "mpox" in November 2022 to avoid stigmatising associations with Africa and primates, and to standardise nomenclature for the two clades.

Question 8

What was the August 2024 PHEIC?

Accepted Answer

On 14 August 2024, WHO declared mpox a PHEIC for the second time — triggered by rapid clade I spread (clade Ib) from DRC to Burundi, Kenya, Rwanda and Uganda with evidence of efficient sexual transmission and higher severity than clade IIb.

Question 9

What is the history of mpox?

Accepted Answer

Monkeypox virus was identified in 1958 in laboratory monkeys in Denmark, then in humans in 1970 in DRC. It remained a rare zoonosis confined to Central and West Africa for decades. A 2003 US outbreak (47 cases) occurred via pet prairie dogs. The 2022 global outbreak was the first multi-country sustained community transmission outside Africa.

Question 10

What is the role of waning smallpox immunity?

Accepted Answer

Smallpox vaccination provides ~85% cross-protection against mpox. Routine vaccination ended in 1980 — leaving growing proportions of the global population without cross-protective immunity, substantially contributing to the expanded 2022 outbreak and ongoing spread.

Question 11

What is ring vaccination?

Accepted Answer

Ring vaccination targets contacts and contacts-of-contacts of confirmed cases — creating a protective ring preventing spread. This strategy was used in smallpox eradication and deployed in the 2022 mpox outbreak in high-income countries, proving more efficient than mass vaccination in localised outbreaks.

Question 12

How does GMJ News cover mpox?

Accepted Answer

GMJ News follows WHO mpox situation reports, PHEIC declarations, JYNNEOS vaccine access, tecovirimat trial results and the stigma dimensions. The 2022 and 2024 outbreaks highlight the importance of global surveillance and equitable vaccine access.

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