Monkeypox (Mpox) outbreak during COVID-19 pandemic - Past and the future.

Monkeypox infection is caused by the Orthopoxvirus (OPXV) genus of the Poxviridae family, closely resembling its more famous sibling smallpox. Recently World Health Organization (WHO), have renamed monkeypox as Mpox citing racial concerns, so we will be referring monkeypox as Mpox There has been a recent outbreak in May 2022 when more than 31,800 confirmed and suspected cases of Mpox were identified in all 6 WHO regions. On 23 July 2022, WHO declared it a public health emergency. Prior to the current outbreak, Mpox had been reported in people from several parts of central and west African countries; and almost all Mpox cases in people outside of Africa were linked to international travel to countries where the disease commonly occurs or through imported animals. With the waning of the smallpox vaccine-induced immunity, Mpox can spread in the global population. Though the virus generally does not cause a high mortality in immunocompetent individuals, however, severe disease and mortality may result if the virus spreads to immunocompromised individuals, children, elderly individuals, pregnant women and individuals living with co-morbidities such as diabetes. The transmission was suspected to have occurred through sexual activity in 95% of the persons with infection. It was found that 98% of the persons with infection were either gay or bisexual men with 41% suffering from HIV infection. The reasons behind this epidemiological behaviour have to be studied further to formulate a hypothesis that, is it the homosexuals who need to be more concerned or is it a global concern and is monkeypox a sexually transmitted infection? The rash along with associated lymphadenopathy is a clue toward Mpox infection,but PCR is needed for the confirmative diagnosis. With the discovery of a vaccine, repurposed antivirals and precautionary steps to prevent the spread of infection, it might help in the containment of the virus. In addition, what we already know about Mpox has to be re-evaluated, because most of the information gathered is from low-resource settings in Africa. The world and health care agencies need to galvanise a well-funded global plan and research initiatives to contain the spread of Mpox. In this article, we have attempted to make the readers aware of the biology,etiopathogenesis including the changes at the cellular level the virus is causing, the changing trends of the virus transmission, and the clinical manifestations.We have also attempted to elaborate on the potential challenges and the need for early diagnosis and containment of this Mpox outbreak. This could be achieved by effectieve use of vaccination and taking social safety measures,especially by the communities at risk. This article is protected by copyright. All rights reserved.