What is mpox (monkeypox)?
How does mpox spread? Mpox is a disease caused by the monkeypox virus, a type of viral infection that primarily spreads through close personal contact. It can also be transmitted indirectly via surfaces or objects that have been in contact with an infected individual. In regions where the virus is present among wild animals, it can be transmitted from these animals to humans through direct contact.
After extensive discussions with international specialists, the World Health Organization has adopted the term “mpox” as the preferred alternative to “monkeypox.”
WHO recommends new name for monkeypox disease
Following consultations with global experts, the World Health Organization (WHO) will soon adopt “mpox” as a preferred term for monkeypox. For the next year, both “monkeypox” and “mpox” will be used concurrently, allowing for a gradual transition and minimizing confusion during the ongoing global outbreak. After this period, “mpox” will replace “monkeypox” as the standard term.
The expansion of the monkeypox outbreak earlier this year led to the emergence of racially and culturally insensitive language online and in various communities, prompting concerns and requests for a name change. In response, WHO held multiple discussions with both public and private stakeholders, including numerous countries, to explore potential alternatives.
WHO’s role in naming diseases falls under the International Classification of Diseases (ICD) and the WHO Family of International Health Related Classifications, which involves a consultative process with member states. In line with the ICD update procedures, WHO solicited input from experts, countries, and the public on possible new names. Following these consultations and further deliberations with WHO’s Director-General Dr. Tedros Adhanom Ghebreyesus, the organization recommends:
- The adoption of “mpox” in English as a synonym for the disease.
- “Mpox” will be introduced alongside “monkeypox” for one year to ease the transition, allowing time to update the ICD and WHO publications.
- “Mpox” will soon be included in the ICD-10 online and will feature in the official 2023 release of ICD-11, which is the global standard for health data and clinical documentation.
- “Monkeypox” will remain searchable in ICD to preserve historical data.
The decision process considered various factors, including scientific accuracy, current usage, ease of pronunciation, multilingual applicability, and the need to avoid geographical or zoological connotations.
The usual ICD update process can be lengthy, but in this instance, it was expedited while adhering to standard procedures. Advisory committees comprising experts from 45 countries contributed to the review.
The integration of “mpox” in other languages was also addressed. WHO will work with relevant authorities and scientific societies to ensure proper translations and handle any arising naming issues through established mechanisms.
WHO will incorporate “mpox” into its communications and encourages others to adopt this change to mitigate any negative impacts associated with the current name and the transition to the new one.
The name “human monkeypox” was established in 1970, predating the WHO’s naming guidelines published in 2015. These guidelines aim to reduce negative impacts on trade, travel, and cultural sensitivities. The naming of viruses is overseen by the International Committee on the Taxonomy of Viruses (ICTV), which has been revisiting the naming of orthopoxvirus species, including the monkeypox virus, and will continue to do so.
In August, global experts agreed on new names for monkeypox virus variants or clades. The former Congo Basin (Central African) clade will now be known as Clade I, and the West African clade as Clade II, with the latter further divided into subclades IIa and IIb. For more details, see the WHO press release on monkeypox clades.
How does mpox spread?
Transmission of Mpox
From Person to Person:
Mpox primarily spreads through close physical contact with an infected individual. This includes direct skin-to-skin contact, such as touching or sexual activity, as well as mouth-to-mouth or mouth-to-skin interactions, like kissing. The virus can also spread through face-to-face encounters where respiratory droplets from talking or breathing can be exchanged. During the global outbreak that began in 2022, sexual contact was a major mode of transmission. Further research is needed to fully understand the dynamics of mpox transmission in various settings and under different conditions.
Individuals with mpox are infectious until all their lesions have crusted over, the scabs have fallen off, and new skin has developed beneath. Healing typically takes between 2 to 4 weeks. Lesions in the mouth, throat, eyes, vagina, and anus must also be fully healed.
The virus may linger on items such as clothing, bedding, towels, objects, electronics, and surfaces that have been in contact with an infected person. Transmission can occur if someone else touches these contaminated items and then touches their own mucous membranes (eyes, nose, mouth) without washing their hands. Regular cleaning and disinfecting of potentially contaminated surfaces and thorough hand washing can help prevent this type of transmission.
Mpox can also be transmitted from a pregnant person to their fetus, during or after birth through skin-to-skin contact, or from an infected parent to an infant or child during close contact.
Although there have been reports of transmission from asymptomatic individuals, it remains unclear how the virus spreads before symptoms appear or after lesions have healed. While live virus has been detected in semen, the extent of transmission through semen, vaginal fluids, amniotic fluid, breast milk, or blood is not yet fully understood.
From Animals to Humans:
Mpox can be contracted from physical contact with animals infected with the virus, such as certain monkey species or terrestrial rodents like tree squirrels. This exposure can occur through bites, scratches, or handling animals or their meat. The virus may also be transmitted by consuming undercooked contaminated meat.
To reduce the risk of contracting mpox from animals, avoid unprotected contact with wild animals, especially those that are sick or deceased. In regions where the virus is present in animals, thoroughly cook any animal products before consumption.
From Humans to Animals:
There have been a few instances where the virus was detected in pet dogs, but it remains uncertain whether these were true infections or simply surface contamination. Since many animals can potentially contract the virus, there is a risk of transmission from humans to animals. Individuals with confirmed or suspected mpox should avoid close contact with pets (such as cats, dogs, hamsters, gerbils), livestock, and wildlife.
For more detailed guidance, pet owners and those working with animals should refer to the WOAH risk guidance on preventing the transmission of the monkeypox virus to animals.
WHO is collaborating with its One Health partners, including the Food and Agriculture Organization (FAO) and the World Organisation for Animal Health (WOAH), to enhance understanding of the virus’s natural reservoirs and to help mitigate the risk of mpox transmission between humans and animals.
What care does someone with mpox need to recover fully?
The care required for someone with mpox will vary based on their symptoms and the likelihood of developing more severe complications. It is crucial for individuals with mpox to follow their healthcare provider’s recommendations. Typically, symptoms last between 2 to 4 weeks and either resolve on their own or with supportive treatments, such as medications to relieve pain or fever (e.g., analgesics and antipyretics).
For those recovering at home, staying hydrated, maintaining a nutritious diet, and ensuring adequate rest are essential. Individuals who are self-isolating should focus on their mental well-being by engaging in relaxing and enjoyable activities, staying connected with loved ones through digital means, and exercising if their condition permits. Seeking support for mental health needs is also important if necessary.
It is advisable for individuals with mpox to avoid scratching their lesions and to manage their rash carefully. This includes washing hands before and after touching lesions, keeping the skin clean and dry, and covering lesions with clothing or a bandage when around others. The rash can be cleaned with sterilized water or antiseptic. For mouth sores, saltwater rinses may be beneficial, and warm baths with baking soda and Epsom salts can alleviate discomfort from body sores. Paracetamol can be used to manage pain from lesions, but if stronger pain relief is required, consulting a healthcare provider is recommended.
Is there a treatment for mpox?
Extensive research into smallpox treatments has led to the development of therapies that may also be effective for mpox. For instance, tecovirimat, an antiviral originally designed for smallpox, received conditional approval from the European Medicines Agency in January 2022 for use in treating mpox under special circumstances. While experience with these treatments during mpox outbreaks is increasing, it remains limited. Consequently, their use often involves participation in clinical trials or expanded access programs, which help gather data to enhance understanding of their optimal application in the future.
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