Mpox and other (zoonotic) poxviruses

Cause: Monkeypox virus (ds DNA virus, replicates in cytoplasm)
Transmission: Direct contact & sexual (predominantly MSM)
Symptoms: flu-like with fever, rash covering entire body, lymph node swelling
Pathogenesis: Infection of respiratory tract or mucosa leading to viremia, infection of lymphatics and other organs, and a second wave of viremia that infects dermis and other organ coverings.
Complications: Proctitis, rectal bleeding; Mortality 0.1% (US outbreak) or higher
Diagnosis: PCR, ELISA, immunoblot
Treatment: supportive; antivirals (tecovirimat)
Immunity: lifelong
Vaccine: Mpox vaccine

Cause: Monkeypox virus, cowpox virus, orf virus
Transmission: Direct contact (zoonotic) from rodents (monkeypox), sheep (orf), cattle (cowpox)
Symptoms: flu-like with fever; lesions (single or multiple)
Pathogenesis: Infection of respiratory tract leading to viremia, infection of lymphatics and other organs, and a second wave of viremia that infects dermis and other organ coverings. Widespread blistering often a cause of death.
Treatment: supportive; antivirals (tecovirimat)
Immunity: lifelong?
Vaccine: Mpox vaccine

Monkeypox Orf images | DermNet

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