Current Prevention and Treatment Strategies to Control Monkeypox
Current Prevention and Treatment Strategies to Control Monkeypox
Farzane Behnezhad,1Javad Charostad,2,*
1. Tehran University of Medical Sciences 2. Shahid Sadoughi University of Medical Sciences
Introduction: Monkeypox infection is an ongoing global outbreak caused by the Monkeypox virus (MPXV), an enveloped double-stranded DNA virus with manifestations similar to smallpox. MPXV is primarily spread by close, sustained physical contact (skin-to-skin, sexual, or respiratory droplets) or fomites. Currently, no specific approved treatments and preventive approaches have been developed for MPXV infection, however, some strategies have been suggested to be effective. The present study aimed to reflect the current opinion on the potential application of pharmacological and preventive strategies such as antivirals, as prophylaxis against monkeypox infection
Methods: This study was a narrative review performed in 2022. We searched four keywords "Monkeypox virus", " Monkeypox", "Treatment", " and "Prevention" in six databases including PubMed, Scopus, Science Direct, Web of Science UpToDate, and Google scholar to determine the related documents on the main objective of the study.
Results: A review of current studies revealed that several medical countermeasures are available for orthopoxviruses such as monkeypox. According to CDC monkeypox treatment guidelines, most people with monkeypox recover fully within 2 to 4 weeks without the need for medical treatment. According to the US Strategic National Stockpile (SNS), there are three smallpox vaccines such as ACAM2000® (live, replication competent vaccinia virus), Aventis Pasteur Smallpox Vaccine (APSV) (an investigational replication-competent vaccinia), and JYNNEOSTM (live, replication incompetent vaccinia virus) (also known as IMVAMUNE, IMVANEX, MVA-BN). The Advisory Committee on Immunization Practices provides recommendations for the use of pre-exposure prophylaxis (PrEP) for individuals with job-related exposure to orthopoxviruses and high-risk exposure groups such as gay, bisexual, and other men who have sex with men (MXM) in the current outbreak. They are required to be vaccinated with either ACAM2000® or JYNNEOSTM as pre-exposure prophylaxis (PrEP). Also, vaccination as post-exposure prophylaxis (PEP) is recommended for healthcare workers and people with high-risk exposure to case patients in the infectious period.
Conclusion: The necessary therapeutic option for monkeypox virus infection is supportive care. Moreover, respiratory and hemodynamic support and skin lesion treatment are recommended. Currently, there are no specific treatments approved for monkeypox virus infections, however, there are several options, including antiviral agents (e.g., brincidofovir, cidofovir and tecovirimat) and immune therapies (e.g., vaccinia immune globulin intravenous (VIGIV)) for patients with moderate to severe symptoms or who are at high risk of severe disease. Future studies on monkeypox virus infection treatment are required to find novel strategies on prevention and treatment of monkeypox virus outbreak.