Advances in the Management of MPOX Infection: Therapeutic and Vaccination Perspectives

Abstract

Purpose of Review This review offers a comprehensive and up-to-date overview of mpox virus (MPXV) infection, highlighting its evolving epidemiology, virological features, transmission patterns, clinical presentation, and diagnostic methods. Particular attention is given to current treatment options and preventive strategies, including vaccination. The review emphasizes insights from recent outbreaks and advances in therapeutic development. Recent Findings Since 2022, MPXV has emerged as a global public health concern with sustained human-to-human transmission, primarily through sexual contact, especially among men who have sex with men and people living with HIV. New viral clades, including clades 1b and 2b, have been identified, exhibiting genetic adaptations that enhance human infectivity. Although tecovirimat remains the primary antiviral treatment, emerging resistance and limited clinical efficacy data raise concerns. Several vaccine platforms, particularly MVA-BN, are in use or under evaluation, though issues remain regarding long-term protection and global accessibility. Summary Mpox has shifted from an endemic zoonosis to a sexually transmitted infection with global reach. While most cases are self-limited, severe disease can occur in immunocompromised individuals. The current therapeutic armamentarium is restricted, and tecovirimat’s utility may be limited by timing, resistance, and viral clade. Vaccination is effective, but not universally available or durable. Enhanced surveillance, improved diagnostics, novel antivirals, and equitable vaccine access are crucial for containment. A One Health approach is essential to address ongoing transmission risks and potential spillover events.