Monkeypox: Virology, laboratory diagnosis and therapeutic approach

J Gene Med. 2023 Sep;25(9):e3521. doi: 10.1002/jgm.3521. Epub 2023 May 2.

Abstract

Monkeypox infection outbreaks have been observed sporadically in Africa, usually as a result of interaction with wildlife reservoirs. The genomes of the new strain range in size from 184.7 to 198.0 kb and are identified with 143-214 open reading frames. Viral cores are rapidly carried on microtubules away from the cell's perimeter and deeper into the cytoplasm once the virus and cell membranes fuse. Depending on the kind of exposure, patients with monkeypox may experience a febrile prodrome 5-13 days after exposure, which frequently includes lymphadenopathy, malaise, headaches, and muscle aches. A different diagnostic approach is available for monkeypox, including histopathological analysis, electron microscopy, immunoassays, polymerase chain reaction, genome sequencing, microarrays, loop-mediated isothermal amplification technology and CRISPR (i.e., "clustered regularly interspaced short palindromic repeats"). There are currently no particular, clinically effective treatments available for the monkeypox virus. An initial treatment is cidofovir. As a monophosphate nucleotide analog, cidofovir is transformed into an inhibitor of viral DNA polymerase by cellular kinases, which is analogous to cidofovir's function in inhibiting viral DNA synthesis. The European Medicine Agency and the Food and Drug Administration have both granted permission for IMVAMUNE, a replication-deficient, attenuated third-generation modified vaccinia Ankara vaccine, to be used for the prevention of smallpox and monkeypox in adults.

Keywords: laboratory diagnosis; monkeypox; therapeutic approach.

Publication types

  • Review

MeSH terms

  • Cidofovir / pharmacology
  • Cidofovir / therapeutic use
  • Clinical Laboratory Techniques
  • Humans
  • Monkeypox virus / genetics
  • Mpox (monkeypox)* / diagnosis
  • Mpox (monkeypox)* / drug therapy
  • Mpox (monkeypox)* / epidemiology
  • United States
  • Vaccinia virus / genetics

Substances

  • Cidofovir