Mpox primer for clinicians: what makes the difference in 2024?

Curr Opin Infect Dis. 2025 Jan 16. doi: 10.1097/QCO.0000000000001091. Online ahead of print.

Abstract

Purpose of review: The 2024 mpox outbreak, primarily driven by the possibly more virulent clade Ib strain, prompted the WHO declaring it a public health emergency of international concern (PHEIC) on August 14, 2024. This review provides essential guidance for clinicians managing mpox cases, as it contrasts the features of the 2024 outbreak with those of the 2022 epidemic to support better clinical decision-making.

Recent findings: The review highlights significant differences between the 2024 and 2022 outbreaks, including total case numbers, demographic distribution, and fatality rates. It also examines the increased severity associated with clade Ib. The article reviews the differential diagnosis of mpox, diagnostic tools, updates on Tecovirimat treatment, and infection control practices, particularly among healthcare workers. Vaccination strategies, including the role of smallpox vaccines and at-risk groups, are also discussed, along with recommendations for countries outside Africa.

Summary: The findings underscore the importance of early diagnosis and appropriate treatment for mpox in light of the 2024 outbreak's unique characteristics. Clinicians are advised to stay informed about updated diagnostic and therapeutic strategies, including vaccine recommendations, to mitigate the spread of the disease.