Abstract

Research Article

Human Poxvirus Infections: Epidemiology, Transmission, and Clinical Features of Major Orthopoxvirus Diseases

Trisha Chakraborty, Naima Siddiqua, Subrin Shabab Trisa, Syeda Fatima Anwar and Gazi Wafa Akbar*

Published: 17 June, 2026 | Volume 9 - Issue 1 | Pages: 34-39

Poxviruses are big, double-stranded DNA viruses that can infect a variety of animal hosts, including humans. Other clinically significant poxvirus infections, such as monkeypox (mpox), cowpox, and molluscum contagiosum, continue to present new and re-emerging public health issues even after smallpox was eradicated. The epidemiology, transmission dynamics, clinical manifestations, diagnostic methods, and treatment approaches of the four main human poxvirus infections are all covered in this study’s methodical narrative synthesis.
Relevant studies published between 2000 and 2025 were found by a systematic search of PubMed, Scopus, and Google Scholar; 34 of them were included in the final analysis. Results show that poxviruses differ significantly in host range, transmission patterns, and disease severity, despite sharing common biological traits including cytoplasmic replication and distinctive cutaneous lesion progression. While mpox has resurfaced worldwide, exhibiting persistent human-to-human transmission during the 2022–2023 outbreak, smallpox is still historically relevant because of its high fatality and successful eradication. Cowpox is still an uncommon zoonotic disease associated with animal reservoirs, while Molluscum contagiosum is still very common, especially in children and immunocompromised people. Antiviral medications like tecovirimat offer treatment options for severe cases, and advances in molecular diagnostics, especially polymerase chain reaction, have improved detection.
The impact of dwindling population immunity and growing human-animal interaction is demonstrated by the resurgence and persistence of poxvirus diseases. To reduce future epidemics, more surveillance, better diagnostic capabilities, and integrated One Health policies are crucial.

Read Full Article HTML DOI: 10.29328/journal.ijcmbt.1001038 Cite this Article Read Full Article PDF

Keywords:

Orthopoxvirus; Monkeypox (MPXV); Smallpox; Cowpox; Molluscum contagiosum

References

  1. Poxviridae. CAB International; 2002. Available from: https://www.cabidigitallibrary.org/doi/full/10.5555/20023085623
  2. Hughes AL, Irausquin S, Friedman R. The evolutionary biology of poxviruses. Infect Genet Evol. 2010;10(1):50-9. Available from: https://doi.org/10.1016/j.meegid.2009.10.001
  3. Moss B. Poxvirus DNA replication. Cold Spring Harb Perspect Biol. 2013;5(9):a010199. Available from: https://doi.org/10.1101/cshperspect.a010199
  4. McFadden G. Poxvirus tropism. Nat Rev Microbiol. 2005;3(3):201-13. Available from: https://doi.org/10.1038/nrmicro1099
  5. Meza-Romero R, Navarrete-Dechent C, Downey C. Molluscum contagiosum: An update and review of new perspectives in etiology, diagnosis, and treatment. Clin Cosmet Investig Dermatol. 2019;12:373-81. Available from: https://doi.org/10.2147/CCID.S187224
  6. Muyembe-Tamfum JJ, Mulembakani P, Lekie RB, et al. Smallpox and its eradication in the Democratic Republic of Congo: Lessons learned. Vaccine. 2011;29 Suppl 4:D13-8. Available from: https://doi.org/10.1016/j.vaccine.2011.10.049
  7. Riedel S. Edward Jenner and the history of smallpox and vaccination. Proc (Bayl Univ Med Cent). 2005;18(1):21-5. Available from: https://doi.org/10.1080/08998280.2005.11928028
  8. Nguyen PY, Ajisegiri WS, Costantino V, Chughtai AA, MacIntyre CR. Reemergence of human monkeypox and declining population immunity. Emerg Infect Dis. 2021;27(4):1007-15. Available from: https://doi.org/10.3201/eid2704.203569
  9. Ranjan S, Vashishth K, Sak K, Tuli HS. The emergence of mpox: Epidemiology and current therapeutic options. Curr Pharmacol Rep. 2023;9(3):144-53. Available from: https://doi.org/10.1007/s40495-023-00318-y
  10. Bunge EM, Hoet B, Chen L, Lienert F, Weidenthaler H, Baer LR, et al. The changing epidemiology of human monkeypox. PLoS Negl Trop Dis. 2022;16:e0010141. Available from: https://doi.org/10.1371/journal.pntd.0010141
  11. Babkin IV, Babkina IN. A retrospective study of the orthopoxvirus molecular evolution. Infect Genet Evol. 2012;12(8):1597-604. Available from: https://doi.org/10.1016/j.meegid.2012.07.011
  12. Russo AT, Grosenbach DW, Chinsangaram J, Honeychurch KM, Long PG, Lovejoy C, et al. An overview of tecovirimat for smallpox treatment and expanded anti-orthopoxvirus applications. Expert Rev Anti Infect Ther. 2021;19(3):331-44. Available from: https://doi.org/10.1080/14787210.2020.1819791
  13. Esposito JJ, Fenner F. Poxviruses. J Gen Virol. 2001;82(6):1231-45. Available from: https://doi.org/10.1099/vir.0.19565-0
  14. Liu Q, Fu L, Wang B, et al. Clinical characteristics of human mpox (monkeypox) in 2022: A systematic review and meta-analysis. Pathogens. 2023;12(1):146. Available from: https://doi.org/10.3390/pathogens12010146
  15. Likos AM, Sammons SA, Olson VA, Sun Y, Wu X, Peng X, et al. A tale of two clades: Monkeypox viruses. J Gen Virol. 2005;86(10):2661-72. Available from: https://doi.org/10.1099/vir.0.81215-0
  16. Rimoin AW, Mulembakani PM, Johnston SC, Smith JOL, Kisalu NK, Kinkela TL, et al. Major increase in human monkeypox incidence 30 years after smallpox vaccination campaigns cease in the Democratic Republic of Congo. Proc Natl Acad Sci U S A. 2010;107(37):16262-7. Available from: https://doi.org/10.1073/pnas.1005769107
  17. Chen X, Anstey AV, Bugert JJ. Molluscum contagiosum virus infection. Clin Dermatol. 2006;24(2):131-9. Available from: https://doi.org/10.1016/j.clindermatol.2005.11.007
  18. Learned LA, Reynolds MG, Wassa DW, Li Y, Olson YA, Karem K, et al. Extended interhuman transmission of monkeypox in a hospital community in the Republic of the Congo, 2003. Am J Trop Med Hyg. 2005;73(2):428-34. Available from: https://doi.org/10.4269/ajtmh.2005.73.428
  19. McCollum AM, Damon IK. Human monkeypox. Clin Infect Dis. 2014;58(2):260-7. Available from: https://doi.org/10.1093/cid/cit703
  20. Damon IK. Status of human monkeypox: Clinical disease, epidemiology and research. Vaccine. 2011;29 Suppl 4:D54-9. Available from: https://doi.org/10.1016/j.vaccine.2011.04.014
  21. Adler H, Gould S, Hine P, Snell LB, Wong W, Houlihan CF, et al. Clinical features and management of human monkeypox: A retrospective observational study in the UK. Lancet Infect Dis. 2022;22(8):1153-62. Available from: https://doi.org/10.1016/S1473-3099(22)00228-6
  22. Sklenovská N, Van Ranst M. Emergence of monkeypox as the most important orthopoxvirus infection in humans. Front Public Health. 2018;6:241. Available from: https://doi.org/10.3389/fpubh.2018.00241
  23. Thornhill JP, Barkati S, Walmsley S, Rockstroh J, Antinori A, Harrison JB, et al. Monkeypox virus infection in humans across 16 countries, April–June 2022. N Engl J Med. 2022;387(8):679-91. Available from: https://doi.org/10.1056/NEJMoa2207323
  24. World Health Organization. Multi-country monkeypox outbreak in non-endemic countries. Geneva: WHO; 2022. Available from: https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON388
  25. Grant R, Nguyen LL, Breban R. Modelling human-to-human transmission of monkeypox. Bull World Health Organ. 2020;98(9):638-40. Available from: https://doi.org/10.2471/BLT.19.242347
  26. Kumar N, Acharya A, Gendelman HE, Byrareddy SN. The 2022 outbreak and the pathobiology of the monkeypox virus. J Autoimmun. 2022;131:102855. Available from: https://doi.org/10.1016/j.jaut.2022.102855
  27. Ogoina D, Iroezindu M, James HI, Oladokun R, Yinka-Ogunleye A, Wakama P, et al. Clinical course and outcome of human monkeypox in Nigeria. Clin Infect Dis. 2020;71(8):e210-4. Available from: https://doi.org/10.1093/cid/ciaa143
  28. Vaughan A, Aarons E, Astbury J, Brooks T, Chand M, Flegg P, et al. Human-to-human transmission of monkeypox virus, United Kingdom, October 2018. Emerg Infect Dis. 2020;26(4):782-5. Available from: https://doi.org/10.3201/eid2604.191164
  29. Reed KD, Melski JW, Graham MB, Regnery RL, Sotir MJ, Wegner MV, et al. The detection of monkeypox in humans in the Western Hemisphere. N Engl J Med. 2004;350(4):342-50. Available from: https://doi.org/10.1056/NEJMoa032299
  30. Petersen E, Kantele A, Koopmans M, Asogun D, Yinka-Ogunleye A, Ihekweazu C, et al. Human monkeypox: Epidemiologic and clinical characteristics, diagnosis, and prevention. Infect Dis Clin North Am. 2019;33(4):1027-43. Available from: https://doi.org/10.1016/j.idc.2019.03.001
  31. Jezek Z, Grab B, Szczeniowski MV, Paluku KM, Mutombo M. Human monkeypox: Secondary attack rates. Bull World Health Organ. 1988;66(4):465-70.
  32. Kaler J, Hussain A, Flores G, Kheiri S, Desrosiers D. Monkeypox: A comprehensive review of trans-mission, pathogenesis, and manifestation. Cureus, 2022;14(7), e26531. Available from: https://doi.org/10.7759/cureus.26531

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