The document provides a detailed overview of mpox (monkeypox), a viral zoonotic disease caused by the monkeypox virus. It covers its clinical features, diagnostic criteria, management strategies, and treatment options, including vaccination and antiviral agents. Key symptoms include rashes starting from the face and spreading, and the document emphasizes the importance of patient isolation and supportive care.

1. Dr. S CHANDRASEKAR, MD
HOD & PROFESSOR OF MEDICINE
DEPT. OF GENERAL MEDICINE
SMC

2. WHY??
WHO declares Mpox outbreak global public
health emergency

3. INTRODUCTION
 Viral zoonotic disease
 MPXV is enveloped double stranded DNA
belonging to Orthopoxvirus genus of
Poxviridae family.
 2 strains
Clade 1
(deadlier)
Clade 2

5.  INCUBATION PERIOD
Usually 6-13 days but can range from
5 to 21 day.
 PERIOD OF COMMUNICABILITY
1 to 2 days before the rash to until all the
scabs falls off or subsided

6. SUSPECTED CASE PROBABLE CASE CONFIRMED CASE
History of travel to
affected countries within
last 21 days presenting
with unexplained acute
rash AND 1 or more of
the following symptoms
1. Swollen lymph nodes
2. Fever
3. Headache
4. Body ache
5. Profound weakness
Person meeting case
definition of suspected
case, clinically compatible
illness and has
epidemiological link like
face to face exposure,
direct physical contact
with skin lesions, health
care workers without PPE
A case which is laboratory
confirmed for monkey pox
virus by RT -PCR

10. CLINICAL FEATURES

11. PRODROMAL PHASE

12. SKIN INVOLVEMENT
• ENANTHEM – First lesions on tongue and
mouth
• CENTRIFUGAL SPREAD - Macules starts from
face spreading to arms, legs, palms and soles
within 24 hours.
• Follows macular, papular,vesicular and
pustular phase. Classic is vesicopustular.
• Predilection to palms and soles is
characteristic of Monkey pox.

13. STAGES OF RASH
4 -5 DAYS 5-6 DAYS 6-7DAYS

14. RASHES IN MPOX
4 -5 DAYS 5-6 DAYS 6-7DAYS

18. COMPLICATIONS
• Secondary infections
• Pneumonia
• Sepsis
• Encephalitis
• Corneal involvement can lead to loss of vision

19. DIAGNOSIS
Traveller from outbreak /endemic region or community transmission
ASYMPTOMATIC Observe for development of any signs and symptoms
for 21 days.
SYMPTOMATIC
(RT –PCR)
RASH PHASE RECOVERY PHASE
• Lesion roof
• Lesion fluid
• Lesion base
• Lesion crust
• Naso or oropharyngeal
swab
• Blood
• Urine
• Blood
• Urine

20. DIAGNOSTIC MODALITIES
a) PCR for orthopoxvirus genus(Cowpox, buffalopox,
camelpox,MONKEYPOX)should be done
b) If positive,then confirm with monkeypox specific
conventional or real time PCR.
c) Additional virus isolation and Next generation
sequencing will be done

21. MANAGEMENT
1. Patient isolation
2. Protection of compromised skin and mucous
membrane
3. Rehydration threapy and Nutritional support
4. Symptom allievation
5. Montioring and treatment of complications

24. ANTIVIRAL AGENTS
• TECOVIRIMAT(TPOXX) –STOMP Trial
• BRINCIDOFOVIR
• VACCINIA IMMUNE GLOBULIN
INTRAVENOUS(VIGIV)
• CIDOFOVIR

28. VACCINE
• JYNNEOS - CDC recommended vaccine
• 2 doses with 4 weeks apart
intradermally(0.1ml) or s/c (0.5ml)in high risk
groups
• Vaccine effectiveness -66 to 89%

29. THANK YOU

30. • Some people, the first symptom of mpox is a rash, while others may have
fever, muscle aches or sore throat first.
• The mpox rash often begins on the face and spreads over the body,
extending to the palms of the hands and soles of the feet. {It can also start
on other parts of the body where contact was made, such as the genitals}.
• Rash starts as a flat sore, which develops into a blister filled with liquid that
may be itchy or painful. As the rash heals, the lesions dry up, crust over and
fall off.
• Some people may have one or a few skin lesions and others have hundreds
or more. These can appear anywhere on the body including: palms of hands
and soles of feet face, mouth and throat groin and genital areas anus.
• Note: Blisters are a feature of Chicken Pox but chicken pox is not usually
associated with Swollen Lymph Nodes Secondly Mpox blisters are mainly on
palms and soles

31. TREATMENT
• Supportive treatment, pain fever
management nutrition hydration Isolation.
Prevention of secondary infection
Medication Tecovirimat, not yet freely
available but as trial enrollment