Mpox (monkeypox) pathfinder

This summary covers the epidemiology, diagnosis, management and follow up treatment for mpox. Includes coverage of vaccines and therapeutics.

This topic reviews the virology, epidemiology, clinical manifestations, and diagnosis of mpox.

This topic reviews the treatment and prevention of mpox. Contains a section covering antiviral therapy.

This topic will address the virology of vaccinia virus, available vaccines, vaccination procedures, contraindications, and adverse events.

The profile identifies, assesses the quality, categorizes and briefly summarizes the emerging scientific literature. It includes key findings on epidemiology, prevention and control, clinical presentation and treatment. | Bhuiya A, DeMaio P, Bain T, Al-Khateeb S, Wang A, Sharma K, Alam S, El-Kadi A, Vélez CM, Soueidan S, Loeb M, Lavis JN, Wilson MG. Living evidence profile #6.9: What is the best-available evidence related to the monkeypox outbreak? Hamilton: McMaster Health Forum, 15 September 2022.

Tecovirimat is an oral antiviral therapy approved in Canada for the treatment of human smallpox disease in adult and pediatric patients weighing at least 13 kg. While tecovirimat is only approved for the treatment of smallpox, CADTH conducted a review of the evidence and convened an Implementation Advice Panel to prioritize the patient populations that are most likely to benefit from tecovirimat for the treatment of human monkeypox infection. | CADTH (Candian Agency for Drugs and Technologies.

The objective of this reviews is to assist policymakers, health professionals, and consumers in making appropriate decisions for the treatment of mpox.
There are two parts to this Cochrane Review: a review of evidence from randomized controlled trials (RCTs), and a narrative review of safety data from non‐randomized studies.
Authors' conclusions: Randomized controlled trials review - This review found no evidence from randomized controlled trials concerning the efficacy and safety of therapeutics in humans with mpox.
Authors’ conclusions: Non‐randomized studies review - Very low‐certainty evidence from non‐randomized studies indicates no serious safety signals emerging for the use of tecovirimat in people with mpox infection. In contrast, very low‐certainty evidence raises a safety signal that brincidofovir may cause liver injury. This is also suggested by indirect evidence from brincidofovir use in smallpox. This warrants further investigation and monitoring.