Mpox [Monkeypox]: New Dynamics of Transmission

Transmission Mechanisms in Recent Outbreaks

Recent epidemiological manifestations of monkeypox have revealed a shift in the pathogen’s spread dynamics, establishing intimate skin-to-skin contact as one of its most efficient routes of transmission.

Although historically the virus was transmitted through exposure to respiratory droplets or contact with contaminated wound material, contemporary outbreaks have been characterized by direct transmission during close and prolonged physical contact.

The exchange of bodily fluids and repeated friction against the urogenital mucous membranes of an infected individual facilitate the massive transfer of viral particles to the epidermal microtraumas of a healthy person.

This characteristic has transformed the pattern of the disease’s spread, concentrating chains of transmission within social networks involving high levels of physical interaction.

Recognition of this direct mechanism has been essential for adapting public health strategies and focusing vaccination and prevention efforts on the most vulnerable populations.

Atypical mucocutaneous lesions

The clinical presentation of the virus in recent transmission dynamics differs from classic cases, with primary skin manifestations concentrated in the anogenital region and the oral cavity.

Unlike the traditional pattern, in which pustules were distributed uniformly and widely across the face and extremities, affected patients now present with ulcerative lesions, painful vesicles, and circumscribed papules almost exclusively at the sites of initial physical contact.

These epithelial abnormalities are often accompanied by severe inflammation of the rectum, known as proctitis, which causes acute anal pain, tenesmus, and bleeding during bowel movements.

Because these skin lesions may be few in number or clinically mimic those caused by the herpes virus or syphilis, diagnosis can be significantly delayed.

Confirming the presence of the condition through polymerase chain reaction (PCR) testing is essential for isolating the patient and halting the spread of the lesions.

Summary

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