**Background:** The monkeypox virus, a double-stranded DNA virus of the Orthopoxvirus genus, was first identified in laboratory monkeys in 1958 and in humans in 1970 in the Democratic Republic of the Congo. Historically endemic to West and Central Africa, the virus has caused sporadic outbreaks outside Africa, notably in the United States in 2003. However, the current outbreak beginning in May 2022 is unprecedented in scale and geographic spread: as of the review's writing, 86,930 laboratory-confirmed cases and 1051 probable cases have been reported worldwide, with 116 fatalities. For the first time, most cases occurred in countries without direct epidemiological links to endemic regions, prompting the WHO to declare a Public Health Emergency of International Concern on 23 July 2022. The review aims to consolidate information on the virus's spread, transmission, clinical presentation, and management to aid frontline healthcare workers.
**Methods:** This is a narrative review of the literature. The authors do not specify a systematic search strategy, inclusion/exclusion criteria, or quality assessment. They synthesized information from published studies, WHO reports, and other official sources to describe the virology, epidemiology, transmission, pathogenesis, clinical features, diagnosis, prevention, and treatment of monkeypox.
**Key Results:** The review reports that the current outbreak is predominantly caused by the West African clade, which has a lower case-fatality rate (<4%) compared to the Central African clade (≈11% in unvaccinated individuals). Epidemiologically, 96.9% of cases are male, with a median age of 34 years; 84.8% of cases occur in men who have sex with men, and 81.71% of transmissions are linked to direct skin/mucosal contact during sexual activities. Over half of cases with known HIV status are HIV-positive. The incubation period ranges from 5 to 21 days. Clinically, 58% of patients experience prodromal symptoms (fever, headache, myalgia, lymphadenopathy), followed by a rash that typically begins on the face (95% of cases) and palms/soles (75%). In the current outbreak, anogenital and perioral lesions are common, with oral mucosal involvement in 70% of cases. The disease is self-limiting within 2–4 weeks, but complications include pneumonia, encephalitis, kidney injury, myocarditis, and secondary infections. The case-fatality ratio is estimated between 1% and 10%. Diagnosis is confirmed by PCR of skin lesions. Prevention relies on smallpox vaccination (≈85% efficacy), with MVA-BN (JYNNEOS) and ACAM2000 vaccines available. Post-exposure vaccination within 4 days can prevent disease, and within 14 days may reduce severity. Treatment is supportive; Tecovirimat has been authorized by the EMA for monkeypox but is not widely available.
**Clinical Implications:** The review emphasizes that monkeypox should be considered in the differential diagnosis of patients presenting with rash, especially if they have epidemiological risk factors such as male sex, men who have sex with men, HIV positivity, or recent sexual contact. Early diagnosis via PCR is critical for containment. Healthcare workers should use personal protective equipment when caring for suspected cases. Vaccination is recommended for high-risk groups and post-exposure prophylaxis. Supportive care and monitoring for complications are the mainstays of management. The authors advocate for a One Health approach integrating human, animal, and environmental health to understand and control the outbreak.