Monkeypox Outbreak: an Overview of Potential Therapeutic Options

Opinion statement Monkeypox is an emergent pathogen that can be transmitted between humans and certain animal reservoirs. Although monkeypox belongs to orthopoxviruses including variola virus (smallpox) and resembles signs and symptoms of smallpox infection, it is rarely fatal. However, it may cause serious complications and death. In this review, we aim to summarize data on potential treatments for monkeypox infection. We found three antivirals (i.e., cidofovir, brincidofovir, and tecovirimat) posing antiviral activity against orthopoxviruses and having potential activity against monkeypox. Vaccinia immunoglobulin may be considered pre- or post-exposure prophylaxis against the monkeypox virus. Bisexual, gay, and men having sex with other men, Hispanic and black individuals, and immunocompromised patients may be at higher risk for severe infection and complication. So, they may be prioritized in terms of vaccination and preventive measures against MPXV. Symptomatic management and adequate public health measures are the foremost care line. The earlier administration of antivirals, the better clinical outcomes. There is a lack of evidence-based clinical guidelines. Robust research into MPX treatment and prevention is urgently needed. Moreover, clear recommendations for special populations including immunocompromised patients (e.g., HIV patients), pregnant women, and children are required. Also, secondary complications such as bacterial infections, psychological complications, and keratitis should be considered.