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Dr Mohan Z Mani

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Thiruvalla, Kerala
On Sep 2018

Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."

Prof. Somashekhar Nimbalkar
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Ex-Member, Governing Body, National Neonatology Forum, New Delhi
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Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018

Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."

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Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018

Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
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Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
On Sep 2018

Dr. Arunava Biswas

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Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."

Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata

Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
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Muzaffarnagar Medical College,
On Aug 2018

Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".

Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
On Aug 2018

Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".

Dr. Mamta Gupta
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018

Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.

Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."

Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
On May 11,2011

Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."

Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
On April 2011

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.

Dr. Anuradha
On Jan 2020

Important Notice

Year : 2023 | Month : March | Volume : 17 | Issue : 3 | Page : EE01 - EE04 Full Version

Monkeypox Pathogenesis, Transmission, Preventive Measures and Treatment Modalities

Published: March 1, 2023 | DOI:
Vaishnavi Uttam Goradwar, Anil Agrawal

1. 2nd Year MBBS Student, Jawaharlal Nehru Medical College, Wardha, Maharashtra, India. 2. Professor, Department of Pathology, Jawaharlal Nehru Medical College, Wardha, Maharashtra, India.

Correspondence Address :
Vaishnavi Uttam Goradwar,
2nd Year MBBS, Department of Medicine, Jawaharlal Nehru Medical College, Wardha, Maharashtra, India.


Monkeypox is a disease transmitted through animals but can also spread from human to human. The causative agent is monkeypox virus which is a ds-DNA virus. Monkeypox virus belongs to the orthopox genus of the poxviridae family. Other members of this family are the variola virus and the vaccinia virus. This virus was first discovered in 1958. In 1970, when various types of research were going on to eradicate smallpox, the first case of smallpox in humans was reported in the Democratic Republic of Congo. Both smallpox and monkeypox share the same clinical features. Other symptoms are adenopathy and papular rashes. Monkeypox can spread through various modes of transmission. The most common mode is direct contact with contagious animals or contagious humans. Disease progression can be limited by spreading awareness, among the people about the factors responsible for transmission, clinical manifestations, and preventive methodologies.


Poxvirus, Smallpox, Viremia, Zoonotic disease

Viruses belonging to the Poxviridae family are enveloped and possess ds-DNA (1). Transmission of the monkeypox virus is infrequent in humans are the common hosts of poxviruses are non human primates, rodent, and rabbit (2). According to taxonomical classification, the Poxviridae family is again classified into two families: Chorodopoxvirinae and Entomopoxvirinae (3). The Chorodopoxvirinae family is further categorised into 18 genera. Smallpox virus and monkeypox virus have similar clinical presentations (4). World Health Organisation (WHO) announced the global monkeypox outburst an international emergency, more than 16,000 patients over more than 70 countries had been infected with the virus. Only five patients had died, and no one outside of Central and West Africa, where the disease is endemic. This shows a mortality in the current global outburst of approximately 0.03%.

Yet, as per the reports of WHO, mortality rate of monkeypox is approximately 3-6% years (5). In the early 1970’s, monkeypox was noticed only in hosts other than humans (6). Patients belonged to 42 states, of over five WHO regions, from 1st January 2022. Overall, diagnosed cases were 2103 from 1st January to 15th June 2022 , which included one fatal case and one infected case. From May 2022, maximum patients were seen (7).

Pathogenesis of Monkeypox

The Central African (Congo Basin) clade and the West African clade are two definite genetic clades of the monkeypox virus. The Congo Basin clade is more virulent and is responsible for greater severity (8). During the 2003 US outburst, a higher rate of fatality, morbidity, viremia, and human-to-human transmission was related to the Congo Basin clade of Monkeypox virus (6). Genomic comparison between Central and West African strains resulted in a set of genes that may be comprised in categorising clade virulence. Central African Monkeypox prevents T-cell stimulation, which inhibits secretion of cytokines of inflammation in human cells deriving from the individuals infected earlier with monkeypox (8). Hammarlund E et al., observed that in the presence of fewer monkeypox viruses, the immune response which was T-cell mediated was reduced by 75%. This indicates that host T-cell responses are decreased by a regulator that is produced by monkeypox (9).

The monkeypox virus inhibitor of complement enzyme is not present in West African strains. This enzyme contributes to viral virulence and also regulates the host’s immune system (10). This strain decreases the host reactions, by inducing cell death in the host (8). Some research says that Central African monkeypox silences the gene transcription which is involved in the immunity of the host (11). Poxviruses are ds-DNA viruses that multiply in the cytoplasm of cells of vertebrates (12). Usually, DNA viruses undergo replication, and genome expression takes place in the nucleus, but this doesn’t happen in Poxviruses (13). Poxviruses mostly depend on proteins coded by viruses. They help the viruses to multiply in the cytoplasm (14). The center of the genome possess genes which perform functions, such as viral transcription, on the other end those found at the terminal end are responsible for virus-host interactions (15). A total of 150 genes are encoded by the poxviruses, out of which, 50 are seen in sequenced members of the family, and 90 are common within the subfamily of chordopoxviruses (16). Most of the viral conserved genes are related to their functions and form the center of the genome (12).

The proteins responsible for regulatory actions against the host’s immune system can be divided in two classes based on whether they function inside the cell or outside the cell as mentioned in (Table/Fig 1). Proteins which are present inside the cell are virotransducer proteins and virostealth proteins. The former play an important role as it interferes with the cell’s response to the infection (17),(18), while the latter decrease the possibility of identification of the viral particle by the host’s immune system (12). (Table/Fig 1) shows two different categories of viromimic proteins. These two proteins play a major role in regulating the response of the immune system. The viroreceptors found as glycoproteins on the cell membrane competitively bind to cytokines and chemokine of the host (17),(18). As a result, virokines mimic cytokines, chemokines, and growth factors of the host. These proteins decrease the host reaction that, interferes with the survival of viruses and also promotes signals for replication of viruses (4). These regulatory proteins function simultaneously to destroy the host’s immune response to facilitate the multiplication of viruses.


Monkeypox can spread through various modes of transmission. The most common mode is direct contact with contagious animals or contagious humans (Table/Fig 1). Most human infections are due to close contact with contagious animals (7). Symptoms and late manifestations are shown in (Table/Fig 2) (19). Transmission from animal to human can be through close contact. Viruses shed in faeces can be another source of infection (20). Some areas of Africa have scarce resources and infrastructure due to which people sleep outside in open areas or stay near forests, where infectious animals are commonly found (19). Food scarcity in certain regions can also lead to people with no option, but to hunt and cook small animals, which make them more vulnerable to monkeypox infection. Human-to-human transmission mostly occurs due to prolonged contact of respiratory droplets or direct contact, with lesions of the infected individual (21). Other sources of contamination are sharing the same beds, living in the same rooms or sharing the same dishes for eating food, and sharing the same household. Other modes of transmission can be close contact with infected articles and direct contact with lesions of an affected patient. Both monkeypox and smallpox share same infectious pathway, which begins with exposure to the respiratory droplets of the susceptible host. The later virus multiplies at the point of entry.

Clinical Manifestations

After viral replication is completed, the virus proliferates to surrounding lymph nodes. During secondary viremia, the virus 2reaches the distant lymph node and organs through blood. This complete course is the incubation period, which usually lasts for 7-14 days. No clinical manifestations are seen during the incubation period and hence this period is non infectious (22). The manifestations of monkeypox can be seen during the prodromal phase. During the prodromal stage, the person is highly contagious. This is because of manifestations like mucocutaneous lesions and enlargement of lymph nodes. The common non specific manifestations are shown in (Table/Fig 2). These symptoms start to appear 1-2 weeks after an individual has contracted monkeypox (23). During the prodromal stage, common manifestations that activate the immune system appear like pyrexia, myalgia, enlargement of lymph nodes, etc. Early triggering of the immune system will lead to lymphadenopathy of various sites such as maxillary, cervical, and inguinal along with the beginning of fever. In recent cases, Harris E stated that for few patients, the symptoms of the prodromal stage can be mild or even go unnoticed, indicating that such patients might be unaware of the infection till the rashes appear (24). In common situations, the temperature decreases on day 1 or upto 3 days after the beginning of rashes. The rashes first appear on the face and then appear centrifugally all over the body (7). The lesions which can be observed in the mouth and these lesions can lead to difficulty in eating and drinking for the patient. These skin lesions lead to excess perturbation of the skin and this can be an opportunity for a secondary infection to occur such complications have been noted in 20% of unvaccinated monkeypox patients (25). A distinct presentation of rashes is seen in infected patients.

The classic observation seen in monkeypox infection is a disseminated vesiculopapular rash (26). This rash goes through many stages before entering the desquamation stage. This is the stage where scabs begin to peel off. All these lesions manifest first as enanthem, macule, and papule and then as vesicle and pustule (27). All the above lesions tend to become crusted within 2-4 weeks (23). Lesions first appear on the tongue and mouth, then on the skin. These lesions are called enantham. The individual is labeled as non infectious, once the crusted lesions are peeled off. This process is known as desquamation. In some individuals, scars persist once the scab is peeled off. Few cases often manifest as areas of excessive pigmentation and less pigmentation, where the rashes are highly concentrated (28). In some primates, it has been observed that the severity of the lesion increases as the pustule formation occurs along with rapid ulcer formation, necrosis, and hyperplasia of the interstitium (23). Further, oedema can be prominently seen at the margins of the area of necrosis. The appearance of inflammation and necrosis indicates that preventive measures are needed to avoid secondary bacterial infections and skin infections (26).

Infected individuals suffer from severe dehydration which occurs due to Gastrointestinal (GIT) manifestations like vomiting and diarrhoea that arise by the 2nd week of infection. The throat and mouth ulcers cause complications with the maintenance of nutrition, furthering possibilities of dehydration in the cases (27). Vaccinated individuals have fewer complications related to a monkeypox infection as compared to unvaccinated individuals (8). Because of cross-immunity, people who received vaccination against smallpox in the early 1970's are having fewer chances to develop complications related to monkeypox virus infection. Due to extremely increased immune responses, septic shock and sepsis may also occur (26). Monkeypox virus infection is usually self-limiting although long-term complications are barely seen. Lobular pneumonia is a late manifestation of monkeypox infection. It is generally found in people that, are also infected with the influenza virus. Lobular pneumonia and severe inflammation can limit the intake of air and decreases the ability of food and fluid intake in the patient (26).

Preventive Measures

A two-fold approach is required for the anticipation. The primary aim must be, to quickly cure the ones who are infected and facilitate care after the exposure to reduce the emergence of infection. The second aim will be to make vaccines accessible. The initial step toward preventing the dispersal is to increase awareness among people and increased surveillance of present cases (29),(30). The information gained from the COVID-19 pandemic can be utilised as certain evidence-based precautionary methods are lacking (31). From coronavirus pandemic, we learned that prior diagnosis, and isolation of infectious patients, are necessary for a community to be aware to decrease the spread of viral endemics and pandemics (32). To prevent discrimination, we need to minimise or avoid stigmatisation and optimise disease response. Educational campaigning about the transmission and spread of the disease will aid in minimising the stigma among the common people (33).


Monkeypox virus requires several weeks for recovery, as it is a self-limited disease that doesn’t require any clinical assistance. However, some patients may require to be hospitalised and may require additional care due to unavoidable symptoms. Anti-viral drug therapy is advised for those patients who are at high-risk of getting infected. Treatment of monkeypox involves the administration of multiple antiviral drugs (34),(35). Tecovirimat is a drug of choice, for many patients among all the available antivirals. Combined treatment of tecovirimat and cidofovir may also be beneficial in patients with severe infections (27).

Tecovirimat: Both oral and intravenously (i.v.) forms of Tecovirimat are available. VP37 Protein present in Orthopoxovirus is inhibited by this medication, therefore, the interactivity between the virus and the host cell is blocked. This results in the prohibition of the virus and prevents the host cell from infection. The i.v. dose of tecovirimat depends on the functions of the kidney and the weight of the patient; the duration of treatment is 14 days. There is no contraindication when the drug is administered orally (27). Tecovirimat is considered to be the first-line treatment in pregnant and lactating females. The dosage used in the study of animals was 23 times greater than the dosage used in humans, yet it didn’t show any particular effect on the animal foetus (27).

Cidofovir: Studies in animals demonstrated that Cidofovir is effective against monkeypox (36). Severe acute kidney failure can occur in high doses of Cidofovir (37). Patients that are to be given Cidofovir should also be given saline intravenously for rehydrating the patient and probenecid orally (38). Based on studies, it is indicated that this drug can cause cancer and developmental malformations. The drug has the risk of developing neutropenia; hence, while taking this drug the neutrophil count of a patient must be monitored. There is a threat of liver impairment along with pancreatitis and metabolic acidosis. This drug is contraindicated in pregnant females, as it can cause developmental malformations in the foetus. Cidofovir, brincidofovir should be avoided in lactating females due to its severe adverse effects (26).


Monkeypox can be transmitted through various modes of transmission. The most common mode is direct contact with contagious animals or contagious humans. Monkeypox virus is a self-limiting disease which requires some weeks for recovery. Individuals suffer from dehydration, throat and mouth ulcers. Disease progression can be limited by spreading awareness among the people about the factors responsible for transmission, clinical manifestations, and preventive methodologies.


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DOI and Others

DOI: 10.7860/JCDR/2023/60630.17563

Date of Submission: Oct 07, 2022
Date of Peer Review: Nov 08, 2022
Date of Acceptance: Dec 06, 2022
Date of Publishing: Mar 01, 2023

• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? No
• For any images presented appropriate consent has been obtained from the subjects. NA

• Plagiarism X-checker: Oct 08, 2022
• Manual Googling: Nov 22, 2022
• iThenticate Software: Dec 05, 2022 (6%)

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