ABSTRACT Background With the re‐emergence of monkeypox (Mpox), it is vital for communities to assess and effectively respond to emerging outbreaks. This paper aims to review the potential of clade I Mpox to result in a widespread outbreak by assessing genetically enhanced virulence, transmission, and clinical manifestations. It highlights antiviral therapies, vaccine strategies, and public health initiatives that offer adaptive guidance for policy and management strategies. Methods A comprehensive literature search written in English was conducted using the PubMed, Scopus, Web of Science, World Health Organization, and the Center for Disease Control and Prevention sources to compile the most up‐to‐date information on Mpox. Results The Mpox virus has evolved into two genetically and clinically distinct clades: clade I (Central African) and clade II (West African). Previously, Clade II strains caused a 2022–2023 global outbreak. Genetic mutations in clade I strains have resulted in higher virulence, immune evasion capabilities, and case‐fatality rates, causing concern for a future pandemic. To effectively protect against, treat, and contain clade I Mpox, a substantial understanding of its virological, clinical, and epidemiological characteristics is essential. Given the recent history of pandemics, there is much reason to be forward‐looking to elicit a more effective response to the next one. Clade I Mpox is better adapted to evade and suppress the human immune response, rendering it more lethal. The similarities to smallpox allow for vaccines tailored for smallpox to be used to prevent Mpox, with good efficacy. Furthermore, some drugs can be used to treat active infections, targeting various components of the Mpox life cycle. Conclusion Among Mpox clades, clade I is more of a concern as it is more lethal. A solid understanding of the clinical presentation and routes of transmission, measures could be better taken to identify cases and take the proper steps to avoid the spread.
Rahman et al. (Fri,) studied this question.