Abstract
Compared to 2022, the global situation regarding Mpox, formerly known as monkeypox, has significantly changed and is expected to continue evolving until 2026. It has become an international public health crisis as a disease that nobody paid attention to before but has now captured international concern, especially in those countries in Central and West Africa (PHEIC). Subsequent to the widespread transmission of Clade IIb in 2022, mainly among sexual networks outside of Africa, a new highly virulent Clade Ib strain of the virus appeared at the end of 2023 in the Democratic Republic of the Congo (DRC). In this paper, the surveillance, genetic, and clinical information related to the multi-country outbreak of 2022, with particular focus on the rising Clade Ib epidemic up to 2026, will be discussed. We consider the changes in the transmission and juxtapose the sexual transmission of Clade IIb with the sexual and household spread, which has mainly occurred among children in East Africa and is mainly of Clade Ib. We review ongoing treatment, evaluate the outcomes of the PALM007 trial of tecovirimat, and examine the science of combination therapy. Specifically, we analyze in silico and in vitro evidence that can justify the concept of using natural products as supplementary countermeasures, which include Curcuma longa, Withania somnifera, and Azadirachta indica. Lastly, we present the strategies of public health, particularly in the areas where there is a deficiency in surveillance, and we present the plans of vaccination and certain issues in high-neck places like India.
Keywords: Mpox Clade Ib, Genomic Surveillance, Tecovirimat, PALM007, Integrative Medicine, Phytochemicals.