Transmission
MPX is a zoonotic disease. The natural reservoir for MPX has not yet been identified, but it is thought that rodents could be the most likely reservoir for this particular virus. Transmission of MPXV from animals to humans can occur in contact with the body fluids of infected animals or when scratched by infected animals, and transmission through urine and feces may be an additional source of infection (Fig. 5). Interpersonal transmission can occur through continuous face-to-face contact with large respiratory droplets, or through direct contact with viral lesions, body fluids, and through virally infected materials such as bedding and clothing, etc [60]. According to the Centers for Disease Control and Prevention (CDC), MXPV transmission is more likely to come from intimate person-to-person contact, including kissing, hugging, sex, or touching body parts with MPX sores [61]. Mother-to-child transmission can also occur through the placenta during and after birth through close contact [61]. The first major outbreak of MPX in 2022 in a non-endemic country mainly affected men (homosexual or bisexual) [62,63]. Unlike other viral diseases such as SARS-CoV-2 infection, MPXV-infected individuals seem to spread only after the first symptoms appear [64]. It is not clear whether MPXV can be transmitted through semen and vaginal fluids.