Mohamud Sheek-Hussein1, Ahmed R. Alsuwaidi2, Emma A. Davies3, Fikri M. Abu-Zidan4

1Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
2Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
3Department of Virology, Manchester University NHS Foundation Trust, Manchester, UK
4The Research Office, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates

Keywords: Emergency, human monkeypox, orthopoxvirus, pandemic, public health, transmission, vaccine


Monkeypox (MPXV) is an emerging zoonotic disease carrying a global health threat. Using a multi disciplinary approach, we review the current MPXV virus infection outbreak including virology, prevention, clinical presentation, and disaster management. MPXV is caused by a double stranded deoxyribonucleic acid virus. Despite its clinical similarities with smallpox, it is less severe with low mortality. Human to human transmission occurs through prolonged direct or close contact, or through blood, body fluids, or mucosal lesions. Risk groups include frontline health workers who care for MPXV patients, household members of an infected patient, and men who have sex with men. Skin lesions are usually, but not always, at the same stage. They may affect the face followed by the distal extremities with fewer lesions on the trunk (centrifugal distribution). Lesions may involve the mouth, genitalia, conjunctiva, and rectum. The majority of cases are mild. Nevertheless, the disease may have long term effects on the skin, the neurological system, and the eye. Vaccination against MPXV is available but meanwhile should be limited to those who are at high risk. Those vaccinated against smallpox (usually older than 40 years) might be immune against MPXV. Infectious diseases are without borders. If proper action is not taken, there is considerable risk that MPXV will be entrenched worldwide. Our world has a delicate balance between animals, environment, and humans reflecting the need for a “one globe, one health approach” to address this risk. Following the principles of disaster management and using the lessons we have learned from the COVID-19 pandemic will reduce the impact of the MPXV outbreak.

How to cite this article: Sheek-Hussein M, Alsuwaidi AR, Davies EA, Abu-Zidan FM. Monkeypox: A current emergency global health threat. Turk J Emerg Med 2023;23:5-16.

Ethics Committee Approval

Data of the review are public published data. The study does not require ethical approval.

Author Contributions

All autors have contributed to the idea. Mohamud Sheek‑Hussein retrieved the literature on the public health section and vaccination and wrote it. Ahmed Alsuwaidi retrieved the literature on the clinical management section and wrote it. Emma Davies retrieved the literature on the virology section, wrote it, and drew two of the illustrations. Fikri Abu‑Zidan supervised the project, retrieved the literature on the disaster medicine section and wrote it, organized the structure of the manuscript, drew two of the illustrations, and repeatedly edited the manuscript. All authors read and approved the final version of the paper. All authors have contributed equally to this manuscript.

Conflict of Interest

None declared.

Financial Disclosure



The authors thDr Stephanie Thomas, Consultant Medical Microbiologist, Manchester University Foundation Trust, for her constructive suggestions and guidance during the planning stage of this review.