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mpox monkeypox viral illness caused virus species genus orthopoxvirus continues threat today upsurge cases democratic republic congo countries clades raised concern vaccines vaccination considered public health interventions common symptoms skin rash mucosal lesions last 2a4 weeks accompanied fever headache muscle aches back pain low energy swollen lymph nodes transmitted close contact contaminated materials infected animals pregnancy passed fetus newborn birth treated supportive care attention nutrition hydration prevention secondary infections treatment including hiv present epidemic