Emergence of mpox in the post-smallpox era-a narrative review on mpox epidemiology.


Journal

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
ISSN: 1469-0691
Titre abrégé: Clin Microbiol Infect
Pays: England
ID NLM: 9516420

Informations de publication

Date de publication:
Dec 2023
Historique:
received: 11 03 2023
revised: 09 07 2023
accepted: 08 08 2023
medline: 29 11 2023
pubmed: 14 8 2023
entrez: 13 8 2023
Statut: ppublish

Résumé

The 2022 mpox outbreak drew global attention to this neglected pathogen. While most of the world was taken by surprise, some countries have seen this pathogen emerge and become endemic several decades prior to this epidemic. This narrative review provides an overview of mpox epidemiology since its discovery through the 2022 global outbreak. We searched PubMed for relevant literature about mpox epidemiology and transmission through 28 February 2023. The emergence of human mpox is intertwined with the eradication of smallpox and the cessation of the global smallpox vaccination campaign. The first human clade I and II monkeypox virus (MPXV) infections were reported as zoonoses in Central and West Africa, respectively, around 1970 with sporadic infections reported throughout the rest of the decade. Over the next five decades, Clade I MPXV was more common and caused outbreaks of increasing size and frequency, mainly in the Democratic Republic of the Congo. Clade II MPXV was rarely observed, until its re-emergence and ongoing transmission in Nigeria, since 2017. Both clades showed a shift from zoonotic to human-to-human transmission, with potential transmission through sexual contact being observed in Nigeria. In 2022, clade II MPXV caused a large human outbreak which to date has caused over 86,000 cases in 110 countries, with strong evidence of transmission during sexual contact. By February 2023, the global epidemic has waned in most countries, but endemic regions continue to suffer from mpox. The changing epidemiology of mpox demonstrates how neglected zoonosis turned into a global health threat within a few decades. Thus, mpox pathophysiology and transmission dynamics need to be further investigated, and preventive and therapeutic interventions need to be evaluated. Outbreak response systems need to be strengthened and sustained in endemic regions to reduce the global threat of mpox.

Sections du résumé

BACKGROUND BACKGROUND
The 2022 mpox outbreak drew global attention to this neglected pathogen. While most of the world was taken by surprise, some countries have seen this pathogen emerge and become endemic several decades prior to this epidemic.
OBJECTIVES OBJECTIVE
This narrative review provides an overview of mpox epidemiology since its discovery through the 2022 global outbreak.
SOURCES METHODS
We searched PubMed for relevant literature about mpox epidemiology and transmission through 28 February 2023.
CONTENT BACKGROUND
The emergence of human mpox is intertwined with the eradication of smallpox and the cessation of the global smallpox vaccination campaign. The first human clade I and II monkeypox virus (MPXV) infections were reported as zoonoses in Central and West Africa, respectively, around 1970 with sporadic infections reported throughout the rest of the decade. Over the next five decades, Clade I MPXV was more common and caused outbreaks of increasing size and frequency, mainly in the Democratic Republic of the Congo. Clade II MPXV was rarely observed, until its re-emergence and ongoing transmission in Nigeria, since 2017. Both clades showed a shift from zoonotic to human-to-human transmission, with potential transmission through sexual contact being observed in Nigeria. In 2022, clade II MPXV caused a large human outbreak which to date has caused over 86,000 cases in 110 countries, with strong evidence of transmission during sexual contact. By February 2023, the global epidemic has waned in most countries, but endemic regions continue to suffer from mpox.
IMPLICATIONS CONCLUSIONS
The changing epidemiology of mpox demonstrates how neglected zoonosis turned into a global health threat within a few decades. Thus, mpox pathophysiology and transmission dynamics need to be further investigated, and preventive and therapeutic interventions need to be evaluated. Outbreak response systems need to be strengthened and sustained in endemic regions to reduce the global threat of mpox.

Identifiants

pubmed: 37574113
pii: S1198-743X(23)00389-0
doi: 10.1016/j.cmi.2023.08.008
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

1487-1492

Informations de copyright

Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.

Auteurs

Christophe Van Dijck (C)

Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium.

Nicole A Hoff (NA)

Department of Epidemiology, University of California, Los Angeles, CA, USA.

Placide Mbala-Kingebeni (P)

Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of Congo; Université de Kinshasa, Democratic Republic of Congo.

Nicola Low (N)

Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.

Muge Cevik (M)

Division of Infection and Global Health, University of St Andrews, St Andrews, Scotland.

Anne W Rimoin (AW)

Department of Epidemiology, University of California, Los Angeles, CA, USA.

Jason Kindrachuk (J)

Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada.

Laurens Liesenborghs (L)

Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium. Electronic address: lliesenborghs@itg.be.

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Classifications MeSH