Increased outbreaks of monkeypox highlight gaps in actual disease burden in Sub-Saharan Africa and in animal reservoirs

Haider, Najmul; Guitian, Javier; Simons, David; Asogun, Danny; Ansumana, Rashid; Honeyborne, Isobella; Velavan, Thirumalaisamy P.; Ntoumi, Francine; Valdoleiros, Sofia R; Petersen, Eskild; Kock, Richard; Zumla, Alimuddin

doi:10.1016/j.ijid.2022.05.058

Cited by 80 publications

(88 citation statements)

References 30 publications

(34 reference statements)

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“…To date, the reported cases are predominantly, but not exclusively, among young males without a travel history to endemic regions in Central and West Africa ( 2, 3 ). The initial epidemiological investigations suggest a link with sexual contact among men who have sex with men (MSM) ( 1–3, 6 ). Prior to the current outbreak, monkeypox infections had been assumed to be primarily caused by exposure to animal reservoirs but human-to-human transmissions via direct routes including skin-to-skin contact, bodily fluids and respiratory droplets have also been documented ( 7, 8 ).…”

Section: Main Textmentioning

confidence: 99%

Heavy-tailed sexual contact networks and the epidemiology of monkeypox outbreak in non-endemic regions, May 2022

Endo

Murayama

Abbott

et al. 2022

Preprint

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A global outbreak of monkeypox across non-endemic regions including Europe and North America was confirmed in May 2022. The current outbreak has shown distinct epidemiological features compared with past outbreaks in non-endemic settings, most notably its observed rapid growth and predominant spread among men who have sex with men (MSM). We use a branching process transmission model fitted to empirical sexual partnership data in the UK to show that the heavy-tailed nature of the sexual partnership degree distribution, where a small fraction of individuals have disproportionately large numbers of partners, can explain the sustained growth of monkeypox cases among the MSM population despite the absence of such patterns of spread in past outbreaks. We also suggest that the basic reproduction number (R0) for monkeypox over the MSM sexual contact network may be substantially greater than 1 for a plausible range of assumptions, which poses a challenge to outbreak containment efforts. Ensuring ongoing support and tailored public health messaging to facilitate prevention and early detection among MSM with a large number of sexual partners is warranted.

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Section: Main Textmentioning

confidence: 99%

Heavy-tailed sexual contact networks and the epidemiology of monkeypox outbreak in non-endemic regions, May 2022

Endo

Murayama

Abbott

et al. 2022

Preprint

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“…In total, 71 MPX cases but no deaths were reported, all in patients who had been exposed to infected prairie dogs [ 6 ]. In recent years, a few small clusters and single MPX cases were identified in the UK (2018 and 2019), Israel (2018), Singapore (2019) and the US (2021), all linked to travel to Nigeria, which has experienced re-emergence of MPX and reported over 500 suspected cases since 2017 [ 7 ]. On the 4 May 2022, a patient with a recent travel history to Nigeria and an unexplained rash presented to a UK hospital.…”

Section: Monkeypox Discovery and Outbreaksmentioning

confidence: 99%

Monkeypox: A New Threat?

Kmieć

Kirchhoff

2022

IJMS

154

124

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The global vaccination programme against smallpox led to its successful eradication and averted millions of deaths. Monkeypox virus (MPXV) is a close relative of the Variola (smallpox) virus. Due to antigenic similarity, smallpox vaccines cross-protect against MPXV. However, over 70% of people living today were never vaccinated against smallpox. Symptoms of monkeypox (MPX) include fever, head- and muscle ache, lymphadenopathy and a characteristic rash that develops into papules, vesicles and pustules which eventually scab over and heal. MPX is less often fatal (case fatality rates range from <1% to up to 11%) than smallpox (up to 30%). MPXV is endemic in sub-Saharan Africa, infecting wild animals and causing zoonotic outbreaks. Exotic animal trade and international travel, combined with the increasing susceptibility of the human population due to halted vaccination, facilitated the spread of MPXV to new areas. The ongoing outbreak, with >10,000 cases in >50 countries between May and July 2022, shows that MPXV can significantly spread between people and may thus become a serious threat to public health with global consequences. Here, we summarize the current knowledge about this re-emerging virus, discuss available strategies to limit its spread and pathogenicity and evaluate its risk to the human population.

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“…But, recently, in 2022, with the concurrent COVID-19 pandemic [ 5 ], an ongoing outbreak in the UK and other European and non-European countries has also been reported, with 2677 cases confirmed up to 21 June 2022 [ 6 ]. This multi-country outbreak is occurring with the sustainable human-to-human transmission among non-travellers, to a large extent amongst men who have sex with men (MSM) [ 7 , 8 ]. Then, concern has been raised due to the suspicion that monkeypox has been transmitted sexually [ 9 ].…”

mentioning

confidence: 99%