MMWR Morb Mortal Wkly Rep. 2023 Jan 20;72(3):68-72. doi: 10.15585/mmwr.mm7203a4.
Monkeypox (mpox) is a zoonotic disease caused by Monkeypox virus (MPXV), an Orthopoxvirus; the wild mammalian reservoir species is not known. There are two genetic clades of MPXV: clade I and clade II (historically found in central and west Africa, respectively), with only Cameroon reporting both clades (1). Human cases have historically been reported from 1) mostly rural, forested areas in some central and west African countries; 2) countries reporting cases related to population migration or travel of infected persons; and 3) exposure to imported infected mammals (2). The annual number of cases in Africa has risen since 2014 and cumulatively surpassed reports from the previous 40 years for most countries. This reemergence of mpox might be due to a combination of environmental and ecological changes, animal or human movement, the cessation of routine smallpox vaccination since its eradication in 1980, improvements in disease detection and diagnosis, and genetic changes in the virus (2). This report describes the epidemiology of mpox since 1970 and during 2018-2021, using data from national surveillance programs, World Health Organization (WHO) bulletins, and case reports, and addresses current diagnostic and treatment challenges in countries with endemic disease. During 2018-2021, human cases were recognized and confirmed in six African countries, with most detected in the Democratic Republic of the Congo (DRC) and Nigeria. The reemergence and increase in cases resulted in its being listed in 2019 as a priority disease for immediate and routine reporting through the Integrated Disease Surveillance and Response strategy in the WHO African region.* In eight instances, patients with mpox were identified in four countries outside of Africa after travel from Nigeria. Since 2018, introductory and intermediate training courses on prevention and control of mpox for public health and health care providers have been available online at OpenWHO. The global outbreak that began in May 2022 has further highlighted the need for improvements in laboratory-based surveillance and access to treatments and vaccines to prevent and contain the infection, including in areas of Africa with endemic mpox.
猴痘（mpox）是一种由猴痘病毒（MPXV）引起的人畜共患病，属于正痘病毒属；野生动物宿主尚未确定。MPXV 有两个遗传分支：分支 I 和分支 II（分别历史上发现于中非和西非），只有喀麦隆报告了这两个分支（1）。人类病例历史上报告于 1）大多数中非和西非国家的农村森林地区；2）报告与感染者人口迁移或旅行相关病例的国家；以及 3）接触进口受感染的哺乳动物（2）。自 2014 年以来，非洲的病例年度数量增加，大多数国家的累计病例数超过了前 40 年的报告数。猴痘的再次出现可能是由于环境和生态变化、动物或人类的流动、1980 年根除天花以来常规接种疫苗的停止、疾病检测和诊断的改进以及病毒的遗传变化（2）。本报告描述了自 1970 年以来以及 2018-2021 年期间的猴痘流行病学情况，使用了来自国家监测计划、世界卫生组织（世卫组织）公报和病例报告的数据，并讨论了在存在地方性疾病的国家当前的诊断和治疗挑战。在 2018-2021 年期间，六个非洲国家报告和确认了人类病例，其中大多数在刚果民主共和国（刚果（金））和尼日利亚发现。病例的再次出现和增加导致 2019 年将其列为世卫组织非洲区域综合疾病监测和应对战略下立即和常规报告的优先疾病*。在四个非洲以外的国家，有八例从尼日利亚旅行回来的患者被确定患有猴痘。自 2018 年以来，公共卫生和卫生保健提供者预防和控制猴痘的入门和中级培训课程可在 OpenWHO 在线获取。自 2022 年 5 月开始的全球疫情进一步凸显了需要改进基于实验室的监测以及获取治疗和疫苗，以预防和控制感染，包括在有地方性猴痘的非洲地区。
