Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium.
Department of Epidemiology, University of California, Los Angeles, CA, USA.
Clin Microbiol Infect. 2023 Dec;29(12):1487-1492. doi: 10.1016/j.cmi.2023.08.008. Epub 2023 Aug 11.
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.
2022 年猴痘疫情引起了全球对这种被忽视的病原体的关注。虽然世界大部分地区都对此感到惊讶，但一些国家在此次疫情爆发前几十年就已经看到这种病原体出现并成为地方病。
本综述性文章概述了自发现猴痘以来至 2022 年全球疫情爆发期间的猴痘流行病学。
我们在 PubMed 上检索了截至 2023 年 2 月 28 日关于猴痘流行病学和传播的相关文献。
人类猴痘的出现与天花的根除和全球天花疫苗接种运动的停止交织在一起。第一例人类 I 型和 II 型猴痘病毒（MPXV）感染分别作为人畜共患病在中非和西非被报告，分别发生在 1970 年左右，此后十年间也有散发病例报告。在接下来的五十年里，I 型猴痘病毒更为常见，并导致越来越大规模和越来越频繁的暴发，主要发生在刚果民主共和国。II 型猴痘病毒很少被观察到，直到 2017 年在尼日利亚重新出现并持续传播。两个分支都显示出从人畜共患病向人与人之间传播的转变，在尼日利亚观察到了潜在的性接触传播。2022 年，II 型猴痘病毒引起了一次大规模的人类暴发，迄今为止，在 110 个国家已造成超过 86000 例病例，有强有力的证据表明在性接触过程中传播。到 2023 年 2 月，大多数国家的全球疫情已经减弱，但流行地区仍在遭受猴痘的影响。
猴痘的流行病学变化表明，被忽视的人畜共患病在几十年内如何转变为全球健康威胁。因此，需要进一步研究猴痘的发病机制和传播动力学，并评估预防和治疗干预措施。需要加强和维持流行地区的暴发应对系统，以减少猴痘的全球威胁。
