State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, 20 Dong-Da Street, Fengtai District, Beijing, 100071, China.
Nanjing Municipal Center for Disease Control and Prevention, Affiliated Nanjing Center for Disease Control and Prevention of Nanjing Medical University, Nanjing, China.
Global Health. 2023 Aug 17;19(1):58. doi: 10.1186/s12992-023-00959-0.
Outbreaks of monkeypox have been ongoing in non-endemic countries since May 2022. A thorough assessment of its global zoonotic niche and potential transmission risk is lacking.
We established an integrated database on global monkeypox virus (MPXV) occurrence during 1958 - 2022. Phylogenetic analysis was performed to examine the evolution of MPXV and effective reproductive number (R) was estimated over time to examine the dynamic of MPXV transmissibility. The potential ecological drivers of zoonotic transmission and inter-regional transmission risks of MPXV were examined.
As of 24 July 2022, a total of 49 432 human patients with MPXV infections have been reported in 78 countries. Based on 525 whole genome sequences, two main clades of MPXV were formed, of which Congo Basin clade has a higher transmissibility than West African clade before the 2022-monkeypox, estimated by the overall R (0.81 vs. 0.56), and the latter significantly increased in the recent decade. R of 2022-monkeypox varied from 1.14 to 4.24 among the 15 continuously epidemic countries outside Africa, with the top three as Peru (4.24, 95% CI: 2.89-6.71), Brazil (3.45, 95% CI: 1.62-7.00) and the United States (2.44, 95% CI: 1.62-3.60). The zoonotic niche of MPXV was associated with the distributions of Graphiurus lorraineus and Graphiurus crassicaudatus, the richness of Rodentia, and four ecoclimatic indicators. Besides endemic areas in Africa, more areas of South America, the Caribbean States, and Southeast and South Asia are ecologically suitable for the occurrence of MPXV once the virus has invaded. Most of Western Europe has a high-imported risk of monkeypox from Western Africa, whereas France and the United Kingdom have a potential imported risk of Congo Basin clade MPXV from Central Africa. Eleven of the top 15 countries with a high risk of MPXV importation from the main countries of 2022-monkeypox outbreaks are located at Europe with the highest risk in Italy, Ireland and Poland.
The suitable ecological niche for MPXV is not limited to Africa, and the transmissibility of MPXV was significantly increased during the 2022-monkeypox outbreaks. The imported risk is higher in Europe, both from endemic areas and currently epidemic countries. Future surveillance and targeted intervention programs are needed in its high-risk areas informed by updated prediction.
自 2022 年 5 月以来，非流行国家的猴痘疫情持续爆发。目前仍缺乏对其全球人畜共患病生态位和潜在传播风险的全面评估。
我们建立了一个全球 1958 年至 2022 年猴痘病毒（MPXV）发生的综合数据库。对 MPXV 进行了系统发育分析，以检验其进化情况，并随时间推移估计有效繁殖数（R）以检验 MPXV 传播的动态。还检验了人畜共患病传播的潜在生态驱动因素和 MPXV 的跨区域传播风险。
截至 2022 年 7 月 24 日，在 78 个国家共报告了 49322 例人类猴痘感染病例。基于 525 个全基因组序列，形成了两个主要的 MPXV 分支，其中刚果盆地分支在 2022 年猴痘疫情前的传染性高于西非分支，整体 R 值（0.81 对 0.56），后者在最近十年显著增加。在非洲以外的 15 个连续流行国家中，2022 年猴痘的 R 值在 1.14 至 4.24 之间，秘鲁（4.24，95%CI：2.89-6.71）、巴西（3.45，95%CI：1.62-7.00）和美国（2.44，95%CI：1.62-3.60）位列前三。MPXV 的人畜共患病生态位与 Graphiurus lorraineus 和 Graphiurus crassicaudatus 的分布、啮齿动物的丰富度以及四个生态气候指标有关。除了非洲的流行地区外，南美洲、加勒比国家以及东南亚和南亚的更多地区在病毒传入后，在生态上适合 MPXV 的发生。西欧大部分地区从西非输入猴痘的风险较高，而法国和英国则有从中非输入刚果盆地分支 MPXV 的潜在风险。在 2022 年猴痘疫情主要国家中，15 个猴痘输入风险较高的国家中有 11 个位于欧洲，意大利、爱尔兰和波兰的风险最高。
MPXV 的适宜生态位不仅限于非洲，而且在 2022 年猴痘疫情期间，MPXV 的传播能力显著增强。欧洲的输入风险更高，既来自流行地区，也来自当前流行国家。需要根据最新预测，在其高风险地区开展有针对性的监测和干预计划。
