Marty Aileen M, Beÿ Christian K, Koenig Kristi L
Herbert Wertheim College of Medicine, Department of Translational Medicine, and College of Arts, Sciences, and Education and Florida International University, Miami, Florida, USA.
School of Medicine, University of California San Diego, La Jolla, California, USA.
One Health. 2024 Nov 7;19:100927. doi: 10.1016/j.onehlt.2024.100927. eCollection 2024 Dec.
The declaration of a second Public Health Emergency of International Concern (PHEIC) for mpox in August 2024 underscores the urgent need for a comprehensive understanding of the evolving epidemiology [1] clinical manifestations, and zoonotic potential of this emerging threat [2]. This work delves into the intricate interplay between human and animal mpox infections, with a specific focus on the unique characteristics of various viral clades and their implications for individual and public health. There is a critical need to elucidate the factors driving multiple spillover events and the subsequent emergence of new clades better adapted to human-to-human transmission. We hypothesize that anthropogenic changes, including deforestation, urbanization, and climate change are facilitating increased human-to-animal contact, leading to more frequent zoonotic transmissions and viral adaptations. Our conceptual framework integrates One Health principles, evolutionary virology, and epidemiological modeling to investigate the demographic, clinical, and treatment differences among mpox clades in both humans and animals. We employ a mixed-methods approach, combining genomic analysis, clinical data review, and ecological surveys to construct a comprehensive picture of mpox's changing dynamics. The research questions explore the differences in epidemiological and clinical profiles among mpox clades and the factors that likely contribute to successful cross-species transmission and human adaptation. This manuscript introduces an updated Identify, Isolate, Inform (3I) Tool meticulously redesigned to significantly improve the early detection, containment, and reporting of mpox cases across diverse settings. By integrating clinical, virological, and ecological data, this work aims to lay the groundwork for enhanced risk assessment, targeted interventions, and global preparedness strategies in the face of this evolving zoonotic threat.
2024年8月宣布猴痘为第二个国际关注的突发公共卫生事件（PHEIC），这凸显了全面了解这一新兴威胁不断演变的流行病学[1]、临床表现及人畜共患病潜力的迫切需求[2]。本研究深入探讨了人类和动物猴痘感染之间的复杂相互作用，特别关注各种病毒分支的独特特征及其对个人和公共卫生的影响。迫切需要阐明推动多次溢出事件以及随后出现更适应人际传播的新分支的因素。我们假设，包括森林砍伐、城市化和气候变化在内的人为变化正在促使人类与动物的接触增加，导致更频繁的人畜共患病传播和病毒适应。我们的概念框架整合了“同一健康”原则、进化病毒学和流行病学建模，以研究人类和动物猴痘分支在人口统计学、临床和治疗方面的差异。我们采用混合方法，结合基因组分析、临床数据审查和生态调查，以构建猴痘变化动态的全面图景。研究问题探讨了猴痘分支在流行病学和临床特征上的差异，以及可能促成成功跨物种传播和人类适应的因素。本手稿介绍了一种经过精心重新设计的更新版识别、隔离、通报（3I）工具，旨在显著改善在不同环境中对猴痘病例的早期检测、控制和报告。通过整合临床、病毒学和生态数据，这项工作旨在为面对这种不断演变的人畜共患病威胁时加强风险评估、有针对性的干预措施和全球防范战略奠定基础。
