Petersen Eskild, Hvid Ulrik, Tomori Oyewale, Pedersen Anders Gorm, Wallinga Jacco, Pebody Richard, Cenciarelli Orlando, Aavitsland Preben, Van Laeken David, Andreasen Viggo, Schneider Uffe, Simonsen Julia Kinane, Goedknegt Marlies Jilles Francine, Johannesen Caroline Klint, Lundgren Jens D, Koch Anders, Søborg Bolette, Ekström Anna Mia, Nohynek Hannah, Aarestrup Frank M, Krause Tyra G, Simonsen Lone
PandemiX Center, Dept of Science & Environment, Roskilde University, Roskilde, Denmark.
African Centre of Excellence for Genomics of Infectious Diseases, Redeemer's University, Ede, Nigeria.
Int J Infect Dis. 2025 Apr;153:107373. doi: 10.1016/j.ijid.2024.107373. Epub 2024 Dec 27.
The recent expansion of mpox in Africa is characterized by a dramatic increase in zoonotic transmission (clade Ia) and the emergence of a new clade Ib that is transmitted from human to human by close contact. Clade Ia does not pose a threat in areas without zoonotic reservoirs. But clade Ib may spread widely, as did clade IIb which has spread globally since 2022 among men who have sex with men. It is not clear whether controlling clade Ib will be more difficult than clade IIb. The population at risk potentially counts 100 million but only a million vaccine doses are expected in the next year. Surveillance is needed with exhaustive case detection, polymerase chain reaction confirmation, clade determination, and about severe illness. Such data is needed to identify routes of transmission and core transmitters, such as sex workers. Health care workers are vaccinated to ensure their protection, but this will not curb mpox transmission. With the recent inequitable distribution of COVID-19 vaccines in mind, it is a global responsibility to ensure that low-income nations in the mpox epicenter have meaningful access to vaccines. Vaccination serves not only to reduce mortality in children but limit the risk of future mpox variants emerging that may spread in human populations globally.
人畜共患传播（A系分支Ia）急剧增加，以及出现了一种通过密切接触在人与人之间传播的新的B系分支Ib。在没有人畜共患宿主的地区，A系分支Ia不会构成威胁。但B系分支Ib可能会广泛传播，就像自2022年以来在男男性行为者中全球传播的B系分支IIb一样。目前尚不清楚控制B系分支Ib是否会比控制B系分支IIb更困难。潜在的高危人群有1亿，但预计明年仅有100万剂疫苗。需要进行监测，包括详尽的病例发现、聚合酶链反应确认、分支鉴定以及对重症情况的监测。需要此类数据来确定传播途径和核心传播者，比如性工作者。医护人员接种疫苗以确保自身防护，但这无法遏制猴痘传播。鉴于近期新冠疫苗分配不均的情况，确保猴痘疫情中心的低收入国家能够切实获得疫苗是一项全球责任。接种疫苗不仅有助于降低儿童死亡率，还能限制未来可能在全球人群中传播的猴痘变异株出现的风险。
