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Int J Infect Dis. 2019 Jan;78:78-84. doi: 10.1016/j.ijid.2018.11.008. Epub 2018 Nov 16.

Monkeypox - Enhancing public health preparedness for an emerging lethal human zoonotic epidemic threat in the wake of the smallpox post-eradication era.

Author information

1
Institute of Clinical Medicine, University of Aarhus, Denmark; The Royal Hospital, Muscat, Oman; ESCMID Emerging Infections Task Force, Basel, Switzerland. Electronic address: eskildp@dadlnet.dk.
2
Institute for Global Health, University College London, London, United Kingdom. Electronic address: i.abubakar@ucl.ac.uk.
3
Nigeria Centre for Disease Control, Jabi, Abuja, Nigeria. Electronic address: chikwe.ihekweazu@gmail.com.
4
Faculty of Epidemiology and Population Health, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom. Electronic address: David.Heymann@lshtm.ac.uk.
5
University Marien NGouabi and Fondation Congolaise pour la Recherche Médicale (FCRM), Brazzaville, Congo. Electronic address: ffntoumi@hotmail.com.
6
National Institute for Communicable Diseases, Johannesburg, South Africa. Electronic address: lucilleb@nicd.ac.za.
7
Department of Public Health, Faculty of Clinical Sciences, College of Medicine, Ambrose Alli University, Ekpoma, Nigeria. Electronic address: asogun2001@yahoo.com.
8
Zambia National Public Health Institute, Ministry of Health, Lusaka, Zambia. Electronic address: vmukonka@gmail.com.
9
Institute for Global Health, University College London, London, United Kingdom. Electronic address: swaiblule@gmail.com.
10
HerpeZ and UNZA-UCLMS Project, University Teaching Hospital, Lusaka, Zambia; School of Life Sciences, University of Lincoln, Lincoln, United Kingdom. Electronic address: MBates@lincoln.ac.uk.
11
Division of Infection and Immunity, Center for Clinical Microbiology, University College London, London, United Kingdom. Electronic address: i.honeyborne@ucl.ac.uk.
12
National Institute of Medical Research Muhimbili, Dar es Salaam, Tanzania. Electronic address: gsmfinanga@yahoo.com.
13
UNZA-UCLMS Project, and Lusaka Apex University Medical School, Lusaka, Zambia. Electronic address: pbmwaba2000@gmail.com.
14
Public Health England, London, United Kingdom; Chatham House Centre on Global Health Security, London, United Kingdom. Electronic address: Osman.Dar@phe.gov.uk.
15
National Institute for Infectious Diseases, Lazzaro Spallanzani, IRCCS, Rome, Italy. Electronic address: francesco.vairo@inmi.it.
16
Institute of Endemic Diseases, University of Khartoum, Khartoum, Sudan. Electronic address: mmukhtar@tropmedicine.org.
17
Department of Pathobiology and Population Sciences, The Royal Veterinary College, Hertfordshire, United Kingdom. Electronic address: rkock@rvc.ac.uk.
18
Division of Infection and Immunity, Center for Clinical Microbiology, University College London, London, United Kingdom. Electronic address: t.mchugh@ucl.ac.uk.
19
National Institute for Infectious Diseases, Lazzaro Spallanzani, IRCCS, Rome, Italy. Electronic address: giuseppe.ippolito@inmi.it.
20
Division of Infection and Immunity, Center for Clinical Microbiology, University College London, United Kingdom; The National Institute of Health Research Biomedical Research Centre at UCL Hospitals, London, United Kingdom. Electronic address: a.zumla@ucl.ac.uk.

Abstract

The identification of monkeypox in 3 separate patients in the United Kingdom in September raised media and political attention on an emerging public health threat. Nigeria, whose last confirmed case of monkeypox was in 1978, is currently experiencing an unusually large and outbreak of human monkeypox cases, a 'One Human-Environmental-Animal Health' approach is being effectively used to define and tackle the outbreak. As of 13th October 2018, there have been one hundred and sixteen confirmed cases the majority of whom are under 40 years. Over the past 20 years ten Central and West African countries have reported monkeypox cases which have risen exponentially. We review the history and evolution of monkeypox outbreaks in Africa and USA, the changing clinical presentations, and discuss possible factors underlying the increasing numbers being detected including the cessation of smallpox vaccination programs. Major knowledge gaps remain on the epidemiology, host reservoir, and emergence, transmission, pathogenesis and prevention of monkeypoz.

PMID:
30453097
DOI:
10.1016/j.ijid.2018.11.008
[Indexed for MEDLINE]
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