The re-emergence and transmission of Monkeypox virus in Nigeria: the role of one health

Recent Advances in Mpox Epidemic: Global Features and Vaccine Prevention Research

Monkeypox (mpox) is a zoonotic disease (zoonose) caused by the monkeypox virus (MPXV). MPXV, a member of the Orthopoxviridae family, is categorized into two clades, Central Africa (I) and West Africa (II), each of which is further subdivided into subclades a and b. Clade I generally causes more serious illness and higher mortality rates, while Clade II results in milder illness. Historically, mpox epidemics were localized to specific regions and countries in Africa. Since 2022, the mpox epidemic, fueled by MPXV Clade IIb, has swiftly spread across various nations and regions, jeopardizing public health and safety. However, starting in 2024, Clade Ib gradually replaced Clade IIb. The notable genetic variation in Clade Ib may provide MPXV with new opportunities to evade the immune system and adapt to hosts. According to the World Health Organization (WHO), from 1 January 2022, to 24 November 2024, there were 117,663 confirmed cases and 2 probable cases, resulting in 263 deaths across 127 Member States in all six WHO regions. As of 9 January 2025, 12 countries outside Africa have reported imported MPXV Clade Ib cases, with secondary cases emerging in the United Kingdom, Germany, and China. Due to the incomplete development of a vaccine specifically for MPXV, the smallpox vaccine remains in use for preventing mpox or for emergency vaccination post-exposure. Therefore, the persistent spread of mpox is still a major concern, requiring greater awareness and vaccination efforts in populations at high risk. This paper aims to summarize the etiological characteristics, epidemic situation, and vaccine prevention efforts for mpox, offering a reference for managing this serious epidemic and ensuring effective scientific prevention and control.

Understanding the resurgence of mpox: key drivers and lessons from recent outbreaks in Africa

Mpox has re-emerged as a significant public health threat, particularly in Africa. This study explores the key drivers behind the recent resurgence, focusing on epidemiological trends, transmission dynamics, and lessons learned from recent outbreaks. The research involved a comprehensive review of recent mpox outbreaks, analyzing factors, such as socio-economic conditions, environmental influences, and genetic evolution. Findings indicate that the resurgence is linked to the cessation of smallpox vaccination, increased human-wildlife interactions, and rapid urbanization in endemic regions. The virus, which was previously confined to rural areas, has now spread to urban populations, and crossed national borders, driven by high population mobility and socio-economic instability. A notable shift in transmission dynamics has been observed, with increased human-to-human transmission, particularly among men who have sex with men (MSM), contributing to more severe and widespread outbreaks. The study highlights the urgent need to strengthen health systems in Africa, particularly in the areas of diagnostics, surveillance, and public health preparedness. Challenges such as inadequate laboratory infrastructure and delayed response mechanisms have exposed vulnerabilities in current public health frameworks. To prevent future outbreaks, targeted strategies must be implemented, including enhanced community engagement, improved access to vaccines and treatments, and timely, accurate reporting of cases. Coordinated global action is essential to prevent mpox from becoming a more persistent and widespread public health threat. This research discusses the importance of proactive measures and international cooperation in addressing the ongoing threat posed by mpox, particularly in regions with limited healthcare resources.

Clade Ib: a new emerging threat in the Mpox outbreak

Monkeypox, a zoonotic virus in the Orthopoxvirus genus, has drawn global attention for its impact on public health. In the current Mpox outbreak, a novel clade, Ib, has emerged as a significant and potentially fatal threat. This review examines the dynamics of MPXV transmission, person-to-person spread, and infection mechanisms, highlighting key risk factors. We explore the clinical features of Mpox, focusing on symptomology, illness duration, and the distinguishing characteristics of clade Ib compared to other clades. A critical analysis addresses diagnostic techniques and emphasizes the need for robust surveillance, particularly for clade Ib detection. We review recent prevention and treatment strategies, including antiviral drugs and vaccines, with a focus on clade Ib containment. The conclusion underscores the urgency of global collaboration to prevent and prepare for emerging threats like clade Ib and identifies crucial research paths and knowledge gaps. This review offers a comprehensive overview of clade Ib, covering its emergence, genetic traits, epidemiological impact, transmission patterns, clinical features, the role of Artificial Intelligence (AI) in outbreak management, detection challenges, and implications for public health response.

Mpox in East Africa: Learning from COVID-19 and Ebola to Strengthen Public Health Responses

The Africa Centers for Disease Control and Prevention declared mpox a Public Health Emergency of Continental Security (PHECS) in Africa. African public health systems have moved to mobilize a response against a backdrop of inherent significant challenges. With this commentary, we discuss how lessons from past public health emergencies, particularly COVID-19 and Ebola outbreaks, have prepared the region for improved disease surveillance, rapid response strategies, and effective public health communication and how these lessons can be applied to the mpox response, emphasizing the importance of strong healthcare infrastructure, effective data sharing, community engagement, targeted interventions, and robust contact tracing. Additionally, addressing misinformation and building public trust are crucial for controlling the spread of any disease. By leveraging these strategies, African countries can enhance their response to mpox. This includes improving diagnostic capabilities, strengthening cross-border collaborations, and prioritizing vaccination campaigns where needed. Ultimately, by applying the hard-earned lessons from the COVID-19 pandemic and Ebola outbreak, the East Africa region can better address the challenges posed by mpox and safeguard public health.

A critical review of mpox outbreaks, risk factors, and prevention efforts in Africa: lessons learned and evolving practices

OBJECTIVES

In recent years, mpox, a zoonotic disease caused by the mpox virus, has transcended its primary association with Central and West Africa, emerging as a global public health concern. The virus poses a substantial threat, particularly, to vulnerable demographics such as young children and individuals with compromised immune systems. This critical literature review aimed to comprehensively evaluate the burden, risk factors, and current management strategies associated with mpox in Africa.

METHODS

This critical literature review was guided by Jesson & Laccy's guidelines on conducting critical literature reviews. We searched PubMed and Google Scholar databases and websites of the World Health Organization and health ministries in different African countries. We included articles written in English and published between 2010 and 2023. The synthesis of findings involved several steps, including summarizing themes, integrating themes, and linking themes to research questions.

RESULTS

A total of 25 articles were included in this review. The review revealed that mpox cases are concentrated in Central African countries. The risk factors for mpox identified include being in contact with bushmeat or rodents, not having been vaccinated against smallpox, being HIV-positive, and having close physical contact with someone with the disease. The clinical presentation of mpox revealed in this review includes a skin rash, fever, lymphadenopathy, headache, pruritus, sore throat, and body aches. Four themes arose on strategies to prevent and control mpox in Africa.

CONCLUSIONS

The prevention and control of mpox in Africa require an improvement in community education, vaccination, disease surveillance, and infection control measures.