Emergence of Monkeypox as the Most Important Orthopoxvirus Infection in Humans

Abstract

Monkeypox is an emerging zoonotic disease recognized as the most important orthopoxvirus infection in humans in the smallpox post-eradication era. The clinical presentation of monkeypox is similar to the one of smallpox. The case fatality rate of monkeypox (10%) lies between the case fatality rate of variola major (30%) and variola minor (1%). The disease is endemic in the Democratic Republic of the Congo, but other countries of Central and West Africa either reported cases of monkeypox in humans or circulation in wildlife. The disease was also imported once into the USA. The disease has always been considered rare and self-limiting, however recent sporadic reports suggest otherwise. Unfortunately, the collected data is limited, dispersed and often incomplete. Therefore, the objective of this review is to trace all reported human monkeypox outbreaks and relevant epidemiological information. The frequency and geographical spread of human monkeypox cases have increased in recent years, and there are huge gaps in our understanding of the disease's emergence, epidemiology, and ecology. The monkeypox virus is considered a high threat pathogen causing a disease of public health importance. Therefore, there is an urgent need to focus on building surveillance capacities which will provide valuable information for designing appropriate prevention, preparedness and response activities.

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

“…The monkeypox virus was first discovered in 60 years ago (von Magnus et al, 1959) and continues to remain on the radar of WHO since then (Heymann et al, 1998;Breman et al, 1980;WHO, 1984;WHO, 2018a,b). This zoonotic infection remains endemic to Central and West Africa in animal(s) reservoir(s), with increasing numbers of human cases and outbreaks being reported (Sklenovska and van Ranst, 2018;Hoff et al, 2017;Learned et al, 2005;Durski et al, 2018a;Yinka-Ogunleye et al, 2018). Monkeypox is caused by a double stranded DNA virus which belongs to the Orthopoxvirus genus of the family Poxviridae family (WHO, 2018a,b;CDC, 2018;Shchelkunov et al, 2001).…”

“…Several reviews have summarised human monkeypox outbreaks over the past 38 years (Rimoin et al, 2010;Sklenovská and Van Ranst, 2018;Durski et al, 2017;Durski et al, 2018b). Population-based surveillance studies conducted in nine health zones in DRC identified 760 laboratory-confirmed human monkeypox cases with an annual cumulative incidence of 5.53 per 10,000 (2.18-14.42) (Rimoin et al, 2010).…”

“…Indirect or direct contact with live or dead animals is assumed to be the driver of human monkeypox infections in humans (Durski et al, 2018a;Sklenovská and Van Ranst, 2018). Monkeypox primarily occurs in animals in the equatorial rain forests in West Africa and Central Africa (WHO, 2018a,b;CDC, 2018;Nigeria CDC, 2018;Khodakevich et al, 1986;Hutin et al, 2001).…”

Systematic Review of Important Viral Diseases in Africa in Light of the ‘One Health’ Concept

“…Apart from Ebola virus, Cote d'Ivoire has also been hit by monkeypox. Up to 1990, two confirmed human cases of MPXV had been reported from the country [96,97]. One common practice that has been reported from the MPXV outbreak-prone belt of the African continent is that monkeys are eaten as a delicacy, which may be a significant source of disease transmission apart from other activities, like hunting and butchering.…”

Scrutinizing surface glycoproteins and poxin-schlafen protein to design a heterologous recombinant vaccine against monkeypox virus

“…Monkeypox is an endemic disease in the Democratic Republic of the Congo. The virus was also imported once into the USA (Sklenovská et al, 2018).…”