Intrafamily Transmission of Monkeypox Virus, Central African Republic, 2018

Besombes, Camille; Gonofio, Ella; Konamna, Xavier; Sélékon, Benjamin; Gessain, Antoine; Berthet, Nicolás; Manuguerra, Jean-Claude; Fontanet, Arnaud; Nakouné, Emmanuel

doi:10.3201/eid2508.190112

Cited by 74 publications

(100 citation statements)

References 8 publications

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“…In Nigeria or Sierra Leone, human cases more likely correspond to indigenous zoonotic spillover than to importation from a neighboring country 14 , 54 . Although three modes of transmission (familial, health care-related and transport-related) were identified during the small outbreak that occurred in Bangassou in 2016 11 , human-to-human transmission in CAR is generally confined to a single family 55 . It rarely spreads over long distances, with the exception of the street vendor from Ippy who probably infected his girlfriend in the town of Rafaï, several hundred kilometers away.…”

Section: Discussionmentioning

confidence: 99%

Genomic history of human monkey pox infections in the Central African Republic between 2001 and 2018

Berthet

Descorps-Declère

Besombes

et al. 2021

Sci Rep

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116

108

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Monkeypox is an emerging infectious disease, which has a clinical presentation similar to smallpox. In the two past decades, Central Africa has seen an increase in the frequency of cases, with many monkeypox virus (MPXV) isolates detected in the Democratic Republic of Congo (DRC) and the Central African Republic (CAR). To date, no complete MPXV viral genome has been published from the human cases identified in the CAR. The objective of this study was to sequence the full genome of 10 MPXV isolates collected during the CAR epidemics between 2001 and 2018 in order to determine their phylogenetic relationships among MPXV lineages previously described in Central Africa and West Africa. Our phylogenetic results indicate that the 10 CAR isolates belong to three lineages closely related to those found in DRC. The phylogenetic pattern shows that all of them emerged in the rainforest block of the Congo Basin. Since most human index cases in CAR occurred at the northern edge of western and eastern rainforests, transmissions from wild animals living in the rainforest is the most probable hypothesis. In addition, molecular dating estimates suggest that periods of intense political instability resulting in population movements within the country often associated also with increased poverty may have led to more frequent contact with host wild animals. The CAR socio-economic situation, armed conflicts and ecological disturbances will likely incite populations to interact more and more with wild animals and thus increase the risk of zoonotic spillover.

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Section: Discussionmentioning

confidence: 99%

Genomic history of human monkey pox infections in the Central African Republic between 2001 and 2018

Berthet

Descorps-Declère

Besombes

et al. 2021

Sci Rep

Self Cite

116

108

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“…Monkeypox data from the DRC accounted for approximately one-third of the eligible articles [5,13,14,[16][17][18][19][20][21][22][23][24][25][26][27][28]. The remaining articles had monkeypox data from the CAR [29][30][31][32][33][34][35], United States (US) [36][37][38][39][40][41], Nigeria [5,[42][43][44], Republic of the Congo [15,[45][46][47], Sierra Leone [42,48,49],…”

Section: Number Of Reports By Countrymentioning

confidence: 99%

“…Details are presented in S3 Table . A review of these articles did not establish any evolution in SAR over time. More than half of the articles (9/16) reported an SAR of 0% [8,23,30,42,[49][50][51][52]57], and this spanned the decades from the 1970s through 2010-2019. Similarly, over those same five decades, the SAR ranged from 0.3-10.2% in 6/16 articles [5,14,20,22,54,56].…”

Section: Secondary Attack Ratementioning

confidence: 99%

“…In 11 articles, describing outbreaks from 10 different countries, investigators reported that none of the 49 cases were vaccinated. These countries were Cameroon [5,50], Liberia [42], Nigeria [42], Sierra Leone [42], CAR [30,31,34], Republic of the Congo [46], DRC [23], Côte d'Ivoire [51], South Sudan [58], and the UK [56]. The outbreaks in these countries were small, with one to six cases per outbreak, except for the Republic of the Congo with 11 cases [46] and South Sudan with 19 cases [58].…”

Section: Smallpox Vaccination Statusmentioning

confidence: 99%

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The changing epidemiology of human monkeypox – a potential threat? A systematic review

Bunge¹,

Hoet²,

Chen

et al. 2021

Preprint

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Monkeypox, a zoonotic disease caused by an orthopoxvirus, results in a smallpox-like disease in humans. Since monkeypox in humans was initially diagnosed in 1970 in the Democratic Republic of the Congo (DRC), it has spread to other regions of Africa (primarily West and Central), and cases outside Africa have emerged in recent years. We conducted a systematic review of peer-reviewed and grey literature on how monkeypox epidemiology has evolved, with particular emphasis on the number of confirmed, probable, and/or possible cases, age at presentation, mortality, and geographical spread. The review is registered with PROSPERO (CRD42020208269). We identified 48 peer-reviewed articles and 18 grey literature sources for data extraction. The number of human monkeypox cases has been on the rise since the 1970s, with the most dramatic increases occurring in the DRC. The median age at presentation has increased from 4 (1970s) to 21 years (2010-2019). There was an overall case fatality rate of 8.7%, with a significant difference between clades - Central African 10.6% (95% CI: 8.4% - 13.3%) vs. West African 3.6% (95% CI: 1.7% - 6.8%). Since 2003, import- and travel-related spread outside of Africa has occasionally resulted in outbreaks. Interactions/activities with infected animals or individuals are risk behaviors associated with acquiring monkeypox. Our review shows an escalation of monkeypox cases, especially in the highly endemic DRC, a spread to other countries, and a growing median age from young children to young adults. These findings may be related to the cessation of smallpox vaccination, which provided some cross-protection against monkeypox, leading to increased human-to-human transmission. The appearance of outbreaks beyond Africa highlights the global relevance of the disease. Increased surveillance and detection of monkeypox cases are essential tools for understanding the continuously changing epidemiology of this resurging disease.

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“…In the last week of October, another relative of this index case female was reported to have contracted the disease. In this investigation, it was observed that the disease spread among the index case female's family members and relatives through three waves of infection and hence was considered as an intrafamilial transmission of MPXV disease [168].…”

Section: Central African Republicmentioning

confidence: 99%

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

et al. 2020

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Emerging and re-emerging viral diseases are of great public health concern. The recent emergence of Severe Acute Respiratory Syndrome (SARS) related coronavirus (SARS-CoV-2) in December 2019 in China, which causes COVID-19 disease in humans, and its current spread to several countries, leading to the first pandemic in history to be caused by a coronavirus, highlights the significance of zoonotic viral diseases. Rift Valley fever, rabies, West Nile, chikungunya, dengue, yellow fever, Crimean-Congo hemorrhagic fever, Ebola, and influenza viruses among many other viruses have been reported from different African countries. The paucity of information, lack of knowledge, limited resources, and climate change, coupled with cultural traditions make the African continent a hotspot for vector-borne and zoonotic viral diseases, which may spread globally. Currently, there is no information available on the status of virus diseases in Africa. This systematic review highlights the available information about viral diseases, including zoonotic and vector-borne diseases, reported in Africa. The findings will help us understand the trend of emerging and re-emerging virus diseases within the African continent. The findings recommend active surveillance of viral diseases and strict implementation of One Health measures in Africa to improve human public health and reduce the possibility of potential pandemics due to zoonotic viruses.

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Intrafamily Transmission of Monkeypox Virus, Central African Republic, 2018

Abstract: Monkeypox is a rare viral zoonotic disease; primary infections are reported from remote forest areas of Central and West Africa. We report an investigation of a monkeypox outbreak in Lobaye, southwest Central African Republic, in October 2018.

Cited by 74 publications

References 8 publications

Genomic history of human monkey pox infections in the Central African Republic between 2001 and 2018

Genomic history of human monkey pox infections in the Central African Republic between 2001 and 2018

The changing epidemiology of human monkeypox – a potential threat? A systematic review

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

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