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Haider N, Guitian J, Simons D, Asogun D, Ansumana R, Honeyborne I, Velavan TP, Ntoumi F, Valdoleiros SR, Petersen E, Kock R, Zumla A. Increased outbreaks of monkeypox highlight gaps in actual disease burden in Sub-Saharan Africa and in animal reservoirs. Int J Infect Dis 2022; 122:107-111. [PMID: 35640830 PMCID: PMC9534138 DOI: 10.1016/j.ijid.2022.05.058] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 05/25/2022] [Accepted: 05/25/2022] [Indexed: 01/25/2023] Open
Abstract
We explain research gaps on Monkeypox (MPX) virus epidemiology in endemic countries and present hypotheses for the recent increase of MPX cases in West Africa as a possible explanation for the current epidemic in Europe, America, and Australia. The detection of >400 MPX cases in less than a month in May 2022, across many countries underscores the epidemic potential of MPX in humans and demonstrates several important research gaps. First, the true burden of MPX in West and Central Africa is poorly understood, although it is critical for prevention and control of future outbreaks. Second, the diversity and extent of the animal reservoir remain unknown. We hypothesize that the synanthropic rodent population has increased in recent years in Africa leading to more human-rodent interactions and thus increased transmission of MPXV. We further hypothesise that nearly 45 years after the end of routine smallpox vaccination, the larger and more interconnected immune-naïve population has crossed a threshold resulting in more sustainable human-to-human transmission of MPXV. The current epidemic in the Western World is possibly a consequence of increased local transmission of MPXV in Africa. A new estimation of the basic and effective reproduction rate (R0 and Re) in different populations is required. National, regional, and international collaborations are needed to address research gaps related to MPX outbreaks.
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Affiliation(s)
- Najmul Haider
- The Royal Veterinary College, University of London, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, United Kingdom.
| | - Javier Guitian
- The Royal Veterinary College, University of London, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, United Kingdom.
| | - David Simons
- The Royal Veterinary College, University of London, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, United Kingdom.
| | - Danny Asogun
- Irrua Specialized Teaching Hospital, Irrua, Nigeria.
| | - Rashid Ansumana
- School of Community Health Science, Njala University, Bo Campus, Sierra Leone.
| | - Isobella Honeyborne
- Division of Infection and Immunity, Centre for Clinical Microbiology, University College London, United Kingdom.
| | - Thirumalaisamy P Velavan
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany; Vietnamese-German Center for Medical Research (VG-CARE), Hanoi, Vietnam.
| | - Francine Ntoumi
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany; Congolese Foundation for Medical Research, Brazzaville, Republic of Congo.
| | - Sofia R Valdoleiros
- Infectious Diseases Department, Centro Hospitalar Universitário de São João, Porto, Portugal; European Society for Clinical Microbiology and Infectious Diseases, Basel, Switzerland.
| | - Eskild Petersen
- European Society for Clinical Microbiology and Infectious Diseases, Basel, Switzerland; Institute for Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - Richard Kock
- The Royal Veterinary College, University of London, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, United Kingdom.
| | - Alimuddin Zumla
- Division of Infection and Immunity, Centre for Clinical Microbiology, University College London, United Kingdom; NIHR-BRC, University College London Hospitals, London, United Kingdom.
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