Article Category:
Review Article

The Human Mpox Global Outbreak: Available Control Tools and the Opportunity to Break a Cycle of Neglect in Endemic Countries

Jean B. Nachega Division of Infectious Diseases, Department of Medicine, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, South Africa;
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;
Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania;
Department of Infectious Diseases and Microbiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania;
Center for Global Health, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania;

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Placide Mbala-Kingebeni Institut National de la Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo;
University of Kinshasa School of Medicine, Kinshasa, Democratic Republic of the Congo;

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Philip J. Rosenthal Division of Infectious Diseases, Department of Medicine, University of California, San Francisco, California;

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Anne W. Rimoin Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California;

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Nicole A. Hoff Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California;

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Laurens Liesenborghs Institute of Tropical Medicine, Antwerp, Belgium;

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Veerle Vanlerberghe Institute of Tropical Medicine, Antwerp, Belgium;

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Graciela Andrei Department of Microbiology and Immunology, Rega Institute, KU Leuven, Leuven, Belgium;

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Angeli Rawat Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Canada;

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Lindsay A. Wilson Platform Life Sciences, Vancouver, Canada;

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Jamie Forrest Platform Life Sciences, Vancouver, Canada;

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Edward J. Mills Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Canada;
Platform Life Sciences, Vancouver, Canada;

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Michel P. Hermans Department of Endocrinology, St-Luc University Hospital, Brussels, Belgium;

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Sabue Mulangu Institut National de la Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo;
University of Kinshasa School of Medicine, Kinshasa, Democratic Republic of the Congo;

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Francine Ntoumi Fondation Congolaise pour la Recherche Médicale, Brazzaville, Republic of Congo;
Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany;

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Alimuddin Zumla Division of Infection and Immunity, Centre for Clinical Microbiology, University College London, London, United Kingdom;
National Institute for Health and Care Research Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, United Kingdom

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Jean-Jacques Muyembe-Tamfum Institut National de la Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo;
University of Kinshasa School of Medicine, Kinshasa, Democratic Republic of the Congo;

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DOI:
https://doi.org/10.4269/ajtmh.23-0161
Volume/Issue:
Volume 109: Issue 4
Page(s):
719–724
Restricted access
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ABSTRACT.

The 2022 global outbreak of human Mpox (formerly monkeypox) virus (MPXV) infection outside of the usual endemic zones in Africa challenged our understanding of the virus’s natural history, transmission dynamics, and risk factors. This outbreak has highlighted the need for diagnostics, vaccines, therapeutics, and implementation research, all of which require more substantial investments in equitable collaborative partnerships. Global multidisciplinary networks need to tackle MPXV and other neglected emerging and reemerging zoonotic pathogens to address them locally and prevent or quickly control their worldwide spread. Political endorsement from individual countries and financial commitments to maintain control efforts will be essential for long-term sustainability.

Author Notes

Address correspondence to Jean B. Nachega, Department of Epidemiology, Department of Infectious Diseases and Microbiology, and Center for Global Health, University of Pittsburgh School of Public Health, 130 DeSoto St., Crabtree Hall A532, Pittsburgh, PA 15261. E-mail: jbn16@pitt.edu

Financial support: J. B. N. is supported by NIH/NIAID and Fogarty International Center (FIC) grant numbers NIH/FIC 1R25TW011217-01, NIH/FIC 1D43TW010937-01A1, NIH/FIC D43TW011827-01A1, NIH/FIC 1R21TW011706-0, and NIH/NIAID 5U01AI096299-13. A. W. R. and N. A. H. are supported by grant HDTRA12110040, funded by the U.S. Defense Threat Reduction Agency, titled “Monkeypox Threat Reduction Network (MPX-TRN): Using the Sentinel Sites in the Democratic Republic of the Congo”; L. L. is supported by the Research Foundation–Flanders (Grant G096222N). F. N. and A. Z. are codirectors of the Pan-African Network on Emerging and Re-Emerging Infections (PANDORA-ID-NET; https://www.pandora-id.net/) funded by the European and Developing Countries Clinical Trials Partnership (EDCTP) within the EU Horizon 2020 Framework Programme. They also acknowledge support from the EDCTP Central Africa Clinical Research Network (CANTAM-3; http://cantam.net/en/). A. Z. is a UK National Institute for Health Research senior investigator and a Mahathir Science Award and EU-EDCTP Pascoal Mocumbi Prize laureate. J.-J. M.-T. is supported by Africa–Centers for Disease Control and Prevention, the Bill and Melinda Gates Foundation, and NIH/NIAID grant number 75N91019D00024-P00001-759102000025-5; as a codiscoverer of the Ebola virus in 1976, he was awarded “Le Prix Christophe Mérieux” from the Institut de France in 2015 and is also the recipient of the third Hideyo Noguchi Africa Prize for Medical Research in 2019 from the Government of Japan for his research to confront Ebola and other emerging and reemerging pathogens and efforts to train legions of disease fighters in Africa.

Disclosure: We searched PubMed using medical subject headings (MeSHs). We focused on keywords and related variants to monkeypox (MeSH terms: MESH.EXACT[“Monkeypox”] OR MESH.EXACT[“Monkeypox virus”]). We also searched terms related to Variola virus, Vaccinia virus, Orthopoxvirus, and smallpox vaccine. We reviewed articles discussing the etiology, vaccination, and transmission of monkeypox virus in both humans and animals that were published in English up to November 2022. The authors were also recommended specific articles to review. The final reference list was generated based on the relevance of the articles to the scope of this viewpoint. The views and conclusions in this paper are those of the authors and do not necessarily represent the views of their institutions.

Authors’ addresses: Jean B. Nachega, Division of Infectious Diseases, Department of Medicine, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, South Africa, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, Department of Infectious Diseases and Microbiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, and Center for Global Health, University of Pittsburgh School of Public Health, Pittsburgh, PA, E-mail: jbn16@pitt.edu. Placide Mbala-Kingebeni, Sabue Mulangu, and Jean-Jacques Muyembe-Tamfum, Institut National de la Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo, and University of Kinshasa School of Medicine, Kinshasa, Democratic Republic of the Congo, E-mails: mbalaplacide@gmail.com, sabuemulo@yahoo.fr, and jjmuyembet@gmail.com. Philip J. Rosenthal, Division of Infectious Diseases, Department of Medicine, University of California, San Francisco, CA, E-mail: philip.rosenthal@ucsf.edu. Anne W. Rimoin and Nicole A. Hoff, Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, E-mails: arimoin@g.ucla.edu and nhoff84@ucla.edu. Laurens Liesenborghs and Veerle Vanlerberghe, Institute of Tropical Medicine, Antwerp, Belgium, E-mails: lliensenborghs@itg.be and vvanlerberghe@itg.be. Graciela Andrei, Department of Microbiology and Immunology, Rega Institute, KU Leuven, Leuven, Belgium, E-mail: graciela.andrei@kuleuven.be. Angeli Rawat, Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Canada, E-mail: angelirawat@gmail.com. Lindsay A. Wilson and Jamie Forrest, Platform Life Sciences, Vancouver, Canada, E-mails: lwilson@platformlifesciences.com and jforrest@platformlifesciences.com. Edward J. Mills, Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Canada, and Platform Life Sciences, Vancouver, Canada, E-mail: emills@platformlifesciences.com. Michel P. Hermans, Department of Endocrinology, St-Luc University Hospital, Brussels, Belgium, E-mail: michel.hermans@saintluc.uclouvain.be. Francine Ntoumi, Fondation Congolaise pour la Recherche Médicale, Brazzaville, Republic of Congo, and Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany, E-mail: ffntoumi@hotmail.com. Alimuddin Zumla, Division of Infection and Immunity, Centre for Clinical Microbiology, University College London, United Kingdom, and National Institute for Health and Care Research Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, United Kingdom, E-mail: a.i.zumla@gmail.com.

Copyright:
© American Society of Tropical Medicine and Hygiene 2023
Received:
13 Mar 2023
|
Accepted:
22 May 2023
|
Published Online:
14 Aug 2023
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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