Mpox Control and Prevention

Résumé fourni par la source

Abstract Monkeypox, recently renamed mpox, is an orthopoxvirus closely related to smallpox. Previously limited to sporadic outbreaks in rural Central and West Africa with infrequent importation of cases to other locations, a new global mpox outbreak beginning in May 2022 was declared a Public Health Emergency of International Concern by the World Health Organization, and has exhibited a number of unprecedented characteristics: 1. The current epidemic is associated with a novel variant (clade IIb.1) and has spread to all populated continents; 2. Until recently, sustained person-to-person transmission was limited, with most point sources stemming from zoonotic exposures spilling over into humans—now it’s become the norm; 3. Transmission now occurs mainly through physical contact during sex, which was previously uncommon, and as such, new clinical presentations have been reported, including anogenital lesions and rashes; 4. Whereas previously mpox spread mostly among children, the current outbreak has been overwhelmingly comprised of men who have sex with men (MSM); and 5. The vast majority of recent infections have been mild and self-limiting, in contrast to historic disease manifestation. Recent circulation of mpox challenges established notions of this disease and present unique concerns for public health surveillance and control. Limited familiarity with mpox beyond Africa, novel clinical presentations, and limited testing availability may have each contributed to underascertainment and underreporting of infections in the early period of the current outbreak. Stigma-informed approaches in communication, community engagement, vaccine reintroduction, and comprehensive surveillance remain critical for future measures of prevention and control.