Mpox (formerly known as monkeypox)
is an infectious
viral disease
A viral disease (or viral infection) occurs when an organism's body is invaded by pathogenic viruses, and infectious virus particles (virions) attach to and enter susceptible cells.
Structural Characteristics
Basic structural characteristics, ...
that can occur in humans and some other animals.
Symptoms include a
rash
A rash is a change of the human skin which affects its color, appearance, or texture.
A rash may be localized in one part of the body, or affect all the skin. Rashes may cause the skin to change color, itch, become warm, bumpy, chapped, dry, c ...
that forms
blisters and then crusts over, fever, and
swollen lymph nodes
Edema, also spelled oedema, and also known as fluid retention, dropsy, hydropsy and swelling, is the build-up of fluid in the body's Tissue (biology), tissue. Most commonly, the legs or arms are affected. Symptoms may include skin which feels t ...
.
[ The illness is usually mild and most of those infected will recover within a few weeks without treatment.] The time from exposure to onset of symptoms ranges from five to twenty-one days and symptoms typically last from two to four weeks. Cases may be severe, especially in children, pregnant women or people with suppressed immune systems.
The disease is caused by the monkeypox virus
''Monkeypox virus'' (MPV, MPXV, or hMPXV) is a species of double-stranded DNA virus that causes monkeypox in humans and other mammals. Monkeypox virus is a zoonotic virus belonging to the ''orthopoxvirus'' genus, making it closely related to the ...
, a zoonotic
A zoonosis (; plural zoonoses) or zoonotic disease is an infectious disease of humans caused by a pathogen (an infectious agent, such as a bacterium, virus, parasite or prion) that has jumped from a non-human (usually a vertebrate) to a human. ...
virus in the genus ''Orthopoxvirus
''Orthopoxvirus'' is a genus of viruses in the family ''Poxviridae'' and subfamily ''Chordopoxvirinae''. Vertebrates, including mammals and humans, and arthropods serve as natural hosts. There are 12 species in this genus. Diseases associated wi ...
''. The variola virus, the causative agent of smallpox
Smallpox was an infectious disease caused by variola virus (often called smallpox virus) which belongs to the genus Orthopoxvirus. The last naturally occurring case was diagnosed in October 1977, and the World Health Organization (WHO) c ...
, is also in this genus. Human-to-human transmission can occur through direct contact with infected skin or body fluids, including sexual contact. People remain infectious from the onset of symptoms until all the lesions have scabbed and healed. It may spread from infected animals by handling infected meat or via bites or scratches. Diagnosis can be confirmed by PCR testing a lesion for the virus's DNA.
Vaccination is recommended for those at high risk of infection. Evidence shows that the MVA-BN vaccine is 86% effective at reducing the risk of mpox illness. The aim of treatment is to manage the symptoms and prevent complications as there is no specific treatment for the disease. Antiviral drugs such as tecovirimat
Tecovirimat, sold under the brand name Tpoxx among others, is an antiviral medication with activity against orthopoxviruses such as smallpox and monkeypox. It is the first antipoxviral drug approved in the United States. It is an inhibitor of t ...
can be used to treat mpox, although their effectiveness has not been proved.
Mpox is endemic in central and western Africa
West Africa or Western Africa is the westernmost region of Africa. The United Nations defines Western Africa as the 16 countries of Benin, Burkina Faso, Cape Verde, The Gambia, Ghana, Guinea, Guinea-Bissau, Ivory Coast, Liberia, Mali, Maurita ...
, where several species of mammals are suspected to act as a natural reservoir of the virus. The first human cases were diagnosed in 1970 in the Democratic Republic of the Congo
The Democratic Republic of the Congo (french: République démocratique du Congo (RDC), colloquially "La RDC" ), informally Congo-Kinshasa, DR Congo, the DRC, the DROC, or the Congo, and formerly and also colloquially Zaire, is a country in ...
(DRC). Since then the frequency and severity of outbreaks has significantly increased, possibly as a result of waning immunity
Immunity may refer to:
Medicine
* Immunity (medical), resistance of an organism to infection or disease
* ''Immunity'' (journal), a scientific journal published by Cell Press
Biology
* Immune system
Engineering
* Radiofrequence immunity desc ...
since the cessation of routine smallpox vaccination. The 2022–2023 mpox outbreak
An outbreak of mpox, a viral disease then commonly known as "monkeypox", was confirmed in May 2022. The initial cluster of cases was found in the United Kingdom, where the first case was detected in London on 6 May 2022 in a patient w ...
represents the first incidence of widespread community transmission
In medicine, public health, and biology, transmission is the passing of a pathogen causing communicable disease from an infected host individual or group to a particular individual or group, regardless of whether the other individual was previou ...
outside of Africa. This was initially identified in the United Kingdom in May 2022, with subsequent cases confirmed in 111 countries as of May 2023. The World Health Organization
The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of ...
(WHO) declared the outbreak a Public Health Emergency of International Concern
A public health emergency of international concern (PHEIC) is a formal declaration by the World Health Organization (WHO) of "an extraordinary event which is determined to constitute a public health risk to other States through the internatio ...
(PHEIC) between 23 July 2022 and 10 May 2023.
Nomenclature
The name ''monkeypox'' was originally coined because the disease was first identified in laboratory monkeys. This was subsequently criticised for being a misnomer for a number of reasons.
* monkeys are not the main host or reservoir
* this would reinforce stigma about African countries as a source of disease
* this could encourage racist and homophobic stereotypes that compare people with non-human primates.
Following requests by a number of public health organisations and scientists, who argued that these issues were harming the fight to contain the disease outbreak, in August 2022 the subtypes of monkeypox virus were renamed CladeI and CladeII, and in November 2022, the World Health Organization announced it "will adopt the term ''mpox'' in its communications, and encourages others to follow these recommendations".
Signs and symptoms
The incubation period
Incubation period (also known as the latent period or latency period) is the time elapsed between exposure to a pathogenic organism, a chemical, or radiation, and when symptoms and signs are first apparent. In a typical infectious disease, the in ...
for mpox is between 3 and 17 days. Initial symptoms of mpox infection are fever, muscle pains
Myalgia (also called muscle pain and muscle ache in layman's terms) is the medical term for muscle pain. Myalgia is a symptom of many diseases. The most common cause of acute myalgia is the overuse of a muscle or group of muscles; another lik ...
, and sore throat, followed by an itchy or painful rash, headache, swollen lymph nodes, and fatigue. Not everyone will exhibit the complete range of symptoms.
The rash comprises many small lesions which may appear on the palms and soles, face, mouth and throat, genitals or anus.[ They begin as small flat spots, before becoming small bumps which then fill with fluid and subsequently burst and scab over, persisting for around ten days.][
Some patients may manifest only a single sore from the disease while others may have hundreds.] It is possible for a person to be infected with monkeypox virus without showing any symptoms. Symptoms typically last for two to four weeks, but may last longer if the patient has a weakened immune system.
Complications
Complications include secondary infections, pneumonia
Pneumonia is an inflammatory condition of the lung primarily affecting the small air sacs known as alveoli. Symptoms typically include some combination of productive or dry cough, chest pain, fever, and difficulty breathing. The severi ...
, sepsis
Sepsis, formerly known as septicemia (septicaemia in British English) or blood poisoning, is a life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs. This initial stage is follo ...
, encephalitis, and loss of vision following cornea
The cornea is the transparent front part of the eye that covers the iris, pupil, and anterior chamber. Along with the anterior chamber and lens, the cornea refracts light, accounting for approximately two-thirds of the eye's total optical ...
l infection.[ Persons with weakened immune systems, whether due to medication, medical conditions, or HIV, are more likely to develop severe disease.] If infection occurs during pregnancy, this may lead to still birth
Stillbirth is typically defined as fetal death at or after 20 or 28 weeks of pregnancy, depending on the source. It results in a baby born without signs of life. A stillbirth can result in the feeling of guilt or grief in the mother. The term i ...
or other complications.
Outcome
Provided there are no complications, sequelae
A sequela (, ; usually used in the plural, sequelae ) is a pathological condition resulting from a disease, injury, therapy, or other trauma. Derived from the Latin word, meaning “sequel”, it is used in the medical field to mean a complication ...
are rare; after healing, the scabs may leave pale marks before becoming darker scars.
Prior to the 2022 outbreak, the risk of death in those infected was estimated from 0% to 11%, however in the 2022 global outbreak 112 deaths were reported in 87,000 cases. Most reported deaths in this outbreak were among those who were immunocompromised either due to medication or poorly controlled HIV infection.
In other animals
It is thought that small mammals provide a reservoir
A reservoir (; from French ''réservoir'' ) is an enlarged lake behind a dam. Such a dam may be either artificial, built to store fresh water or it may be a natural formation.
Reservoirs can be created in a number of ways, including contro ...
for the virus in endemic
Endemism is the state of a species being found in a single defined geographic location, such as an island, state, nation, country or other defined zone; organisms that are indigenous to a place are not endemic to it if they are also found else ...
areas. Spread among animals occurs via the fecal-oral route and through the nose, through wounds and eating infected meat. The disease has also been reported in a wide range of other animals including monkeys, anteaters, hedgehogs, prairie dogs, squirrels, and shrews. Signs and symptoms in animals are not well researched and further studies are in progress.
There have been instances of animal infection outside of endemic Africa; during the 2003 US outbreak, prairie dogs (''Cynomys ludovicianus'') became infected and presented with fever, cough, sore eyes
Conjunctivitis, also known as pink eye, is inflammation of the outermost layer of the white part of the eye and the inner surface of the eyelid. It makes the eye appear pink or reddish. Pain, burning, scratchiness, or itchiness may occur. The ...
, poor feeding and rash. There has also been an instance of a domestic dog (''Canis familiaris'') which became infected displaying lesions and ulceration.
Cause
Mpox in both humans and animals is caused by infection with the monkeypox virus
''Monkeypox virus'' (MPV, MPXV, or hMPXV) is a species of double-stranded DNA virus that causes monkeypox in humans and other mammals. Monkeypox virus is a zoonotic virus belonging to the ''orthopoxvirus'' genus, making it closely related to the ...
– a double-stranded DNA virus
A DNA virus is a virus that has a genome made of deoxyribonucleic acid (DNA) that is replicated by a DNA polymerase. They can be divided between those that have two strands of DNA in their genome, called double-stranded DNA (dsDNA) viruses, and ...
in the genus ''Orthopoxvirus
''Orthopoxvirus'' is a genus of viruses in the family ''Poxviridae'' and subfamily ''Chordopoxvirinae''. Vertebrates, including mammals and humans, and arthropods serve as natural hosts. There are 12 species in this genus. Diseases associated wi ...
'', family ''Poxviridae
''Poxviridae'' is a family of double-stranded DNA viruses. Vertebrates and arthropods serve as natural hosts. There are currently 83 species in this family, divided among 22 genera, which are divided into two subfamilies. Diseases associated wit ...
,'' making it closely related to the smallpox
Smallpox was an infectious disease caused by variola virus (often called smallpox virus) which belongs to the genus Orthopoxvirus. The last naturally occurring case was diagnosed in October 1977, and the World Health Organization (WHO) c ...
, cowpox
Cowpox is an infectious disease caused by the ''cowpox virus'' (CPXV). It presents with large blisters in the skin, a fever and swollen glands, historically typically following contact with an infected cow, though in the last several decades more ...
, and vaccinia
''Vaccinia virus'' (VACV or VV) is a large, complex, enveloped virus belonging to the poxvirus family. It has a linear, double-stranded DNA genome approximately 190 kbp in length, which encodes approximately 250 genes. The dimensions of the ...
viruses. The two subtypes of virus are CladeI and CladeII. CladeII is further divided into subclades: CladeIIa and CladeIIb. Cases identified as part of the 2022-2023 global outbreak are caused by CladeIIb. CladeI is largely limited to the DRC
The Democratic Republic of the Congo (french: République démocratique du Congo (RDC), colloquially "La RDC" ), informally Congo-Kinshasa, DR Congo, the DRC, the DROC, or the Congo, and formerly and also colloquially Zaire, is a country in ...
and is estimated to cause more severe disease and higher mortality than Clades IIa and IIb.
The virus is considered to be endemic in tropical rainforest
Tropical rainforests are rainforests that occur in areas of tropical rainforest climate in which there is no dry season – all months have an average precipitation of at least 60 mm – and may also be referred to as ''lowland equa ...
regions of Central and West Africa. In addition to monkeys, the virus has been identified in Gambian pouched rat
The Gambian pouched rat (''Cricetomys gambianus''), also commonly known as the African giant pouched rat, is a species of nocturnal pouched rat of the giant pouched rat genus ''Cricetomys'', in the family Nesomyidae. It is among the largest m ...
s (''Cricetomys gambianus''), dormice
A dormouse is a rodent of the family Gliridae (this family is also variously called Myoxidae or Muscardinidae by different taxonomists). Dormice are nocturnal animals found in Africa, Asia, and Europe. They are named for their long, dormant hibe ...
(''Graphiurus
The African dormice (genus ''Graphiurus'') are dormice that live throughout sub-Saharan Africa in a variety of habitats. They are very agile climbers and have bushy tails. They eat invertebrates and small vertebrates.
Species
Genus ''Graphiurus' ...
'' spp.) and African squirrels ('' Heliosciurus'', and '' Funisciurus''). The use of these animals as food may be an important source of transmission to humans.
Transmission
Mpox can be transmitted from one person to another through contact with infectious lesion material or fluid on the skin, in the mouth or on the genitals; this includes touching, close contact and during sex. It may also spread by means of respiratory droplets from talking, coughing or sneezing. During the 2022-2023 outbreak, transmission between people was almost exclusively via sexual contact. There is a lower risk of infection from fomite
A fomite () or fomes () is any inanimate object that, when contaminated with or exposed to infectious agents (such as pathogenic bacteria, viruses or fungi), can transfer disease to a new host.
Transfer of pathogens by fomites
A fomite is any ...
s (objects which can become infectious after being touched by an infected person) such as clothing or bedding, but precautions should be taken.
The virus then enters the body through broken skin, or mucosal surfaces such as the mouth, respiratory tract, or genitals.
The natural reservoir
In infectious disease ecology and epidemiology, a natural reservoir, also known as a disease reservoir or a reservoir of infection, is the population of organisms or the specific environment in which an infectious pathogen naturally lives and r ...
of monkeypox virus is thought to be small mammals in tropical Africa. The virus can be transmitted from animal to human from bites or scratches, or during activities such as hunting, skinning, or cooking infected animals''.''
Diagnosis
Clinical differential diagnosis must consider other rash illnesses, such as chickenpox, measles, bacterial skin infections, scabies, syphilis and medication-associated allergies. Diagnosis can be verified by testing for the virus. Polymerase chain reaction
The polymerase chain reaction (PCR) is a method widely used to rapidly make millions to billions of copies (complete or partial) of a specific DNA sample, allowing scientists to take a very small sample of DNA and amplify it (or a part of it) ...
(PCR) testing of samples from skin lesions is the preferred laboratory test.
Prevention
The MVA-BN vaccine, originally developed for smallpox, has been approved for use by persons who are either considered at high risk of exposure to mpox, or who may have recently been exposed to it. The United States Centers for Disease Control and Prevention
The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency, under the Department of Health and Human Services, and is headquartered in Atlanta, Georgi ...
(CDC) recommends that persons investigating mpox outbreaks, those caring for infected individuals or animals, and those exposed by close or intimate contact with infected individuals or animals should receive a vaccination.
Historically, smallpox vaccine
The smallpox vaccine is the first vaccine to be developed against a contagious disease. In 1796, British physician Edward Jenner demonstrated that an infection with the relatively mild cowpox virus conferred immunity against the deadly smallpox ...
had been reported to reduce the risk of mpox among previously vaccinated persons in Africa. The decrease in immunity to poxviruses in exposed populations is a factor in the increasing prevalence of human mpox. It is attributed to waning cross-protective immunity among those vaccinated before 1980, when mass smallpox vaccinations were discontinued, and to the gradually increasing proportion of unvaccinated individuals.
The CDC has made detailed recommendations in addition to the standard precautions for infection control. These include that healthcare providers don a gown, mask, goggles, and a disposable filtering respirator (such as an N95), and that an infected person should be isolated a private room to keep others from possible contact.
Those living in countries where mpox is endemic should avoid contact with sick mammals such as rodents, marsupials, non-human primates (dead or alive) that could harbour monkeypox virus and should refrain from eating or handling wild game (bush meat
Bushmeat is meat from wildlife species that are hunted for human consumption, most often referring to the meat of game in Africa. Bushmeat represents
a primary source of animal protein and a cash-earning commodity for inhabitants of humid tro ...
).
During the 2022-2023 outbreak, several public health authorities launched public awareness campaigns in order to reduce spread of the disease.
Treatment
Most cases of mpox present with mild symptoms and there is complete recovery within 2 to 4 weeks. There is no specific treatment for the disease, although antivrals such as tecovirimat
Tecovirimat, sold under the brand name Tpoxx among others, is an antiviral medication with activity against orthopoxviruses such as smallpox and monkeypox. It is the first antipoxviral drug approved in the United States. It is an inhibitor of t ...
have been approved for the treatment of severe mpox.. Pain is common and may be severe; supportive care such as pain or fever control may be administered. Patients with mild disease should isolate
Isolate may refer to:
Arts, entertainment, and media
* ''Isolate'' (film), a 2013 Australian film
* ''Isolate'' (Circus Maximus album), 2007
* ''Isolate'' (Gary Numan album), 1992
Language
* Isolating language, with near-unity morpheme/word ...
at home, stay hydrated, eat well, and take steps to maintain their mental health.
Patients who are at high risk from the disease include children, pregnant women, the elderly and those who are immunocompromised
Immunodeficiency, also known as immunocompromisation, is a state in which the immune system's ability to fight infectious diseases and cancer is compromised or entirely absent. Most cases are acquired ("secondary") due to extrinsic factors that a ...
. For these patients, or those who have severe disease, hospital admission and careful monitoring of symptoms is recommended, Symptomatic treatment is recommended for complications such as proctitis, and pruritis
Itch (also known as pruritus) is a sensation that causes the desire or reflex to scratch. Itch has resisted many attempts to be classified as any one type of sensory experience. Itch has many similarities to pain, and while both are unpleasan ...
.
Epidemiology
History
Mpox was first identified as a distinct illness in 1958 among laboratory monkeys in Copenhagen
Copenhagen ( or .; da, København ) is the capital and most populous city of Denmark, with a proper population of around 815.000 in the last quarter of 2022; and some 1.370,000 in the urban area; and the wider Copenhagen metropolitan ar ...
, Denmark. The first documented cases in humans was in 1970, in six unvaccinated children during the smallpox eradication efforts; the first being a 9-month-old boy in the Democratic Republic of the Congo
The Democratic Republic of the Congo (french: République démocratique du Congo (RDC), colloquially "La RDC" ), informally Congo-Kinshasa, DR Congo, the DRC, the DROC, or the Congo, and formerly and also colloquially Zaire, is a country in ...
(DRC). From 1981 to 1986, over 300 cases of human mpox were reported in the DRC, the majority being due to contact with animals. The virus has been detected In Gambian pouched rat
The Gambian pouched rat (''Cricetomys gambianus''), also commonly known as the African giant pouched rat, is a species of nocturnal pouched rat of the giant pouched rat genus ''Cricetomys'', in the family Nesomyidae. It is among the largest m ...
s, dormice
A dormouse is a rodent of the family Gliridae (this family is also variously called Myoxidae or Muscardinidae by different taxonomists). Dormice are nocturnal animals found in Africa, Asia, and Europe. They are named for their long, dormant hibe ...
and African squirrels, which are often used as food.
Many more mpox cases have been reported in Central and West Africa, and in the Democratic Republic of Congo in particular: 2000 cases per year are known between 2011 and 2014. The collected data is often incomplete and unconfirmed, which hinders realistic estimations of the number of cases of mpox over time. Originally thought to be uncommon in humans, cases increased since the 1980s, possibly as a result of waning immunity
Immunity may refer to:
Medicine
* Immunity (medical), resistance of an organism to infection or disease
* ''Immunity'' (journal), a scientific journal published by Cell Press
Biology
* Immune system
Engineering
* Radiofrequence immunity desc ...
since the stopping of routine smallpox vaccination.
Deaths
Historically, the case fatality rate
In epidemiology, case fatality rate (CFR) – or sometimes more accurately case-fatality risk – is the proportion of people diagnosed with a certain disease, who end up dying of it. Unlike a disease's mortality rate, the CFR does not take int ...
(CFR) of past outbreaks was estimated at between 1% and 10%, with Clade I considered to be more severe than Clade II. However the CFR of the 2022-2023 global outbreak (caused by Clade IIb) has been very low - estimated at 0.16%, with the majority of deaths in individuals who were already immunocompromised
Immunodeficiency, also known as immunocompromisation, is a state in which the immune system's ability to fight infectious diseases and cancer is compromised or entirely absent. Most cases are acquired ("secondary") due to extrinsic factors that a ...
. The huge difference between these estimates is attributed to: -
* under-reporting of mild cases in the endemic areas
* evolution
Evolution is change in the heritable characteristics of biological populations over successive generations. These characteristics are the expressions of genes, which are passed on from parent to offspring during reproduction. Variation ...
of the virus to cause milder disease in humans
* better general health, and better healthcare, in the populations most affected by the 2022-2023 global outbreak.
Future threat
The natural reservoir of monkeypox virus has not been conclusively determined, although small rodents are the most likely candidate. Without a major vaccination campaign, mpox outbreaks in humans will continue indefinitely in the endemic areas, with an ongoing risk that disease outbreaks will spread to non-endemic areas. Other evidence - that the virus is evolving to be more transmissible among humans, that it can infect a wide range of host species, and that human to animal transmission can occur - lead to concerns that mpox may either become established in new natural reservoirs outside of Africa, or cause future global epidemics.
Outbreaks
This section is an incomplete list of disease outbreaks which have been reported outside the endemic countries in tropical Africa (Benin, Cameroon, the Central African Republic, the Democratic Republic of the Congo, Gabon, Ghana, Ivory Coast, Liberia, Nigeria, the Republic of the Congo, Sierra Leone, and South Sudan). Outbreaks of mpox are frequent in areas where the disease is endemic - these areas often have poor healthcare infrastructure and outbreaks are rarely documented.
United States
In May 2003, a young child became ill with fever and rash after being bitten by a prairie dog purchased at a local swap meet near Milwaukee
Milwaukee ( ), officially the City of Milwaukee, is both the most populous and most densely populated city in the U.S. state of Wisconsin and the county seat of Milwaukee County. With a population of 577,222 at the 2020 census, Milwaukee ...
, Wisconsin
Wisconsin () is a state in the upper Midwestern United States. Wisconsin is the 25th-largest state by total area and the 20th-most populous. It is bordered by Minnesota to the west, Iowa to the southwest, Illinois to the south, Lake M ...
. In total, 71 cases of mpox were reported through 20 June 2003. All cases were traced to Gambian pouched rats imported from Accra, Ghana
Ghana (; tw, Gaana, ee, Gana), officially the Republic of Ghana, is a country in West Africa. It abuts the Gulf of Guinea and the Atlantic Ocean to the south, sharing borders with Ivory Coast in the west, Burkina Faso in the north, and To ...
, in April 2003 by a Texas exotic animal distributor. No deaths resulted. Electron microscopy and serologic studies were used to confirm that the disease was human mpox. Everyone affected reported direct or close contact with prairie dogs, later found to be infected with the monkeypox virus.
In July 2021, in the US, an American returning from a trip in Nigeria was diagnosed with mpox. Subsequent testing identified the virus as belonging to cladeII. The patient was hospitalized and treated with tecovirimat and was discharged after 32 days.
Sudan
During 2022, an outbreak of Clade I mpox was reported in refugee camps in Sudan.
Nigeria
In September 2017, monkeypox virus was reported in Nigeria. The subsequent outbreak was, at that time, the largest ever outbreak of cladeII of the virus, with 118 confirmed cases. Unlike previous outbreaks of this clade, infection was predominantly among young male adults and human-to-human transmission appears to have readily occurred. Seven deaths (5 male, 2 female, case fatality rate of 6%) were reported, including a baby and four HIV/AIDS
Human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS) is a spectrum of conditions caused by infection with the human immunodeficiency virus (HIV), a retrovirus. Following initial infection an individual ...
patients. Additionally, a pregnant woman in her second trimester had a spontaneous miscarriage attributed to monkeypox virus infection.
In May 2022, the Nigerian government released a report stating that between 2017 and 2022, 558 cases were confirmed across 32 states and the Federal Capital Territory. There were 8 deaths reported, making for a 3.5% Case Fatality Ratio
In epidemiology, case fatality rate (CFR) – or sometimes more accurately case-fatality risk – is the proportion of people diagnosed with a certain disease, who end up dying of it. Unlike a disease's mortality rate, the CFR does not take int ...
. In 2022, NCDC implemented a National Technical Working Group for reporting and monitoring infections, strengthening response capacity.
United Kingdom
In September 2018, the United Kingdom's first case of mpox was recorded. The person, a Nigerian national, is believed to have contracted mpox in Nigeria before travelling to the United Kingdom. A second case was confirmed in the town of Blackpool, with a further case that of a medical worker who cared for the case from Blackpool.
In December 2019, mpox was diagnosed in a person in South West England who had travelled to the UK from Nigeria.
In May 2021, in the UK, three cases of mpox from a single household were identified by Public Health Wales
Public Health Wales (PHW; ) is an NHS Trust which was established on 1 October 2009 as part of a major restructuring of the health service in Wales. It aims to protect and improve health and wellbeing and reduce health inequalities in Wales.
M ...
. The index case
The index case or patient zero is the first documented patient in a disease epidemic within a population, or the first documented patient included in an epidemiological study.
It can also refer to the first case of a condition or syndrome (not n ...
had travelled from Nigeria
Nigeria ( ), , ig, Naìjíríyà, yo, Nàìjíríà, pcm, Naijá , ff, Naajeeriya, kcg, Naijeriya officially the Federal Republic of Nigeria, is a country in West Africa. It is situated between the Sahel to the north and the Gulf o ...
.
Singapore
In May 2019, a 38-year-old man who travelled from Nigeria was hospitalised in an isolation ward at the National Centre for Infectious Diseases
The National Centre for Infectious Diseases (Abbreviation: NCID; ms, Pusat Nasional bagi Penyakit Berjangkit; ta, தேசிய தொற்றுநோய் மையம்; Chinese: ), previously known as the Communicable Disease Centre ...
in Singapore, after being confirmed as the country's first case of mpox. As a result, 22 people were quarantined. The case may have been linked to a simultaneous outbreak in Nigeria.
2022–2023 Global outbreak
An outbreak of mpox was confirmed in May 2022. The initial cluster of cases was found in the United Kingdom, where the first case was detected in London on 6 May 2022 in a patient with a recent travel history from Nigeria
Nigeria ( ), , ig, Naìjíríyà, yo, Nàìjíríà, pcm, Naijá , ff, Naajeeriya, kcg, Naijeriya officially the Federal Republic of Nigeria, is a country in West Africa. It is situated between the Sahel to the north and the Gulf o ...
(where the disease is endemic
Endemism is the state of a species being found in a single defined geographic location, such as an island, state, nation, country or other defined zone; organisms that are indigenous to a place are not endemic to it if they are also found else ...
). On 16 May, the UK Health Security Agency
The UK Health Security Agency (UKHSA) is a government agency in the United Kingdom, responsible since April 2021 for England-wide public health protection and infectious disease capability, and replacing Public Health England. It is an executiv ...
(UKHSA) confirmed four new cases with no link to travel to a country where mpox is endemic. All four cases appeared to have been infected in London. From 18 May onwards, cases were reported from an increasing number of countries and regions, predominantly in Europe and in the Americas but also in Asia, in Africa, and in Oceania. In May 2023, the World Health Organization declared an end to the global health emergency declared in response to the worldwide outbreak of mpox virus.
See also
* 2003 Midwest monkeypox outbreak
Beginning in May 2003, by July a total of 71 cases of human monkeypox were found in six Midwestern states including Wisconsin (39 cases), Indiana (16), Illinois (12), Kansas (1), Missouri (2), and Ohio (1). The cause of the outbreak was traced ...
* 2022–2023 mpox outbreak
An outbreak of mpox, a viral disease then commonly known as "monkeypox", was confirmed in May 2022. The initial cluster of cases was found in the United Kingdom, where the first case was detected in London on 6 May 2022 in a patient w ...
* 2022–2023 mpox outbreak in Canada
* 2022–2023 mpox outbreak in the United States
* 2022–2023 mpox outbreak in the United Kingdom
Notes
References
External links
CDC – Mpox
WHO – Monkeypox Fact Sheet
"Could Monkeypox Take Over Where Smallpox Left Off?"
''Scientific American
''Scientific American'', informally abbreviated ''SciAm'' or sometimes ''SA'', is an American popular science magazine. Many famous scientists, including Albert Einstein and Nikola Tesla, have contributed articles to it. In print since 1845, it ...
'', 4 March 2013.
MonkeypoxTracker
– Monkeypox statistics visualization site
PoxApp – the mpox app
– Assesses skin lesions and symptoms with artificial intelligence
Artificial intelligence (AI) is intelligence—perceiving, synthesizing, and inferring information—demonstrated by machines, as opposed to intelligence displayed by animals and humans. Example tasks in which this is done include speech r ...
developed by Stanford University
{{Authority control
Animal viral diseases
Naming controversies
Poxviruses
2022 neologisms
Virus-related cutaneous conditions
Wikipedia medicine articles ready to translate