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As the world still vividly recalls the previous monkeypox (mpox) outbreak that impacted over 120 countries worldwide with more than 99,000 cases in 2022, we are now facing a second wave of infections from the monkeypox virus (MPXV), characterized by an exponential increase in cases. The current 2024 outbreak has already recorded more than 20,000 cases in Africa, marking a dramatic escalation compared to previous outbreaks. The predominance of the newly identified clade Ib variant, first detected in the Democratic Republic of the Congo (DRC) and now identified across multiple African nations and beyond, underscores its enhanced transmissibility and potential for international spread, evidenced by cases in Sweden and Thailand. The World Health Organization (WHO) declared on August 14, 2024, the current mpox outbreak a Public Health Emergency of International Concern (PHEIC), calling for heightened global public health measures. The ongoing pattern of unusual, frequent, and extensive outbreaks of mpox with potential global implications poses significant questions. This review addresses, in the format of 50 questions and answers, the 2024 mpox outbreak, detailing its characteristics, epidemiological data, and impact compared to previous outbreaks. It comprehensively explores critical questions related to MPXV virological characteristics, immunological response, clinical manifestations, epidemiology, diagnostics, and available treatments. The review also documents the significant and evolving challenges posed by the current mpox outbreak, highlighting its scale, spread, and public health response.
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http://dx.doi.org/10.1111/all.16374 | DOI Listing |
Lancet Microbe
September 2025
Institut Pasteur de Bangui, Bangui, Central African Republic; Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon. Electronic address:
Background: The spread of monkeypox virus (Orthopoxvirus monkeypox) clade Ib from the Democratic Republic of the Congo to neighbouring countries has raised global concerns, leading to WHO declaring mpox a public health emergency on Aug 14, 2024. We applied genomic epidemiology to investigate the causes of recurrent mpox outbreaks in the Central African Republic. We aimed to determine whether frequent zoonotic spillovers or increased human-to-human transmissions are driving mpox epidemiology.
View Article and Find Full Text PDFPLoS Med
September 2025
Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.
Background: Limited mpox vaccination coverage, declining cross-protection from historical smallpox vaccination campaigns, and persistent zoonotic reservoirs leave many sub-Saharan countries susceptible to mpox outbreaks. With millions of vaccine doses made available to the region since late 2024 and the absence of country-specific guidelines for allocation, estimating the country-specific impact of one-time mass vaccination strategies is necessary for ongoing outbreaks and other countries at future risk.
Methods And Findings: We adapted a next generation matrix model to project disease transmission potential for 47 sub-Saharan countries from 2025 to 2050 under four transmission scenarios with different contributions of community versus sexual contacts.
BMJ Glob Health
September 2025
Medecins Sans Frontieres UK, London, England, UK.
Int J Infect Dis
September 2025
School of Health Sciences Research, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand; Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand. Electronic address:
Objectives: The 2022 global mpox outbreak revealed major surveillance gaps, particularly among marginalized populations such as sex workers, whose role in undetected MPXV transmission remains poorly understood. This study aims to assess the seroprevalence of MPXV IgG antibodies and identify associated risk factors among sex workers in Chiang Mai, Thailand.
Methods: In this cross-sectional study, 262 sex workers recruited from March to December 2022 were tested for prior MPXV exposure using an in-house indirect ELISA targeting the recombinant MPXV E8L antigen.
Ann Med Surg (Lond)
September 2025
Department of Research, Toufik's World Organization, Sumy, Ukraine.
In 2022, the presumption of monkeypox (mpox) to be of limited epidemiology shifted when a global outbreak was announced. Being a member of the Orthopoxvirus genus in the Poxviridae family, it'd been reported in over 82 countries with over 17 000 confirmed cases by July 2022, thus showing its capability for spreading rapidly. As the smallpox vaccine offers 85% cross-immunity against mpox, the outbreak highlighted the attenuation of global immunity against orthopoxviruses after the cessation of vaccination campaigns against smallpox.
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