Emergence of Monkeypox — West and Central Africa, 1970–2017

TLDR

Monkeypox cases have risen across a broad geographic area, with more countries reporting endemic disease in the past decade than before, yet many lack surveillance capacity and disease knowledge, heightening concern for further spread. The study aims to identify and address gaps in surveillance, diagnostics, infection control, and epidemiological knowledge to enable an effective monkeypox response. The authors convened a WHO–CDC–partner consultation in November 2017 to review recent African monkeypox cases and identify surveillance and response improvements. Confirmed monkeypox cases have been reported in six African countries and captive chimpanzees in Cameroon since 2016.

Abstract

The recent apparent increase in human monkeypox cases across a wide geographic area, the potential for further spread, and the lack of reliable surveillance have raised the level of concern for this emerging zoonosis. In November 2017, the World Health Organization (WHO), in collaboration with CDC, hosted an informal consultation on monkeypox with researchers, global health partners, ministries of health, and orthopoxvirus experts to review and discuss human monkeypox in African countries where cases have been recently detected and also identify components of surveillance and response that need improvement. Endemic human monkeypox has been reported from more countries in the past decade than during the previous 40 years. Since 2016, confirmed cases of monkeypox have occurred in Central African Republic, Democratic Republic of the Congo, Liberia, Nigeria, Republic of the Congo, and Sierra Leone and in captive chimpanzees in Cameroon. Many countries with endemic monkeypox lack recent experience and specific knowledge about the disease to detect cases, treat patients, and prevent further spread of the virus. Specific improvements in surveillance capacity, laboratory diagnostics, and infection control measures are needed to launch an efficient response. Further, gaps in knowledge about the epidemiology and ecology of the virus need to be addressed to design, recommend, and implement needed prevention and control measures.