5. Mpox Epidemiology
Sub-Saharan Africa has possibly seen Mpox for several thousands of
years since humans initially contracted the virus via close contact with
diseased animals30. Mpox was recognised as a distinct
sickness after smallpox was eradicated in 1970 and it became clear that
smallpox-like infections were still happening in rural
areas30. The Mpox virus was first discovered in
monkeys used for research in 1958 at State Serum Institutes in
Copenhagen, Denmark, and Africa 12. Mpox has received
attention as a disease of significant global public health since the
outbreak of the first epidemic in the USA in 2003, which was linked with
infected pet prairie dogs31. It was assumed that the
native prairie dogs housed with imported rodents from Ghana in the
western region of Africa were the primary source of the outbreak because
the bulk of the affected people became ill after interacting with pet
prairie dogs. Mpox has been connected to a rise in cases that began in
the Midwest of the US in the summer of 200330. Mpox
cases have been reported in several countries since 2003, with the worst
epidemic occurring in Nigeria in 201731.
The Centres for Disease Control and Prevention (CDC) had reported 5783
instances of Mpox as of July 1, 2022, spread over 52 different nations.Figure 4 shows the geographical distribution of the cases
worldwide. Currently, the western hemisphere and parts of Europe are
home to the majority of Mpox cases. According to recent studies, the
United Kingdom has the most instances in all of Europe. With a median
age of 31 years, most cases reported of Mpox currently affect people
under the age of 40. This group only emerged after the smallpox
vaccination campaign had been abandoned, further illuminating the lack
of cross-protective immunity12. According to the
external Situation report issued on June 10, 2023, the World Health
Organisation (WHO) received reports of 87,929 laboratory-confirmed cases
of monkeypox (mpox) from 111 countries across all six WHO Regions
between January 1, 2022, and June 5, 2023. This totals 146 deaths. Since
the last situation update, 552 new cases (a 0.6% rise) and six new
fatalities have been reported. The number of new cases worldwide fell
somewhat in the most recent reporting week. The Americas have recorded
the most cases in the last three weeks. Cases have increased in several
countries, including Cameroon. Europe and Southeast Asia have also
reported additional cases, but with some delay. The number of cases in
Africa has dramatically grown, exceeding the previously recorded
average. As of June 5, 2023, 15 nations had confirmed new cases within
the maximum illness incubation time. The United States, Brazil, and
Spain are among the countries with the most cumulative instances. These
10 countries account for 83.9% of all instances globally. The monkeypox
outbreak continues, with low levels of transmission in Europe and the
Americas, a minor decline in the Western Pacific, and an increase in
cases in South-East Asia. The number of cases has recently increased in
Africa, where transmission is more constant. Most patients are men, and
the age distribution is consistent. Children make up a minor fraction of
cases, with the majority being recorded in the Americas region.
Transmission occurs largely among homosexual, bisexual, and other males
who have intercourse with other men. The predominant mechanism of
transmission is through skin and mucosal contact during sex, followed by
non-sexual contact between people. The most typically reported exposure
contexts are parties involving sexual interaction, however this is
changing with time. Rash, fever, systemic rash, and vaginal rash are all
common symptoms. However, reliable information on transmission and
exposure settings is scarce in the WHO African Region, making it
difficult to gain a thorough knowledge of the virus’s spread there.