The Implication of the Evolving Epidemiology of Human Monkeypox - Global and National Dimensions: A Narrative Review.

• ¹, Department of Medicine, University of Maiduguri, Borno State, NG

Background: Monkeypox was known to be an ignored disease, often reported from Africa, until recently when it attracted global attention due to multi-country surge in cases. This review is aimed at highlighting the implications of the changing epidemiology of the disease and identify related research gaps.

Methods: We conducted a detailed review of 46  relevant peer-reviewed, grey literature and relevant websites on the evolving epidemiology of monkeypox.  The last search was performed on 30th June 2022.

Results: Cases of monkeypox has been on steady rise in some African countries since the first confirmed case in 1970, with most report from the Democratic Republic of Congo (DRC). Since 2003, import- and travel-related spread outside of Africa has occasionally resulted in outbreaks. Our review shows a recent Multi – country escalation of cases in non – endemic countries. Most of the existing literatures are on epidemiological report. There is dearth of interventional studies on biological behaviour of the virus, therapeutics and vaccination. The surge in cases after 40 years of caseation of smallpox vaccination, which provide cross- protection against monkeypox and growing median ages of cases from children to adults suggest wanning immunity. Risk factors include international travels and interactions/activities with infected animals or individuals.

Conclusion: Persistence of cases of monkeypox without intervention for over four decades in endemic countries and lack of support from global scientific community is responsible for the evolving epidemiology of monkeypox and Multi-country outbreak.  Global synergy is urgently needed to prevent and control the spread of the infection.