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    Rising mpox cases in Africa and globally, driven by waning immunity and sustained human transmission, underscore the need for better diagnostics and expanded vaccine use. Continued research is vital for mpox control.

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    Area of Science:

    • Epidemiology
    • Virology
    • Public Health

    Background:

    • Mpox (monkeypox virus) is endemic in Africa and has recently seen global outbreaks of both Clade I and Clade II.
    • Declining population immunity, a consequence of discontinued smallpox vaccinations, is a significant factor in the changing mpox epidemiology.
    • Sustained human-to-human transmission is occurring globally, exacerbated by reduced immunity.

    Purpose of the Study:

    • To highlight the pandemic potential of mpox.
    • To underscore the role of waning immunity in current mpox outbreaks.
    • To emphasize the need for improved diagnostics, medical countermeasures, and expanded vaccine availability.

    Main Methods:

    • Review of epidemiological data on mpox outbreaks.
    • Analysis of factors contributing to sustained human-to-human transmission.
    • Assessment of the impact of waning population immunity on mpox spread.

    Main Results:

    • Mpox cases are increasing in endemic African regions and appearing in non-endemic countries.
    • Genetic mutations in the mpox virus are affecting diagnostic accuracy and potentially virulence.
    • Insufficient population immunity is fueling widespread transmission.

    Conclusions:

    • Waning immunity post-smallpox vaccination is a critical driver of current mpox outbreaks.
    • There is an urgent need for enhanced diagnostics and medical countermeasures for mpox.
    • Expanding mpox vaccine availability for both outbreak response and routine use in endemic areas is crucial.