Mpox and the one health approach

Area of Science:

• Epidemiology
• Genomics
• Public Health Policy

Background:

• The 2022 mpox (monkeypox) outbreak, driven by Clade IIb, marked a global shift.
• Sustained transmission of Clade I variants continues in Central Africa.
• Emergence of a novel Clade Ib lineage with distinct mutational signatures is noted.

Purpose of the Study:

• To synthesize current evidence on mpox epidemiology, genomics, clinical aspects, and policy.
• To emphasize the emergence of mpox Clade Ib and its One Health implications.
• To inform preparedness strategies for future mpox outbreaks.

Main Methods:

• A narrative, non-systematic review of literature from major databases (PubMed, Scopus, Web of Science, Embase).
• Inclusion of official reports from global health organizations (WHO, Africa CDC, CDC, ECDC, FAO).
• Synthesis of evidence aligned with SANRA principles, covering data up to May 2025.

Main Results:

• Mpox epidemiology has evolved, with Clade I variants and a new Clade Ib lineage.
• Recent outbreaks show pediatric predominance and household transmission, differing from earlier patterns.
• Vaccine effectiveness (JYNNEOS) is variable; tecovirimat showed no significant clinical benefit in trials.

Conclusions:

• Integrated One Health strategies are essential for mpox outbreak containment and prevention.
• Equitable vaccine deployment and long-term surveillance are critical components of preparedness.
• Genomic sequencing and environmental surveillance are vital for tracking mpox transmission dynamics.