1Dolapo, D., 2Abanida, E. A., and *3Adegboro, B.
1Department of Community Health, College of Health Sciences, Nile University of Nigeria, Abuja, Nigeria
2Plot D-1A, Kaduna Court, Gaduwa Estate, Abuja, Nigeria
3Department of Medical Microbiology and Immunology, College of Health Sciences, Nile University of Nigeria, Abuja, Nigeria
*Correspondence to: boazadegboro@gmail.com; boaz.adegboro@nileuniversity.edu.ng
Abstract:
Mpox, previously known as monkeypox, is a viral illness caused by the monkeypox virus (MPXV), a species of the Poxviridae family, and genus Orthopoxvirus. The resurgence of Mpox, particularly in low- and middle-income countries (LMICs), underscores the need for a comprehensive systems-level analysis. The Centre for Disease Control and Prevention (CDC)’s Emerging Infectious Diseases (EID) modelling framework, combined with genomic surveillance, offers a robust approach to understanding and mitigating such outbreaks. Integrating these methods can enhance outbreak prediction, surveillance, and response strategies, particularly in resource-constrained settings. This review aims to identify systemic vulnerabilities and health systems gaps in control of Mpox in LMICs, opportunities for modelling Mpox within the CDC EID framework, and the role of genomic epidemiology in Mpox surveillance, especially in combination with the EID framework. We used a narrative review and followed a structured method designed to capture the range of interventions on EID modelling and genomic surveillance related to Mpox. Previous modelling results indicated that close-contact transmission within and between households were unlikely to result in a large number of Mpox clade I cases. Studies that modelled the impact of vaccination and sexual behaviour adaptations on Mpox cases found that initial decline in cases were likely caused by behavioural adaptation, but vaccination averted more cases overall and was key to hastening outbreak control. Studies revealed that the geographical pattern of Mpox reported in the Nigeria outbreak suggested a possible new and widespread zoonotic reservoir, but the animal reservoir remains unknown. Integrating genomic data into Mpox surveillance can facilitate early detection, identification of animal reservoir and inform targeted interventions. This review found that CDC successfully leveraged a SARS-CoV-2 wastewater surveillance system for Mpox and concluded that integrating the CDC’s EID modelling and genomic surveillance can significantly enhance Mpox management in LMICs.
Keywords: Mpox, Emerging Infection, Modelling, Genomic Surveillance, Zoonotic outbreaks
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