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Assessing the acceptance of the monkeypox vaccine is crucial for the success of vaccination programs, yet the prevalence reports remain inconclusive. The aim of this study was to determine the global prevalence of monkeypox vaccine acceptance and identify its associated factors. A meta-analysis was conducted with a comprehensive search strategy on the following databases, including Scopus, Embase, and PubMed, for articles published up to April 5, 2024. This study utilizes a single-arm meta-analysis to calculate the pooled prevalence of monkeypox vaccine acceptance. A Z-test was employed to identify factors associated with the vaccine acceptance. Our study analyzed 51 articles encompassing 98,746 participants, revealing an overall monkeypox vaccine acceptance rate of 65%. Notably, the highest acceptance rates were observed among men who have sex with men (MSMs), while healthcare workers (HCWs) showed the lowest acceptance rates. Additionally, our findings indicated an increased acceptance in individuals with educational attainment beyond a bachelor's degree, a history of COVID-19 and influenza vaccination, homosexual orientation, and HIV-positive status. Conversely, lower acceptance risk was associated with those with educational attainment below a bachelor's degree, heterosexual orientation, and bisexual orientation. In conclusion, our current study has determined the rate of monkeypox vaccine acceptance and identified its associated factors. These findings offer valuable insights as the foundation for targeted policies to manage and increase acceptance rates.

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Monkeypox virus (MPXV) can spread among humans through direct contact with lesions, scabs, or saliva; via respiratory secretions; and indirectly from fomites; via percutaneous injuries; and by crossing the placenta to the fetus during pregnancy. Since 2022, most patients with mpox in the United States have experienced painful skin lesions, and some have had severe illness. During 2021-2022, CDC initiated aircraft contact investigations after receiving reports of travelers on commercial flights with probable or confirmed mpox during their infectious period. Data were collected 1) during 2021, when two isolated clade II mpox cases not linked to an outbreak were imported into the United States by international travelers and 2) for flights arriving in or traveling within the United States during April 30-August 2, 2022, after a global clade II mpox outbreak was detected in May 2022. A total of 113 persons (100 passengers and 13 crew members) traveled on 221 flights while they were infectious with mpox. CDC developed definitions for aircraft contacts based on proximity to mpox cases and flight duration, sent information about these contacts to U.S. health departments, and received outcome information for 1,046 (68%) of 1,538 contacts. No traveler was found to have acquired mpox via a U.S. flight exposure. For persons with mpox and their contacts who had departed from the United States, CDC forwarded contact information as well as details about the exposure event to destination countries to facilitate their own public health investigations. Findings from these aircraft contact investigations suggest that traveling on a flight with a person with mpox does not appear to constitute an exposure risk or warrant routine contact tracing activities. Nonetheless, CDC recommends that persons with mpox isolate and delay travel until they are no longer infectious.

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On August 14, 2024, the Director General of the World Health Organization (WHO) declared that the increasing outbreaks of mpox (formerly monkeypox) should be regarded as an international public health emergency due to the growing number of cases in endemic and non-endemic geographical areas, and increasing disease severity. The latest update from the WHO and the alerts given regarding the status of mpox follows an upsurge in the incidence and severity of mpox in the Democratic Republic of the Congo (DRC) and an increasing number of African countries, with spread to other continents and countries This Editorial aims to provide an update on the current status of mpox and includes reasons for the increasing global concerns for the spread of the mpox virus (MPXV).

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BACKGROUND: Mpox, is a zoonosis that is known to be endemic in several Central and West African countries. Recently, in 2022, it has emerged in Europe and United States, what raised the alarm to be declared in late June 2024 as a public health event of international concern. This study aimed to give insight about the recent spread of mpox in Sudan, and documents the epidemiologic situation. METHODS: Through a cross-sectional design, Sudan mpox data was extracted from the disease surveillance line-list at the national level at Sudan Federal Ministry of Health. the data was customized and then analyzed using Epi Info7 software. Analysis was done using frequencies and percentages and the results presented in tables and figures. Permission and ethical approval were obtained from the Health Emergency and Epidemic Control Directorate at the Federal Ministry of Health. RESULTS: The outbreak of mpox was confirmed after testing of initial specimens outside Sudan with positivity rate of 72%. Later the cases continued to be reported based on the clinical diagnosis and standard case definition. Out of 375 reported cases, 54.4% were males, while 45.6% were females. The age of cases ranged from one month to 78 years with majority (41.1%) of the cases were children under 5 years of age. Regarding the reported symptoms, all cases had the characteristic skin rash and 74.1% of them had fever. Other symptoms included, headache (31.5%), sore throat (30.9%) and lymphadenopathy (26.1%). For occupation, 35.7% were preschool and 10.4% were school children, 9% of cases were prisoners. Around 22 (5.8%) reported contact history with a confirmed case, while (5.6%) of the cases were imported cases. Cases were reported from 17 states with 42 affected localities (districts) with an overall attack rate of 2.36/ 100,000. The highest number of cases was reported from Gadaref (45.3%), West Darfur (25.9%), Khartoum (13.3%) and north Darfur (3.5%). In Gadaref, 146 (85.8%) of the cases were from a refugees' camp. Started in epi week 19, the outbreak peaked in week 38 and last in week 42. CONCLUSION: Mpox was confirmed in the new Sudan for the first time with cases reported in most of states. Although importation of the virus is hypothesized, internal hidden circulation is possible and more in-depth investigation is highly recommended. The higher rate of infection among preschool, school children and refugees, highlights the need to strengthen the prevention and control measures in schools and camps. More focus on the data completeness is required for better understanding of the disease and can be ensured by the surveillance directorate through training of staff and updating of reporting forms. Strengthening the lab capacity inside the country is a necessity to ensure testing of all the clinically diagnosed cases.

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OBJECTIVE: Monkeypox is a viral zoonotic disease endemic to West and Central Africa; it has been reported in more countries during the last decade than in the previous 40 years. In 2022 a multinational outbreak occurred. This change in the epidemiology of the virus may represent an evolutionary adaptation. The purpose of this study is to analyze the molecular aspects of Monkeypox virus (MPXV) disease that may explain the latter's change in epidemiology during the 2022 outbreak. METHODS: From July 2022 through December 2022, the period of the outbreak, a narrative review was conducted on the available literature, with a total of 271 articles published in the MEDLINE/PubMed and LILACS databases being examined. The chosen articles were organized using the search and reference manager Mendeley Desktop 1.19.4. Duplicates and articles that did not meet the study's objective were eliminated, resulting in the selection of 49 articles for the present review. DISCUSSION: MPXV resurgence poses challenges due to waning immunity and changing epidemiological patterns. Recent outbreaks show different transmission routes, affecting new demographics. Genomic evolution, vaccination history, and potential new animal reservoirs complicate containment efforts. Continued surveillance and vaccination are crucial for control. CONCLUSIONS: It seems possible that MPXV has (re-)emerged to occupy the ecological niche left by the smallpox virus. Mutations of the apolipoprotein B mRNA editing enzyme, catalytic subunit 3G motif, in MPXV clade IIb since 2017 may explain the epidemiological change that has occurred in recent years. This pattern could be due to sustained transmission in a new host or a new route of infection.

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The East African Community (EAC) is experiencing an unprecedented, emerging mpox outbreak since July 2024 in five of eight partner states. We highlight rapid regional response measures, initiated August 2024 coordinated by EAC: field deployment of six mobile laboratories in Burundi, Rwanda, Uganda, Tanzania, Kenya, South Sudan to high-risk areas, donation of one mobile laboratory to Democratic Republic of the Congo and genomic monkeypox virus (MPXV) surveillance support. These interventions aim to limit local mpox spread and support international containment.

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BackgroundIn 2022, a global monkeypox virus (MPXV) clade II epidemic occurred mainly among men who have sex with men. Until early 1980s, European smallpox vaccination programmes were part of worldwide smallpox eradication efforts. Having received smallpox vaccine > 20 years ago may provide some cross-protection against MPXV.AimTo assess the effectiveness of historical smallpox vaccination against laboratory-confirmed mpox in 2022 in Europe.MethodsEuropean countries with sufficient data on case vaccination status and historical smallpox vaccination coverage were included. We selected mpox cases born in these countries during the height of the national smallpox vaccination campaigns (latest 1971), male, with date of onset before 1 August 2022. We estimated vaccine effectiveness (VE) and corresponding 95% CI for each country using logistic regression as per the Farrington screening method. We calculated a pooled estimate using a random effects model.ResultsIn Denmark, France, the Netherlands and Spain, historical smallpox vaccination coverage was high (80-90%) until the end of the 1960s. VE estimates varied widely (40-80%, I2 = 82%), possibly reflecting different booster strategies. The pooled VE estimate was 70% (95% CI: 23-89%).ConclusionOur findings suggest residual cross-protection by historical smallpox vaccination against mpox caused by MPXV clade II in men with high uncertainty and heterogeneity. Individuals at high-risk of exposure should be offered mpox vaccination, following national recommendations, regardless of prior smallpox vaccine history, until further evidence becomes available. There is an urgent need to conduct similar studies in sub-Saharan countries currently affected by the MPXV clade I outbreak.

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BACKGROUND: A monkeypox (MPOX) outbreak occurred in May 2022. On June 3, 2022, the WHO Blueprint organized a consultation on MPOX research knowledge gaps and priority research questions because the engagement of health care providers (HCPs) in providing accurate information and the public's motivation to adapt protective behaviour were crucial. Thus, we conducted this study to explore the knowledge issues, animal patterns, and interactions of HCPs in the context of MPOX and COVID-19 during the MPOX outbreak. METHODS: We conducted a cross-sectional web-based survey among 816 HCPs working in governmental health facilities from many countries, mainly Syria, Egypt, Saudi Arabia, and Cameroon, in September 2022. RESULTS: Four hundred and sixty (56.37%) were aged between 18 and less than 35 years old. About 34.44% were physicians, while only 37.25% worked on the frontlines with patients. 37.99% and 5.88% received vaccinations against chickenpox and MPOX, respectively. In the meantime, 55.39% had taken courses or training programmes regarding COVID-19. Regarding knowledge-seeking behaviours (KSBs) about COVID-19, 38.73% were through passive attention, while only 28.8% got their information through active search. Most of the participants (56.86%) had a moderate level of knowledge regarding COVID-19. Only 8.82% had courses or training programmes regarding MPOX. Regarding KSB about MPOX, 50.86% were obtained through passive attention, while only 18.01% and 23.04% got their information through active and passive search, respectively. Most of the participants (57.60%) had a poor level of knowledge regarding MPOX. The regression analysis of the MPOX knowledge score revealed that individuals working on the frontlines with patients and those who had training programmes or courses were shown to have a higher score by 1.25 and 3.18 points, respectively. CONCLUSIONS: The studied HCPs had poorer knowledge about the MPOX virus than they did about the SARS-CoV-2 virus. Training programmes and education courses had an impact on their knowledge.

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Mpox (formerly known as monkeypox) was declared a Public Health Emergency of International Concern (PHEIC) by the World Health Organization on 23rd July 2022, however cases of the disease have been detected in Nigeria since the 1970s and more recently since it began spreading in more urban areas of the country from 2017 onward. Nigeria has a strong track record of epidemic preparedness and response, spearheaded by the Nigeria Centre for Disease Control. Despite being somewhat separate architectures on paper, epidemic response (in particular, integrated disease surveillance and response) relies on a foundation of primary health care, which is inadequately funded not only in Nigeria, but globally. Situating mpox response within this wider landscape, we draw on ethnographic research from September 2022-March 2023 in southwestern Nigeria on lived experiences of mpox and mpox response, focusing on the perspectives of frontline health workers and community-based suspected or confirmed mpox cases. We aimed to understand how prioritization and resource constraints shape mpox response at a local level, including effects on the everyday work of frontline health workers in public health and clinical care who are left to "make do." We analyze their experiences interfacing with two intersecting infrastructures, community-based surveillance and primary health care. Health workers' improvisation and "repair work," which we detail, enables the surveillance system to function in some capacity. However, health workers must regularly contend with competing priorities and routine care that may be sidelined during an outbreak or epidemic. We argue that this reveals the limitations of a global health security agenda as it materializes at a local level and the need for strengthening primary health care for longer-term sustainability.

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