International researchers led by a team from the University of Oxford report that they have created created an open-access database and map visualisation of affected countries to track the occurrence of cases as the global monkeypox outbreak continues to spread.
The report, published in The Lancet Infectious Diseases, points out that the pattern of dispersal outside African countries where the disease is endemic has been "much larger" in this year’s outbreak compared with those in the past.
"The size of the outbreak clusters is growing each day, as is the geographical spread across Europe and North America," the authors said. "Within the first week of the initial report, 24 countries reported suspected and confirmed cases of monkeypox virus, some of which had known travel links to the UK, Spain, Canada, and Western Europe."
However, of the total 920 confirmed and 70 suspected cases up to June 5, only 64 confirmed cases had a known travel history, including 32 associated with travel from Europe, three from West Africa, two from Canada, and one from Australia.
Both national and international public health authorities are investigating possible reasons why this outbreak has a broader geographical reach, they said.
Factors that May have Contributed to Current Outbreak
Longer-term trends that may have contributed to recent outbreaks include:
- Cessation of smallpox vaccination programmes
- Encroachment of humans into forested areas
- Growing international mobility
The database shows that the overwhelming majority of confirmed cases logged globally outside Africa so far in this outbreak have been in young adult males, consistent with the UK Health Security Agency’s finding that in the UK it is gay, bisexual, or men who have sex with men who have been disproportionately affected.
A recent prescient review published in in PLoS Negl Trop Dis in February this year had noted an escalation of monkeypox cases in Africa, a spread to other countries, and an increased median age for those affected from young children to young adults. "Increased surveillance and detection of monkeypox cases are essential tools for understanding the continuously changing epidemiology of this resurging disease," the authors had said.
New Database Updated in Near Real-time
The new database is compiled from verified sources, including reports from governments and public health organisations and news media reporting of health official statements, with curators on call 24 hours a day, 7 days a week to ensure data are updated in near real-time. Ideally, the authors said, the data will be paired with virus genomic data and integrated directly with countries' own epidemiological data. They are also collaborating with the WHO Hub for Pandemic and Epidemic Intelligence to define and update key epidemiological parameters, such as the incubation period and serial interval, across different settings.
"Global efforts are needed to ensure similar efforts to rapidly harmonise and publish detailed epidemiological data are supported during future outbreaks of emerging and re-emerging pathogens," they said.
"This example will be a learning pathway to build better surveillance systems globally."
Lead Image Credit: UKHSA
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