Thread by @guerreroespejo

A systematic #Review of #monkeypox (before the current epidemic outside of Africa)

A zoonotic disease caused by an orthopoxvirus, results in a smallpox-like disease in humans.
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journals.plos.org/plosntds/artic…

Since #monkeypox in humans was initially diagnosed in 1970 in the Democratic Republic of the Congo (#DRC), it has spread to:
✔️ other regions of Africa (primarily West and Central), and
✔️cases outside Africa have emerged in recent years.
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The number of human #monkeypox cases has been on the rise since the 1970s, with the most dramatic increases occurring in the #DRC.

The median age at presentation has increased from 4 (1970s) to 21 years (2010–2019).
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There was an overall case #fatality rate of 8.7%, with a significant difference between clades of #monkeypox virus:
✔️Central African 10.6% (95% CI: 8.4%– 13.3%) vs.
✔️West African 3.6% (95% CI: 1.7%– 6.8%).
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Since 2003, import- and travel-related spread outside of Africa has occasionally resulted in outbreaks.

Interactions/activities with infected animals or individuals are risk behaviors associated with acquiring monkeypox.
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The escalation of #monkeypox cases, especially in the highly endemic DRC, a spread to other countries, and a growing median age from young children to young adults may be related to the cessation of smallpox vaccination, which provided some cross-protection against monkeypox.
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Increased surveillance and detection of #monkeypox cases are essential tools for understanding the continuously changing epidemiology of this resurging disease.
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