Mpox Outbreak Highlights Need to Prevent Future Zoonotic Diseases

Introduction

The current global outbreak of mpox is yet another warning for the adoption of a preventative, One Health, approach to minimize the risk of future emergence of known and unknown zoonotic pathogens, argue Professors Diana Bell and Andrew Cunningham.

Main Item

The scientists, writing a commentary published in the CABI One Health journal, say the world "cannot afford to ignore yet another warning" such as that presented by mpox, which has so far seen 62,406 cases in 104 countries and 19 deaths*.

According to the World Health Organization (WHO), mpox is a viral zoonosis (a virus transmitted to humans from animals) with symptoms similar to those seen in the past in smallpox patients, although it is clinically less severe.

With the eradication of smallpox in 1980 and subsequent cessation of smallpox vaccination, mpox has emerged as the most important orthopoxvirus for public health, the WHO states. Mpox primarily occurs in central and west Africa, often in proximity to tropical rainforests, and has been increasingly appearing in urban areas. A range of African rodents appears to be the natural animal hosts of the mpox virus.

Professor Bell, Professor of Conservation Biology at the University of East Anglia (UEA), and Professor Cunningham, Deputy Director of Science at ZSL's Institute of Zoology, ZSL (Zoological Society of London), says the unintended consequence of smallpox eradication - and ending the smallpox vaccination campaign - has been to "render the global human population immunologically naïve to orthopoxvirus infection for the first time in history."

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Professors Bell and Cunningham, in their commentary, argue:

"This has occurred at a time when the majority of people worldwide live in high population densities in cities and when connectivity across the world has never been higher, both of which facilitate the emergence and spread of infectious diseases."

"It is not surprising. Therefore, novel zoonotic orthopoxvirus infections have increased recently, or an international human mpox disease outbreak has occurred."

"A One Health approach, including consideration of land-use change and the bushmeat and exotic pet trades, is required to prevent opportunities for the emergence of mpox, or diseases caused by other orthopoxviruses, and for a rapid and effective response to any outbreaks to limit their spread."

The researchers highlight three examples where mpox has pathways to spread and where a One Health approach to its prevention is particularly needed - land use change, the bushmeat trade, and the pet trade.

Concerning the bushmeat trade, for instance, Professors Cunningham and Bell suggest that the Gambian giant pouched rat, which is a possible carrier of mpox virus, is "commonly eaten due to its relatively large size and is, therefore, of particular interest as a potential source of zoonotic infection."

They add that despite extensive legislation banning the import of threatened taxa, or indeed any wild meat from Africa, significant quantities of bushmeat are smuggled via personal luggage into major European and US cities on passenger flights from West and Central African countries where mpox is endemic in wild animals.

With regards to the pet trade, the scientists say that a 2003 outbreak of mpox in six US states was traced back to a consignment of 800 live small mammals imported from Ghana to Texas. Virological testing of some of these animals found MPV infection in three dormice, two rope squirrels, and at least one Gambian giant pouched rat.

Professors Bell and Cunningham state:

"The demand is global with intercontinental smuggling involving South America and Asia as well as Africa and Europe, fuelling the biodiversity conservation and ecosystem services crises and escalating the threat of human exposure to known and unknown pathogens harbored by wildlife along trade routes and within destination countries."

They conclude by suggesting that a One Health approach to preventing further zoonotic disease outbreaks could incorporate promoting alternatives to bushmeat, routinely vaccinating people at high risk of exposure, and educating people on hygienic procedures such as the wearing of gloves when handling live and dead wild animals.

Commentary Reference

Bell, D., and Cunningham, A., 'Monkeypox: we cannot afford to ignore yet another warning,' CABI One Health, published 23 September 2022.

*Monkeypox cases: Numbers correct as of 20 September 2022.

Attribution/Source(s):

This peer reviewed publication was selected for publishing by the editors of Disabled World due to its significant relevance to the disability community. Originally authored by CABI, and published on 2022/09/24 (Edit Update: 2024/04/18), the content may have been edited for style, clarity, or brevity. For further details or clarifications, CABI can be contacted at cabi.org. NOTE: Disabled World does not provide any warranties or endorsements related to this article.

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