The reemergence of the human monkeypox: strengthening Africa's epidemic preparedness and response system.

The reemergence of the monkeypox (MPX) virus poses a serious threat to global health security. While the first human case was reported in Democratic Republic of Congo in 1970, a recent outbreak of this disease in May 2022 has gone 'viral,' spreading to most continents and occurring in nonendemic countries. Outside Africa, there have been reports of cases of MPX in countries such as Singapore in May 2019, Israel in September 2018, UK in September 2018, among others which have been traced back to importation of infected wild rodents from Africa. The Centers for Disease Control and Prevention (CDC) recommends that the standard laboratory facility to carry out MPX tests is Biosafety Containment Level (BSL)-2 working standards if the laboratory staff has taken smallpox vaccine within the last 3 years and BSL-3 working standards if the laboratory staff has not taken the smallpox vaccine. However, African countries have a shortage of BSL laboratories. Hence, there is a need to improve the integrated surveillance of the MPX virus, strengthen diagnostic capacity, capacity building of health workforce, public education programs, fund research, and development, among others. Leveraging a 'One Health' approach will offer fresh insight into the human-animal-environment interface and boost the understanding on the possibility and mechanisms of spillback and reverse zoonosis as well as disease severity and risk factors for severe disease as well as its epidemiology in various subpopulations. Not leaving Africa behind in the prevention, diagnosis, and management of MPX is important to stopping the spread and reemergence of this virus.