Why Mpox Is Poised to Shape Global Health Strategies in the Coming Years
From Emergency Declarations to Ongoing Surveillance
The World Health Organization (WHO) has declared the mpox outbreak a public‑health emergency of international concern (PHEIC) twice – first in July 2022 and again in August 20241,2. These declarations signal that the virus is not a fleeting event but a persistent threat that demands coordinated monitoring, rapid diagnostics, and sustained public‑health investment.
What We’ve Learned From Past Outbreaks
Historical data illustrate the breadth of mpox’s impact. The 2003 multistate outbreak in the United States involved six states and highlighted the role of close contact with infected animals4. More recent surveillance in the Democratic Republic of the Congo (DRC) documents a surge of suspected and confirmed cases between 2010 and 2023, underscoring the virus’s endemic nature in Central Africa3.
Identifying the Hidden Reservoirs
Research consistently points to rodents and small mammals as the most likely natural hosts. Ecological niche modeling identified several mammal species with the highest probability of harboring mpox virus5, while laboratory perform confirmed virus isolation from wild squirrels7. A 2025 preprint revealed high genetic diversity of mpox virus across three rodent species in the DRC, suggesting that multiple wildlife reservoirs sustain viral circulation8.
Genomic Insights Driving Future Response
Advances in sequencing have transformed how we track mpox evolution. Whole‑genome analyses from 2023 show APOBEC3‑mediated editing, indicating sustained human‑to‑human transmission since at least 201612. Clade I genomic surveys in the DRC (2018‑2024) reveal a predominance of zoonotic spillover events, reinforcing the need for wildlife‑focused surveillance13. Similar work in the Republic of the Congo confirms the genetic distinctiveness of clade I strains14, while a 2024 medRxiv preprint maps recurrent zoonotic transmission across West Africa15.
One‑Health Approaches: Bridging Human, Animal, and Environmental Health
Studies on bushmeat markets in Côte d’Ivoire demonstrate how wildlife trade can amplify pathogen exposure27,28. DNA‑typing of bushmeat provides a powerful tool for tracking illegal trade and assessing zoonotic risk11. Broader investigations into wildlife disease drivers—such as anthrax in tropical rainforests—highlight the interconnectedness of ecosystem health and emerging infections23,24.
Emerging Diagnostic Technologies
Rapid, specific PCR assays now enable detection of both West African and Congo Basin mpox strains within hours36. Multiplex real‑time PCR platforms further expand testing capacity for a range of poxviruses37. These tools, combined with bioinformatic pipelines (e.g., Trimmomatic, SPAdes, MAFFT, IQ‑TREE) streamline genome assembly and phylogenetic analysis, making real‑time outbreak tracking feasible42‑50.
Future Trends to Watch
1. Integrated Wildlife Surveillance Networks
Building on DNA‑typing of bushmeat and longitudinal market monitoring11,28, regional networks are likely to adopt standardized sampling of rodents, primates, and other mammals. This will create early‑warning systems that flag novel viral lineages before they cross into humans.
2. Real‑Time Genomic Epidemiology
With the proven utility of whole‑genome sequencing for tracking APOBEC3 editing and clade dynamics12,13, future responses will rely on cloud‑based platforms that automatically upload, assemble, and analyze mpox genomes. Tools such as Nextclade and BEAST already power viral phylogenetics and will become routine in public‑health labs48,55.
3. Targeted Vaccination Strategies
Given the WHO’s recommendation to combine vaccination with other interventions1, risk‑based vaccination campaigns will focus on high‑exposure groups—health‑care workers, wildlife handlers, and communities engaged in bushmeat trade. Ongoing research into vaccine effectiveness against diverse clades will refine these strategies.
4. Strengthened One‑Health Policies
Evidence linking wildlife disease drivers (e.g., anthrax) to broader ecosystem health23,24 will push governments to adopt policies that regulate wildlife markets, protect habitats, and fund cross‑disciplinary research. The integration of ecological data with human case surveillance is poised to become a standard pillar of outbreak preparedness.
5. Community‑Driven Education and Reporting
Public‑health messaging that emphasizes the classic mpox symptom triad—rash, fever, swollen lymph nodes—remains essential1. Mobile reporting apps and community health worker networks will accelerate detection of suspect cases, especially in remote regions where laboratory capacity is limited.
Frequently Asked Questions
What are the most common symptoms of mpox?
Typical signs include a painful skin rash or mucosal lesions lasting 2–4 weeks, fever, headache, muscle aches, back pain, low energy, and swollen lymph nodes1.
How is mpox transmitted?
Transmission occurs through close contact with infected individuals, contaminated materials, or infected animals1.
Are there vaccines available?
Yes. The WHO recommends vaccination alongside other public‑health measures to control mpox spread1.
Which animal species are most likely to carry mpox?
Ecological studies point to several rodent species and squirrels as probable reservoirs5,7,8. Ongoing DNA‑typing of bushmeat further refines this list11.
What diagnostic tests are used?
Real‑time PCR assays can specifically detect West African and Congo Basin strains in minutes36. Multiplex PCR panels expand testing to other poxviruses37.
Seize Action
Stay informed and help shape the next wave of mpox preparedness. Read our guide on mpox vaccination, share this article with colleagues, and subscribe to our newsletter for the latest updates on wildlife‑borne diseases.
Got questions or experiences with mpox in your community? Depart a comment below—your insight could be the key to early detection.
For authoritative information, visit the WHO Mpox Fact Sheet and the CDC Monkeypox page.
