The Spread of Monkeypox in 2022: A Wake-up Call for Global Health Systems

Amina Rehman^* and Faisal Qureshi
^*Correspondence: Amina Rehman, Department of Public Health and Infectious Diseases, Aga Khan University, Karachi, Pakistan, Email:

Introduction

In the midst of ongoing global health challenges, including the COVID-19 pandemic, a new infectious threat emerged in 2022 that caught the world’s attention, Monkeypox. Traditionally endemic to certain parts of Central and West Africa, monkeypox had been relatively isolated outside its native regions until it began to spread in non-endemic countries, sparking alarm among global health authorities. The 2022 monkeypox outbreak marked an unprecedented surge in cases, with reports from over 70 countries and thousands of confirmed infections, most notably in Europe and the Americas. This outbreak raised crucial questions about preparedness, surveillance, and response mechanisms, highlighting significant gaps in global health systems.

The rise of monkeypox cases in 2022 was not just a health crisis but a stark reminder that infectious diseases are still capable of crossing borders and threatening public health, even in an era of advanced medical technology and global interconnectedness. It underscored the fragility of public health infrastructures and the need for a coordinated, robust response to emerging infectious diseases. This article delves into the origins, spread, and impact of the monkeypox outbreak of 2022, analyzing how it unfolded and what lessons it offers for global health systems [1].

Description

The origin and nature of monkeypox

Monkeypox is a viral zoonotic disease caused by the monkeypox virus, a member of the Orthopoxvirus genus, which also includes variola (smallpox), cowpox, and vaccinia viruses. Initially discovered in 1958 in laboratory monkeys, monkeypox was first identified in humans in 1970 in the Democratic Republic of Congo. The disease was historically confined to central and western Africa, with most outbreaks occurring in rural, remote areas where human-animal interactions were frequent. Monkeypox is typically transmitted to humans through direct contact with infected animals, such as rodents and primates, but human-to-human transmission can also occur, primarily through respiratory droplets, bodily fluids, or contaminated surfaces. The virus is characterized by flu-like symptoms, followed by a rash that progresses into fluid-filled pustules. The symptoms often resemble those of smallpox, though they tend to be less severe. Despite its relatively low mortality rate, monkeypox can still cause significant health concerns, especially in vulnerable populations. In most cases, the disease resolves within a few weeks, but complications such as bacterial infections, pneumonia, and encephalitis can occur [2].

The 2022 outbreak: A global spread

Although monkeypox outbreaks had been sporadically reported in Africa for decades, the 2022 outbreak presented an entirely different situation. For the first time, a large-scale spread of the virus occurred outside of Africa, affecting countries in Europe, North America, and other regions that had never seen significant monkeypox cases before. By the middle of 2022, thousands of cases had been reported across the world, with significant clusters in countries such as the United Kingdom, Spain, the United States, and Brazil. Health officials were caught off guard by the scale and speed at which the virus spread, and many questioned the factors that contributed to its sudden global dissemination. Experts speculated that the widespread transmission in 2022 was partly driven by the increased mobility of people due to global travel, as well as changes in the virus’s mode of transmission. Monkeypox had historically been associated with animal-to-human transmission, but human-to-human transmission appeared to be a dominant mode in the 2022 outbreak. Cases were particularly concentrated among men who have sex with men (MSM), prompting concerns about the virus’s potential to spread in closecontact settings such as social gatherings, festivals, and other mass events [3].

The World Health Organization (WHO) quickly declared the outbreak a Public Health Emergency of International Concern (PHEIC) in July 2022, signaling the need for a concerted global effort to control the virus. Despite the urgency, the response to the outbreak was met with a range of challenges, including delays in diagnostics, uneven vaccine distribution, and inadequate public health communication.

Challenges faced by global health systems

The 2022 monkeypox outbreak highlighted several key challenges faced by global health systems. Many countries, particularly those outside of Africa, were ill-prepared to detect and report monkeypox cases. With surveillance systems often focused on diseases like COVID-19 and influenza, many public health authorities failed to recognize the initial spread of monkeypox in a timely manner. Although monkeypox had been known for decades, its recent spread caught many health systems off guard. In some countries, there was a lack of knowledge among healthcare workers about the disease, its symptoms, and how to manage it. Additionally, many health authorities had not established protocols or resources for dealing with an outbreak of this nature. The availability of vaccines and antivirals to combat monkeypox was limited, and their distribution was uneven. While some countries with high-income healthcare systems had access to treatments and vaccines, others, especially those in Africa, faced severe shortages. This disparity raised concerns about equity in global health responses. The outbreak disproportionately affected certain communities, including MSM. This led to stigmatization, which further complicated the public health response. Additionally, misinformation about the virus's transmission and prevention spread rapidly on social media, leading to confusion and reluctance to seek medical care. While the WHO and national health organizations provided some guidance on monkeypox, inconsistent messaging and delays in information dissemination led to confusion and mistrust. Clear, timely, and culturally sensitive communication was needed to encourage individuals to take preventive measures and seek appropriate care [4].

Response and mitigation efforts

In response to the outbreak, health authorities took several key actions. The WHO and national health agencies implemented measures such as active case detection, contact tracing, isolation of infected individuals, and quarantine of high-risk contacts. Public health campaigns were launched to raise awareness about the symptoms of monkeypox and the importance of early diagnosis and vaccination. The smallpox vaccine, which also provides some protection against monkeypox, was deployed in many countries to control the spread of the virus. In addition to the smallpox vaccine, antiviral medications such as tecovirimat were made available for individuals at high risk of severe disease. These interventions were effective in limiting the spread, but their uneven availability remained a major challenge. The outbreak also prompted renewed discussions about the role of global health surveillance systems and the need for better preparedness for future infectious disease outbreaks. The 2022 monkeypox outbreak served as a stark reminder that health systems must be agile and ready to respond to emerging threats, even those that might seem unlikely or rare [5].

Conclusion

The spread of monkeypox in 2022 was a significant event in global public health, highlighting the vulnerabilities in our current health systems and the need for stronger, more coordinated responses to emerging infectious diseases. The outbreak served as a wake-up call, emphasizing the importance of preparedness, surveillance, and equitable access to medical resources. As the world continues to recover from the COVID-19 pandemic, the lessons learned from the monkeypox outbreak should drive efforts to strengthen global health infrastructures and ensure that the world is better prepared for the next health crisis.

Moving forward, global health organizations must prioritize the development of robust surveillance systems that can detect and respond to outbreaks quickly and effectively. Public health campaigns should focus on accurate information dissemination and combating misinformation, while international cooperation is essential for ensuring equitable distribution of vaccines and treatments. Ultimately, the 2022 monkeypox outbreak underscored the need for a global, unified approach to health security, one that leaves no country behind in the fight against infectious diseases.

Acknowledgment

None.

Conflict of Interest

None.

References

1. Malik, Imran Riaz, Muhammad Shafique, Mohsin Raza and Waqas Ahmad, et al. "Monkey virus recent breakthrough: Review on efficacy of diagnosis and treatment methods." Pak Euro J Med Life Sci 7 (2024): 267-282.

Google Scholar, Crossref, Indexed at

2. Khan, Naushad, Shah Fahad, Mahnoor Naushad and Aftab Ullah, et al. "Monkey pox and its impact on the human health in the world." Natl J Life Health Sci 3 (2024): 1-4. 

Google Scholar , Cross Ref , Indexedat

3. Paiva Pessoa, M. and G. Figueiredo Augusto. "Analysis of the mpox outbreak in Europe in 2022: Vaccination rollout in the most affected countries." Eur J Public Health 34 (2024): ckae144-2151.

Google Scholar, Crossref, Indexed at

4. Ahmed, Sirwan Khalid, Eman A. Dabou, Fatma M. Ibrahim and Mona G. Mohammed, et al. "Challenges and counteracting strategies including optimum health service practices for frontline nurses during the Mpox outbreak and futuristic vision." SAGE Open Nurs 10 (2024): 23779608241256209.

Google Scholar, Crossref, Indexed at

5. Danladi, Nengak P., Progress Agboola, Peter Olaniyi and Solomon Eze, et al. "Challenges in global distribution and equitable access to monkeypox vaccines." Viruses 16 (2024): 1815.

Google Scholar, Crossref, Indexed at