[Monkeypox virus (mpox) reemergence and One Health : from concept to global reality].

Abstract

The Monkeypox virus (mpox) is a double-stranded DNA orthopoxvirus responsible for a zoonotic disease historically confined to Central and West Africa. First identified in humans in 1970, it was long regarded as an infection characterized by limited human-to-human transmission, primarily driven by repeated zoonotic spillover events from animal reservoirs, particularly rodents. The global outbreak of 2022 fundamentally reshaped this understanding by demonstrating the virus's capacity to sustain prolonged human-to-human transmission across multiple continents. This epidemiological shift has unfolded within a context of increasing anthropogenic pressures, including ecosystem disruption, biodiversity loss, intensified human-wildlife interfaces, rapid urbanisation, and expanding international mobility. In parallel, the progressive decline in population-level immunity to orthopoxviruses following the cessation of smallpox vaccination has expanded the pool of susceptible individuals. In this context, mpox represents a paradigmatic illustration of the One Health framework. Its future trajectory will depend not only on global ecological and societal dynamics but also on strengthening equitable genomic surveillance, particularly in resource-limited settings where the virus has circulated for decades. Enhancing local sequencing capacity, diagnostic infrastructure, and international data sharing is essential for early detection of viral evolution and assessment of its epidemiological implications. Moreover, equitable access to prevention and clinical management tools, especially vaccination, will be a critical determinant of sustainable mpox control.