NGS-SA: Publications and pre-prints of our genomics surveillance work

Tracking the 2022 monkeypox outbreak with epidemiological data in real-time

Authors: Kraemer MUG, Tegally H, Pigott DM, Dasgupta A, Sheldon J, Wilkinson E, Schultheiss M, Han A, Oglia M, Marks S, Kanner J, O’Brien K, Dandamudi S, Rader B, Sewalk K, Bento AI, Scarpino SV, de Oliveira T, Bogoch II, Katz R, Brownstein JS,

Journal: The Lancet Infectious Diseases, 2022. DOI:


Monkeypox virus was first documented in humans in the 1970s and outbreaks have been reported in many countries, with most cases restricted to endemic areas (1). In early May, 2022, monkeypox cases were reported in the UK, Spain, and elsewhere in Europe (2). The pattern of geographical dispersal was much larger compared with past outbreaks that were more localised and occurred often in under-resourced communities (3). The size of the outbreak clusters is growing each day, as is the geographical spread across Europe and North America. Within the first week of the initial report, 24 countries reported suspected and confirmed cases of monkeypox virus, some of which had known travel links to the UK, Spain, Canada, and western Europe. As of June 5, 2022, there have been 920 confirmed and 70 suspected cases. Of 64 confirmed cases with known travel history, 32 were associated with travel from Europe, three from west Africa, two from Canada, and one from Australia. For 26 cases, travel history locations remain unknown.

WHO convened a meeting of experts and technical advisory groups on May 20, 2022, (4) to investigate the causes of the outbreak and have released updated guidance on surveillance, case investigation, and contact tracing.5 The reason for the outbreak having a broader geographical reach is being investigated by the international and national public health community and the research community, contributing to a finer scale understanding of the outbreak dynamics. However, cessation of smallpox vaccination programmes, encroachment of humans into forested areas, and growing international mobility seem to be playing important roles in the epidemiology of monkeypox virus outbreaks.

To support global response efforts, our team created an open-access database and visualisation to track the occurrence of cases in different countries. In addition, where available, we added information on age (aggregated into age ranges, with a minimum range of 5 years), gender, dates of symptom onset and laboratory confirmation, symptoms, locations (aggregated to the state level), travel history, and additional metadata defined by WHO (5).