Public health surveillance and outbreak preparedness for mpox.

PURPOSE OF REVIEW: The 2022 global mpox outbreak showed that surveillance systems were not ready to quickly detect or adapt to the new dynamic of human-to-human spread. While many lessons were learned, ongoing mpox outbreaks underscore the need for focused attention on enhancing mpox surveillance systems. This review presents ongoing challenges, successes, recent advances, and future considerations for seven areas related to surveillance for mpox.

RECENT FINDINGS: The development of real-time polymerase chain reaction assays has greatly improved MPXV detection, though there remain diagnostic gaps and critical needs for expanding genomic surveillance. Challenges to complete case ascertainment, data sharing, and reporting also persist. At the same time, key advances have been made regarding the integration of mpox into existing surveillance and healthcare service delivery for HIV and sexually transmitted infections; use of the One Health approach to understand the interconnectedness of human, animal, and environmental health; and application of newer innovations in surveillance efforts such as wastewater monitoring and artificial intelligence.

SUMMARY: This review highlights recent work that informs how to maintain nimble, sustainable, and coordinated surveillance systems that will not only strengthen the response to the evolving mpox outbreaks but also contribute to future pandemic preparedness initiatives.