Mpox exposure and transmission at the human-animal interface; a One Health approach to viral ecology

The World Health Organization ongoing outbreak of mpox a public health emergency of international concern. At least 110 countries have reported over 83,900 cases, triggering an urgent global response to control viral spread. Mpox is a viral zoonosis which can transmit between humans and other animals, raising the possibility of human to animal transmission and the establishment of new animal reservoirs in regions such as Canada, making the control and potential elimination of mpox in areas where the virus did not exist before very difficult. We propose a One Health approach to examine exposure and transmission of mpox between humans and other animals. We will apply an interdisciplinary approach to build Canadian capacity for research and response to emerging zoonotic infections, and to generate knowledge and evidence to inform measures for mitigation through three principal aims. First, we will examine mpox ecology by analyzing human-animal exposure pathways in endemic regions, including Nigeria and Ghana (where mpox is an established pathogen) and Canada, where it is not yet endemic. This will identify potential exposure and transmission points of contact, where we will next focus surveillance efforts in high risk human and animal populations along the exposure pathway by screening high risk hosts and the environments that they share. Finally, we will work with key communities and leaders to apply our findings and ideally prevent inter-species transmission of mpox and other viral zoonoses. Our team discovered the first cases of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in free ranging Canadian wildlife, and have extensive experience screening over 30 species of Canadian wildlife for SARS-CoV-2. In partnership with colleagues in Ghana and Nigeria, we will expand our approach to address similar challenges around inter-species transmission of mpox on an international scale.