Title: Urgent need for a non-discriminatory and non-stigmatizing nomenclature for monkeypox virus
Authors: Happi C, Adetifa I, Mbala P, Njouom R, Nakoune E, Happi A, Ndodo N, Ayansola O, Mboowa G, Bedford T, Neher RA, Roemer C, Hodcroft E, Tegally H, ’Toole A, Rambaut A, Pybus O, Kraemer MUG, Wilkinson E, Isidro J, Borges V, Pinto M, Gomes JP, Baxter C, Lessells R, Ogwell AE, Kebede Y, Tessema SK, de Oliveira T.
Journal: Virological, (2022)


Monkeypox is a disease caused by the monkeypox virus (MPXV) from the Orthopoxvirus genus in the family Poxviridae [1,2]. Since the first report of monkeypox virus infection in humans in the 1970s [3], repeated outbreaks have been reported periodically in Western and Central Africa and global events have been detected rarely [4,5]. However, a recent global outbreak of MPVX has been detected without a clear link to Africa [6]. As of 8 June 2022, at least 1111 human cases of MPXV have been confirmed or suspected and cases have been detected in 44 countries [7]. MPXV infection is caused normally by spill-over events to humans from animals such as rodents, squirrels, and non-human primates [1,4,5]. The virus can be also transmitted from one person to another by close contact with lesions, body fluids, respiratory droplets and contaminated materials [1,4]. Case counts and epidemiological patterns suggest that the current global outbreak is sustained by human-to-human transmission [6,8].

The prevailing perception in the international media and scientific literature is that MPXV is endemic in people in some African countries. However, it is well established that nearly all MPXV outbreaks in Africa prior to the 2022 outbreak, have been the result of spillover from animals to humans and only rarely have there been reports of sustained human-to-human transmissions. In the context of the current global outbreak, continued reference to, and nomenclature of this virus being African is not only inaccurate but is also discriminatory and stigmatizing. The most obvious manifestation of this is the use of photos of African patients to depict the pox lesions in mainstream media in the global north. Recently, Foreign Press Association, Africa issued a statement urging the global media to stop using images of African people to highlight the outbreak in Europe [9].

Although the origin of the new global MPXV outbreak is still unknown, there is growing evidence that the most likely scenario is that cross-continent, cryptic human transmission has been ongoing for longer than previously thought. However, there is an increasing narrative in the media and among many scientists that are trying to link the present global outbreak to Africa or West Africa, or Nigeria. Further, the use of geographical labels for strains of MPXV, specifically, references to the 2022 outbreak as belonging to the “West African” or “Western African” clade, strain, or genotype. We therefore believe that a nomenclature that is neutral, non-discriminatory and non-stigmitizing will be more appropriate for the global health community.

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