@article{fdi:010093804,
  title = {{N}ational monkeypox surveillance, {C}entral {A}frican {R}epublic, 2001-2021},
  author = {{B}esombes, {C}. and {M}brenga, {F}. and {S}chaeffer, {L}. and {M}alaka, {C}. and {G}onofio, {E}. and {L}andier, {J}ordi and {V}ickos, {U}. and {K}onamna, {X}. and {S}elekon, {B}. and {D}ankpea, {J}.{N}. and {V}on {P}laten, {C}. and {H}oundjahoue, {F}.{G}. and {O}ua{\¨ie}mon, {D}.{S}. and {H}assanin, {A}. and {B}erthet, {N}. and {M}anuguerra, {J}.{C}. and {G}essain, {A}. and {F}ontanet, {A}. and {N}akoun{\'e}-{Y}andoko, {E}.},
  editor = {},
  language = {{ENG}},
  abstract = {{W}e analyzed monkeypox disease surveillance in {C}entral {A}frican {R}epublic ({CAR}) during 2001-2021. {S}urveillance data show 95 suspected outbreaks, 40 of which were confirmed as monkeypox, comprising 99 confirmed and 61 suspected monkeypox cases. {A}fter 2018, {CAR}'s annual rate of confirmed outbreaks increased, and 65% of outbreaks occurred in 2 forested regions bordering the {D}emocratic {R}epublic of the {C}ongo. {T}he median patient age for confirmed cases was 15.5 years. {T}he overall case-fatality ratio was 7.5% (12/160) for confirmed and suspected cases, 9.6% (8/83) for children <16 years of age. {D}ecreasing cross-protective immunity from smallpox vaccination and recent ecologic alterations likely contribute to increased monkeypox outbreaks in {C}entral {A}frica. {H}igh fatality rates associated with monkeypox virus clade {I} also are a local and international concern. {O}ngoing investigations of zoonotic sources and environmental changes that increase human exposure could inform practices to prevent monkeypox expansion into local communities and beyond endemic areas.},
  keywords = {{REPUBLIQUE} {CENTRAFRICAINE}},
  booktitle = {},
  journal = {{E}merging {I}nfectious {D}iseases},
  volume = {28},
  numero = {12},
  pages = {2435--2445},
  ISSN = {1080-6040},
  year = {2022},
  DOI = {10.3201/eid2812.220897},
  URL = {https://www.documentation.ird.fr/hor/fdi:010093804},
}