Besombes C. auteur aut IRD Mbrenga F. auteur aut IRD Schaeffer L. auteur aut IRD Malaka C. auteur aut IRD Gonofio E. auteur aut IRD Landier Jordi auteur aut IRD Vickos U. auteur aut IRD Konamna X. auteur aut IRD Selekon B. auteur aut IRD Dankpea J.N. auteur aut IRD Von Platen C. auteur aut IRD Houndjahoue F.G. auteur aut IRD Ouaïmon D.S. auteur aut IRD Hassanin A. auteur aut IRD Berthet N. auteur aut IRD Manuguerra J.C. auteur aut IRD Gessain A. auteur aut IRD Fontanet A. auteur aut IRD Nakouné-Yandoko E. auteur aut IRD text journalArticle eng text/pdf reformatted digital access We analyzed monkeypox disease surveillance in Central African Republic (CAR) during 2001-2021. Surveillance data show 95 suspected outbreaks, 40 of which were confirmed as monkeypox, comprising 99 confirmed and 61 suspected monkeypox cases. After 2018, CAR's annual rate of confirmed outbreaks increased, and 65% of outbreaks occurred in 2 forested regions bordering the Democratic Republic of the Congo. The median patient age for confirmed cases was 15.5 years. The overall case-fatality ratio was 7.5% (12/160) for confirmed and suspected cases, 9.6% (8/83) for children <16 years of age. Decreasing cross-protective immunity from smallpox vaccination and recent ecologic alterations likely contribute to increased monkeypox outbreaks in Central Africa. High fatality rates associated with monkeypox virus clade I also are a local and international concern. Ongoing 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. specialized 052 050 28 12 2435-2445 2022 1080-6040 https://www.documentation.ird.fr/hor/fdi:010093804 10.3201/eid2812.220897 1080-6040 [F B010093804] https://www.documentation.ird.fr/hor/fdi:010093804 https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2025-07/010093804.pdf IRD - Base Horizon / Pleins textes 2025-05-14 2025-07-09 fdi:010093804 fre