Human monkeypox (MPX) is a smallpox-like disease primarily reported in the rainforests of Central Africa. Until recently, MPX was considered a rare zoonotic infection in humans;however the dramatic increase in reports of human MPX over the last decade in the Democratic Republic of Congo (DRC) and recent outbreaks in the United States, Republic of Congo, and Sudan underscore the importance of understanding tie capacity and geographic range for disease emergence. To study the risk factors driving MPX geographic distribution, prevalence, and risk of future emergence necessitates an interdisciplinary approach. The candidate proposes to undertake three primary career development activities: 1) training in remote sensing and spatial statistics;2) training to understand the fundamental aspects of specimen processing and analysis, including virus growth, PCR, sequencing of MPX virus specimens;and 3) training in advanced epidemiologic methods to integrate ecologic and laboratory data with epidemiologic and clinical data/These training objectives are linked to the following research objectives: 1) to determine if prevalence and geographic distribution of human MPX has increased over time;2) to identify behavioral, demographic and environmental risk factors for human MPX infection;and 3) to understand the role played by differential transmission and evolution of MPX. The research component will supplement and leverage a unique collection of biological specimens, existing research infrastructure in DRC, and access to remotely sensed data sets. The proposed research represents the first study in two decades to assess the prevalence of MPX in an endemic region and to establish if the epidemiology of the virus has changed over time. Together, the career development and research activities proposed in this application will advance understanding of the variables that drive emergence of human MPX and support the development of the candidate as a productive independent investigator with the capacity to study fundamental ecologic, epidemiologic and biologic drivers of viral emergence.
