猴痘(Mpox)疫情之現況與因應

Mpox: An Emerging Infectious Disease

台灣將新興傳染疾病「猴痘(Mpox)」自2022年6月23日起新增為第二類法定傳染病需24小時內通報，世界衛生組織(world health organization, WHO)也在2022年7月23日第7度宣布「國際關注的突發公共衛生事件」(public healthemergency of international concern, PHEIC)。這是自2005年PHEIC系統創建以來，首次在未經專家組認可的情況，發布最高等級的公衛警報。2022年5月歐洲Mpox疫情開始，擴大到美國，高峰為2022年8月。疫情開始至2022年12月底，全球確認感染Mpox的80,000多病例中，約65人死亡，且絕大多數症狀輕微；美國累計病例占全球總數35%為最多，約30,000名個案中，32名死亡個案（致死率為0.1%）。近期全球疫情趨緩，雖然WHO於今年（2023年）5月11日宣布，Mpox疫情不再是國際關注公共衛生緊急事件。惟亞太國家今(2023)年4月開始出現本土Mpox疫情，由日本開始、韓國、泰國、中國。台灣於2022年6月24日首例境外移入Mpox個案出現，2023年02月開始出現本土猴痘病例至今（2023年9月11日）累計確診328例病例（312例本土及16例境外移入）。本篇探討Mpox此新興傳染疾病之目前流行現況及因應。

Human beings have experienced the unprecedented emerging coronavirus disease 2019 (COVID-19) pandemic for more than two years. COVID-19 not only impacted on the individual level as many experienced the loss of friends and relatives, it also impacted the economy, freedom, and work due to isolation policy. Consequently, people have become more attentive towards emerging infectious diseases. Wearing masks and washing hands have also become a national movement. Mpox is another emerging infectious disease that may lead to local epidemics in Taiwan like COVID-19, thus causing a severe social impact . The atypical symptoms of the Mpox outbreak in Europe, America and Asia since May 2022, specifically the relatively small number of cutaneous, mucosal anogenital or oral lesions, makes the diagnosis more challenging. Mpox global outbreak is driven by human-to-human transmission via close contact (mainly sexual transmission). Mpox has been most prevalent among men who have sex with men (MSM), people with multiple sexual partners, and sex workers. Mpox is an important global public health issue, and may lead to social discrimination of those at higher risk. Therefore, we need to know more about Mpox. Since the COVID-19 epidemic is slowing down and immigration control and entry quarantine restriction has eased in Taiwan, it is imperative to improve the ability of clinicians to detect potential Mpox cases, provide early diagnosis, and prevent infection via two dose vaccinations, pre-exposure prophylaxis for high-risk population and post-exposure prophylaxis.