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Cordeiro R, Caetano CP, Sobral D, Ferreira R, Coelho L, Pelerito A, de Carvalho IL, Namorado S, Loyens DB, Mexia R, Fernandes C, Neves JM, João AL, Rocha M, Duque LM, Correia I, Baptista T, Brazão C, Sousa D, Filipe P, Alpalhão M, Maltez F, Póvoas D, Pinto R, Caria J, Patrocínio de Jesus R, Pacheco P, Peruzzu F, Méndez J, Ferreira L, Mansinho K, Alves JV, Vasconcelos J, Domingos J, Casanova S, Duarte F, Gonçalves MJ, Salvador MB, Guimarães MA, Martins S, Oliveira MS, Santos D, Vieira L, Núncio MS, Borges V, Gomes JP. Viral genetics and transmission dynamics in the second wave of mpox outbreak in Portugal and forecasting public health scenarios. Emerg Microbes Infect 2024; 13:2412635. [PMID: 39360827 PMCID: PMC11486115 DOI: 10.1080/22221751.2024.2412635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2024] [Revised: 09/27/2024] [Accepted: 09/30/2024] [Indexed: 10/05/2024]
Abstract
In 2023, a second wave of the global mpox epidemic, which is mainly affecting men who have sex with men (MSM), was observed in some countries. Herein, we benefited from a large viral sequence sampling (76/121; 63%) and vast epidemiological data to characterise the re-emergence and circulation of the Monkeypox virus (MPXV) in Portugal during 2023. We also modelled transmission and forecasted public health scenarios through a compartmental susceptible-exposed-infectious-recovered (SEIR) model. Our results suggest that the 2023 mpox wave in Portugal resulted from limited introduction(s) of MPXV belonging to C.1.1 sublineage, hypothetically from Asia, followed by sustained viral transmission and potential exportation to other countries. We estimated that the contribution of the MSM high sexual activity group to mpox transmission was 120 (95% CrI: 30-3553) times higher than that of the low sexual activity group. However, among the high sexual activity group, vaccinated individuals likely contributed approximately eight times less [0.123 (95% CrI: 0.068-0.208)] than the unvaccinated ones. Vaccination was also linked to potential reduced disease severity, with a Mpox Severity Score of 6.0 in the vaccinated group compared to 7.0 in unvaccinated individuals. Scenario analysis indicated that transmission is highly sensitive to sexual behaviour, projecting that a slight increase in the MSM sub-population with high sexual activity can trigger new mpox waves. This study strongly supports that continued vaccination, targeted awareness among risk groups and routine genomic epidemiology is needed to anticipate and respond to novel MPXV threats (e.g. global dissemination of clade I viruses).
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Affiliation(s)
- Rita Cordeiro
- Emergency Response and Biopreparedness Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
- Institute of Environmental Health, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Constantino P. Caetano
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Daniel Sobral
- Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Rita Ferreira
- Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Luís Coelho
- Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Ana Pelerito
- Emergency Response and Biopreparedness Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
- Institute of Environmental Health, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Isabel Lopes de Carvalho
- Emergency Response and Biopreparedness Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
- Institute of Environmental Health, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Sónia Namorado
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Dinis B. Loyens
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Ricardo Mexia
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Cândida Fernandes
- Serviço de Dermatovenereologia, Consulta de DST, Unidade Local de Saúde de São José, Lisbon, Portugal
| | - José Miguel Neves
- Serviço de Dermatovenereologia, Consulta de DST, Unidade Local de Saúde de São José, Lisbon, Portugal
| | - Ana Luísa João
- Serviço de Dermatovenereologia, Consulta de DST, Unidade Local de Saúde de São José, Lisbon, Portugal
| | - Miguel Rocha
- GAT - Grupo de Ativistas em Tratamentos, GAT-CheckpointLX, Lisbon, Portugal
| | - Luís Miguel Duque
- GAT - Grupo de Ativistas em Tratamentos, GAT-CheckpointLX, Lisbon, Portugal
- Serviço de Infeccologia, Hospital Garcia de Orta, Almada, Portugal
| | - Inês Correia
- GAT - Grupo de Ativistas em Tratamentos, GAT-Intendente, Lisbon, Portugal
| | - Teresa Baptista
- GAT - Grupo de Ativistas em Tratamentos, GAT-Intendente, Lisbon, Portugal
| | - Cláudia Brazão
- Dermatology Department, Unidade Local de Saúde de Santa Maria, Lisbon, Portugal
| | - Diogo Sousa
- Dermatology Department, Unidade Local de Saúde de Santa Maria, Lisbon, Portugal
| | - Paulo Filipe
- Dermatology Department, Unidade Local de Saúde de Santa Maria, Lisbon, Portugal
- Dermatology Research Unit (PFilipe Lab), Instituto de Medicina Molecular João Lobo Antunes, University of Lisbon, Lisbon, Portugal
- Dermatology University Clinic, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Miguel Alpalhão
- Dermatology Department, Unidade Local de Saúde de Santa Maria, Lisbon, Portugal
- Dermatology Research Unit (PFilipe Lab), Instituto de Medicina Molecular João Lobo Antunes, University of Lisbon, Lisbon, Portugal
- Dermatology University Clinic, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Fernando Maltez
- Institute of Environmental Health, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
- Serviço de Doenças Infeciosas, Hospital de Curry Cabral, Unidade Local de Saúde de São José, Lisbon, Portugal
| | - Diana Póvoas
- Serviço de Doenças Infeciosas, Hospital de Curry Cabral, Unidade Local de Saúde de São José, Lisbon, Portugal
- Instituto Gulbenkian de Ciência, Oeiras, Portugal
| | - Raquel Pinto
- Serviço de Doenças Infeciosas, Hospital de Curry Cabral, Unidade Local de Saúde de São José, Lisbon, Portugal
| | - João Caria
- Serviço de Doenças Infeciosas, Hospital de Curry Cabral, Unidade Local de Saúde de São José, Lisbon, Portugal
| | - Rita Patrocínio de Jesus
- Serviço de Infeciologia, Hospital Professor Doutor Fernando Fonseca, Unidade Local de Saúde Amadora/Sintra, Amadora, Portugal
| | - Patrícia Pacheco
- Serviço de Infeciologia, Hospital Professor Doutor Fernando Fonseca, Unidade Local de Saúde Amadora/Sintra, Amadora, Portugal
| | - Francesca Peruzzu
- Serviço de Infeciologia, Hospital Professor Doutor Fernando Fonseca, Unidade Local de Saúde Amadora/Sintra, Amadora, Portugal
| | - Josefina Méndez
- Serviço de Doenças Infecciosas, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Luís Ferreira
- Serviço de Doenças Infecciosas, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Kamal Mansinho
- Serviço de Doenças Infecciosas e Medicina Tropical, Hospital de Egas Moniz, Unidade Local de Saúde de Lisboa Ocidental, Lisbon, Portugal
| | - João Vaz Alves
- Serviço de Doenças Infecciosas e Medicina Tropical, Hospital de Egas Moniz, Unidade Local de Saúde de Lisboa Ocidental, Lisbon, Portugal
| | - Joana Vasconcelos
- Emergency Response and Biopreparedness Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - João Domingos
- Serviço de Doenças Infecciosas e Medicina Tropical, Hospital de Egas Moniz, Unidade Local de Saúde de Lisboa Ocidental, Lisbon, Portugal
| | - Sara Casanova
- Serviço de Doenças Infecciosas e Medicina Tropical, Hospital de Egas Moniz, Unidade Local de Saúde de Lisboa Ocidental, Lisbon, Portugal
| | - Frederico Duarte
- Serviço de Doenças Infeciosas, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal
| | - Maria João Gonçalves
- Serviço de Doenças Infeciosas, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal
| | - Mafalda Brito Salvador
- Unidade de Doenças Sexualmente Transmissíveis, Unidade de Cuidados de Saúde Personalizados da Lapa, Unidade Local de Saúde de São José, Lisbon, Portugal
| | | | - Sueila Martins
- UL-PPCIRA, Unidade Local de Saúde Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Marvin Silva Oliveira
- Serviço de Patologia Clínica, Unidade Local de Saúde do Tâmega e Sousa, Penafiel, Portugal
| | - Daniela Santos
- Technology and Innovation Unit, Department of Human Genetics, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Luís Vieira
- Technology and Innovation Unit, Department of Human Genetics, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Maria Sofia Núncio
- Emergency Response and Biopreparedness Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
- Institute of Environmental Health, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Vítor Borges
- Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - João Paulo Gomes
- Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
- Veterinary and Animal Research Centre (CECAV), Faculty of Veterinary Medicine, Lusófona University, Lisbon, Portugal
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Ghosn J, Assoumou L, Ouattara M, Rubenstein E, Pialoux G, Katlama C, Surgers L, Duvivier C, Pavie J, Viard JP, Algarte-Genin M, Gibowski S, Ollivier M, Costagliola D, Molina JM. Impact of vaccination with third generation modified vaccinia Ankara and sexual behaviour on mpox incidence in men who have sex with men: analysis among participants of the ANRS-174 DOXYVAC trial. THE LANCET REGIONAL HEALTH. EUROPE 2024; 45:101020. [PMID: 39188858 PMCID: PMC11345388 DOI: 10.1016/j.lanepe.2024.101020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 07/17/2024] [Accepted: 07/18/2024] [Indexed: 08/28/2024]
Abstract
Background Mpox was first reported in France on May 19 and third-generation live Modified Vaccinia Ankara (MVA-BN) vaccination of multiple-partner men who have sex with men (MSM) was recommended as of July 11, 2022. We assessed the impact of vaccination and of sexual behavior adopted during the epidemic period on mpox incidence in the ANRS-174-DOXYVAC trial enrolling MSM on HIV pre-exposure prophylaxis (PrEP) with history of sexually-transmitted infections (STI) in the previous year. Methods We compared pre-epidemic socio-behavioral characteristics and change in sexual behaviors after the onset of the epidemic of participants with mpox and mpox-free. Then we compared incidence rates of mpox per 1000 person-months (p-m) between May 9-July 10 (before vaccination of MSM, period-1) and July 11-September 20 2022 (after vaccination launch, period-2) and explored factors explaining the period effect using Poisson regression model. Findings 472 MSM had data before and after May 9, 2022. Twenty percent had received smallpox vaccine during childhood. Mpox occurred in 77/472 participants (incidence 49.3 per 1000 p-m (95% CI 38.9-61.6)). MVA-BN vaccination roll-out was rapid, with 86% (341/398) of eligible participants having received at least one dose by September 20, 2022. Sexual behavior significantly changed before and after May 9, with a decrease in the proportion of mpox-free participants with >10 partners during last 3 months (45% vs 38%, p = 0.0035). Mpox incidence was 67.4 per 1000 p-m (95% CI 51.6-86.6) in period-1, and 24.4 per 1000 p-m (95% CI 13.9-39.6) in period-2, with an incidence rate ratio of 0.36 (95% CI 0.21-0.63). In multivariable Poisson regression model, only MVA-BN vaccination in 2022 remained significantly associated with mpox incidence, with a 99% risk reduction (95% CI 96.6-99.7). Interpretation In MSM on PrEP enrolled in the ANRS-174-DOXYVAC trial, rapid roll-out of MVA-BN vaccination was associated with a strong reduction in mpox incidence. Funding ANRS Maladies Infectieuses Emergentes (ANRS/MIE).
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Affiliation(s)
- Jade Ghosn
- Assistance Publique-Hôpitaux de Paris.Nord, Hôpital Bichat-Claude Bernard, Service des Maladies Infectieuses et Tropicales, Paris F75018, France
- Université Paris Cité, INSERM, UMRS 1137 IAME, Paris F75018, France
| | - Lambert Assoumou
- Sorbonne Université, INSERM, Institut Pierre Louis d’Épidémiologie et de Santé Publique, Paris F75012, France
| | - Moussa Ouattara
- Sorbonne Université, INSERM, Institut Pierre Louis d’Épidémiologie et de Santé Publique, Paris F75012, France
| | - Emma Rubenstein
- Assistance Publique-Hôpitaux de Paris, Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Louis, Paris F75010, France
| | - Gilles Pialoux
- Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Service des Maladies Infectieuses et Tropicales, Hôpital Tenon, Paris F75020, France
| | - Christine Katlama
- Sorbonne Université, INSERM, Institut Pierre Louis d’Épidémiologie et de Santé Publique, Paris F75012, France
- Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Service des Maladies Infectieuses et Tropicales, Hôpital Pitié-Salpêtrière, Paris F75013, France
| | - Laure Surgers
- Sorbonne Université, INSERM, Institut Pierre Louis d’Épidémiologie et de Santé Publique, Paris F75012, France
- Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, Paris F75012, France
| | - Claudine Duvivier
- Assistance Publique-Hôpitaux de Paris-Necker Hospital, Infectious Diseases Department, Necker-Pasteur Infectiology Center, Paris F75015, France
- Université Paris Cité, INSERM U1016, CNRS UMR8104, Institut Cochin, Paris, France
- IHU Imagine, Paris, France
| | - Juliette Pavie
- Assistance Publique-Hôpitaux de Paris-Centre, Unité de Thérapeutique en Immuno-Infectiologie, Hôpital Hôtel-Dieu, Paris F75004, France
| | - Jean-Paul Viard
- Assistance Publique-Hôpitaux de Paris-Centre, Unité de Thérapeutique en Immuno-Infectiologie, Hôpital Hôtel-Dieu, Paris F75004, France
| | - Michèle Algarte-Genin
- Sorbonne Université, INSERM, Institut Pierre Louis d’Épidémiologie et de Santé Publique, Paris F75012, France
| | - Severine Gibowski
- Agence Nationale de Recherche sur le SIDA et les Hépatites virales – Maladies Infectieuses et Émergentes (ANRS-MIE), Paris F75015, France
| | - Manon Ollivier
- Agence Nationale de Recherche sur le SIDA et les Hépatites virales – Maladies Infectieuses et Émergentes (ANRS-MIE), Paris F75015, France
| | - Dominique Costagliola
- Sorbonne Université, INSERM, Institut Pierre Louis d’Épidémiologie et de Santé Publique, Paris F75012, France
| | - Jean-Michel Molina
- Assistance Publique-Hôpitaux de Paris, Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Louis, Paris F75010, France
- Université Paris Cité, INSERM UMR 944, Paris F75010, France
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Liang C, Suen SC, Hong C, Kim A, Singhal R, Simon P, Perez M, Holloway IW. A Microsimulation Model of Mpox in Los Angeles County: Implications for Future Disease Prevention and Control Strategies among Men Who Have Sex with Men. Open Forum Infect Dis 2024; 11:S137-S145. [PMID: 39415828 PMCID: PMC11477083 DOI: 10.1093/ofid/ofae401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2024] Open
Abstract
Background The 2022 monkeypox (mpox) outbreak in Los Angeles County (LAC) emphasized the need to prepare for emergent infectious disease outbreaks. Vaccination and promotion of sexual risk reduction practices appeared successful in LAC, as mpox cases declined starting in August. Nonetheless, questions persisted regarding the effectiveness of targeting vaccinations and the role of sexual risk reduction in reducing mpox cases. Methods We collaborated with the LAC Department of Public Health to develop a microsimulation for men who have sex with men (MSM). This model tracked mpox dynamics by age, race/ethnicity, and HIV status and was calibrated and validated against surveillance data. We simulated counterfactual scenarios to understand the effects of variation in vaccination rates, timing of vaccination rollout, vaccine allocation, and sexual contact rates. Results In the simulation, doubling the vaccination rate reduced cumulative cases over a 40-week time horizon by 13% but would necessitate 88 995 additional doses. Initiating vaccination 2 weeks earlier decreased cases by 11%, while an 8-week delay yielded a 20% increase in cases. A 3-week earlier decrease in sexual contact rates reduced cumulative cases by 60%, while a 3-week delay resulted in a 95% increase. Prioritizing people with HIV (PWH) for vaccination reduced cumulative cases, while allocating vaccines to a single racial/ethnic group was not effective. Conclusions Our study highlights the significance of policies to support timely vaccination and sexual partnership reduction to address mpox outbreaks among MSM. These findings also underscore the need to target vulnerable risk groups, such as PWH.
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Affiliation(s)
- Citina Liang
- Daniel J. Epstein Department of Industrial and Systems Engineering, University of Southern California Viterbi School of Engineering, Los Angeles, California, USA
| | - Sze-chuan Suen
- Daniel J. Epstein Department of Industrial and Systems Engineering, University of Southern California Viterbi School of Engineering, Los Angeles, California, USA
| | - Chenglin Hong
- School of Social Work, University of Connecticut, Hartford, Connecticut, USA
| | - Andrea Kim
- Los Angeles County Department of Public Health, Los Angeles, California, USA
| | - Rita Singhal
- Los Angeles County Department of Public Health, Los Angeles, California, USA
| | - Paul Simon
- Department of Epidemiology, University of California Los Angeles Fielding School of Public Health, Los Angeles, California, USA
| | - Mario Perez
- Los Angeles County Department of Public Health, Los Angeles, California, USA
| | - Ian W Holloway
- Department of Social Welfare, Luskin School of Public Affairs, University of California Los Angeles, Los Angeles, California, USA
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Priyanka TMC, Gowrisankar A, Banerjee S. Mpox outbreak: Time series analysis with multifractal and deep learning network. CHAOS (WOODBURY, N.Y.) 2024; 34:101103. [PMID: 39413265 DOI: 10.1063/5.0236082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2024] [Accepted: 10/02/2024] [Indexed: 10/18/2024]
Abstract
This article presents an overview of an mpox epidemiological situation in the most affected regions-Africa, Americas, and Europe-tailoring fractal interpolation for pre-processing the mpox cases. This keen analysis has highlighted the irregular and fractal patterns in the trend of mpox transmission. During the current scenario of public health emergency of international concern due to an mpox outbreak, an additional significance of this article is the interpretation of mpox spread in light of multifractality. The self-similar measure, namely, the multifractal measure, is utilized to explore the heterogeneity in the mpox cases. Moreover, a bidirectional long-short term memory neural network has been employed to forecast the future mpox spread to alert the outbreak as it seems to be a silent symptom for global epidemic.
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Affiliation(s)
- T M C Priyanka
- Department of Mathematics, School of Advanced Sciences, Vellore Institute of Technology, Vellore 632 014, Tamil Nadu, India
| | - A Gowrisankar
- Department of Mathematics, School of Advanced Sciences, Vellore Institute of Technology, Vellore 632 014, Tamil Nadu, India
| | - Santo Banerjee
- Dipartimento di Scienze Matematiche, Politecnico di Torino, Corso Duca degli Abruzzi, 24, 10129 Torino, Italy
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Telford E, D'Ortenzio E, Yazdanpanah Y. A Second Mpox Outbreak in Brazil: A Call for Action to Guarantee Equity in Access to Health Innovations. Clin Infect Dis 2024; 79:660-662. [PMID: 39012173 DOI: 10.1093/cid/ciae292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Accepted: 05/29/2024] [Indexed: 07/17/2024] Open
Affiliation(s)
- Erica Telford
- ANRS Emerging Infectious Diseases (ANRS MIE), Inserm, Paris, France
| | - Eric D'Ortenzio
- ANRS Emerging Infectious Diseases (ANRS MIE), Inserm, Paris, France
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Martínez-Arias A, Valerio L, Vallès X, Díez SR, Langa LS, Pedregal ÈF, Rodríguez ÀH, Isnard-Blanchard M, Simó JMB, Gil NP, Cirera A, Clotet B, Gené Tous E. Mpox cases finding: Evaluation of a Primary Care detection program in the Northern Metropolitan area from Barcelona (Spain). Aten Primaria 2024; 57:103089. [PMID: 39321646 PMCID: PMC11459901 DOI: 10.1016/j.aprim.2024.103089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 07/10/2024] [Accepted: 07/30/2024] [Indexed: 09/27/2024] Open
Abstract
MAIN AIM In July 2022, an extensive outbreak of Mpox (monkeypox) was considered by WHO as a Public Health Emergency. The objective of this study is to describe the obtained results from a Mpox case detection program in a semi-urban healthcare area where approximately 420 Primary Care physicians work. DESIGN An observational prospective study performed between June 01, 2022 and December 31, 2023. SETTING The Northern Metropolitan area of Barcelona, with 1400.000hab (Catalonia, Spain). METHODS An unified Mpox management procedure was agreed, including a prior online training of Primary Care professionals, to individually assess all Mpox suspected cases from a clinical and epidemiological perspective. PARTICIPANTS All patients who met clinical and/or epidemiological criteria of Mpox. DATA COLLECTION Age, gender, risk classification (suspected/probable), cluster-linked (yes/no), high-risk sexual contact (yes/no), general symptoms, genital lesion and final diagnostic. RESULTS A total of 68 suspected Mpox cases were included, from which 16 (26.6%) were Mpox confirmed by PCR. Up to 13 (81.2%) were male and, among them, 12 (75%) men who have sex with men (MSM). The series, however, included two minors and three women. Among MSM, 3 (18.7%) were HIV positive and 3 had no regular access to the Public Healthcare system. Among discarded patients, any infectious disease was diagnosed in 55% of cases. CONCLUSIONS In spite of the short series, this Primary Care community-based study identified a sub-population group showing a different profile of Mpox cases compared to other published series (lower HIV prevalence, higher representativeness of heterosexual transmission and hard to reach population).
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Affiliation(s)
- Andrés Martínez-Arias
- Consorci Corporació Sanitària Parc Taulí, Emergency Service, Universitat Autònoma de Barcelona, Medicine Department, Bellaterra, Catalonia, Spain.
| | - Lluís Valerio
- Programa de Salut Internacional (PROSICS) Metropolitana nord, Primary Care Service, Universitat Autònoma de Barcelona, Badalona, Catalonia, Spain
| | - Xavier Vallès
- Programa de Salut Internacional (PROSICS) Metropolitana nord, Institut per a la Recerca en Ciències de la Salut, Hospital Universitari Germans Trias i Pujol, Institut Català de la Salut, Universitat Autònoma de Barcelona, Badalona, Catalonia, Spain
| | - Sílvia Roure Díez
- Programa de Salut Internacional (PROSICS) Metropolitana nord, Infectious Diseases Service, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Catalonia, Spain
| | - Laura Soldevila Langa
- Programa de Salut Internacional (PROSICS) Metropolitana nord, Infectious Diseases Service, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Catalonia, Spain
| | - Èlia Fernandez Pedregal
- Programa de Salut Internacional (PROSICS) Metropolitana nord, Infectious Diseases Service, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Catalonia, Spain
| | - Àgueda Hernàndez Rodríguez
- Microbiology Service, Hospital Universitari Germans Trias i Pujol, Institut Català de la Salut, Universitat Autònoma de Barcelona, Badalona, Catalonia, Spain
| | - Mar Isnard-Blanchard
- North Metropolitan Primary Care Directorate, Institut Català de la Salut, Sabadell, Catalonia, Spain
| | - Josep Maria Bonet Simó
- North Metropolitan Primary Care Directorate, Institut Català de la Salut, Sabadell, Catalonia, Spain
| | - Núria Prat Gil
- North Metropolitan Primary Care Directorate, Institut Català de la Salut, Sabadell, Catalonia, Spain
| | - Anna Cirera
- North Metropolitan Primary Care Directorate, Institut Català de la Salut, Sabadell, Catalonia, Spain
| | - Bonaventura Clotet
- Programa de Salut Internacional (PROSICS) Metropolitana nord, Infectious Diseases Service, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Catalonia, Spain
| | - Emili Gené Tous
- Consorci Corporació Sanitària Parc Taulí, Emergency Service, Universitat Autònoma de Barcelona, Medicine Department, Bellaterra, Catalonia, Spain
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Poliker E, Anis E, Kaliner E, Avni G, Mor Z. One Country, Different Reactions- How did the Gay Community in Israel Respond to the New Mpox Threat? AIDS Behav 2024:10.1007/s10461-024-04486-w. [PMID: 39259240 DOI: 10.1007/s10461-024-04486-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2024] [Indexed: 09/12/2024]
Abstract
Mpox affected mainly men who have sex with men (MSM). This study aimed to assess MSM's response to the threat, and compare MSM living in central Israel vs. its periphery. Data were collected by anonymous electronic surveys between September and October 2022 through a geospatial application ("Grindr"). Of the 665 MSM participants, 221 (33.2%) were vaccinated against mpox. In the multivariate analysis, living in central Israel, being in steady relationships, HIV infection, PrEP use, noticing suspicious skin lesions, and changing sexual behavior predicted vaccination. Of all participants, 317 (47.6%) changed their sexual behavior. In the multivariate analysis, living in central Israel, engaging in risky sexual behavior and being vaccinated against mpox predicted sexual behavior change. Of the 444 participants who were not vaccinated, 245 (55.1%) lived in peripheral regions of Israel. Those who lived in the periphery were less likely to get vaccinated or change their sexual behavior compared with MSM who lived in central Israel. Although the study was limited in size and the study population was relatively homogeneous, MSM perceived mpox as a potential threat on health, and almost 50% changed their sexual behavior and nearly one-third were vaccinated against mpox. The trend was mainly observed in MSM who were at high risk to acquire mpox and those who lived in central Israel.
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Affiliation(s)
- Eliyahu Poliker
- Central District Department of Health, Ministry of Health, 91 Sderot Hertzel Street, 7243003, Ramla, Israel.
| | - Emilia Anis
- Division of Epidemiology, Ministry of Health, 39 Yirmiyahu Street, 9101002, Jerusalem, Israel
| | - Ehud Kaliner
- Central District Department of Health, Ministry of Health, 91 Sderot Hertzel Street, 7243003, Ramla, Israel
| | - George Avni
- Israel AIDS Task Force, 18 Hanatsiv Street, 6701808, Tel Aviv, Israel
| | - Zohar Mor
- Central District Department of Health, Ministry of Health, 91 Sderot Hertzel Street, 7243003, Ramla, Israel
- School of Health Sciences, Ashkelon Academic College, 12 Ben Tzvi Street, 78211, Ashkelon, Israel
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Muntoni AP, Mazza F, Braunstein A, Catania G, Dall'Asta L. Effectiveness of probabilistic contact tracing in epidemic containment: The role of superspreaders and transmission path reconstruction. PNAS NEXUS 2024; 3:pgae377. [PMID: 39285934 PMCID: PMC11404514 DOI: 10.1093/pnasnexus/pgae377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Accepted: 08/15/2024] [Indexed: 09/19/2024]
Abstract
The recent COVID-19 pandemic underscores the significance of early stage nonpharmacological intervention strategies. The widespread use of masks and the systematic implementation of contact tracing strategies provide a potentially equally effective and socially less impactful alternative to more conventional approaches, such as large-scale mobility restrictions. However, manual contact tracing faces strong limitations in accessing the network of contacts, and the scalability of currently implemented protocols for smartphone-based digital contact tracing becomes impractical during the rapid expansion phases of the outbreaks, due to the surge in exposure notifications and associated tests. A substantial improvement in digital contact tracing can be obtained through the integration of probabilistic techniques for risk assessment that can more effectively guide the allocation of diagnostic tests. In this study, we first quantitatively analyze the diagnostic and social costs associated with these containment measures based on contact tracing, employing three state-of-the-art models of SARS-CoV-2 spreading. Our results suggest that probabilistic techniques allow for more effective mitigation at a lower cost. Secondly, our findings reveal a remarkable efficacy of probabilistic contact-tracing techniques in performing backward and multistep tracing and capturing superspreading events.
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Affiliation(s)
- Anna Paola Muntoni
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, Torino 10129, Italy
- Statistical inference and computational biology, Italian Institute for Genomic Medicine, c/o IRCSS, Candiolo 10060, Italy
| | - Fabio Mazza
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, Torino 10129, Italy
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Via Ponzio 34/5, Milano 20133, Italy
| | - Alfredo Braunstein
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, Torino 10129, Italy
- Statistical inference and computational biology, Italian Institute for Genomic Medicine, c/o IRCSS, Candiolo 10060, Italy
| | - Giovanni Catania
- Departamento de Física Teórica, Universidad Complutense, Madrid 28040, Spain
| | - Luca Dall'Asta
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, Torino 10129, Italy
- Statistical inference and computational biology, Italian Institute for Genomic Medicine, c/o IRCSS, Candiolo 10060, Italy
- Collegio Carlo Alberto, P.za Arbarello 8, Torino 10122, Italy
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9
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Pekar JE, Wang Y, Wang JC, Shao Y, Taki F, Forgione LA, Amin H, Clabby T, Johnson K, Torian LV, Braunstein SL, Pathela P, Omoregie E, Hughes S, Suchard MA, Vasylyeva TI, Lemey P, Wertheim JO. Genomic epidemiology reveals 2022 mpox epidemic in New York City governed by heavy-tailed sexual contact networks. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.07.30.24311083. [PMID: 39132479 PMCID: PMC11312668 DOI: 10.1101/2024.07.30.24311083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 08/13/2024]
Abstract
The global mpox epidemic in 2022 was likely caused by transmission of mpox virus (MPXV) through sexual contact networks, with New York City (NYC) experiencing the first and largest outbreak in the United States. By performing a phylogeographic and epidemiological analysis of MPXV, we identify at least 200 introductions of MPXV into NYC and 84 leading to onward transmission. Through a comparative analysis with human immunodeficiency virus (HIV) in NYC, we find that both MPXV and HIV genomic cluster sizes are best fit by scale-free distributions and that people in MPXV clusters are more likely to have previously received an HIV diagnosis (odds ratio=1.58; p=0.012) and be a member of a recently growing HIV transmission cluster, indicating overlapping sexual contact networks. We then model the transmission of MPXV through sexual contact networks and show that highly connected individuals would be disproportionately infected at the start of an epidemic, thereby likely resulting in the exhaustion of the most densely connected parts of the sexual network. This dynamic explains the rapid expansion and decline of the NYC outbreak, as well as the estimated cumulative incidence of less than 2% within high-risk populations. By synthesizing the genomic epidemiology of MPXV and HIV with epidemic modeling, we demonstrate that MPXV transmission dynamics can be understood by general principles of sexually transmitted pathogens.
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Affiliation(s)
- Jonathan E Pekar
- Bioinformatics and Systems Biology Graduate Program, University of California San Diego, La Jolla, CA 92093, USA
- Department of Biomedical Informatics, University of California San Diego, La Jolla, CA 92093, USA
- Department of Medicine, University of California San Diego, La Jolla, CA 92093, USA
| | - Yu Wang
- Department of Computer Science and Engineering, University of California San Diego, La Jolla, CA 92093, USA
| | - Jade C Wang
- New York City Department of Health and Mental Hygiene, Public Health Laboratory, New York, NY 11101, USA
| | - Yucai Shao
- Department of Biostatistics, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Faten Taki
- New York City Department of Health and Mental Hygiene, Public Health Laboratory, New York, NY 11101, USA
| | - Lisa A Forgione
- New York City Department of Health and Mental Hygiene, Bureau of Hepatitis, HIV, and Sexually Transmitted Infections, Long Island City, NY 11101, USA
| | - Helly Amin
- New York City Department of Health and Mental Hygiene, Public Health Laboratory, New York, NY 11101, USA
| | - Tyler Clabby
- New York City Department of Health and Mental Hygiene, Public Health Laboratory, New York, NY 11101, USA
| | - Kimberly Johnson
- New York City Department of Health and Mental Hygiene, Bureau of Hepatitis, HIV, and Sexually Transmitted Infections, Long Island City, NY 11101, USA
| | - Lucia V Torian
- New York City Department of Health and Mental Hygiene, Bureau of Hepatitis, HIV, and Sexually Transmitted Infections, Long Island City, NY 11101, USA
| | - Sarah L Braunstein
- New York City Department of Health and Mental Hygiene, Bureau of Hepatitis, HIV, and Sexually Transmitted Infections, Long Island City, NY 11101, USA
| | - Preeti Pathela
- New York City Department of Health and Mental Hygiene, Bureau of Hepatitis, HIV, and Sexually Transmitted Infections, Long Island City, NY 11101, USA
| | - Enoma Omoregie
- New York City Department of Health and Mental Hygiene, Public Health Laboratory, New York, NY 11101, USA
| | - Scott Hughes
- New York City Department of Health and Mental Hygiene, Public Health Laboratory, New York, NY 11101, USA
| | - Marc A Suchard
- Department of Biostatistics, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA 90095, USA
- Department of Biomathematics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA
- Department of Human Genetics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Tetyana I Vasylyeva
- Department of Population Health and Disease Prevention, University of California Irvine, Irvine, CA 92617, USA
| | - Philippe Lemey
- Department of Microbiology, Immunology and Transplantation, Rega Institute, Laboratory for Clinical and Epidemiological Virology, KU Leuven, Leuven, Belgium
| | - Joel O Wertheim
- Department of Medicine, University of California San Diego, La Jolla, CA 92093, USA
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Dellicour S, Bastide P, Rocu P, Fargette D, Hardy OJ, Suchard MA, Guindon S, Lemey P. How fast are viruses spreading in the wild? BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.10.588821. [PMID: 38645268 PMCID: PMC11030353 DOI: 10.1101/2024.04.10.588821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Genomic data collected from viral outbreaks can be exploited to reconstruct the dispersal history of viral lineages in a two-dimensional space using continuous phylogeographic inference. These spatially explicit reconstructions can subsequently be used to estimate dispersal metrics allowing to unveil the dispersal dynamics and evaluate the capacity to spread among hosts. Heterogeneous sampling intensity of genomic sequences can however impact the accuracy of dispersal insights gained through phylogeographic inference. In our study, we implement a simulation framework to evaluate the robustness of three dispersal metrics - a lineage dispersal velocity, a diffusion coefficient, and an isolation-by-distance signal metric - to the sampling effort. Our results reveal that both the diffusion coefficient and isolation-by-distance signal metrics appear to be robust to the number of samples considered for the phylogeographic reconstruction. We then use these two dispersal metrics to compare the dispersal pattern and capacity of various viruses spreading in animal populations. Our comparative analysis reveals a broad range of isolation-by-distance patterns and diffusion coefficients mostly reflecting the dispersal capacity of the main infected host species but also, in some cases, the likely signature of rapid and/or long-distance dispersal events driven by human-mediated movements through animal trade. Overall, our study provides key recommendations for the lineage dispersal metrics to consider in future studies and illustrates their application to compare the spread of viruses in various settings.
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11
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Wang Y, Chen H, Lin K, Han Y, Gu Z, Wei H, Mu K, Wang D, Liu L, Jin R, Song R, Rong Z, Wang S. Ultrasensitive single-step CRISPR detection of monkeypox virus in minutes with a vest-pocket diagnostic device. Nat Commun 2024; 15:3279. [PMID: 38627378 PMCID: PMC11021474 DOI: 10.1038/s41467-024-47518-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 04/03/2024] [Indexed: 04/19/2024] Open
Abstract
The emerging monkeypox virus (MPXV) has raised global health concern, thereby highlighting the need for rapid, sensitive, and easy-to-use diagnostics. Here, we develop a single-step CRISPR-based diagnostic platform, termed SCOPE (Streamlined CRISPR On Pod Evaluation platform), for field-deployable ultrasensitive detection of MPXV in resource-limited settings. The viral nucleic acids are rapidly released from the rash fluid swab, oral swab, saliva, and urine samples in 2 min via a streamlined viral lysis protocol, followed by a 10-min single-step recombinase polymerase amplification (RPA)-CRISPR/Cas13a reaction. A pod-shaped vest-pocket analysis device achieves the whole process for reaction execution, signal acquisition, and result interpretation. SCOPE can detect as low as 0.5 copies/µL (2.5 copies/reaction) of MPXV within 15 min from the sample input to the answer. We validate the developed assay on 102 clinical samples from male patients / volunteers, and the testing results are 100% concordant with the real-time PCR. SCOPE achieves a single-molecular level sensitivity in minutes with a simplified procedure performed on a miniaturized wireless device, which is expected to spur substantial progress to enable the practice application of CRISPR-based diagnostics techniques in a point-of-care setting.
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Affiliation(s)
- Yunxiang Wang
- Bioinformatics Center of AMMS, 100850, Beijing, China
| | - Hong Chen
- Bioinformatics Center of AMMS, 100850, Beijing, China
| | - Kai Lin
- Department of Clinical Laboratory, Air Force Medical Center, Air Force Medical University, 100142, Beijing, China
| | - Yongjun Han
- Bioinformatics Center of AMMS, 100850, Beijing, China
| | - Zhixia Gu
- Beijing Ditan Hospital, Capital Medical University, 100015, Beijing, China
| | - Hongjuan Wei
- Bioinformatics Center of AMMS, 100850, Beijing, China
| | - Kai Mu
- Bioinformatics Center of AMMS, 100850, Beijing, China
| | - Dongfeng Wang
- Bioinformatics Center of AMMS, 100850, Beijing, China
| | - Liyan Liu
- Bioinformatics Center of AMMS, 100850, Beijing, China
| | - Ronghua Jin
- Beijing Ditan Hospital, Capital Medical University, 100015, Beijing, China.
| | - Rui Song
- Beijing Ditan Hospital, Capital Medical University, 100015, Beijing, China.
| | - Zhen Rong
- Bioinformatics Center of AMMS, 100850, Beijing, China.
| | - Shengqi Wang
- Bioinformatics Center of AMMS, 100850, Beijing, China.
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12
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Mpox's surge was stopped by behaviour change - before vaccine rollout. Nature 2024; 627:11. [PMID: 38424334 DOI: 10.1038/d41586-024-00566-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
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