Pekar Jonathan E, Wang Yu, Wang Jade C, Shao Yucai, Taki Faten, Forgione Lisa A, Amin Helly, Clabby Tyler, Johnson Kimberly, Torian Lucia V, Braunstein Sarah L, Pathela Preeti, Omoregie Enoma, Hughes Scott, Suchard Marc A, Vasylyeva Tetyana I, Lemey Philippe, Wertheim Joel O
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.
medRxiv. 2024 Aug 1:2024.07.30.24311083. doi: 10.1101/2024.07.30.24311083.
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; =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.
2022年全球猴痘疫情可能是由猴痘病毒（MPXV）通过性接触网络传播所致，纽约市（NYC）经历了美国首例也是规模最大的疫情暴发。通过对MPXV进行系统发育地理学和流行病学分析，我们确定至少有200次MPXV传入纽约市，其中84次导致了病毒的进一步传播。通过与纽约市的人类免疫缺陷病毒（HIV）进行比较分析，我们发现MPXV和HIV的基因组聚类大小均最符合无标度分布，并且MPXV聚类中的人更有可能先前已被诊断出感染HIV（优势比=1.58；P=0.012），且是最近不断扩大的HIV传播聚类的成员，这表明存在重叠的性接触网络。然后，我们对MPXV通过性接触网络的传播进行建模，结果表明在疫情开始时，高度连接的个体将受到不成比例的感染，从而可能导致性网络中连接最密集的部分耗尽。这种动态变化解释了纽约市疫情的迅速蔓延和衰退，以及高危人群中估计累计发病率低于2%的情况。通过将MPXV和HIV的基因组流行病学与疫情建模相结合，我们证明MPXV的传播动态可以通过性传播病原体的一般原理来理解。
