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.
Emerg Microbes Infect. 2024 Dec;13(1):2412635. doi: 10.1080/22221751.2024.2412635. Epub 2024 Oct 11.
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 (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).
在 2023 年,一些国家观察到了第二波主要影响男男性行为者(MSM)的全球猴痘疫情。在此,我们受益于大量病毒序列采样(76/121;63%)和广泛的流行病学数据,以描述葡萄牙在 2023 年重新出现和传播猴痘病毒(MPXV)的情况。我们还通过一个房室易感-暴露-感染-恢复(SEIR)模型来模拟传播并预测公共卫生情景。我们的结果表明,葡萄牙 2023 年的猴痘疫情是由有限的 MPXV 传入引起的,属于 C.1.1 亚谱系,假设来自亚洲,随后是持续的病毒传播和潜在的向其他国家的输出。我们估计,MSM 高性行为群体对猴痘传播的贡献是低性行为群体的 120 倍(95%置信区间:30-3553)。然而,在高性行为群体中,接种疫苗的个体的贡献可能比未接种疫苗的个体少约八倍[0.123(95%置信区间:0.068-0.208)]。接种疫苗还与潜在降低疾病严重程度有关,接种组的猴痘严重程度评分(Mpox Severity Score)为 6.0,而未接种组为 7.0。情景分析表明,传播对性行为高度敏感,预测 MSM 高性行为亚群的轻微增加可能会引发新的猴痘疫情。这项研究强烈支持,需要继续接种疫苗、在风险群体中开展有针对性的宣传以及常规的基因组流行病学,以预测和应对新的 MPXV 威胁(例如,I 型病毒的全球传播)。
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