Jin Shihui, Gan Gregory, Endo Akira, Prem Kiesha, Tan Rayner Kay Jin, Lim Jue Tao, Ejima Keisuke, Dickens Borame L
Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
BMJ Public Health. 2025 May 12;3(1):e002285. doi: 10.1136/bmjph-2024-002285. eCollection 2025.
The ongoing 2023-2024 mpox outbreak in several African countries, driven by the novel Clade Ib strain, has resulted in imported cases being reported in Sweden, Thailand and India. The potential high transmissibility of this new strain and shifts in transmission modes may make territories in Asia, which were minimally affected by previous mpox waves, susceptible to community-wide transmission following importation. While this highlights the importance of early preparedness, current knowledge of the virus's transmission dynamics remains too limited to effectively inform policymaking and resource planning.
A compartmental model was constructed to characterise potential mpox transmission dynamics. Importation-triggered outbreaks were simulated in 37 Asian cities under scenarios with one, three and five initial local infections. The impacts of various non-pharmaceutical interventions (NPIs), including isolation and quarantine, were projected and compared.
Our simulations revealed substantial disparities in outbreak sizes among the 37 Asian cities with large-scale outbreaks expected in territories with a high proportion of sexually active individuals at risk or low immunity from smallpox vaccination. Total case counts in 1 year following initial local infections would increase linearly with initial infection size. In the scenario with three initial local infections, up to 340 cases per million residents were expected without interventions. Isolation for diagnosed cases was projected to lower the outbreak size by 43.8% (IQR: 42.7-44.5%), 67.8% (IQR: 66.5-68.9%), 80.8% (IQR: 79.5-82.0%) and 88.0% (IQR: 86.8-89.1%) when it reduced interpersonal contacts by 25%, 50%, 75% and 100%, respectively. Quarantining close contacts would contribute to a further decrease in cases of up to 22 percentage points over 1 year.
A potential mpox outbreak in an Asian setting could be alleviated through strong surveillance and a timely response from stakeholders. NPIs are recommended for outbreak management due to their demonstrated effectiveness and practicability.
由新型进化枝Ib毒株引发的2023 - 2024年猴痘疫情正在几个非洲国家蔓延，导致瑞典、泰国和印度报告了输入性病例。这种新毒株潜在的高传播性以及传播模式的转变，可能会使此前受猴痘疫情影响极小的亚洲地区在输入病例后易发生社区传播。虽然这凸显了早期准备的重要性，但目前对该病毒传播动态的了解仍然非常有限，无法有效地为政策制定和资源规划提供依据。
构建了一个 compartments模型来描述潜在的猴痘传播动态。在有1例、3例和5例初始本地感染的情况下，模拟了37个亚洲城市因输入引发的疫情。预测并比较了包括隔离和检疫在内的各种非药物干预措施（NPIs）的影响。
我们的模拟结果显示，37个亚洲城市的疫情规模存在显著差异，预计在有高比例性活跃高危个体或因天花疫苗接种免疫力低下的地区会出现大规模疫情。初始本地感染后1年内的病例总数将随初始感染规模呈线性增加。在有3例初始本地感染的情况下，若不采取干预措施，预计每百万居民中病例数可达340例。当确诊病例的隔离措施使人际接触减少25%、50%、75%和100%时，预计疫情规模将分别降低43.8%（四分位距：42.7 - 44.5%）、67.8%（四分位距：66.5 - 68.9%）、80.8%（四分位距：79.5 - 82.0%）和88.0%（四分位距：86.8 - 89.1%）。对密切接触者进行检疫将使1年内病例数进一步减少多达22个百分点。
通过加强监测和利益相关者的及时应对，可以缓解亚洲地区潜在的猴痘疫情。由于非药物干预措施已证明有效且切实可行，因此建议将其用于疫情管理。
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