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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. Transmission dynamics of the 2022 mpox epidemic in New York City. Nat Med 2025; 31:1464-1473. [PMID: 40133528 DOI: 10.1038/s41591-025-03526-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2024] [Accepted: 01/20/2025] [Indexed: 03/27/2025]
Abstract
The 2022 global mpox epidemic was caused by transmission of MPXV clade IIb, lineage B.1 through sexual contact networks, with New York City (NYC) experiencing the first and largest outbreak in the United States. By performing phylogeographic analysis of MPXV genomes sampled from 757 individuals in NYC between April 2022 and April 2023, and 3,287 MPXV genomes sampled around the world, we identify over 200 introductions of MPXV into NYC with at least 84 leading to onward transmission. These infections primarily occurred among men who have sex with men, transgender women and nonbinary individuals. Through a comparative analysis with 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 and be a member of a recently growing HIV transmission cluster. We model MPXV transmission through sexual contact networks and show that highly connected individuals would be disproportionately infected at the start of an epidemic, which would likely result in the exhaustion of the most densely connected parts of the network, and, therefore, explain the rapid expansion and decline of the NYC outbreak. By coupling the genomic epidemiology of MPXV and HIV with epidemic modeling, we demonstrate that the transmission dynamics of MPXV in NYC can be understood by general principles of sexually transmitted pathogens.
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Affiliation(s)
- Jonathan E Pekar
- Institute of Ecology and Evolution, University of Edinburgh, Edinburgh, UK.
- Bioinformatics and Systems Biology Graduate Program, University of California San Diego, La Jolla, CA, USA.
- Department of Biomedical Informatics, University of California San Diego, La Jolla, CA, USA.
- Department of Medicine, University of California San Diego, La Jolla, CA, USA.
| | - Yu Wang
- Department of Computer Science and Engineering, University of California San Diego, La Jolla, CA, USA
| | - Jade C Wang
- Bioinformatics and Systems Biology Graduate Program, University of California San Diego, La Jolla, CA, USA
- New York City Department of Health and Mental Hygiene, Public Health Laboratory, New York, NY, USA
| | - Yucai Shao
- Department of Biostatistics, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Faten Taki
- New York City Department of Health and Mental Hygiene, Bureau of Hepatitis, HIV and Sexually Transmitted Infections, Long Island City, NY, 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, USA
| | - Helly Amin
- New York City Department of Health and Mental Hygiene, Public Health Laboratory, New York, NY, USA
| | - Tyler Clabby
- New York City Department of Health and Mental Hygiene, Public Health Laboratory, New York, NY, USA
| | - Kimberly Johnson
- New York City Department of Health and Mental Hygiene, Bureau of Hepatitis, HIV and Sexually Transmitted Infections, Long Island City, NY, 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, 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, USA
| | - Preeti Pathela
- New York City Department of Health and Mental Hygiene, Bureau of Hepatitis, HIV and Sexually Transmitted Infections, Long Island City, NY, USA
| | - Enoma Omoregie
- New York City Department of Health and Mental Hygiene, Public Health Laboratory, New York, NY, USA
| | - Scott Hughes
- New York City Department of Health and Mental Hygiene, Public Health Laboratory, New York, NY, USA
| | - Marc A Suchard
- Department of Biostatistics, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
- Department of Biomathematics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Department of Human Genetics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Tetyana I Vasylyeva
- Department of Population Health and Disease Prevention, Joe C. Wen School of Public Health, University of California Irvine, Irvine, CA, 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, USA.
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Yellin H, Bornstein S, Balachandran M, Siegel M, Magnus M. Psychosocial and Behavioral Impacts of the Mpox Outbreak among People with and without HIV in the United States. AIDS Behav 2025; 29:1294-1304. [PMID: 39739285 DOI: 10.1007/s10461-024-04603-9] [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] [Accepted: 12/20/2024] [Indexed: 01/02/2025]
Abstract
Over 32,000 mpox cases were identified in the United States (US) within one year of the start of the global outbreak in 2022. Research on how the mpox outbreak affected individuals' lives is limited. We analyzed qualitative and quantitative cross-sectional survey data collected from 60 participants in August 2022 to (1) describe mpox-related psychosocial and behavioral impacts among adults in the US and (2) explore differences in mpox-related impacts by HIV status. Results indicate that the outbreak affected both people with HIV (PWH) and people without HIV (PWOH) in our sample, while also highlighting the unique experience of PWH. The majority of participants reported that they felt at risk, experienced negative impacts across multiple life domains, changed aspects of their behavior, and anticipated mpox-related stigma. These findings can be used to inform the public health response in the event of future mpox outbreaks.
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Affiliation(s)
- Hannah Yellin
- Department of Epidemiology, George Washington University Milken Institute School of Public Health, Washington, DC, USA.
| | - Sydney Bornstein
- Department of Epidemiology, George Washington University Milken Institute School of Public Health, Washington, DC, USA
| | - Madhu Balachandran
- Department of Epidemiology, George Washington University Milken Institute School of Public Health, Washington, DC, USA
| | - Marc Siegel
- Division of Infectious Disease, Department of Medicine, George Washington School of Medicine and Health Sciences, Washington, DC, USA
| | - Manya Magnus
- Department of Epidemiology, George Washington University Milken Institute School of Public Health, Washington, DC, USA
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Orta Portillo GA, Stafylis C, Tapia Y, Klausner JD. Group Sex and Behavior Change Associated With the 2022 Mpox Outbreak Among Men Who Have Sex With Men in Southern California. Sex Transm Dis 2025; 52:55-58. [PMID: 39268962 DOI: 10.1097/olq.0000000000002078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2024]
Abstract
BACKGROUND The monkeypox (mpox) outbreak disproportionately affected sexually active gay, bisexual, and other men who have sex with men. To understand community-level changes in sexual behavior, we surveyed individuals in a semi-urban area in Southern California. METHODS Participants were recruited between October 2022 and April 2023, using palm cards and geolocation-focused online advertisements on social media and dating apps. Eligible participants were male; 18 years or older; those who reported having sex with men; residents of San Bernardino or Riverside counties, California; human immunodeficiency virus (HIV) negative; and currently not taking preexposure prophylaxis. Descriptive analyses were performed. χ2 , Fisher exact, and Student t tests examined the association between group sex behaviors and demographics. RESULTS We enrolled 91 gay, bisexual, and other men who have sex with men with a median age of 35 years (range, 18-70 years). Nearly half reported having participated in group sex in the past year. Overall, 48.9% of group sex participants reported changing their sexual behaviors to prevent mpox transmission, with limiting the number of sex partners being the most reported prevention strategy (47.6%). To prevent mpox infection, participants who engage in group sex reported limiting the number of sex partners (34.4%), using condoms for anal sex (16.7%), avoiding crowded social venues (14.3%), and asking partners about mpox symptoms before sex (9.5%). CONCLUSIONS Survey participants reported modest sexual behavior changes in response to the mpox outbreak. Group sex may increase the risk for mpox, human immunodeficiency virus, and other sexually transmitted infections; therefore, public health messages should include specific discussion of safer group sex practices in sexual health promotion.
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Affiliation(s)
| | | | - Yara Tapia
- From the Departments of Population and Public Health Sciences
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Mazzotta V, Piselli P, Cozzi Lepri A, Matusali G, Cimini E, Esvan R, Colavita F, Gagliardini R, Notari S, Oliva A, Meschi S, Casetti R, Micheli G, Bordi L, Giacinta A, Grassi G, Gebremeskel Tekle S, Cimaglia C, Paulicelli J, Caioli A, Gallì P, Del Duca G, Lichtner M, Sarmati L, Tamburrini E, Mastroianni C, Latini A, Faccendini P, Fontana C, Nicastri E, Siddu A, Barca A, Vaia F, Girardi E, Maggi F, Antinori A. Reactogenicity and Immunogenicity Against MPXV of the Intradermal Administration of Modified Vaccinia Ankara Compared to the Standard Subcutaneous Route. Vaccines (Basel) 2024; 13:32. [PMID: 39852811 PMCID: PMC11769009 DOI: 10.3390/vaccines13010032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2024] [Revised: 12/06/2024] [Accepted: 12/20/2024] [Indexed: 01/26/2025] Open
Abstract
BACKGROUND The recent resurgence of mpox in central Africa has been declared a new public health emergency of international concern (PHEIC) requiring coordinated international responses. Vaccination is a priority to expand protection and enhance control strategies, but the vaccine's need exceeds the currently available doses. Intradermal (ID) administration of one-fifth of the standard modified vaccinia Ankara (MVA-BN) dose was temporarily authorized during the 2022 PHEIC. Studies conducted before 2022 provided evidence about the humoral response against the vaccinia virus (VACV) after vaccination but not against the mpox virus (MPXV). Moreover, no data are available on the T-cell response elicited by MVA-BN administered subcutaneously or intradermally. METHODS We compare the two vaccine administration routes according to reactogenicity (n = 943) and immunogenicity (n = 225) of vaccine recipients attending INMI Spallanzani hospital during the 2022 vaccination campaign in Rome, Italy. RESULTS We found that the ID route elicited higher titers of MPXV-specific IgG (mean difference of 0.26 log2, p = 0.05) and nAbs (0.24 log2, p = 0.08) than the subcutaneous (SC) route one month after the complete vaccination cycle. At the same time, no evidence for a difference in cellular response was found. CONCLUSIONS MVA-BN was globally well tolerated despite higher reactogenicity for the ID than the SC route, especially for the reactions at the local injection site. The ID dose-sparing strategy was proven safe and immunogenic and would make vaccination available to more people. Our data support the current WHO recommendation of using the ID route in low-medium-income countries (LMIC), although response data in people infected with the new 1b clade are urgently needed.
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Affiliation(s)
- Valentina Mazzotta
- Clinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (V.M.); (R.E.); (R.G.); (A.O.); (G.M.); (A.G.); (S.G.T.); (J.P.); (G.D.D.); (E.N.); (A.A.)
| | - Pierluca Piselli
- Clinical Epidemiology Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (C.C.); (A.C.)
| | - Alessandro Cozzi Lepri
- Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health, University College London (UCL), London NW3 2PF, UK;
| | - Giulia Matusali
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (G.M.); (F.C.); (S.M.); (L.B.); (F.M.)
| | - Eleonora Cimini
- Cellular Immunology and Pharmacology Laboratory, National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (E.C.); (S.N.); (R.C.); (G.G.)
| | - Rozenn Esvan
- Clinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (V.M.); (R.E.); (R.G.); (A.O.); (G.M.); (A.G.); (S.G.T.); (J.P.); (G.D.D.); (E.N.); (A.A.)
| | - Francesca Colavita
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (G.M.); (F.C.); (S.M.); (L.B.); (F.M.)
| | - Roberta Gagliardini
- Clinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (V.M.); (R.E.); (R.G.); (A.O.); (G.M.); (A.G.); (S.G.T.); (J.P.); (G.D.D.); (E.N.); (A.A.)
| | - Stefania Notari
- Cellular Immunology and Pharmacology Laboratory, National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (E.C.); (S.N.); (R.C.); (G.G.)
| | - Alessandra Oliva
- Clinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (V.M.); (R.E.); (R.G.); (A.O.); (G.M.); (A.G.); (S.G.T.); (J.P.); (G.D.D.); (E.N.); (A.A.)
| | - Silvia Meschi
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (G.M.); (F.C.); (S.M.); (L.B.); (F.M.)
| | - Rita Casetti
- Cellular Immunology and Pharmacology Laboratory, National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (E.C.); (S.N.); (R.C.); (G.G.)
| | - Giulia Micheli
- Clinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (V.M.); (R.E.); (R.G.); (A.O.); (G.M.); (A.G.); (S.G.T.); (J.P.); (G.D.D.); (E.N.); (A.A.)
| | - Licia Bordi
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (G.M.); (F.C.); (S.M.); (L.B.); (F.M.)
| | - Alessandro Giacinta
- Clinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (V.M.); (R.E.); (R.G.); (A.O.); (G.M.); (A.G.); (S.G.T.); (J.P.); (G.D.D.); (E.N.); (A.A.)
| | - Germana Grassi
- Cellular Immunology and Pharmacology Laboratory, National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (E.C.); (S.N.); (R.C.); (G.G.)
| | - Saba Gebremeskel Tekle
- Clinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (V.M.); (R.E.); (R.G.); (A.O.); (G.M.); (A.G.); (S.G.T.); (J.P.); (G.D.D.); (E.N.); (A.A.)
| | - Claudia Cimaglia
- Clinical Epidemiology Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (C.C.); (A.C.)
| | - Jessica Paulicelli
- Clinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (V.M.); (R.E.); (R.G.); (A.O.); (G.M.); (A.G.); (S.G.T.); (J.P.); (G.D.D.); (E.N.); (A.A.)
| | - Alessandro Caioli
- Clinical Epidemiology Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (C.C.); (A.C.)
| | - Paola Gallì
- Health Direction, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy;
| | - Giulia Del Duca
- Clinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (V.M.); (R.E.); (R.G.); (A.O.); (G.M.); (A.G.); (S.G.T.); (J.P.); (G.D.D.); (E.N.); (A.A.)
| | - Miriam Lichtner
- Infectious Diseases Unit, NESMOS Department, Santa Maria Goretti Hospital of Latina, Sapienza University of Rome, 04100 Latina, Italy;
| | - Loredana Sarmati
- Infectious Diseases Unit, Tor Vergata University Hospital, 00133 Rome, Italy;
| | - Enrica Tamburrini
- Department of Safety and Bioethics, Catholic University of the Sacred Heart, 00136 Rome, Italy;
- Infectious Diseases Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00136 Rome, Italy
| | - Claudio Mastroianni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00161 Rome, Italy;
| | - Alessandra Latini
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, 00144 Rome, Italy;
| | - Paolo Faccendini
- Pharmacy Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy;
| | - Carla Fontana
- Laboratory of Microbiology and Biological Bank Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy;
| | - Emanuele Nicastri
- Clinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (V.M.); (R.E.); (R.G.); (A.O.); (G.M.); (A.G.); (S.G.T.); (J.P.); (G.D.D.); (E.N.); (A.A.)
| | - Andrea Siddu
- General Directorate of Prevention, Ministry of Health, 00144 Rome, Italy; (A.S.); (F.V.)
| | - Alessandra Barca
- Unit of Health Promotion and Prevention, Directorate of Health and Integration, Lazio Region, 00145 Rome, Italy;
| | - Francesco Vaia
- General Directorate of Prevention, Ministry of Health, 00144 Rome, Italy; (A.S.); (F.V.)
| | - Enrico Girardi
- Scientific Direction, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy;
| | - Fabrizio Maggi
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (G.M.); (F.C.); (S.M.); (L.B.); (F.M.)
| | - Andrea Antinori
- Clinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (V.M.); (R.E.); (R.G.); (A.O.); (G.M.); (A.G.); (S.G.T.); (J.P.); (G.D.D.); (E.N.); (A.A.)
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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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7
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De Vos E, Van Gestel L, Brosius I, Kenyon C, Vuylsteke B, De Baetselier I, Mariën J, Bangwen E, Couvreur S, Lecompte A, Van Beckhoven D, Hoorelbeke B, Verstrepen BE, Zaeck LM, de Vries RD, Geurts van Kessel CH, Hens N, Ariën KK, Vercauteren K, Van Esbroek M, Van Dijck C, Liesenborghs L. Potential determinants of the decline in mpox cases in Belgium: A behavioral, epidemiological and seroprevalence study. Int J Infect Dis 2024; 146:107132. [PMID: 38942168 DOI: 10.1016/j.ijid.2024.107132] [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: 01/20/2024] [Revised: 06/06/2024] [Accepted: 06/06/2024] [Indexed: 06/30/2024] Open
Abstract
OBJECTIVES The 2022 mpox epidemic reached a peak in Belgium and the rest of Europe in July 2022, after which it unexpectedly subsided. This study investigates epidemiological, behavioral, and immunological factors behind the waning of the epidemic in Belgium. METHODS We investigated temporal evolutions in the characteristics and behavior of mpox patients using national surveillance data and data from a prospective registry of mpox patients in the Institute of Tropical Medicine (Antwerp). We studied behavioral changes in the population at risk using a survey among HIV-preexposure prophylaxis (PrEP) users. We determined the seroprevalence of anti-orthopoxvirus antibodies among HIV-PrEP users across four-time points in 2022. RESULTS Mpox patients diagnosed at the end of the epidemic had less sexual risk behavior compared to those diagnosed earlier: they engaged less in sex at mass events, had fewer sexual partners, and were less likely to belong to the sexual network's central group. Among HIV-PrEP users there were no notable changes in sexual behavior. Anti-orthopoxvirus seroprevalence did not notably increase before the start of national vaccination campaigns. CONCLUSION The observed changes in group immunity and behavior in the population at greater risk of exposure to mpox seem unable to explain the waning of the mpox epidemic. A change in the profile of mpox patients might have contributed to the decline in cases.
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Affiliation(s)
- Elise De Vos
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
| | - Liesbeth Van Gestel
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Isabel Brosius
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Chris Kenyon
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Bea Vuylsteke
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Irith De Baetselier
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Joachim Mariën
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; Department of Biology, University of Antwerp, Antwerp, Belgium
| | - Eugene Bangwen
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Simon Couvreur
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Amaryl Lecompte
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | | | - Bart Hoorelbeke
- Public Health Emergencies Department, Federal Public Service - Health, Food Chain Safety and Environment, Brussels, Belgium
| | - Babs E Verstrepen
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Luca M Zaeck
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Rory D de Vries
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, Netherlands
| | | | - Niel Hens
- Centre for Health Economic Research and Modelling Infectious Diseases, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium; I-BioStat, Data Science Institute, Hasselt University, Hasselt, Belgium
| | - Kevin K Ariën
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Koen Vercauteren
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Marjan Van Esbroek
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Christophe Van Dijck
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; KU Leuven Department of Microbiology, Immunology and Transplantation, Rega Institute, Laboratory of Virology and Chemotherapy, Leuven, Belgium
| | - Laurens Liesenborghs
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; KU Leuven Department of Microbiology, Immunology and Transplantation, Rega Institute, Laboratory of Virology and Chemotherapy, Leuven, Belgium
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8
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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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9
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Paparini S, Whelan I, Mwendera C, Hayes R, Maatouk I, Lewis R, Prochazka Nunez M, Mozalevskis A, Wi T, Orkin C. Prevention of sexual transmission of mpox: a systematic review and qualitative evidence synthesis of approaches. Infect Dis (Lond) 2024; 56:589-605. [PMID: 38958049 PMCID: PMC11229790 DOI: 10.1080/23744235.2024.2364801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/30/2024] [Accepted: 06/03/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND The ongoing multi-country mpox outbreak in previously unaffected countries is primarily affecting sexual networks of men who have sex with men. Evidence is needed on the effectiveness of recommended preventive interventions. To inform WHO guidelines, a systematic review and qualitative evidence synthesis were conducted on mpox preventive behavioural interventions to reduce: (i) sexual acquisition; (ii) onward sexual transmission from confirmed/probable cases; and (iii) utility of asymptomatic testing. METHODS Medline, EMBASE, PubMed, Cochrane and WHO trial databases, grey literature and conferences were searched for English-language primary research published since 1 January 2022. A reviewer team performed screening, data extraction and bias assessment. A qualitative thematic synthesis explored views and experiences of engagement in prevention in individuals at increased risk. RESULTS There were 16 studies: 1 on contact-tracing, 2 on sexual behaviour, and 13 on asymptomatic testing. Although MPXV was detected in varying proportions of samples (0.17%-6.5%), the testing studies provide insufficient evidence to fully evaluate this strategy. For the qualitative evidence synthesis, four studies evaluated the experiences of most affected communities. Preferences about preventive interventions were shaped by: mpox information; the diversity of sexual practices; accessibility and quality of mpox testing and care; and perceived cost to wellbeing. CONCLUSIONS Evidence on the effectiveness of interventions to prevent the sexual transmission of mpox remains scarce. Limited qualitative evidence on values and preferences provides insight into factors influencing intervention acceptability. Given global and local inequities in access to vaccines and treatment, further research is needed to establish the effectiveness of additional interventions.
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Affiliation(s)
- Sara Paparini
- SHARE Collaborative, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Isabelle Whelan
- SHARE Collaborative, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
- Department of Infection and Immunity, Barts Health NHS Trust, London, UK
| | - Chikondi Mwendera
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Rosalie Hayes
- SHARE Collaborative, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Ismael Maatouk
- Department of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland
| | - Rosamund Lewis
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Mateo Prochazka Nunez
- Department of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland
| | - Antons Mozalevskis
- Department of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland
| | - Teodora Wi
- Department of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland
| | - Chloe Orkin
- SHARE Collaborative, Blizard Institute, Queen Mary University of London, London, UK
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10
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Phillips G, Curtis MG, Felt D, Davoudpour S, Rodriguez-Ortiz AE, Cortez A, French AL, Hosek SG, Serrano PA. Changes in Sexual Behaviors Due to Mpox: a Cross-Sectional Study of Sexual and Gender Minority Individuals in Illinois. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024; 25:628-637. [PMID: 37906357 PMCID: PMC11112966 DOI: 10.1007/s11121-023-01604-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2023] [Indexed: 11/02/2023]
Abstract
The spread of the monkeypox virus (mpox) in 2022 primarily within the sexual networks of men who have sex with men (MSM) triggered a potentially stigmatizing public health response in the USA. Despite mpox being primarily spread through skin-to-skin contact, most messaging has promoted abstinence and/or reduction in sexual risk behaviors. More research is needed on decreases in sexual risk behaviors among sexual and gender minority (SGM) youth and young adults (YYA) related to the most recent mpox epidemic and whether there are factors associated with these decreases in sexual risk behavior. Participants within an ongoing cohort study of SGM YYA who reside in Illinois were offered the opportunity to participate in an mpox survey between September 10th and September 20th, 2022. Analyses looked at demographic factors associated with sexual activity since the start of the outbreak, as well as associations with two sexual risk reduction factors. Survey participation was 68.7% (322/469). Three-quarters of participants (82.6%) reported sexual activity since June 1st. Most sexually active participants (83.5%) adopted at least one sexual risk reduction behavior due to mpox. Black and Latinx individuals were less likely to be sexually active but more likely to report risk reduction behaviors (31.3% and 22.6%, respectively). Participants who received the mpox vaccine were more likely to report sexual activity. SGM YYA in Illinois reported that their sexual behaviors were impacted by the mpox outbreak. However, associations between vaccination and sexual behavior demonstrate that those who are vaccinated do adopt protective methods despite not decreasing sexual activity. Therefore, sex-positive communications and harm reduction messaging may be more appropriate as opposed to abstinence-only prevention, which can further stigmatize an already marginalized group.
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Affiliation(s)
- Gregory Phillips
- Department of Medical Social Sciences, Northwestern University, 625 N. Michigan Ave, Chicago, IL, 60611, USA.
| | - Michael G Curtis
- Department of Medical Social Sciences, Northwestern University, 625 N. Michigan Ave, Chicago, IL, 60611, USA
| | - Dylan Felt
- Department of Medical Social Sciences, Northwestern University, 625 N. Michigan Ave, Chicago, IL, 60611, USA
| | - Shahin Davoudpour
- Department of Medical Social Sciences, Northwestern University, 625 N. Michigan Ave, Chicago, IL, 60611, USA
| | - Anthony E Rodriguez-Ortiz
- Department of Medical Social Sciences, Northwestern University, 625 N. Michigan Ave, Chicago, IL, 60611, USA
| | - Alfred Cortez
- Department of Medical Social Sciences, Northwestern University, 625 N. Michigan Ave, Chicago, IL, 60611, USA
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11
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Rainey JJ, Lin XM, Murphy S, Velazquez-Kronen R, Do T, Hughes C, Harris AM, Maitland A, Gundlapalli AV. Deployment of the National Notifiable Diseases Surveillance System during the 2022-23 mpox outbreak in the United States-Opportunities and challenges with case notifications during public health emergencies. PLoS One 2024; 19:e0300175. [PMID: 38603766 PMCID: PMC11008850 DOI: 10.1371/journal.pone.0300175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 02/23/2024] [Indexed: 04/13/2024] Open
Abstract
Timely case notifications following the introduction of an uncommon pathogen, such as mpox, are critical for understanding disease transmission and for developing and implementing effective mitigation strategies. When Massachusetts public health officials notified the Centers for Disease Control and Prevention (CDC) about a confirmed orthopoxvirus case on May 17, 2023, which was later confirmed as mpox at CDC, mpox was not a nationally notifiable disease. Because existing processes for new data collections through the National Notifiable Disease Surveillance System were not well suited for implementation during emergency responses at the time of the mpox outbreak, several interim notification approaches were established to capture case data. These interim approaches were successful in generating daily case counts, monitoring disease transmission, and identifying high-risk populations. However, the approaches also required several data collection approvals by the federal government and the Council for State and Territorial Epidemiologists, the use of four different case report forms, and the establishment of complex data management and validation processes involving data element mapping and record-level de-duplication steps. We summarize lessons learned from these interim approaches to inform and improve case notifications during future outbreaks. These lessons reinforce CDC's Data Modernization Initiative to work in close collaboration with state, territorial, and local public health departments to strengthen case-based surveillance prior to the next public health emergency.
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Affiliation(s)
- Jeanette J. Rainey
- Division of Global Health Security, Global Health Center, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Xia Michelle Lin
- Detect and Monitor Division, Office of Public Health Data, Surveillance, and Technology, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Sylvia Murphy
- Detect and Monitor Division, Office of Public Health Data, Surveillance, and Technology, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Raquel Velazquez-Kronen
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH, United States of America
| | - Tuyen Do
- Office of the Director, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Christine Hughes
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Aaron M. Harris
- Detect and Monitor Division, Office of Public Health Data, Surveillance, and Technology, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Aaron Maitland
- Division of Health Interview Statistics, National Center of Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, United States of America
| | - Adi V. Gundlapalli
- Office of the Director, Office of Public Health Data, Surveillance, and Technology, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
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12
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Doyle TJ, Gumke M, Stanek D, Moore J, Buck B, Locksmith T, Tomson K, Schmedes S, Churchwell G, Hubsmith SJ, Krishnamoorthy B, Poschman K, Danforth B, Chacreton D. Concurrent Outbreaks of Hepatitis A, Invasive Meningococcal Disease, and Mpox, Florida, USA, 2021-2022. Emerg Infect Dis 2024; 30. [PMID: 38526187 PMCID: PMC10977815 DOI: 10.3201/eid3004.231392] [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] [Indexed: 03/26/2024] Open
Abstract
In 2022, concurrent outbreaks of hepatitis A, invasive meningococcal disease (IMD), and mpox were identified in Florida, USA, primarily among men who have sex with men. The hepatitis A outbreak (153 cases) was associated with hepatitis A virus genotype IA. The IMD outbreak (44 cases) was associated with Neisseria meningitidis serogroup C, sequence type 11, clonal complex 11. The mpox outbreak in Florida (2,845 cases) was part of a global epidemic. The hepatitis A and IMD outbreaks were concentrated in Central Florida and peaked during March--June, whereas mpox cases were more heavily concentrated in South Florida and had peak incidence in August. HIV infection was more common (52%) among mpox cases than among hepatitis A (21%) or IMD (34%) cases. Where feasible, vaccination against hepatitis A, meningococcal disease, and mpox should be encouraged among at-risk groups and offered along with program services that target those groups.
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13
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Grov C, Zohra F, Mirzayi C, Stief M, D'Angelo AB, Dearolf M, Westmoreland DA, Carneiro P, Nash D, Carrico AW. Sexual and Gender Minorities' Vaccine Uptake and Behavioral Change in Response to the Mpox Outbreak in the United States: August 2022 Through November 2022. Clin Infect Dis 2024:ciad793. [PMID: 38262167 DOI: 10.1093/cid/ciad793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND In the summer of 2022, the United States faced a nationwide outbreak of mpox, with cases concentrated in sexual and gender minorities who have sex with men. Understanding rates of mpox vaccine uptake and concomitant behavioral change is essential to guide the implementation of targeted public health responses to the potential reemergence of mpox. METHODS Between August 2022 and November 2022, 8551 individuals recruited via geosocial networking apps completed a brief survey that assessed mpox vaccine uptake, intentions to get a mpox vaccine, and behavioral change. RESULTS In August, 17.4% of participants reported having received at least 1 dose of the mpox vaccine. By November, this prevalence estimate was 35.0%. Black participants were significantly less likely to be vaccinated, and vaccine hesitancy increased among Black participants over time. Among those who had not yet received a vaccination, the intention to get vaccinated decreased over time. We observed trends that coincided with the evolving outbreak, such as decreased worry about mpox and less engagement in risk reduction behaviors over time. CONCLUSIONS Despite a 2-fold increase in mpox vaccine uptake between August 2022 and November 2022 in sexual and gender minorities who have sex with men, disparities in vaccine uptake were observed among Black participants. Findings will guide the implementation of public health responses to the potential reemergence of mpox and other viral infectious diseases (eg, meningitis) with a specific focus on optimizing vaccine uptake in Black communities.
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Affiliation(s)
- Christian Grov
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, New York, New York, USA
- CUNY Institute for Implementation Science in Population Health, New York, New York, USA
| | - Fatima Zohra
- CUNY Institute for Implementation Science in Population Health, New York, New York, USA
| | - Chloe Mirzayi
- CUNY Institute for Implementation Science in Population Health, New York, New York, USA
| | - Matthew Stief
- CUNY Institute for Implementation Science in Population Health, New York, New York, USA
| | - Alexa B D'Angelo
- CUNY Institute for Implementation Science in Population Health, New York, New York, USA
| | - Michelle Dearolf
- CUNY Institute for Implementation Science in Population Health, New York, New York, USA
| | - Drew A Westmoreland
- Department of Epidemiology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Pedro Carneiro
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, New York, New York, USA
| | - Denis Nash
- CUNY Institute for Implementation Science in Population Health, New York, New York, USA
- Department of Epidemiology and Biostatistics, CUNY Graduate School of Public Health and Health Policy, New York, New York, USA
| | - Adam W Carrico
- Department of Health Promotion and Disease Prevention, Florida International Univeristy, Miami, Florida, USA
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14
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Caycho-Rodríguez T, Valencia PD, Ventura-León J, Carbajal-León C, Vilca LW, Gallegos M, Reyes-Bossio M, Noe-Grijalva M, Delgado-Campusano M, Del Carpio Toia ÁM, Torales J, Barria-Asenjo NA. Intention to receive the monkeypox vaccine and its psychological and sociodemographic predictors: a cross-sectional survey in the general population of Peru. PSICOLOGIA-REFLEXAO E CRITICA 2023; 36:39. [PMID: 38108935 PMCID: PMC10728420 DOI: 10.1186/s41155-023-00281-z] [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: 05/12/2023] [Accepted: 12/05/2023] [Indexed: 12/19/2023] Open
Abstract
OBJECTIVE The objective of this study was to identify predictors of intention to be vaccinated against Monkeypox (Mpox) in a sample of Peruvian citizens. METHODS: A set of sociodemographic and psychological predictors were used, such as sex, sexual orientation, educational level, previous diagnosis of COVID-19, marital status, complete vaccination against COVID-19, employment status, living with vulnerable people, presence of chronic disease, area of residence, perceived usefulness of COVID-19 vaccines, fear of Mpox, conspiracy beliefs about Mpox, among others. A total of 472 Peruvian adults participated, selected by non-probabilistic snowball convenience sampling. A sociodemographic survey, the Mpox Fear Scale, was used. Conspiracy Beliefs about Mpox was assessed using three questions created specifically for this study. For inferential purposes, simple ordinal regressions ("crude models") were performed between each factor and the outcome. RESULTS: Regarding their intention to be vaccinated against Mpox, more than 60% expressed clear approval. Being non-heterosexual, having greater emotional fear of Mpox, and perceiving some potential for this disease to become the next pandemic were related to greater intention to vaccinate. On the other hand, being older, having low perceived usefulness of COVID-19 vaccines, and having higher conspiracy beliefs about Mpox were associated with lower intention to vaccinate. CONCLUSION: The study provides initial information for future research seeking to better analyze Mpox vaccination intention. In addition, cross-sectional data are provided that can be used to develop public health policies that target subgroups with low prevalence of intention to vaccinate against Mpox.
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Affiliation(s)
| | - Pablo D Valencia
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de Mexico, Tlanepantla de Baz, State of Mexico, Mexico
| | - José Ventura-León
- Facultad de Ciencias de la Salud, Universidad Privada del Norte, Lima, Peru
| | - Carlos Carbajal-León
- South American Center for Education and Research in Public Health, Universidad Norbert Wiener, Lima, Peru
| | - Lindsey W Vilca
- South American Center for Education and Research in Public Health, Universidad Norbert Wiener, Lima, Peru
| | - Miguel Gallegos
- Pontificia Universidad de Católica de Minas Gerais, Belo Horizonte, Brazil
- Centro Interdisciplinario de Investigaciones en Ciencias de la Salud y del Comportamiento, Consejo Nacional de Investigaciones Científicas y Técnicas, Rivadavia, Entre Ríos, Argentina
| | - Mario Reyes-Bossio
- Facultad de Psicología, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | | | | | - Águeda Muñoz Del Carpio Toia
- Vicerrectorado de investigación, Escuela de Postgrado, Escuela de Medicina Humana, Universidad Católica de Santa María, Arequipa, Peru
| | - Julio Torales
- Departamento de Psiquiatría, Facultad de Ciencias Médicas, Universidad Nacional de Asunción, San Lorenzo, Paraguay
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15
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Hong C. Mpox on Reddit: a Thematic Analysis of Online Posts on Mpox on a Social Media Platform among Key Populations. J Urban Health 2023; 100:1264-1273. [PMID: 37580545 PMCID: PMC10728031 DOI: 10.1007/s11524-023-00773-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/13/2023] [Indexed: 08/16/2023]
Abstract
The 2022-2023 mpox outbreak has disproportionately impacted gay, bisexual, and other men who have sex with men (GBMSM). The US CDC recommended individuals to explore safer sexual practices that minimize the potential risk of exposure and also strongly encouraged for eligible individuals to prioritize vaccination. This study aimed to analyze social media data related to mpox on Reddit since the mpox outbreak and identify themes associated with the impact on social behaviors and social processes among targeted population. Publicly available data were collected from the social media Reddit. We extracted the summarized mpox-related posts since the beginning of May 2022 from popular subreddits that were popular among GBMSM. We thematically analyzed the content to identify the overall themes related to the GBMSM's responses to the outbreak. There is an overall increase in the number of daily mpox-related posts, with three upticks in late May, late July, and early August 2022, which may correspond to the dates that the first mpox case was identified in the USA, the WHO declared a global public health emergency, and the US Department of Health and Human Services declared a public health emergency. Four themes were identified: (1) changes in sexual behaviors and social activities; (2) mpox vaccine attitude, uptake, and hesitancy; (3) perceived and experienced stigma and homophobia, and mental distress; and (4) online information-seeking and mutual aid and support. GBMSM changed their sexual behaviors and social activities to mitigate their exposure to the virus during this outbreak and actively sought and shared information about mpox vaccination in their respective settings, while some were hesitant due to concerns about side effects and potential effectiveness. Perceived and experienced stigma and discrimination on gay- and same sex-identify have impacted GBMSM's mental health. Interventions to promote the mpox vaccine must address the historical medical mistrust and vaccine hesitancy among GBMSM.
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Affiliation(s)
- Chenglin Hong
- Department of Social Welfare, UCLA Luskin School of Public Affairs, 3250 Public Affairs Building, Los Angeles, CA, USA.
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16
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Knox JR, Dolotina B, Moline T, Matthews I, Durrell M, Hanson H, Almirol E, Hotton A, Pagkas-Bather J, Chen YT, English D, Manuzak J, Rower JE, Miles C, Millar B, Jean-Louis G, Rendina HJ, Martins SS, Grov C, Hasin DS, Carrico AW, Shoptaw S, Schneider JA, Duncan DT. HIV Prevention and Care Among Black Cisgender Sexual Minority Men and Transgender Women: Protocol for an HIV Status-Neutral Cohort Study Using an Observational-Implementation Hybrid Approach. JMIR Res Protoc 2023; 12:e48548. [PMID: 38039075 PMCID: PMC10724817 DOI: 10.2196/48548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 09/18/2023] [Accepted: 09/20/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Black cisgender gay, bisexual, and other sexual minority men (SMM) and transgender women (TW) continue to be heavily affected by HIV. Further research is needed to better understand HIV prevention and care outcomes in this population. In particular, there is a need for research examining the impact of substance use and sleep health on HIV prevention and treatment outcomes among Black SMM and TW. OBJECTIVE This paper outlines the study methods being used in the recently launched follow-up study to the Neighborhoods and Networks (N2) study, which we refer to as N2 Part 2 (N2P2). N2P2 aims to address this gap in the literature, build off the findings of the original N2 study, and identify socioenvironmental determinants of health, including whether neighborhood and network factors mediate and moderate these relationships. METHODS Building on the N2 cohort study in Chicago from 2018 to 2022, N2P2 used a prospective longitudinal cohort design and an observational-implementation hybrid approach. With sustained high levels of community engagement, we aim to recruit a new sample of 600 Black SMM and TW participants residing in the Chicago metropolitan statistical area. Participants are asked to participate in 3 study visits across an 18-month study period (1 visit every 9 months). Four different forms of data are collected per wave: (1) an in-person survey, (2) biological specimen collection, (3) a daily remote ecological momentary assessment for 14 days after each study visit, and (4) data from electronic health records. These forms of data collection continue to assess neighborhood and network factors and specifically explore substance use, sleep, immune function, obesity, and the implementation of potential interventions that address relevant constructs (eg, alcohol use and pre-exposure prophylaxis adherence). RESULTS The N2P2 study was funded in August 2021 by the National Institute of Drug Abuse (R01DA054553 and R21DA053156) and National Heart, Lung, and Blood Institute (R01HL160325). This study was launched in November 2022. Recruitment and enrollment for the first wave of data collection are currently ongoing. CONCLUSIONS The N2P2 study is applying innovative methods to comprehensively explore the impacts of substance use and sleep health on HIV-related outcomes among an HIV status-neutral cohort of Black SMM and TW in Chicago. This study is applying an observational-implementation hybrid design to help us achieve findings that support rapid translation, a critical priority among populations such as Black SMM and TW that experience long-standing inequities with regard to HIV and other health-related outcomes. N2P2 will directly build off the findings that have resulted from the original N2 study among Black SMM and TW in Chicago. These findings provide a better understanding of multilevel (eg, individual, network, and neighborhood) factors that contribute to HIV-related outcomes and viral suppression among Black SMM and TW. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/48548.
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Affiliation(s)
- Justin R Knox
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Brett Dolotina
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Tyrone Moline
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Isabella Matthews
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Mainza Durrell
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Hillary Hanson
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Ellen Almirol
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Anna Hotton
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Jade Pagkas-Bather
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Yen-Tyng Chen
- Department of Psychiatry, Rutgers University, New Brunswick, NJ, United States
| | - Devin English
- Department of Psychiatry, Rutgers University, New Brunswick, NJ, United States
| | - Jennifer Manuzak
- Division of Immunology, School of Medicine, Tulane University, New Orleans, LA, United States
| | - Joseph E Rower
- Center for Human Toxicology, University of Utah, Salt Lake City, UT, United States
| | - Caleb Miles
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Brett Millar
- Department of Psychiatry, Rutgers University, New Brunswick, NJ, United States
| | - Girardin Jean-Louis
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Coral Gables, FL, United States
| | - H Jonathon Rendina
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - Silvia S Martins
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Christian Grov
- Einstein-CUNY-Rockefeller Center for AIDS Research, School of Public Health and Health Policy, City University of New York, New York, NY, United States
| | - Deborah S Hasin
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Adam W Carrico
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Coral Gables, FL, United States
| | - Steve Shoptaw
- Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - John A Schneider
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Dustin T Duncan
- Mailman School of Public Health, Columbia University, New York, NY, United States
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17
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Smith LE, Potts HW, Brainard J, May T, Oliver I, Amlôt R, Yardley L, Rubin GJ. Did mpox knowledge, attitudes and beliefs affect intended behaviour in the general population and men who are gay, bisexual and who have sex with men? An online cross-sectional survey in the UK. BMJ Open 2023; 13:e070882. [PMID: 37827743 PMCID: PMC10583036 DOI: 10.1136/bmjopen-2022-070882] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 09/21/2023] [Indexed: 10/14/2023] Open
Abstract
OBJECTIVES To investigate rates of mpox beliefs, knowledge and intended behaviours in the general population and in gay, bisexual or other men who have sex with men (GBMSM), and factors associated with intended behaviours. To test the impact of motivational messages (vs a factual control) on intended behaviours. DESIGN Cross-sectional online survey including a nested randomised controlled trial. SETTING Data collected from 5 September 2022 to 6 October 2022. PARTICIPANTS Participants were aged 18 years or over and lived in the UK (general population). In addition, GBMSM were male, and gay, bisexual or had sex with men. The general population sample was recruited through a market research company. GBMSM were recruited through a market research company, the dating app Grindr and targeted adverts on Meta (Facebook and Instagram). MAIN OUTCOME MEASURES Intention to self-isolate, seek medical help, stop all sexual contact, share details of recent sexual contacts and accept vaccination. RESULTS Sociodemographic characteristics differed by sample. There was no effect of very brief motivational messaging on behavioural intentions. Respondents from Grindr and Meta were more likely to intend to seek help immediately, completely stop sexual behaviour and be vaccinated or intend to be vaccinated, but being less likely to intend to self-isolate (ps<0.001). In the general population sample, intending to carry out protective behaviours was generally associated with being female, older, having less financial hardship, greater worry, higher perceived risk to others and higher perceived susceptibility to and severity of mpox (ps<0.001). There were fewer associations with behaviours in the Grindr sample, possibly due to reduced power. CONCLUSIONS GBMSM were more likely to intend to enact protective behaviours, except for self-isolation. This may reflect targeted public health efforts and engagement with this group. Associations with socioeconomic factors suggest that providing financial support may encourage people to engage with protective behaviours.
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Affiliation(s)
- Louise E Smith
- Department of Psychological Medicine, King's College London, London, UK
| | - Henry Ww Potts
- Institute of Health Informatics, University College London, London, UK
| | - Julii Brainard
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Tom May
- School of Psychological Science, University of Bristol, Bristol, UK
| | | | | | - Lucy Yardley
- School of Psychological Science, University of Bristol, Bristol, UK
| | - G James Rubin
- Department of Psychological Medicine, King's College London, London, UK
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18
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Shang W, Cao G, Wu Y, Kang L, Wang Y, Gao P, Liu J, Liu M. Spatiotemporal cluster of mpox in men who have sex with men: A modeling study in 83 countries. J Med Virol 2023; 95:e29166. [PMID: 37822046 DOI: 10.1002/jmv.29166] [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: 06/29/2023] [Revised: 09/11/2023] [Accepted: 09/30/2023] [Indexed: 10/13/2023]
Abstract
Mpox outbroke globally during 2022-2023, with more than 90% of cases occurring in men who have sex with men (MSM). However, the spatiotemporal distribution of mpox is not well established yet. This study aimed to explore the spatiotemporal clustering of mpox cases in MSM worldwide. We obtained the numbers of mpox cases from Our World in Data, the number of MSM from the Joint United Nations Programme on HIV/AIDS (UNAIDS), UNAIDS DATA 2021 and UNAIDS Global AIDS Update 2022 and literature. We evaluated the spatiotemporal cluster of mpox in MSM using retrospective space-time analyses method. The total number of mpox cases was 85 795 during May 1, 2022 to March 31, 2023. The most likely cluster was Spain (likelihood ratio = 4764.97; p < 0.001), with a cluster period from July 26 to August 14, 2022. There were 11 secondary clusters, which included 46 countries located in western Europe, eastern and northern South America, northern Europe, Canada, Central Africa, southern and central Europe, Latin America, Turkey, Dominican Republic, New Zealand, and Australia. The findings may inform current and future control strategies of mpox and might provide references for the identification of the spatiotemporal distribution of new and emerging infectious diseases in specific populations.
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Affiliation(s)
- Weijing Shang
- School of Public Health, Peking University, Beijing, China
| | - Guiying Cao
- School of Public Health, Peking University, Beijing, China
| | - Yu Wu
- School of Public Health, Peking University, Beijing, China
| | - Liangyu Kang
- School of Public Health, Peking University, Beijing, China
| | - Yaping Wang
- School of Public Health, Peking University, Beijing, China
| | - Peng Gao
- School of Public Health, Peking University, Beijing, China
| | - Jue Liu
- School of Public Health, Peking University, Beijing, China
| | - Min Liu
- School of Public Health, Peking University, Beijing, China
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19
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Cascalheira CJ, Hong C, Beltran RM, Karkkainen K, Beikzadeh M, Sarrafzadeh M, Holloway IW. Analysis of Smartphone Text Data Related to mpox from a U.S. Sample of Gay, Bisexual, and Other Men Who Have Sex with Men During the 2022 Outbreak. LGBT Health 2023; 10:560-565. [PMID: 37219872 PMCID: PMC10552145 DOI: 10.1089/lgbt.2022.0307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023] Open
Abstract
Purpose: We sought to understand technology-based communication regarding mpox (monkeypox) among gay, bisexual, and other men who have sex with men (GBMSM) during the global outbreak in 2022. Methods: Forty-four GBMSM (Mage = 25.3 years, 68.2% cisgender, 43.2% non-White) living in the United States participated. From May 2022 to August 2022, all text data related to mpox (174 instances) were downloaded from the smartphones of GBMSM. Text data and smartphone app usage were analyzed. Results: Content analysis revealed 10 text-based themes and 7 app categories. GBMSM primarily used search and browser, texting, and gay dating apps to share vaccine updates, seek mpox vaccination, find general mpox information, share mpox information with other GBMSM, and discuss links between mpox and gay culture. Data visualizations revealed that changes in communication themes and app usage were responsive to major milestones in the mpox outbreak. Conclusion: GBMSM used apps to facilitate a community-driven mpox response.
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Affiliation(s)
- Cory J. Cascalheira
- Department of Counseling and Educational Psychology, New Mexico State University, Las Cruces, New Mexico, USA
| | - Chenglin Hong
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, California, USA
- Gay Sexuality and Social Policy Initiative, Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, California, USA
| | - Raiza M. Beltran
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, California, USA
| | - Kimmo Karkkainen
- Department of Computer Science, Henry Samueli School of Engineering, University of California, Los Angeles, Los Angeles, California, USA
| | - Mehrab Beikzadeh
- Department of Computer Science, Henry Samueli School of Engineering, University of California, Los Angeles, Los Angeles, California, USA
| | - Majid Sarrafzadeh
- Department of Computer Science, Henry Samueli School of Engineering, University of California, Los Angeles, 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
- Department of Computer Science, Henry Samueli School of Engineering, University of California, Los Angeles, Los Angeles, California, USA
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20
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Abstract
PURPOSE OF REVIEW We reviewed the available literature on mpox in People with HIV (PWH). We highlight special considerations of mpox infection related to epidemiology, clinical presentation, diagnostic and treatment considerations, prevention, and public health messaging in PWH. RECENT FINDINGS During the 2022 mpox outbreak, PWH were disproportionally impacted worldwide. Recent reports suggest that the disease presentation, management, and prognosis of these patients, especially those with advanced HIV disease, can widely differ from those without HIV-associated immunodeficiency. Mpox can often be mild and resolve on its own in PWH with controlled viremia and higher CD4 counts. However, it can be severe, with necrotic skin lesions and protracted healing; anogenital, rectal, and other mucosal lesions; and disseminated organ systems involvement. Higher rates of healthcare utilization are seen in PWH. Supportive, symptomatic care and single or combination mpox-directed antiviral drugs are commonly used in PWH with severe mpox disease. Data from randomized clinical control trials on the efficacy of therapeutic and preventive tools against mpox among PWH are needed to better guide clinical decisions.
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Affiliation(s)
- Carlos S Saldana
- Division of Infectious Diseases, Emory University School of Medicine, Ponce de Leon Center, 341 Ponce de Leon Ave NE, Atlanta, GA, 30308, USA.
| | - Colleen F Kelley
- Division of Infectious Diseases, Emory University School of Medicine, Ponce de Leon Center, 341 Ponce de Leon Ave NE, Atlanta, GA, 30308, USA
| | - Bruce M Aldred
- Division of Infectious Diseases, Emory University School of Medicine, Ponce de Leon Center, 341 Ponce de Leon Ave NE, Atlanta, GA, 30308, USA
| | - Valeria D Cantos
- Division of Infectious Diseases, Emory University School of Medicine, Ponce de Leon Center, 341 Ponce de Leon Ave NE, Atlanta, GA, 30308, USA
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21
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Torres TS, Silva MST, Coutinho C, Hoagland B, Jalil EM, Cardoso SW, Moreira J, Magalhaes MA, Luz PM, Veloso VG, Grinsztejn B. Evaluation of Mpox Knowledge, Stigma, and Willingness to Vaccinate for Mpox: Cross-Sectional Web-Based Survey Among Sexual and Gender Minorities. JMIR Public Health Surveill 2023; 9:e46489. [PMID: 37459174 PMCID: PMC10411424 DOI: 10.2196/46489] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/30/2023] [Accepted: 06/20/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND The 2022 multicountry mpox outbreak positioned the condition as a public health emergency of international concern. By May 2023, Brazil ranked second globally in the cumulative number of mpox cases and deaths. The higher incidence of mpox among gay and other men who have sex with men in the current mpox outbreak deepens the stigma and discrimination against sexual and gender minorities (SGM). This might worsen the structural barriers impacting access to health services, which ultimately leads to undertesting and underreporting of cases. There are no data available on mpox knowledge and stigma in Latin America. OBJECTIVE We aimed to evaluate mpox knowledge, stigma, and willingness to vaccinate for mpox among SGM, and to describe sociodemographic and behavioral characteristics according to self-reported mpox diagnosis. METHODS A cross-sectional, internet-based survey was conducted in a convenience sample of adults (aged >18 years) living in Brazil recruited through advertisements on dating apps, social media, referral institutions for infectious diseases websites, and mass media (October-November 2022). We compared participants' characteristics according to self-reported mpox diagnosis using chi-square test or Fisher exact test for qualitative variables and Kruskal-Wallis test for quantitative variables. RESULTS We enrolled 6236 participants: 5685 (91.2%) were cisgender men; 6032 (96.7%) were gay, bisexual, or pansexual; 3877 (62.2%) were White; 4902 (78.7%) had tertiary education; and 4070 (65.2%) reported low or middle income. Most participants (n=5258, 84.4%) agreed or strongly agreed that "LGBTQIA+ individuals are being discriminated and stigmatized due to mpox." Mpox awareness was 96.9% (n=6044), and 5008 (95.1%) were willing to get vaccinated for mpox. Overall, 324 (5.2%) reported an mpox diagnosis. Among these, 318 (98.1%) reported lesions, 178 (56%) local pain, and 316 (99.4%) sought health care. Among participants not reporting a diagnosis, 288 (4.9%) had a suspicious lesion, but only 158 (54.9%) of these had sought health care. Compared to participants with no diagnosis, those reporting an mpox diagnosis were younger (P<.001), reported more sex partners (P<.001), and changes in sexual behavior after mpox onset (P=.002). Moreover, participants diagnosed with mpox reported more frequently being tested for HIV in the prior 3 months (P<.001), living with HIV (P<.001), currently using HIV pre-exposure prophylaxis (P<.001), and previous sexually transmitted infection diagnosis (P<.001). CONCLUSIONS Our results point to high mpox knowledge and willingness to vaccinate among SGM in Brazil. Participants self-reporting mpox diagnosis more frequently reported to be living with HIV, STI diagnosis, and current pre-exposure prophylaxis use, highlighting the importance of an mpox assessment that includes comprehensive sexual health screenings. Efforts to decrease stigma related to mpox among SGM are necessary to avoid mpox underdiagnosis.
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Affiliation(s)
- Thiago Silva Torres
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Carolina Coutinho
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Brenda Hoagland
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Emilia Moreira Jalil
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Sandra Wagner Cardoso
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Monica Avelar Magalhaes
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz (ICICT-Fiocruz), Rio de Janeiro, Brazil
| | - Paula Mendes Luz
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Valdilea G Veloso
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Beatriz Grinsztejn
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
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22
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Brand SPC, Cavallaro M, Cumming F, Turner C, Florence I, Blomquist P, Hilton J, Guzman-Rincon LM, House T, Nokes DJ, Keeling MJ. The role of vaccination and public awareness in forecasts of Mpox incidence in the United Kingdom. Nat Commun 2023; 14:4100. [PMID: 37433797 PMCID: PMC10336136 DOI: 10.1038/s41467-023-38816-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 05/15/2023] [Indexed: 07/13/2023] Open
Abstract
Beginning in May 2022, Mpox virus spread rapidly in high-income countries through close human-to-human contact primarily amongst communities of gay, bisexual and men who have sex with men (GBMSM). Behavioural change arising from increased knowledge and health warnings may have reduced the rate of transmission and modified Vaccinia-based vaccination is likely to be an effective longer-term intervention. We investigate the UK epidemic presenting 26-week projections using a stochastic discrete-population transmission model which includes GBMSM status, rate of formation of new sexual partnerships, and clique partitioning of the population. The Mpox cases peaked in mid-July; our analysis is that the decline was due to decreased transmission rate per infected individual and infection-induced immunity among GBMSM, especially those with the highest rate of new partners. Vaccination did not cause Mpox incidence to turn over, however, we predict that a rebound in cases due to behaviour reversion was prevented by high-risk group-targeted vaccination.
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Affiliation(s)
- Samuel P C Brand
- The Zeeman Institute for Systems Biology Infectious Disease Epidemiology Research (SBIDER), Coventry, UK.
- School of Life Sciences, University of Warwick, Coventry, UK.
| | - Massimo Cavallaro
- The Zeeman Institute for Systems Biology Infectious Disease Epidemiology Research (SBIDER), Coventry, UK
- School of Life Sciences, University of Warwick, Coventry, UK
- Mathematics Institute, University of Warwick, Coventry, UK
| | | | | | | | | | - Joe Hilton
- The Zeeman Institute for Systems Biology Infectious Disease Epidemiology Research (SBIDER), Coventry, UK
- School of Life Sciences, University of Warwick, Coventry, UK
| | - Laura M Guzman-Rincon
- The Zeeman Institute for Systems Biology Infectious Disease Epidemiology Research (SBIDER), Coventry, UK
- School of Life Sciences, University of Warwick, Coventry, UK
| | - Thomas House
- Department of Mathematics, University of Manchester, Manchester, UK
| | - D James Nokes
- The Zeeman Institute for Systems Biology Infectious Disease Epidemiology Research (SBIDER), Coventry, UK
- School of Life Sciences, University of Warwick, Coventry, UK
| | - Matt J Keeling
- The Zeeman Institute for Systems Biology Infectious Disease Epidemiology Research (SBIDER), Coventry, UK
- School of Life Sciences, University of Warwick, Coventry, UK
- Mathematics Institute, University of Warwick, Coventry, UK
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23
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Lewis RF, Kuppalli K, Hoxha A, Doherty MC, on behalf of WHO mpox response incident management team. Emergency committee recommendations on mpox - what's next? Bull World Health Organ 2023; 101:300-300A. [PMID: 37131950 PMCID: PMC10140684 DOI: 10.2471/blt.23.290134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Affiliation(s)
- Rosamund F Lewis
- Epidemic and Pandemic Prevention and Preparedness Department, Health Emergencies Programme, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Krutika Kuppalli
- Epidemic and Pandemic Prevention and Preparedness Department, Health Emergencies Programme, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Ana Hoxha
- Alert and Response Coordination Department, World Health Organization, Geneva, Switzerland
| | - Meg C Doherty
- Department of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland
| | - on behalf of WHO mpox response incident management team
- Epidemic and Pandemic Prevention and Preparedness Department, Health Emergencies Programme, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
- Alert and Response Coordination Department, World Health Organization, Geneva, Switzerland
- Department of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland
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24
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Kumar P, Chaudhary B, Yadav N, Devi S, Pareek A, Alla S, Kajal F, Nowrouzi-Kia B, Chattu VK, Gupta MM. Recent Advances in Research and Management of Human Monkeypox Virus: An Emerging Global Health Threat. Viruses 2023; 15:v15040937. [PMID: 37112916 PMCID: PMC10146223 DOI: 10.3390/v15040937] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/01/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023] Open
Abstract
In 2003, the United States saw an epidemic of monkeypox that was later traced back to rodents of West Africa infected with the monkeypox virus (MPXV). Disease in the United States seemed less severe than the smallpox-like disease in the Democratic Republic of the Congo (DRC). In this study, researchers analyzed data from Central Africa: two distinct MPXV clades were confirmed by sequencing the genomes of MPXV isolates from Western Africa, the United States, and Central Africa. By comparing open reading frames across MPXV clades, scientists can infer which virus proteins might account for the observed variation in pathogenicity in humans. Monkeypox can be prevented and controlled with a better understanding of MPXV's molecular etiology and epidemiological and clinical features. In light of the current outbreaks worldwide, we provide updated information on monkeypox for medical professionals in this review.
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Affiliation(s)
- Parveen Kumar
- Shri Ram College of Pharmacy, Karnal 132116, Haryana, India
| | - Benu Chaudhary
- Guru Gobind Singh College of Pharmacy, Yamunanagar 135001, Haryana, India
| | - Nishant Yadav
- B.S. Anangpuria Institute of Pharmacy, Faridabad 121004, Haryana, India
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, Punjab, India
| | - Sushma Devi
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, Punjab, India
| | - Ashutosh Pareek
- Department of Pharmacy, Banasthali Vidyapith, Banasthali 304022, Rajasthan, India
| | - Sujatha Alla
- Department of Engineering Management & Systems Engineering, Frank Batten College of Engineering, Old Dominion University, Norfolk, VA 23529, USA
- Center for Technology and Innovations, Global Health Research and Innovations Canada, Toronto, ON M1J 2W8, Canada
| | - Fnu Kajal
- Department of Health Promotion Sciences, University of Arizona, Tucson, AZ 85719, USA
| | - Behdin Nowrouzi-Kia
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada
| | - Vijay Kumar Chattu
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada
- Department of Community Medicine, Faculty of Medicine, Datta Meghe Institute of Medical Sciences, Wardha 442107, Maharashtra, India
- Center for Transdisciplinary Research, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, Tamil Nadu, India
| | - Madan Mohan Gupta
- School of Pharmacy, Faculty of Medical Sciences, The University of the West Indies, St. Augustine 3303, Trinidad and Tobago
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Vairo F, Leone S, Mazzotta V, Piselli P, De Carli G, Lanini S, Maggi F, Nicastri E, Gagliardini R, Vita S, Siddu A, Rezza G, Barca A, Vaia F, Antinori A, Girardi E. The possible effect of sociobehavioral factors and public health actions on the mpox epidemic slowdown. Int J Infect Dis 2023; 130:83-85. [PMID: 36906119 DOI: 10.1016/j.ijid.2023.03.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 02/16/2023] [Accepted: 03/03/2023] [Indexed: 03/11/2023] Open
Abstract
OBJECTIVES A pre-exposure vaccination campaign to prevent the spread of the mpox virus was initiated in Italy in August 2022. We explore the possible factors affecting the trend of mpox cases in an Italian region (Lazio) with a rapid roll-out of the vaccination campaign. METHODS We estimated the impact of the communication and vaccination campaign by fitting a Poisson segmented regression model. Results By September 30, 2692, high-risk men who have sex with men had received at least one dose of vaccine, with a vaccination coverage of 37%. The analysis of surveillance data showed a significant decreasing trend in the number of mpox cases starting from the second week after vaccination (incidence rate ratio 0.452 [0.331-0.618]). CONCLUSION The reported trend in mpox cases is likely to result from a combination of multiple social and public health factors combined with a vaccination campaign.
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Affiliation(s)
- Francesco Vairo
- National Institute for Infectious Diseases 'Lazzaro Spallanzani' (IRCCS), Rome, Italy
| | - Sara Leone
- National Institute for Infectious Diseases 'Lazzaro Spallanzani' (IRCCS), Rome, Italy
| | - Valentina Mazzotta
- National Institute for Infectious Diseases 'Lazzaro Spallanzani' (IRCCS), Rome, Italy.
| | - Pierluca Piselli
- National Institute for Infectious Diseases 'Lazzaro Spallanzani' (IRCCS), Rome, Italy
| | - Gabriella De Carli
- National Institute for Infectious Diseases 'Lazzaro Spallanzani' (IRCCS), Rome, Italy
| | - Simone Lanini
- National Institute for Infectious Diseases 'Lazzaro Spallanzani' (IRCCS), Rome, Italy
| | - Fabrizio Maggi
- National Institute for Infectious Diseases 'Lazzaro Spallanzani' (IRCCS), Rome, Italy
| | - Emanuele Nicastri
- National Institute for Infectious Diseases 'Lazzaro Spallanzani' (IRCCS), Rome, Italy
| | - Roberta Gagliardini
- National Institute for Infectious Diseases 'Lazzaro Spallanzani' (IRCCS), Rome, Italy
| | - Serena Vita
- National Institute for Infectious Diseases 'Lazzaro Spallanzani' (IRCCS), Rome, Italy
| | - Andrea Siddu
- Directorate General of Health Prevention, Ministry of Health, Rome, Italy
| | - Giovanni Rezza
- Directorate General of Health Prevention, Ministry of Health, Rome, Italy
| | - Alessandra Barca
- Unit of Health Promotion and Prevention, Directorate of Health and integration, Lazio Region, Italy
| | - Francesco Vaia
- National Institute for Infectious Diseases 'Lazzaro Spallanzani' (IRCCS), Rome, Italy
| | - Andrea Antinori
- National Institute for Infectious Diseases 'Lazzaro Spallanzani' (IRCCS), Rome, Italy
| | - Enrico Girardi
- National Institute for Infectious Diseases 'Lazzaro Spallanzani' (IRCCS), Rome, Italy
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Dukers-Muijrers NHTM, Evers Y, Widdershoven V, Davidovich U, Adam PCG, Op de Coul ELM, Zantkuijl P, Matser A, Prins M, de Vries HJC, den Heijer C, Hoebe CJPA, Niekamp AM, Schneider F, Reyes-Urueña J, Croci R, D'Ambrosio A, van der Valk M, Posthouwer D, Ackens R, ter Waarbeek H, Noori T, Hoornenborg E. Mpox vaccination willingness, determinants, and communication needs in gay, bisexual, and other men who have sex with men, in the context of limited vaccine availability in the Netherlands (Dutch Mpox-survey). Front Public Health 2023; 10:1058807. [PMID: 36684959 PMCID: PMC9850232 DOI: 10.3389/fpubh.2022.1058807] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 12/13/2022] [Indexed: 01/07/2023] Open
Abstract
Introduction In the 2022 multicountry mpox (formerly named monkeypox) outbreak, several countries offered primary preventive vaccination (PPV) to people at higher risk for infection. We study vaccine acceptance and its determinants, to target and tailor public health (communication-) strategies in the context of limited vaccine supply in the Netherlands. Methods Online survey in a convenience sample of gay, bisexual and other men who have sex with men, including transgender persons (22/07-05/09/2022, the Netherlands). We assessed determinants for being (un)willing to accept vaccination. We used multivariable multinominal regression and logistic regression analyses, calculating adjusted odds ratios (aOR) and 95 percent confidence-intervals. An open question asked for campaigning and procedural recommendations. Results Of respondents, 81.5% (n = 1,512/1,856) were willing to accept vaccination; this was 85.2% (799/938) in vaccination-eligible people and 77.7% (713/918) in those non-eligible. Determinants for non-acceptance included: urbanization (rural: aOR:2.2;1.2-3.7; low-urban: aOR:2.4;1.4-3.9; vs. high-urban), not knowing mpox-vaccinated persons (aOR:2.4;1.6-3.4), and lack of connection to gay/queer-community (aOR:2.0;1.5-2.7). Beliefs associated with acceptance were: perception of higher risk/severity of mpox, higher protection motivation, positive outcome expectations post vaccination, and perceived positive social norms regarding vaccination. Respondents recommended better accessible communication, delivered regularly and stigma-free, with facts on mpox, vaccination and procedures, and other preventive options. Also, they recommended, "vaccine provision also at non-clinic settings, discrete/anonymous options, self-registration" to be vaccinated and other inclusive vaccine-offers (e.g., also accessible to people not in existing patient-registries). Conclusion In the public health response to the mpox outbreak, key is a broad and equitable access to information, and to low-threshold vaccination options for those at highest risk. Communication should be uniform and transparent and tailored to beliefs, and include other preventive options. Mpox vaccine willingness was high. Public health efforts may be strengthened in less urbanized areas and reach out to those who lack relevant (community) social network influences.
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Affiliation(s)
- Nicole H. T. M. Dukers-Muijrers
- Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, Heerlen, Netherlands
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Ymke Evers
- Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, Heerlen, Netherlands
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Veja Widdershoven
- Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, Heerlen, Netherlands
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Udi Davidovich
- Department of Infectious Diseases, Public Health Service of Amsterdam (GGD Amsterdam), Amsterdam, Netherlands
- Department of Social Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Philippe C. G. Adam
- Institute for Prevention and Social Research in Utrecht, Utrecht, Netherlands
- Centre for Social Research in Health, University of New South Wales (UNSW) Sydney, Kensington, NSW, Australia
| | - Eline L. M. Op de Coul
- Epidemiology and Surveillance Unit, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | | | - Amy Matser
- Department of Infectious Diseases, Public Health Service of Amsterdam (GGD Amsterdam), Amsterdam, Netherlands
- Amsterdam University Medical Center (UMC) Location University of Amsterdam, Infectious Diseases, Amsterdam, Netherlands
- Amsterdam Institute for Infection and Immunity (AII), Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands
| | - Maria Prins
- Department of Infectious Diseases, Public Health Service of Amsterdam (GGD Amsterdam), Amsterdam, Netherlands
- Amsterdam University Medical Center (UMC) Location University of Amsterdam, Infectious Diseases, Amsterdam, Netherlands
- Amsterdam Institute for Infection and Immunity (AII), Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands
| | - Henry J. C. de Vries
- Department of Infectious Diseases, Public Health Service of Amsterdam (GGD Amsterdam), Amsterdam, Netherlands
- Epidemiology and Surveillance Unit, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
- Amsterdam University Medical Center (UMC) Location University of Amsterdam, Infectious Diseases, Amsterdam, Netherlands
- Department of Dermatology, Location Academic Medical Centre, Amsterdam Institute for Infection and Immunity (AII), Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Casper den Heijer
- Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, Heerlen, Netherlands
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Christian J. P. A. Hoebe
- Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, Heerlen, Netherlands
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
- Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center (MUMC+), Maastricht, Netherlands
| | - Anne-Marie Niekamp
- Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, Heerlen, Netherlands
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Francine Schneider
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | | | - Roberto Croci
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Angelo D'Ambrosio
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Marc van der Valk
- Amsterdam University Medical Center (UMC) Location University of Amsterdam, Infectious Diseases, Amsterdam, Netherlands
- Stichting HIV Monitoring, Amsterdam, Netherlands
| | - Dirk Posthouwer
- Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center (MUMC+), Maastricht, Netherlands
- Department of Internal Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center (MUMC+), Maastricht, Netherlands
| | - Robin Ackens
- Department of Integrated Care, Maastricht University Medical Centre (MUMC+), Maastricht, Netherlands
| | - Henriette ter Waarbeek
- Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, Heerlen, Netherlands
| | - Teymur Noori
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Elske Hoornenborg
- Department of Infectious Diseases, Public Health Service of Amsterdam (GGD Amsterdam), Amsterdam, Netherlands
- Amsterdam University Medical Center (UMC) Location University of Amsterdam, Infectious Diseases, Amsterdam, Netherlands
- Amsterdam Institute for Infection and Immunity (AII), Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands
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Yan W, Du M, Qin C, Liu Q, Wang Y, Liang W, Liu M, Liu J. Association between public attention and monkeypox epidemic: A global lag-correlation analysis. J Med Virol 2023; 95:e28382. [PMID: 36478381 PMCID: PMC10108296 DOI: 10.1002/jmv.28382] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/28/2022] [Accepted: 12/01/2022] [Indexed: 12/13/2022]
Abstract
The human monkeypox has become a public health problem globally. Google Trends Index (GTI) is an indicator of public attention, being potential for infectious disease outbreak surveillance. In this study, we used lag-correlation analysis to evaluate the spearman correlation coefficients between public attention and monkeypox epidemic by -36 to +36 days-lag in top 20 countries with most cumulated cases until September 30, 2022, the meta-analyses were performed to pool the coefficients of countries among all lags. We also constructed vector autoregression model and Granger-causality test to probe the significance of GTI in monkeypox forecasting. The strongest spearman correlation was found at lag +13 day (r = 0.53, 95% confidence interval: 0.371-0.703, p < 0.05). Meta-analysis showed significantly positive correlation when the lag was from -12 to +36 day, which was most notable on the third posterior day (lag +3 day). The pooled spearman correlation coefficients were all above 0.200 when the lag ranged from +1 to +20 day, and the causality of GTI for daily case was significant in worldwide and multiple countries. The findings suggested a robust association between 13-days-priority GTI and daily cases worldwide. This work introduced a potential monitor indicator on the early warning and surveillance of monkeypox outbreak.
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Affiliation(s)
- Wenxin Yan
- Department of Epidemiology and Biostatistics, School of Public HealthPeking UniversityBeijingChina
| | - Min Du
- Department of Epidemiology and Biostatistics, School of Public HealthPeking UniversityBeijingChina
| | - Chenyuan Qin
- Department of Epidemiology and Biostatistics, School of Public HealthPeking UniversityBeijingChina
| | - Qiao Liu
- Department of Epidemiology and Biostatistics, School of Public HealthPeking UniversityBeijingChina
| | - Yaping Wang
- Department of Epidemiology and Biostatistics, School of Public HealthPeking UniversityBeijingChina
| | - Wannian Liang
- Vanke School of Public HealthTsinghua UniversityBeijingChina
| | - Min Liu
- Department of Epidemiology and Biostatistics, School of Public HealthPeking UniversityBeijingChina
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public HealthPeking UniversityBeijingChina
- Institute for Global Health and DevelopmentPeking UniversityBeijingChina
- Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases GroupPeking UniversityBeijingChina
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Gujjar P, Chaudhay R, Verma I, Bansal N, Gupta S, Bansal S. Recent Advances in the Prevention and Management of Monkeypox Viral Infection in Humans. Curr Drug Targets 2023; 24:1032-1045. [PMID: 37842888 DOI: 10.2174/0113894501258154231008194028] [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: 04/17/2023] [Revised: 07/18/2023] [Accepted: 07/31/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND There have been several neglected infectious pathogens that have reemerged in the last few decades, including the monkeypox virus, a virus from the orthopoxviral genus that causes monkeypox and is transmitted between animals and humans. The human monkeypox outbreak has spread to several different countries. Because of the outbreak's unusually high case count and lack of connections to endemic nations, there are concerns that the monkeypox transmission pattern may have changed. OBJECTIVE The current study aimed to provide recent advancements in the prevention and management of the monkeypox virus in humans. METHODOLOGY We have highlighted recent advancements in the prevention and management of the monkeypox virus in humans in this work. RESULTS For the treatment and prevention of monkeypox, new medications and vaccinations are being used, and more study is needed to understand the epidemiology, biology, and ecology of the virus in endemic regions and stop future global outbreaks. Vaccines available in the market for the treatment of viruses are JYNEOS and ACAM2000. Some of the antiviral drugs, such as tecovirimat, brincidofovir, cidofovir, trifluridine, and vaccinia immune globulin, are used for the treatment of the monkeypox virus. Some of the vaccines, such as NIOCH-14, Cidofovir, CMX-001, and ST-246, are currently in clinical trials. CONCLUSION We have, herein, covered features of monkeypox viral biology that are important for risk assessment and getting ready for an outbreak of the monkeypox virus, with a focus on recent advances in knowledge of the virus's host range, evolutionary potential, and potential targets for neutralization.
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Affiliation(s)
- Preeti Gujjar
- Department of Pharmacology, M. M. College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, 133206, India
| | - Rishabh Chaudhay
- Department of Pharmacology, M. M. College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, 133206, India
| | - Inderjeet Verma
- Department of Pharmacology, M. M. College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, 133206, India
| | - Nitin Bansal
- Department of Pharmacy, Chaudhary Bansilal University, Bhiwani, India
| | - Sumeet Gupta
- Department of Pharmacology, M. M. College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, 133206, India
| | - Seema Bansal
- Department of Pharmacology, M. M. College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, 133206, India
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29
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Silva MST, Jalil EM, Torres TS, Coutinho C, Jalil CM, Cardoso SW, Veloso VG, Grinsztejn B. Monkeypox and transgender women: The need for a global initiative. Travel Med Infect Dis 2022; 50:102479. [PMID: 36257591 PMCID: PMC9573897 DOI: 10.1016/j.tmaid.2022.102479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Mayara Secco Torres Silva
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz Monkeypox Study Group), Av Brasil 4365, Manguinhos, 21040-360, Rio de Janeiro, Brazil
| | - Emilia Moreira Jalil
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz Monkeypox Study Group), Av Brasil 4365, Manguinhos, 21040-360, Rio de Janeiro, Brazil
| | - Thiago Silva Torres
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz Monkeypox Study Group), Av Brasil 4365, Manguinhos, 21040-360, Rio de Janeiro, Brazil
| | - Carolina Coutinho
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz Monkeypox Study Group), Av Brasil 4365, Manguinhos, 21040-360, Rio de Janeiro, Brazil
| | - Cristina Moreira Jalil
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz Monkeypox Study Group), Av Brasil 4365, Manguinhos, 21040-360, Rio de Janeiro, Brazil
| | - Sandra Wagner Cardoso
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz Monkeypox Study Group), Av Brasil 4365, Manguinhos, 21040-360, Rio de Janeiro, Brazil
| | - Valdilea Gonçalves Veloso
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz Monkeypox Study Group), Av Brasil 4365, Manguinhos, 21040-360, Rio de Janeiro, Brazil
| | - Beatriz Grinsztejn
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz Monkeypox Study Group), Av Brasil 4365, Manguinhos, 21040-360, Rio de Janeiro, Brazil.
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Ulloque-Badaracco JR, Alarcón-Braga EA, Hernandez-Bustamante EA, Al-kassab-Córdova A, Benites-Zapata VA, Bonilla-Aldana DK, Rodriguez-Morales AJ. Acceptance towards Monkeypox Vaccination: A Systematic Review and Meta-Analysis. Pathogens 2022; 11:1248. [PMID: 36364999 PMCID: PMC9697127 DOI: 10.3390/pathogens11111248] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 10/23/2022] [Accepted: 10/25/2022] [Indexed: 08/19/2023] Open
Abstract
Vaccination it is considered a vital strategy in order to mitigate monkeypox by protecting from severe disease and helping in reduction of hospitalisations. In this sense, this study aims to estimate the global prevalence of vaccination acceptance against monkeypox. We conducted a systematic review with a comprehensive search strategy for the following databases: PubMed, Scopus and Web of Science. A random-effect model meta-analysis was carried out using observational studies assessing the intention of vaccines against monkeypox from multiple continents. The quality assessment was developed using the Newcastle-Ottawa Scale adapted for cross-sectional studies. In addition, a subgroup analysis by study location and population and a sensitivity analysis was developed.Eleven cross-sectional studies were included. A total of 8045 participants were included. The pooled prevalence of monkeypox vaccination acceptance in all participants was 56.0% (95%CI: 42.0-70.0%). In the subgroup analysis of monkeypox vaccine acceptance according to continents, the prevalence of vaccine acceptance was 50.0% (95%CI: 24.0-76.0%) in Asian countries and 70.0% (95%CI: 55.0-84.0%) in European countries. The prevalence of vaccine acceptance was 43.0% (95%CI: 35.0-50.0%) in the general population, 63.0% (95%CI: 42.0-70.0%) in healthcare workers, and 84.0% (95%CI: 83.0-86.0%) in the LGBTI community. Despite the high prevalence of monkeypox vaccination acceptance in the LGBTI community found in our study, vaccination acceptance from healthcare workers and the general population are lower. Governments could use these results for planning, developing or promoting vaccination strategies and public health policies focused on these populations.
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Affiliation(s)
| | - Esteban A. Alarcón-Braga
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima 15023, Peru
- Sociedad Científica de Estudiantes de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima 15023, Peru
| | - Enrique A. Hernandez-Bustamante
- Sociedad Cientifica de Estudiantes de Medicina, Universidad Nacional de Trujillo, Trujillo 13011, Peru
- Grupo Peruano de Investigación Epidemiológica, Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima 15012, Peru
| | - Ali Al-kassab-Córdova
- Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Universidad San Ignacio de Loyola, Lima 15012, Peru
| | | | | | - Alfonso J. Rodriguez-Morales
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundacion Universitaria Autonoma de las Americas, Pereira 660003, Risaralda, Colombia
- Institucion Universitaria Vision de las Americas, Pereira 660003, Risaralda, Colombia
- Master of Clinical Epidemiology and Biostatistics, Universidad Cientifica del Sur, Lima 15024, Peru
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