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Otmar CD, Merolla AJ. Social Determinants of Message Exposure and Health Anxiety Among Young Sexual Minority Men in the United States During the 2022 Mpox Outbreak. HEALTH COMMUNICATION 2025; 40:1314-1325. [PMID: 39225351 DOI: 10.1080/10410236.2024.2397272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
This study tested the structural influence model of communication in the context of the 2022 global outbreak of the Mpox virus among young sexual minority men. The primary objective was to understand how distinct social determinants, including education, race/ethnicity, and interpersonal discrimination, influenced exposure to Mpox messages in daily life and affected health anxiety concerning the Mpox virus in the United States. We also explored the significance of LGBTQ+ community connectedness as a crucial form of social capital during the outbreak. We collected a three-wave longitudinal dataset and examined within-person and between-person associations using a random-intercept cross-lagged panel model. Participants (N = 254) reported that internet sources and social media were their primary information sources for Mpox messages during the outbreak. Educational attainment, racial minority status, and LGBTQ+ community connectedness were significantly associated with message exposure. Young sexual minority men who faced greater interpersonal discrimination in their daily lives also reported higher rates of Mpox-related health anxiety. Longitudinal analysis indicated that (at the within-person level) Mpox anxiety was significantly associated with greater Mpox message exposure in the month following the outbreak, but that relationship waned in the subsequent month. The theoretical implications highlight the relevance of minority stress variables in the structural influence model of communication framework and suggest the importance of community connectedness as a distinct form of social capital shaping message exposure and health anxiety during the Mpox outbreak in the United States.
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Affiliation(s)
| | - Andy J Merolla
- Department of Communication, University of California, Santa Barbara
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Wang H, de Paulo KJID, Gültzow T, Zimmermann HML, Jonas KJ. Brief Report: Determinants of Potential Sexual Activity Reduction in the Face of the Mpox Epidemic. Int J Behav Med 2025; 32:308-324. [PMID: 38233626 DOI: 10.1007/s12529-023-10252-4] [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: 12/14/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND The current mpox epidemic is most prevalent among men-who-have-sex-with-men (MSM). Vaccination programs are being rolled-out to curb the epidemic. Behavioural measures have been called for as well, for example, by the WHO and national public health authorities to reduce the number of sexual partners and sexual activity. We investigated intentions and determinants among Dutch MSM to follow such behavioural measures. METHODS Early in July 2022, in the context of a dynamic ongoing epidemic, 394 MSM answered an online questionnaire investigating concepts such as perceived mpox risk, vaccination and behavioural change intentions and collecting socio-demographic and sexual behaviour information. RESULTS The overall intentions to reduce number of partners and sexual activity were high, but only a minority had developed definite intentions. Determinant analysis revealed that dating/open relationship status was a positive predictor; vaccination intentions did not predict sexual behaviour change; those not on PrEP were more likely to change their sexual behaviour. Mpox infection concern was the main predictor for behaviour change intentions. CONCLUSIONS Our results show that behavioural measures to avoid an mpox infection are present in majority of participants in our survey, but high intentions are held by a minority. Taking the historic complexity of behavioural change pleas among MSM into account sensitive, additional public health measures are necessary to reach and to inform MSM about potential benefits of sexual behaviour change.
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Affiliation(s)
- Haoyi Wang
- Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
| | | | - Thomas Gültzow
- Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
- Department of Theory, Methods & Statistics, Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands
| | - Hanne M L Zimmermann
- Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
| | - Kai J Jonas
- Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands.
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3
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Spaziante M, Leone S, D'Amato M, De Carli G, Tonziello G, Malatesta GN, Agresta A, De Santis C, Vantaggio V, Pitti G, Fusco MC, Piselli P, Barca A, Girardi E, Scognamiglio P, Vairo F. Interrupted time series analysis to evaluate the impact of COVID-19-pandemic on the incidence of notifiable infectious diseases in the Lazio region, Italy. BMC Public Health 2025; 25:132. [PMID: 39806341 PMCID: PMC11726930 DOI: 10.1186/s12889-024-21256-4] [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] [Received: 11/07/2024] [Accepted: 12/30/2024] [Indexed: 01/16/2025] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) emergency has represented a profound upheaval in the dynamics of infectious diseases transmission worldwide. This phenomenon has been at least in part driven by the introduction of non-pharmaceutical interventions (NPIs), implemented to counteract viral transmission. Our study aimed to assess the magnitude and the features of the impact of the COVID-19 pandemic on the incidence of notifiable infectious diseases (NIDs) in the Lazio region, Italy. METHODS Data on NIDs in the Lazio Region with symptom onset date included in the time interval from 1 January 2017 to 31 December 2023 were collected from different surveillance system databases available at SERESMI/Lazio Region Unit and classified into five categories based on the main transmission route of the disease. Descriptive statistics were performed and interrupted time series (ITS) analysis was used to assess the effect of the COVID-19 pandemic and subsequent recovery period on monthly NIDs cases. RESULTS Immediately after the start of the COVID-19 pandemic, a significant, sharp and immediate reduction in monthly cases was recorded for all NIDs (-86.73%), regardless of the transmission route. The decrease was particularly significant for vector-borne, food-borne and respiratory-transmitted diseases (RDs), and in general in females. During the COVID-19 recovery phase, monthly cases of all NIDs showed a significant positive level change, particularly significant for sexually transmitted/blood-borne diseases, contact diseases and RDs. DISCUSSION The COVID-19 pandemic has been responsible for the disruption of all NIDs transmission patterns, while the magnitude and dynamics of its effects varied depending on the transmission route; furthermore, the impact of the pandemic wave was still noticeable during the post-COVID-19 era and the incidence trajectories of NIDs in this phase were peculiar for each disease category.
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Affiliation(s)
- Martina Spaziante
- National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense, Rome, 292-00149, Italy
| | - Sara Leone
- National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense, Rome, 292-00149, Italy
| | - Maurizio D'Amato
- National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense, Rome, 292-00149, Italy
| | - Gabriella De Carli
- National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense, Rome, 292-00149, Italy
| | - Gilda Tonziello
- National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense, Rome, 292-00149, Italy.
| | - Giorgio Nicolò Malatesta
- National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense, Rome, 292-00149, Italy
| | - Alessandro Agresta
- National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense, Rome, 292-00149, Italy
| | - Claudia De Santis
- National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense, Rome, 292-00149, Italy
| | - Valentina Vantaggio
- National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense, Rome, 292-00149, Italy
| | - Giovanni Pitti
- National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense, Rome, 292-00149, Italy
| | - Maria Concetta Fusco
- National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense, Rome, 292-00149, Italy
| | - Pierluca Piselli
- National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense, Rome, 292-00149, Italy
| | - Alessandra Barca
- Directorate for Health and Social Policy, Lazio Region, Via R. Raimondi Garibaldi, 7, Rome, 00145, Italy
| | - Enrico Girardi
- National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense, Rome, 292-00149, Italy
| | - Paola Scognamiglio
- National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense, Rome, 292-00149, Italy
- Directorate for Health and Social Policy, Lazio Region, Via R. Raimondi Garibaldi, 7, Rome, 00145, Italy
| | - Francesco Vairo
- National Institute for Infectious Diseases "Lazzaro Spallanzani" IRCCS, Via Portuense, Rome, 292-00149, Italy
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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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Cabanillas B, Murdaca G, Guemari A, Torres MJ, Azkur AK, Aksoy E, Vitte J, Fernández-Santamaria R, Karavelia A, Castagnoli R, Valdelvira R, Orsi A, Ogliastro M, Massaro E, Yücel EÖ, Novak N, Agache I, Akdis M, Akdis CA. Monkeypox 2024 outbreak: Fifty essential questions and answers. Allergy 2024; 79:3285-3309. [PMID: 39495103 DOI: 10.1111/all.16374] [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] [Received: 09/20/2024] [Revised: 10/05/2024] [Accepted: 10/16/2024] [Indexed: 11/05/2024]
Abstract
As the world still vividly recalls the previous monkeypox (mpox) outbreak that impacted over 120 countries worldwide with more than 99,000 cases in 2022, we are now facing a second wave of infections from the monkeypox virus (MPXV), characterized by an exponential increase in cases. The current 2024 outbreak has already recorded more than 20,000 cases in Africa, marking a dramatic escalation compared to previous outbreaks. The predominance of the newly identified clade Ib variant, first detected in the Democratic Republic of the Congo (DRC) and now identified across multiple African nations and beyond, underscores its enhanced transmissibility and potential for international spread, evidenced by cases in Sweden and Thailand. The World Health Organization (WHO) declared on August 14, 2024, the current mpox outbreak a Public Health Emergency of International Concern (PHEIC), calling for heightened global public health measures. The ongoing pattern of unusual, frequent, and extensive outbreaks of mpox with potential global implications poses significant questions. This review addresses, in the format of 50 questions and answers, the 2024 mpox outbreak, detailing its characteristics, epidemiological data, and impact compared to previous outbreaks. It comprehensively explores critical questions related to MPXV virological characteristics, immunological response, clinical manifestations, epidemiology, diagnostics, and available treatments. The review also documents the significant and evolving challenges posed by the current mpox outbreak, highlighting its scale, spread, and public health response.
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Affiliation(s)
- Beatriz Cabanillas
- Department of Allergy, Instituto de Investigacion Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Giuseppe Murdaca
- Department of Internal Medicine, University of Genova, Genova, Italy
- Allergology and Clinical Immunology Unit, San Bartolomeo Hospital, Sarzana, Italy
| | - Amir Guemari
- IDESP and PREMEDICAL, University of Montpellier-INSERM, INRIA, Montpellier, France
| | - Maria Jose Torres
- Allergy Unit, Hospital Regional Universitario de Málaga, Allergy Research Group, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, ARADyAL, Malaga University, Málaga, Spain
| | - Ahmet Kursat Azkur
- Department of Virology, Faculty of Veterinary Medicine, Kirikkale University, Kirikkale, Turkey
| | - Emel Aksoy
- Department of Virology, Faculty of Veterinary Medicine, Kirikkale University, Kirikkale, Turkey
| | - Joana Vitte
- IDESP and PREMEDICAL, University of Montpellier-INSERM, INRIA, Montpellier, France
- University of Reims Champagne-Ardenne, INSERM UMR 1250 and Immunology Laboratory, University Hospital of Reims, Reims, France
| | - Ruben Fernández-Santamaria
- Immunology Department, IIS-Fundacion Jimenez Diaz, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Aspasia Karavelia
- Department of Ear-Nose-Throat Surgery, General Hospital of Nafplio, Nafplio, Greece
| | - Riccardo Castagnoli
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Rafael Valdelvira
- Department of Allergy, Instituto de Investigacion Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Andrea Orsi
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
- Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, Genova, Italy
| | - Matilde Ogliastro
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
| | - Elvira Massaro
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
| | - Esra Özek Yücel
- Division of Pediatrics, Department of Pediatric Allergy and Immunology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Natalija Novak
- Department of Dermatology and Allergy, Venusberg Campus 1, Bonn, Germany
| | - Ioana Agache
- Transylvania University, Brasov, Romania
- Theramed Medical Center, Brasov, Romania
| | - Mubeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
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6
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Cordeiro R, Caetano CP, Sobral D, Ferreira R, Coelho L, Pelerito A, de Carvalho IL, Namorado S, Loyens DB, Mexia R, Fernandes C, Neves JM, João AL, Rocha M, Duque LM, Correia I, Baptista T, Brazão C, Sousa D, Filipe P, Alpalhão M, Maltez F, Póvoas D, Pinto R, Caria J, Patrocínio de Jesus R, Pacheco P, Peruzzu F, Méndez J, Ferreira L, Mansinho K, Alves JV, Vasconcelos J, Domingos J, Casanova S, Duarte F, Gonçalves MJ, Salvador MB, Guimarães MA, Martins S, Oliveira MS, Santos D, Vieira L, Núncio MS, Borges V, Gomes JP. Viral genetics and transmission dynamics in the second wave of mpox outbreak in Portugal and forecasting public health scenarios. Emerg Microbes Infect 2024; 13:2412635. [PMID: 39360827 PMCID: PMC11486115 DOI: 10.1080/22221751.2024.2412635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2024] [Revised: 09/27/2024] [Accepted: 09/30/2024] [Indexed: 10/05/2024]
Abstract
In 2023, a second wave of the global mpox epidemic, which is mainly affecting men who have sex with men (MSM), was observed in some countries. Herein, we benefited from a large viral sequence sampling (76/121; 63%) and vast epidemiological data to characterise the re-emergence and circulation of the Monkeypox virus (MPXV) in Portugal during 2023. We also modelled transmission and forecasted public health scenarios through a compartmental susceptible-exposed-infectious-recovered (SEIR) model. Our results suggest that the 2023 mpox wave in Portugal resulted from limited introduction(s) of MPXV belonging to C.1.1 sublineage, hypothetically from Asia, followed by sustained viral transmission and potential exportation to other countries. We estimated that the contribution of the MSM high sexual activity group to mpox transmission was 120 (95% CrI: 30-3553) times higher than that of the low sexual activity group. However, among the high sexual activity group, vaccinated individuals likely contributed approximately eight times less [0.123 (95% CrI: 0.068-0.208)] than the unvaccinated ones. Vaccination was also linked to potential reduced disease severity, with a Mpox Severity Score of 6.0 in the vaccinated group compared to 7.0 in unvaccinated individuals. Scenario analysis indicated that transmission is highly sensitive to sexual behaviour, projecting that a slight increase in the MSM sub-population with high sexual activity can trigger new mpox waves. This study strongly supports that continued vaccination, targeted awareness among risk groups and routine genomic epidemiology is needed to anticipate and respond to novel MPXV threats (e.g. global dissemination of clade I viruses).
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Affiliation(s)
- Rita Cordeiro
- Emergency Response and Biopreparedness Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
- Institute of Environmental Health, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Constantino P. Caetano
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Daniel Sobral
- Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Rita Ferreira
- Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Luís Coelho
- Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Ana Pelerito
- Emergency Response and Biopreparedness Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
- Institute of Environmental Health, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Isabel Lopes de Carvalho
- Emergency Response and Biopreparedness Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
- Institute of Environmental Health, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Sónia Namorado
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Dinis B. Loyens
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Ricardo Mexia
- Department of Epidemiology, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Cândida Fernandes
- Serviço de Dermatovenereologia, Consulta de DST, Unidade Local de Saúde de São José, Lisbon, Portugal
| | - José Miguel Neves
- Serviço de Dermatovenereologia, Consulta de DST, Unidade Local de Saúde de São José, Lisbon, Portugal
| | - Ana Luísa João
- Serviço de Dermatovenereologia, Consulta de DST, Unidade Local de Saúde de São José, Lisbon, Portugal
| | - Miguel Rocha
- GAT - Grupo de Ativistas em Tratamentos, GAT-CheckpointLX, Lisbon, Portugal
| | - Luís Miguel Duque
- GAT - Grupo de Ativistas em Tratamentos, GAT-CheckpointLX, Lisbon, Portugal
- Serviço de Infeccologia, Hospital Garcia de Orta, Almada, Portugal
| | - Inês Correia
- GAT - Grupo de Ativistas em Tratamentos, GAT-Intendente, Lisbon, Portugal
| | - Teresa Baptista
- GAT - Grupo de Ativistas em Tratamentos, GAT-Intendente, Lisbon, Portugal
| | - Cláudia Brazão
- Dermatology Department, Unidade Local de Saúde de Santa Maria, Lisbon, Portugal
| | - Diogo Sousa
- Dermatology Department, Unidade Local de Saúde de Santa Maria, Lisbon, Portugal
| | - Paulo Filipe
- Dermatology Department, Unidade Local de Saúde de Santa Maria, Lisbon, Portugal
- Dermatology Research Unit (PFilipe Lab), Instituto de Medicina Molecular João Lobo Antunes, University of Lisbon, Lisbon, Portugal
- Dermatology University Clinic, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Miguel Alpalhão
- Dermatology Department, Unidade Local de Saúde de Santa Maria, Lisbon, Portugal
- Dermatology Research Unit (PFilipe Lab), Instituto de Medicina Molecular João Lobo Antunes, University of Lisbon, Lisbon, Portugal
- Dermatology University Clinic, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Fernando Maltez
- Institute of Environmental Health, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
- Serviço de Doenças Infeciosas, Hospital de Curry Cabral, Unidade Local de Saúde de São José, Lisbon, Portugal
| | - Diana Póvoas
- Serviço de Doenças Infeciosas, Hospital de Curry Cabral, Unidade Local de Saúde de São José, Lisbon, Portugal
- Instituto Gulbenkian de Ciência, Oeiras, Portugal
| | - Raquel Pinto
- Serviço de Doenças Infeciosas, Hospital de Curry Cabral, Unidade Local de Saúde de São José, Lisbon, Portugal
| | - João Caria
- Serviço de Doenças Infeciosas, Hospital de Curry Cabral, Unidade Local de Saúde de São José, Lisbon, Portugal
| | - Rita Patrocínio de Jesus
- Serviço de Infeciologia, Hospital Professor Doutor Fernando Fonseca, Unidade Local de Saúde Amadora/Sintra, Amadora, Portugal
| | - Patrícia Pacheco
- Serviço de Infeciologia, Hospital Professor Doutor Fernando Fonseca, Unidade Local de Saúde Amadora/Sintra, Amadora, Portugal
| | - Francesca Peruzzu
- Serviço de Infeciologia, Hospital Professor Doutor Fernando Fonseca, Unidade Local de Saúde Amadora/Sintra, Amadora, Portugal
| | - Josefina Méndez
- Serviço de Doenças Infecciosas, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Luís Ferreira
- Serviço de Doenças Infecciosas, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Kamal Mansinho
- Serviço de Doenças Infecciosas e Medicina Tropical, Hospital de Egas Moniz, Unidade Local de Saúde de Lisboa Ocidental, Lisbon, Portugal
| | - João Vaz Alves
- Serviço de Doenças Infecciosas e Medicina Tropical, Hospital de Egas Moniz, Unidade Local de Saúde de Lisboa Ocidental, Lisbon, Portugal
| | - Joana Vasconcelos
- Emergency Response and Biopreparedness Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - João Domingos
- Serviço de Doenças Infecciosas e Medicina Tropical, Hospital de Egas Moniz, Unidade Local de Saúde de Lisboa Ocidental, Lisbon, Portugal
| | - Sara Casanova
- Serviço de Doenças Infecciosas e Medicina Tropical, Hospital de Egas Moniz, Unidade Local de Saúde de Lisboa Ocidental, Lisbon, Portugal
| | - Frederico Duarte
- Serviço de Doenças Infeciosas, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal
| | - Maria João Gonçalves
- Serviço de Doenças Infeciosas, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal
| | - Mafalda Brito Salvador
- Unidade de Doenças Sexualmente Transmissíveis, Unidade de Cuidados de Saúde Personalizados da Lapa, Unidade Local de Saúde de São José, Lisbon, Portugal
| | | | - Sueila Martins
- UL-PPCIRA, Unidade Local de Saúde Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Marvin Silva Oliveira
- Serviço de Patologia Clínica, Unidade Local de Saúde do Tâmega e Sousa, Penafiel, Portugal
| | - Daniela Santos
- Technology and Innovation Unit, Department of Human Genetics, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Luís Vieira
- Technology and Innovation Unit, Department of Human Genetics, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Maria Sofia Núncio
- Emergency Response and Biopreparedness Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
- Institute of Environmental Health, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Vítor Borges
- Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - João Paulo Gomes
- Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
- Veterinary and Animal Research Centre (CECAV), Faculty of Veterinary Medicine, Lusófona University, Lisbon, Portugal
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Berry MT, Khan SR, Schlub TE, Notaras A, Kunasekaran M, Grulich AE, MacIntyre CR, Davenport MP, Khoury DS. Predicting vaccine effectiveness for mpox. Nat Commun 2024; 15:3856. [PMID: 38719852 PMCID: PMC11078999 DOI: 10.1038/s41467-024-48180-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 04/22/2024] [Indexed: 05/12/2024] Open
Abstract
The Modified Vaccinia Ankara vaccine developed by Bavarian Nordic (MVA-BN) was widely deployed to prevent mpox during the 2022 global outbreak. This vaccine was initially approved for mpox based on its reported immunogenicity (from phase I/II trials) and effectiveness in animal models, rather than evidence of clinical efficacy. However, no validated correlate of protection after vaccination has been identified. Here we performed a systematic search and meta-analysis of the available data to test whether vaccinia-binding ELISA endpoint titer is predictive of vaccine effectiveness against mpox. We observe a significant correlation between vaccine effectiveness and vaccinia-binding antibody titers, consistent with the existing assumption that antibody levels may be a correlate of protection. Combining this data with analysis of antibody kinetics after vaccination, we predict the durability of protection after vaccination and the impact of dose spacing. We find that delaying the second dose of MVA-BN vaccination will provide more durable protection and may be optimal in an outbreak with limited vaccine stock. Although further work is required to validate this correlate, this study provides a quantitative evidence-based approach for using antibody measurements to predict the effectiveness of mpox vaccination.
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Affiliation(s)
- Matthew T Berry
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Shanchita R Khan
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Timothy E Schlub
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Adriana Notaras
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | | | - Andrew E Grulich
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - C Raina MacIntyre
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
- College of Public Service and Community Solutions, and College of Health Solutions, Arizona State University, Tempe, AZ, USA
| | - Miles P Davenport
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
| | - David S Khoury
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
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Haverkate MR, Willemstein IJ, van Ewijk CE, Adam PC, Lanooij SJ, Jonker-Jorna P, van Bokhoven C, van Rijckevorsel GG, Hoornenborg E, David S, Mollema L, Te Wierik MJ, Lange J, Franz E, de Melker HE, Op de Coul EL, Hahné SJ. Factors potentially contributing to the decline of the mpox outbreak in the Netherlands, 2022 and 2023. Euro Surveill 2024; 29:2300608. [PMID: 38785092 PMCID: PMC11128738 DOI: 10.2807/1560-7917.es.2024.29.21.2300608] [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: 11/03/2023] [Accepted: 03/18/2024] [Indexed: 05/25/2024] Open
Abstract
BackgroundIn 2022 and 2023, a global outbreak of mpox affected mostly gay, bisexual and other men having sex with men (GBMSM). Outbreak control in the Netherlands included isolation, quarantine, post-exposure prophylaxis vaccination and primary preventive vaccination (PPV).AimWe describe the course of the outbreak, the vaccination programme, vaccine effectiveness (VE) of full vaccination against symptomatic disease, and trends in behaviour to generate hypotheses about factors that influenced the outbreak's decline.MethodsIn this observational study, we collected data from public health services on notified cases, number of PPV invitations and PPV doses administered. We calculated PPV uptake and coverage. Trends in behavioural data of GBMSM visiting sexual health centres were analysed for all consultations in 2022. We estimated VE using the screening method.ResultsUntil 31 December 2023, 1,294 mpox cases were reported. The outbreak peaked in early July 2022 and then declined sharply. PPV started on 25 July 2022; in total 29,851 doses were administered, 45.8% received at least one dose, 35.4% were fully vaccinated. The estimated VE was 68.2% (95% CI 4.3-89.5%). We did not observe an evident decrease in high-risk behaviour.DiscussionIt is unlikely that PPV was a driver of the outbreak's decline, as incidence started to decline well before the start of the PPV programme. The possible impact of behavioural change could not be demonstrated with the available indicators, however, the data had limitations, hampering interpretation. We hypothesise that infection-induced immunity in high-risk groups was an important factor explaining the decline.
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Affiliation(s)
- Manon R Haverkate
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Inge Jm Willemstein
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Catharina E van Ewijk
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Philippe Cg Adam
- Institute for Prevention and Social Research, Utrecht, the Netherlands
- University of New South Wales Sydney, Sydney, Australia
| | - Susan J Lanooij
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | | | | | - Gini Gc van Rijckevorsel
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- Public Health Service Amsterdam, Amsterdam, the Netherlands
| | | | - Silke David
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Liesbeth Mollema
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Margreet J Te Wierik
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Jente Lange
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Eelco Franz
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Hester E de Melker
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Eline Lm Op de Coul
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Susan Jm Hahné
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands
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Akhmetzhanov AR, Wu PH. Transmission potential of mpox in mainland China, June-July 2023: estimating reproduction number during the initial phase of the epidemic. PeerJ 2024; 12:e16908. [PMID: 38344294 PMCID: PMC10859083 DOI: 10.7717/peerj.16908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/17/2024] [Indexed: 02/15/2024] Open
Abstract
Despite reporting very few mpox cases in early 2023, mainland China observed a surge of over 500 cases during the summer. Amid ambiguous prevention strategies and stigma surrounding mpox transmission, the epidemic silently escalated. This study aims to quantify the scale of the mpox epidemic and assess the transmission dynamics of the virus by estimating the effective reproduction number (Re) during its early phase. Publicly available data were aggregated to obtain daily mpox case counts in mainland China, and the Re value was estimated using an exponential growth model. The mean Re value was found to be 1.57 (95% credible interval [1.38-1.78]), suggesting a case doubling time of approximately 2 weeks. This estimate was compared with Re values from 16 other countries' national outbreaks in 2022 that had cumulative case count exceeding 700 symptomatic cases by the end of that year. The Re estimates for these outbreaks ranged from 1.13 for Portugal to 2.31 for Colombia. The pooled mean Re was 1.49 (95% credible interval [1.32-1.67]), which aligns closely with the Re for mainland China. These findings underscore the need for immediate and effective control measures including targeted vaccination campaigns to mitigate the further spread and impact of the epidemic.
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Affiliation(s)
- Andrei R. Akhmetzhanov
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Global Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Pei-Hsuan Wu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
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10
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Khan G, Perveen N. The 2022 monkeypox outbreak 1 year on: The 5 Ws. Rev Med Virol 2024; 34:e2489. [PMID: 37930054 DOI: 10.1002/rmv.2489] [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] [Received: 08/03/2023] [Revised: 10/20/2023] [Accepted: 10/27/2023] [Indexed: 11/07/2023]
Abstract
In May 2022, World Health Organization (WHO) reported an outbreak of Mpox in several European countries which were previously Mpox free. Mpox (formerly known as monkeypox) is a zoonotic viral disease endemic in Central and West Africa. The sudden emergence of Mpox outside Africa and its subsequent rapid spread lead the WHO to declare the outbreak as Public Health Emergency of International Concern. By 15 May 2023, a total of 87,704 confirmed cases and 140 deaths had been reported from 111 countries and territories worldwide. Looking back on this outbreak 1 year later, several important questions have arisen. Here, we address these questions using the classic 5 Ws: What, When, Where, Who and Why? We discuss these questions to understand how this outbreak emerged and how it was effectively managed. We outline what needs to be done to prevent, or at least minimise, outbreaks due to emerging and re-emerging viral infections.
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Affiliation(s)
- Gulfaraz Khan
- Department of Microbiology & Immunology, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Nighat Perveen
- Department of Biology, College of Science, United Arab Emirates University, Al-Ain, United Arab Emirates
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Del Duca G, Tavelli A, Mastrorosa I, Aguglia C, Lanini S, Brita AC, Gagliardini R, Vita S, Vergori A, Paulicelli J, Natalini G, D’Urso A, Piselli P, Gallì P, Mondillo V, Mastroianni C, Tamburrini E, Sarmati L, Stingone C, Lichtner M, Nicastri E, Farinella M, Leserri F, Siddu A, Maggi F, d’Arminio Monforte A, Vairo F, Barca A, Vaia F, Girardi E, Mazzotta V, Antinori A. Risk Awareness as a Key Determinant of Early Vaccine Uptake in the Mpox Vaccination Campaign in an Italian Region: A Cross-Sectional Analysis. Vaccines (Basel) 2023; 11:1761. [PMID: 38140166 PMCID: PMC10748194 DOI: 10.3390/vaccines11121761] [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: 10/18/2023] [Revised: 11/16/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND we aim to investigate attitudes toward vaccination by analyzing empirical factors associated with vaccine acceptance in the Lazio region mpox vaccination (MpoxVax) campaign in Italy. METHODS all subjects who accessed MpoxVax and signed the informed consent were prospectively enrolled in the MPOX-VAC Study and were asked to fill out an anonymous survey. Two endpoints were selected: 'delayed acceptance' and 'early acceptance', defined as access for vaccination >60 and ≤30 days from the vaccination campaign starting (VCS), respectively. RESULTS over the study period, 1717 individuals underwent vaccination: 129 (7%) > 60 [1588 (92.5%) ≤ 60] and 676 (60%) ≤ 30 days from VCS. A bisexual orientation, a lower education level and a worse perceived physical and mental health were associated with delayed access to vaccination. Being pre-exposure prophylaxis (PrEP) users and, marginally, HIV positive; having a high perceived risk for mpox infection; and reporting high-risk behaviors like the use of recreational drugs/chems, sex under the influence of drugs and/or alcohol and having a higher number of principal sexual partners, were associated with early access to vaccination. CONCLUSIONS according to our data, risk awareness was a major determinant of early MpoxVax acceptance. Conversely, worse perceived health status and a low educational level were critical factors associated with delayed vaccination.
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Affiliation(s)
- Giulia Del Duca
- Clinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (G.D.D.); (C.A.); (S.L.); (A.C.B.); (R.G.); (S.V.); (A.V.); (J.P.); (G.N.); (A.D.); (E.N.); (V.M.); (A.A.)
| | | | - Ilaria Mastrorosa
- Clinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (G.D.D.); (C.A.); (S.L.); (A.C.B.); (R.G.); (S.V.); (A.V.); (J.P.); (G.N.); (A.D.); (E.N.); (V.M.); (A.A.)
| | - Camilla Aguglia
- Clinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (G.D.D.); (C.A.); (S.L.); (A.C.B.); (R.G.); (S.V.); (A.V.); (J.P.); (G.N.); (A.D.); (E.N.); (V.M.); (A.A.)
- Department of System Medicine, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Simone Lanini
- Clinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (G.D.D.); (C.A.); (S.L.); (A.C.B.); (R.G.); (S.V.); (A.V.); (J.P.); (G.N.); (A.D.); (E.N.); (V.M.); (A.A.)
| | - Anna Clelia Brita
- Clinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (G.D.D.); (C.A.); (S.L.); (A.C.B.); (R.G.); (S.V.); (A.V.); (J.P.); (G.N.); (A.D.); (E.N.); (V.M.); (A.A.)
| | - Roberta Gagliardini
- Clinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (G.D.D.); (C.A.); (S.L.); (A.C.B.); (R.G.); (S.V.); (A.V.); (J.P.); (G.N.); (A.D.); (E.N.); (V.M.); (A.A.)
| | - Serena Vita
- Clinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (G.D.D.); (C.A.); (S.L.); (A.C.B.); (R.G.); (S.V.); (A.V.); (J.P.); (G.N.); (A.D.); (E.N.); (V.M.); (A.A.)
| | - Alessandra Vergori
- Clinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (G.D.D.); (C.A.); (S.L.); (A.C.B.); (R.G.); (S.V.); (A.V.); (J.P.); (G.N.); (A.D.); (E.N.); (V.M.); (A.A.)
| | - Jessica Paulicelli
- Clinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (G.D.D.); (C.A.); (S.L.); (A.C.B.); (R.G.); (S.V.); (A.V.); (J.P.); (G.N.); (A.D.); (E.N.); (V.M.); (A.A.)
| | - Giorgia Natalini
- Clinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (G.D.D.); (C.A.); (S.L.); (A.C.B.); (R.G.); (S.V.); (A.V.); (J.P.); (G.N.); (A.D.); (E.N.); (V.M.); (A.A.)
| | - Angela D’Urso
- Clinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (G.D.D.); (C.A.); (S.L.); (A.C.B.); (R.G.); (S.V.); (A.V.); (J.P.); (G.N.); (A.D.); (E.N.); (V.M.); (A.A.)
| | - Pierluca Piselli
- Department of Epidemiology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (P.P.); (F.V.)
| | - Paola Gallì
- Health Direction, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (P.G.); (V.M.)
| | - Vanessa Mondillo
- Health Direction, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (P.G.); (V.M.)
| | - Claudio Mastroianni
- Department of Public Health and Infectious Diseases, Sapienza University, AOU Policlinico Umberto 1, 00161 Rome, Italy;
| | - Enrica Tamburrini
- Fondazione Policlinico A. Gemelli, Catholic University of the Sacred Heart, 00168 Rome, Italy;
| | - Loredana Sarmati
- Department of System Medicine, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Christof Stingone
- STI/HIV Unit, San Gallicano IRCCS Dermatological Institute, 00144 Rome, Italy;
| | - Miriam Lichtner
- Neuroscience Mental Health and Sense Organs Department, Sapienza University of Rome, Polo Pontino, 04100 Latina, Italy;
| | - Emanuele Nicastri
- Clinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (G.D.D.); (C.A.); (S.L.); (A.C.B.); (R.G.); (S.V.); (A.V.); (J.P.); (G.N.); (A.D.); (E.N.); (V.M.); (A.A.)
| | | | | | - Andrea Siddu
- General Directorate of Prevention, Ministry of Health, 00197 Rome, Italy; (A.S.); (F.V.)
| | - Fabrizio Maggi
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy;
| | | | - Francesco Vairo
- Department of Epidemiology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (P.P.); (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, 00197 Rome, Italy; (A.S.); (F.V.)
| | - Enrico Girardi
- Scientific Direction, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy;
| | - Valentina Mazzotta
- Clinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (G.D.D.); (C.A.); (S.L.); (A.C.B.); (R.G.); (S.V.); (A.V.); (J.P.); (G.N.); (A.D.); (E.N.); (V.M.); (A.A.)
| | - Andrea Antinori
- Clinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (G.D.D.); (C.A.); (S.L.); (A.C.B.); (R.G.); (S.V.); (A.V.); (J.P.); (G.N.); (A.D.); (E.N.); (V.M.); (A.A.)
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12
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Lee D, Choi S, Do H, Chiara A, Kim MK, Chin B, Ryu S. Transmissibility of mpox to the general population from travellers returning to South Korea. J Travel Med 2023; 30:taad080. [PMID: 37306962 PMCID: PMC10481410 DOI: 10.1093/jtm/taad080] [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: 05/22/2023] [Revised: 06/05/2023] [Accepted: 06/05/2023] [Indexed: 06/13/2023]
Abstract
Based on data from three imported mpox cases in South Korea, the overall attack rate was determined to be 1%, while a secondary attack rate of 14% was estimated in the high-exposure group.
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Affiliation(s)
- Dayeong Lee
- Department of Preventive Medicine, Konyang University College of Medicine, Daejeon 35365, South Korea
| | - Sangbum Choi
- Department of Statistics, Korea University, Seoul 02841, South Korea
| | - Hyunkyung Do
- Department of Preventive Medicine, Konyang University College of Medicine, Daejeon 35365, South Korea
| | - Achangwa Chiara
- Department of Preventive Medicine, Konyang University College of Medicine, Daejeon 35365, South Korea
| | - Min-Kyung Kim
- Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Seoul 04564, South Korea
| | - BumSik Chin
- Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Seoul 04564, South Korea
| | - Sukhyun Ryu
- Department of Preventive Medicine, Konyang University College of Medicine, Daejeon 35365, South Korea
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Passini F, Raccagni AR, Diotallevi S, Lolatto R, Bruzzesi E, Candela C, Bertoni C, Trentacapilli B, Lucente MF, Castagna A, Nozza S. Mpox Outbreak 2022: A Comparative Analysis of the Characteristics of Individuals Receiving MVA-BN Vaccination and People Diagnosed with Mpox Infection in Milan, Italy. Pathogens 2023; 12:1079. [PMID: 37764887 PMCID: PMC10537006 DOI: 10.3390/pathogens12091079] [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: 07/13/2023] [Revised: 08/10/2023] [Accepted: 08/23/2023] [Indexed: 09/29/2023] Open
Abstract
Mpox caused a worldwide outbreak in 2022, disproportionately affecting MSM reporting high-risk sexual behaviors. The aim of this study was to compare the characteristics of people receiving MVA-BN vaccination with those of individuals diagnosed with mpox to guide future vaccination policies. This was a retrospective study on people with mpox infection or vaccination at San Raffaele Scientific Institute, Milan, Italy, from May to November 2022. Characteristics were compared using Mann-Whitney or chi-square/Fisher's exact tests; multivariable logistic regression and classification tree analysis were applied. Overall, 473 vaccinated individuals and 135 with mpox were included; 472/473 and 134/135 were MSM. People with mpox were more frequently living with HIV (48.9% vs. 22.4%, p < 0.001), had ≥1 previous STI (75.6% vs. 35.7%, p < 0.001), were chemsex users (37.8% vs. 6.34%, p < 0.001), were with a higher number of partners (23.0% vs. 1.69%, p < 0.001), and had engaged in group sex (55.6% vs. 24.1%, p < 0.001). At multivariable analysis, PLWH (aOR = 2.86, 95%CI = 1.59-5.19, p < 0.001), chemsex users (aOR = 2.96, 95%CI = 1.52-5.79, p = 0.001), those with previous syphilis (aOR = 4.11, 95%CI = 2.22-7.72, p < 0.001), and those with >10 partners (aOR = 11.56, 95%CI = 6.60-21.09, p < 0.001) had a higher risk of infection. This study underscores the importance of prioritizing MSM with prior STIs and multiple partners as well as chemsex users in vaccination policies to curb mpox spread. A destigmatized assessment of sexual history is vital for comprehensive sexual health strategies.
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Affiliation(s)
- Flavia Passini
- Infectious Diseases Unit, Vita-Salute San Raffaele University, 20132 Milan, Italy; (F.P.); (E.B.); (C.C.); (C.B.); (B.T.); (M.F.L.); (A.C.); (S.N.)
| | - Angelo Roberto Raccagni
- Infectious Diseases Unit, Vita-Salute San Raffaele University, 20132 Milan, Italy; (F.P.); (E.B.); (C.C.); (C.B.); (B.T.); (M.F.L.); (A.C.); (S.N.)
| | - Sara Diotallevi
- Infectious Diseases Unit, San Raffaele Scientific Institute, 20132 Milan, Italy; (S.D.); (R.L.)
| | - Riccardo Lolatto
- Infectious Diseases Unit, San Raffaele Scientific Institute, 20132 Milan, Italy; (S.D.); (R.L.)
| | - Elena Bruzzesi
- Infectious Diseases Unit, Vita-Salute San Raffaele University, 20132 Milan, Italy; (F.P.); (E.B.); (C.C.); (C.B.); (B.T.); (M.F.L.); (A.C.); (S.N.)
| | - Caterina Candela
- Infectious Diseases Unit, Vita-Salute San Raffaele University, 20132 Milan, Italy; (F.P.); (E.B.); (C.C.); (C.B.); (B.T.); (M.F.L.); (A.C.); (S.N.)
| | - Costanza Bertoni
- Infectious Diseases Unit, Vita-Salute San Raffaele University, 20132 Milan, Italy; (F.P.); (E.B.); (C.C.); (C.B.); (B.T.); (M.F.L.); (A.C.); (S.N.)
| | - Benedetta Trentacapilli
- Infectious Diseases Unit, Vita-Salute San Raffaele University, 20132 Milan, Italy; (F.P.); (E.B.); (C.C.); (C.B.); (B.T.); (M.F.L.); (A.C.); (S.N.)
| | - Maria Francesca Lucente
- Infectious Diseases Unit, Vita-Salute San Raffaele University, 20132 Milan, Italy; (F.P.); (E.B.); (C.C.); (C.B.); (B.T.); (M.F.L.); (A.C.); (S.N.)
| | - Antonella Castagna
- Infectious Diseases Unit, Vita-Salute San Raffaele University, 20132 Milan, Italy; (F.P.); (E.B.); (C.C.); (C.B.); (B.T.); (M.F.L.); (A.C.); (S.N.)
- Infectious Diseases Unit, San Raffaele Scientific Institute, 20132 Milan, Italy; (S.D.); (R.L.)
| | - Silvia Nozza
- Infectious Diseases Unit, Vita-Salute San Raffaele University, 20132 Milan, Italy; (F.P.); (E.B.); (C.C.); (C.B.); (B.T.); (M.F.L.); (A.C.); (S.N.)
- Infectious Diseases Unit, San Raffaele Scientific Institute, 20132 Milan, Italy; (S.D.); (R.L.)
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14
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Elhusseiny SM, Bebawy AS, Saad BT, Aboshanab KM. Insights on monkeypox disease and its recent outbreak with evidence of nonsynonymous missense mutation. Future Sci OA 2023; 9:FSO877. [PMID: 37485445 PMCID: PMC10357398 DOI: 10.2144/fsoa-2023-0048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/06/2023] [Indexed: 07/25/2023] Open
Abstract
The 2022 monkeypox outbreak has created a new global health threat and pandemic. Monkeypox virus is a descendant of the genus Orthopoxvirus, producing a febrile skin rash disease in humans. Monkeypox is zoonotic transmitted and transmitted from human to human in several ways. Even though this disease is self-limited, it creates important community health worries due to its inconvenience and widespread complications. Herein, we discussed the up-to-date current situation of monkeypox regarding its epidemiology, clinical manifestations, current in-use therapeutics, necessary protective measures, and response to potential occurrences considering the recent pandemic. Also, in this review, a comparative genomic analysis of the recent circulating strains that have been recovered from various countries including, Egypt, USA, Spain, Japan and South Africa has been investigated.
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Affiliation(s)
- Shaza M Elhusseiny
- Department of Microbiology & Immunology, Faculty of Pharmacy, Ahram Canadian University (ACU), 4th Industrial Area, 6th of October City, Cairo, 12566, Egypt
| | - Abraam S Bebawy
- Department of Genomics, HITS Solutions Co., Cairo, 11765, Egypt
| | - Bishoy T Saad
- Department of Bioinformatics, HITS Solutions Co., Cairo, 11765, Egypt
| | - Khaled M Aboshanab
- Department of Microbiology & Immunology, Faculty of Pharmacy, Ain Shams University, Organization of African Unity St., Cairo, Abbassia, 11566, Egypt
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15
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Rossotti R, Calzavara D, Cernuschi M, D'Amico F, De Bona A, Repossi R, Moschese D, Bossolasco S, Tavelli A, Muccini C, Mulé G, d'Arminio Monforte A. Detection of Asymptomatic Mpox Carriers among High-Ri Men Who Have Sex with Men: A Prospective Analysis. Pathogens 2023; 12:798. [PMID: 37375488 DOI: 10.3390/pathogens12060798] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
Mpox is traditionally considered a zoonotic disease with endemic circulation in Africa, but the 2022-2023 outbreak reached an unprecedented high number of cases in non-endemic countries, so that it was declared a public health emergency of international concern. The reasons for this extensive global spread, characterized by sexual transmission amongst men who have sex with men (MSM), have not been fully clarified. The existence of asymptomatic carriers with viable viral shedding might be an explanation and is under-debated after retrospective studies suggested that infection without symptoms might have a prevalence of 6.5%. We aimed to prospectively assess the presence of mpox infection in asymptomatic high-risk MSM using HIV pre-exposure prophylaxis and living with HIV. We selected individuals with no signs of active infection nor suggestive symptoms in the previous 21 days. Eligible individuals collected oral and anal swabs to undergo point-of-care testing for mpox and completed a 21-days follow-up. Seventy-two individuals were enrolled, and none tested positive for mpox infection nor developed symptoms during follow-up. We selected a high-risk population with a significant history of sexual exposure, but we failed to detect any asymptomatic infection. This observation might have important consequences in terms of contact management and epidemic control.
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Affiliation(s)
- Roberto Rossotti
- Department of Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy
- Milano Checkpoint, 20124 Milan, Italy
| | | | - Massimo Cernuschi
- Milano Checkpoint, 20124 Milan, Italy
- Department of Infectious Diseases, San Raffaele Scientific Institute, 20127 Milan, Italy
| | - Federico D'Amico
- Department of Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy
| | - Anna De Bona
- Milano Checkpoint, 20124 Milan, Italy
- Department of Infectious Diseases, ASST Santi Paolo e Carlo, 20142 Milan, Italy
| | | | - Davide Moschese
- Milano Checkpoint, 20124 Milan, Italy
- I Division of Infectious Diseases, ASST Fatebenefratelli-Sacco, 20157 Milan, Italy
| | - Simona Bossolasco
- Milano Checkpoint, 20124 Milan, Italy
- Department of Infectious Diseases, San Raffaele Scientific Institute, 20127 Milan, Italy
| | | | - Camilla Muccini
- Milano Checkpoint, 20124 Milan, Italy
- Department of Infectious Diseases, San Raffaele Scientific Institute, 20127 Milan, Italy
| | - Giovanni Mulé
- Milano Checkpoint, 20124 Milan, Italy
- Department of Infectious Diseases, ASST Santi Paolo e Carlo, 20142 Milan, Italy
| | - Antonella d'Arminio Monforte
- Department of Infectious Diseases, ASST Santi Paolo e Carlo, 20142 Milan, Italy
- ICONA Foundation, 20142 Milan, Italy
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