Investigation of a mpox outbreak in Central African Republic, 2021-2022

Besombes, Camille; Mbrenga, Festus; Malaka, Christian; Gonofio, Ella; Schaeffer, Laura; Konamna, Xavier; Sélékon, Benjamin; Namsenei-Dankpea, J.; Lemon, C. Gildas; Landier, Jordi; Platen, Cassandre Von; Gessain, Antoine; Manuguerra, Jean-Claude; Fontanet, Arnaud; Nakouné, Emmanuel

doi:10.1016/j.onehlt.2023.100523

Cited by 7 publications

(4 citation statements)

References 45 publications

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“…We estimated two different distributions for the serial interval (i.e., the time elapsed between the symptom onset in an index case and in their secondary cases). The first was obtained by pooling together symptom onset dates for 32 infector-infectee transmission links from two household outbreaks in South Sudan, 2005 9 (n=13) and in Central African Republic, 2021-2022 10 (n=19). The second estimate was obtained from 11 infector-infectee transmission links from a hospital-associated outbreak in the Republic of the Congo, 2003 11 .…”

Section: This Studymentioning

confidence: 99%

“… A) Cumulative density function of the incubation period, estimated from data on 15 cases reported in a published review 8 . B) Cumulative density function of the serial interval, estimated from data on 32 transmission links identified within household outbreaks 9,10 , and on data on 11 transmission links identified within a hospital outbreak 11 . C) Cumulative density function of the estimated generation time, based on the same data reported for the serial interval and on estimates of the incubation period.…”

Section: This Studymentioning

confidence: 99%

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Incubation period, serial interval, generation time and reproduction number of mpox clade I

Marziano,

Guzzetta,

Longini

et al. 2024

Preprint

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Section: This Studymentioning

confidence: 99%

Section: This Studymentioning

confidence: 99%

Incubation period, serial interval, generation time and reproduction number of mpox clade I

Marziano,

Guzzetta,

Longini

et al. 2024

Preprint

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“…Additionally, MPXV DNA was identified in the placenta and viral proteins were identified in the chorionic villi and fetal skin by immunohistochemistry ( 6, 7 ). The number of women impacted by clade I MPXV infection during pregnancy is unknown, but the risk to pregnant persons is serious and ongoing because there have been over 40 outbreaks in the Central African Republic alone since 2018 ( 8 ) and more than 19,000 cases in the Democratic Republic of Congo since 2023 ( 9 ). The outcomes of clade IIb MPXV infection during pregnancy are not well described, with few publications characterizing the outcomes of pregnant persons in the United States ( 10, 11 ).…”

Section: Introductionmentioning

confidence: 99%

Mpox virus (MPXV) vertical transmission and fetal demise in a pregnant rhesus macaque model

Krabbe,

Mitzey,

Bhattacharya

et al. 2024

Preprint

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Infection with clade I Mpox virus (MPXV) results in adverse pregnancy outcomes, yet the potential for vertical transmission resulting in fetal harm with clade IIb MPXV, the clade that is currently circulating in the Western Hemisphere, remains unknown. We established a rhesus macaque model of vertical MPXV transmission with early gestation inoculation. Three pregnant rhesus macaques were inoculated intradermally with 1.5 × 10^5 plaque forming units (PFU) of clade IIb MPXV near gestational day (GD) 30 and animals were monitored for viremia and maternal and fetal well-being. Animals were euthanized to collect tissues at 5, 14, or 25 days post-inoculation (dpi). Tissues were evaluated for viral DNA (vDNA) loads, infectious virus titers, histopathology, MPXV mRNA and protein localization, as well as MPXV protein co-localization with placental cells including, Hofbauer cells, mesenchymal stromal cells, endothelial cells, and trophoblasts. vDNA was detected in maternal blood and skin lesions by 5 dpi. Lack of fetal heartbeat was observed at 14 or 25 dpi for two dams indicating fetal demise; the third dam developed significant vaginal bleeding at 5 dpi and was deemed an impending miscarriage. vDNA was detected in placental and fetal tissue in both fetal demise cases. MPXV localized to placental villi by ISH and IHC. Clade IIb MPXV infection in pregnant rhesus macaques results in vertical transmission to the fetus and adverse pregnancy outcomes, like clade I MPXV. Further studies are needed to determine whether antiviral therapy with tecovirimat will prevent vertical transmission and improve pregnancy outcomes.One Sentence SummaryClade IIb Mpox virus infection of pregnant rhesus macaques results in vertical transmission from mother to fetus and adverse pregnancy outcomes.

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“…However, mpox SAR estimated since 2015 for persons in same households with index cases (not necessarily between sexual partners) have been much higher, 50-60% 27,28 . In sensitivity analysis to see if findings about control strategies were dependent on the transmission risk assumptions, we consider six fixed transmission risks (per sexual encounter): 6%, 12%, 24%, 36%, 48% and 60%.…”

mentioning

confidence: 99%

Evaluation of three control strategies to limit mpox outbreaks in an agent based model

Brainard,

Lake,

Hunter

2024

Preprint

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Most of the 2022 mpox outbreaks in high income countries, which predominantly affected men who have sex with men, peaked less than two months after detection. To stop the outbreaks, people were encouraged to limit new sex partners, take up any offers for smallpox vaccination, and self-isolate. The relative contributions of each of these strategies to outbreak reduction are hard to know. To consider the potential relative efficacy of each of these measures individually, we constructed agent-based models using plausible partnership counts, reasonable behaviour choices and published information about smallpox vaccination uptake rates in the UK context during 2022. Compared to a baseline, no intervention scenario, partner reduction was more effective at preventing generation of secondary cases than the vaccine rollout at the speed that the smallpox vaccine rollout occurred in the UK in 2022. These findings suggest that partner reduction by the most affected community rather than pharmaceutical intervention was largely to credit for causing case numbers to peak as early as they did.

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Investigation of a mpox outbreak in Central African Republic, 2021-2022

Cited by 7 publications

References 45 publications

Incubation period, serial interval, generation time and reproduction number of mpox clade I

Incubation period, serial interval, generation time and reproduction number of mpox clade I

Mpox virus (MPXV) vertical transmission and fetal demise in a pregnant rhesus macaque model

Evaluation of three control strategies to limit mpox outbreaks in an agent based model

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