Modelling the potential spread of Clade Ib MPXV in Asian cities
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Background
The ongoing 2023–2024 mpox outbreak in several African countries, driven by the novel Clade Ib strain, has resulted in imported cases reported in Sweden, Thailand, and India. The potentially high transmissibility of this new strain and shifts in transmission modes may make territories in Asia, which were minimally affected by previous mpox waves, vulnerable to community-wide transmission following importation. While this highlights the importance of early preparedness, current knowledge of the virus’s transmission dynamics remains too limited to effectively inform policy-making and resource planning.
Methods
A compartmental model was constructed to characterise the potential mpox transmission dynamics. Importation-triggered outbreaks were simulated in 37 Asian cities with one, three, and five initial local exposures. The impacts of various non-pharmaceutical interventions (NPIs), including isolation and quarantine, were projected and compared.
Findings
Simulated outbreak sizes varied substantially among the cities, with large-scale outbreaks expected in territories with high proportions of sexually active individuals at risk or low immunity from smallpox vaccines. Case count would increase linearly with initial exposures. In the scenario with three initial exposures, up to 58 cases per million residents were expected without interventions. Isolation for diagnosed cases would lower the outbreak size by up to 49.4%. Quarantining close contacts would further decrease cases by 30 percentage points over one year.
Interpretation
The potential mpox outbreak in Asia could be alleviated through strong surveillance and timely response. NPIs are recommended for outbreak management due to their demonstrated effectiveness and practicability.
