Emergence of mpox in Oman: investigating the first cluster and its implications, October 2023

The mpox virus, a member of the orthopoxvirus genus of the Poxviridae family, is the source of this newly recognized viral zoonotic illness. Before October 2023, no mpox cases were reported in Oman. This study describes the first confirmed case of mpox and a related family cluster from North Batinah Governorate. This study aimed to describe the clinical and epidemiologic investigations of the first mpox case and cluster in Oman, including the identification of infection sources; assessing the transmission prevention measures in place for health care settings and the community; and providing recommendations for improving public health measures for the prevention, detection, and response to the emerging threat of mpox.

An outbreak investigation study was conducted involving all three confirmed cases of mpox in October 2023 in North Batinah Governorate, using a previously prepared form for epidemiological investigation of the cases and another form for detailed contact tracing.

The results showed that all three cases were from the same family from Sohar Willayat infected with mpox clade IIb. The possible source of infection for the index case was not declared but was potentially travel-related. Transmission to secondary cases occurs through droplets, direct contact, and bedding within households. All contacts were identified and followed up for 21 days, and no secondary cases occurred outside the household.

Travel-related exposure appeared to be a significant factor in the outbreak of clade IIb in Oman. This investigation serves as a practical exercise for public health preparedness, emphasizing the importance of an adaptive health system. Ensuring robust detection and response measures while accounting for patient privacy, cultural contexts, and available resources, such as institutional quarantine for contacts, is crucial for effectively managing emerging infectious diseases.