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Updated: Sep 15, 2025

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Roles of community and sexual contacts as drivers of clade I mpox outbreaks

Hiroaki Murayama1, Toshiaki R Asakura2,3,4, Borame L Dickens5

  • 1School of Medicine, International University of Health and Welfare, Narita, Japan.

Medrxiv : the Preprint Server for Health Sciences
|July 17, 2025
PubMed

Insights

The mpox clade Ib outbreak in the DRC shows sustained human transmission linked to sexual contacts, particularly involving female sex workers. Mathematical modeling suggests sexual contact dynamics explain its higher outbreak potential compared to clade Ia.

Area of Science:

  • Epidemiology
  • Mathematical Modeling
  • Public Health

Background:

  • A novel mpox (monkeypox) clade Ib outbreak has emerged in the Democratic Republic of the Congo (DRC).
  • This clade exhibits sustained human-to-human transmission, with epidemiological links to sexual contacts, notably involving female sex workers (FSWs).
  • These transmission patterns differ from previous clade Ia outbreaks.

Purpose of the Study:

  • To investigate the transmission dynamics of the mpox clade Ib outbreak in the DRC.
  • To quantify the role of sexual contacts versus community contacts in clade Ib's spread.
  • To compare the outbreak potential of clade Ib with clade Ia.

Main Methods:

  • Mathematical modeling was employed to analyze transmission.
  • Models incorporated age-dependent contact patterns.
  • The study differentiated between sexual and community contact networks.

Main Results:

  • Frequent sexual interactions were identified as a key driver of clade Ib transmission.
  • This additional transmission route helps explain the increased outbreak potential of clade Ib compared to clade Ia.
  • Findings highlight similarities to clade IIb transmission dynamics, primarily among men who have sex with men.

Conclusions:

  • Protecting key populations, such as FSWs for clade Ib, is crucial for controlling mpox outbreaks.
  • Understanding specific transmission routes is vital for targeted public health interventions.
  • The study underscores the importance of considering diverse contact patterns in mpox epidemiology.

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