Global Mpox outbreaks: A comprehensive epidemiological assessment (2022-2024)

The global outbreak of monkeypox (Mpox) in humans has become a substantial public health concern, with over 115,000 confirmed cases across 126 territories worldwide between May 2022 and November 2024. In this context, we examined the basic reproduction number (R₀), doubling time, case fatality rate, and inter-country connectivity of ongoing outbreaks documented in Our World in Data portal.

Epidemiological parameters R₀ and doubling time were examined using a 9-day mean infectious period. Networks were analyzed using correlation and co-occurrence of outbreaks. The disease hub regions were examined using connectivity graphs' degree and betweenness centrality measures. Furthermore, spatial autocorrelation analysis was performed using Moran's I to assess distribution trends.

The R₀ and doubling time varied across regions, with a global mean of 1.046 and 373.12 days, respectively. This finding suggests that sustained transmission is limited; however, the potential for exponential spread of disease outbreaks persists. Global spatial autocorrelation analysis revealed moderate clustering of Mpox cases (Moran's I = 0.067, p-value = 0.075). Outbreak connectivity analysis revealed significant intercountry disease spread, indicating rapid cross-border transmission. Countries such as Germany, the United States, Australia, Italy, Belgium, and Spain were identified as disease-controlling hubs. The results also show the interconnectedness of global cases identified by network analysis.

Understanding outbreak dynamics, global spatial distribution patterns, and connectivity is essential for advancing the One Health approach and mitigating future disease risks. The findings reveal the risk of global Mpox transmission, emphasizing the need for continued surveillance, contact tracing, quarantine measures, and global collaboration to help curtail the global spread of Mpox.