Monkeypox: a review of epidemiological modelling studies and how modelling has led to mechanistic insight

Abstract

Human monkeypox (mpox) virus is a viral zoonosis that belongs to the Orthopoxvirus genus of the Poxviridae family, which presents with similar symptoms as those seen in human smallpox patients. Mpox is an increasing concern globally, with over 80,000 cases in non-endemic countries as of December 2022. In this review, we provide a brief history and ecology of mpox, its basic virology, and the key differences in mpox viral fitness traits before and after 2022. We summarize and critique current knowledge from epidemiological mathematical models, within-host models, and between-host transmission models using the One Health approach, where we distinguish between models that focus on immunity from vaccination, geography, climatic variables, as well as animal models. We report various epidemiological parameters, such as the reproduction number, R 0, in a condensed format to facilitate comparison between studies. We focus on how mathematical modelling studies have led to novel mechanistic insight into mpox transmission and pathogenesis. As mpox is predicted to lead to further infection peaks in many historically non-endemic countries, mathematical modelling studies of mpox can provide rapid actionable insights into viral dynamics to guide public health measures and mitigation strategies.

Attitudes towards Receiving Monkeypox Vaccination: A Systematic Review and Meta-Analysis

“…As reported by the WHO, it is evident that the dynamics of Mpox transmission are undergoing significant shifts. Historically endemic to West or Central Africa [ 43 ], the re-emergence of the virus in Nigeria in 2017 underscored the potential for resurgence and inter-human transmission within familiar territories. However, the sudden rise in Mpox cases in Europe by May 2022, an area previously unaffected, led to swift governmental actions, encompassing an extensive educational paradigm and an expedited vaccine dissemination strategy [ 44 ].…”

“…As reported by the WHO, it is evident that the dynamics of Mpox transmission are undergoing significant shifts. Historically endemic to West or Central Africa [43], the reemergence of the virus in Nigeria in 2017 underscored the potential for resurgence and…”

Mpox: An Overview of Pathogenesis, Diagnosis, and Public Health Implications

“…and "Could it be another threat?" [1]. Analyses must be robust, avoiding misleading inference due to strong and unreliable modeling assumptions [2,3], and thus must employ statistical methodologies aligned with surveillance conditions and be designed to address data quality and management challenges for enhanced modeling efficacy [4].…”

Supercritical and homogenous transmission of monkeypox in the capital of China

“…To estimate the development of Mpox epidemic and to design appropriate control measures, it is essential to understand the dynamics of Mpox transmission in mainland China. Since the 2022 Mpox outbreaks in several countries, a variety of quantitative models, including compartment models, branching process models, agent‐based models, network models, and logistic model, have been used to characterize the transmission of Mpox in Europe, America, and other areas 5–8 . These models contained assumptions about the transmission of Mpox with varying degrees of complexity and could therefore be useful in estimating transmission‐related quantities such as the effective reproduction number (denoted as R e ) at different scales or under different conditions.…”