{"title":"Risk of evolution driven population-wide emergence of mpox: The paradoxic effect of moderate interventions","authors":"F. Nedényi , J.M. Benke , M. Szalai , G. Röst","doi":"10.1016/j.jiph.2025.102799","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>The global mpox outbreak in 2022 was declared a public health emergency of international concern. While in non-endemic countries disease spread remained limited mostly to a high risk group, a main public health concern is that through evolution, mpox gains the ability to widely spread in the entire population.</div></div><div><h3>Methods</h3><div>We construct a stochastic epidemiological model of SEIR type, to investigate the spread of mpox primarily propagating within a core population — consisting of MSM individuals having multiple sexual partners — before affecting the general population. We examine how effective various intervention strategies are in preventing this from happening. These non-pharmaceutical interventions include reducing disease transmission in the core population, in the general population, or in both. Our analysis encompasses the optimal timing for these interventions, considering the effects of early versus late intervention and the potential impact of different mutation patterns on disease spread.</div></div><div><h3>Results</h3><div>Our findings highlight that effective early intervention can be achieved with lower intensity, while delayed intervention requires stronger measures. Notably, our results reveal an intriguing phenomenon where moderate intervention could lead to worse outcome than no intervention. This counterintuitive outcome arises because moderate reductions may prolong transmission chains within the core group, leading to more opportunities for the pathogen to acquire mutations resulting in higher transmission potential in the general population.</div></div><div><h3>Conclusions</h3><div>A comprehensive understanding of the role of the core group in disease dynamics and the mutation patterns are crucial for developing tailored and effective public health strategies. The moderate intervention paradox suggests that to minimize the risk of population-wide emergence, it must be ensured that targeted interventions are highly efficient.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"18 8","pages":"Article 102799"},"PeriodicalIF":4.0000,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Infection and Public Health","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1876034125001480","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0
Abstract
Background
The global mpox outbreak in 2022 was declared a public health emergency of international concern. While in non-endemic countries disease spread remained limited mostly to a high risk group, a main public health concern is that through evolution, mpox gains the ability to widely spread in the entire population.
Methods
We construct a stochastic epidemiological model of SEIR type, to investigate the spread of mpox primarily propagating within a core population — consisting of MSM individuals having multiple sexual partners — before affecting the general population. We examine how effective various intervention strategies are in preventing this from happening. These non-pharmaceutical interventions include reducing disease transmission in the core population, in the general population, or in both. Our analysis encompasses the optimal timing for these interventions, considering the effects of early versus late intervention and the potential impact of different mutation patterns on disease spread.
Results
Our findings highlight that effective early intervention can be achieved with lower intensity, while delayed intervention requires stronger measures. Notably, our results reveal an intriguing phenomenon where moderate intervention could lead to worse outcome than no intervention. This counterintuitive outcome arises because moderate reductions may prolong transmission chains within the core group, leading to more opportunities for the pathogen to acquire mutations resulting in higher transmission potential in the general population.
Conclusions
A comprehensive understanding of the role of the core group in disease dynamics and the mutation patterns are crucial for developing tailored and effective public health strategies. The moderate intervention paradox suggests that to minimize the risk of population-wide emergence, it must be ensured that targeted interventions are highly efficient.
期刊介绍:
The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other.
The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners.
It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.