基因组流行病学揭示了纽约市由重尾性接触网络控制的 2022 年麻风病疫情

Jonathan E Pekar, Yu Wang, Jade C Wang, Yucai Shao, Faten Taki, Lisa A Forgione, Helly Amin, Tyler Cabby, Kimberly Johnson, Lucia V Torian, Sarah L Braunstein, Preeti Pathela, Enoma Omoregie, Scott Hughes, Marc A Suchard, Tetyana I Vasylyeva, Philippe Lemey, Joel O Wertheim
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引用次数: 0

摘要

2022 年的全球麻腮风疫情很可能是由麻腮风病毒(MPXV)通过性接触网络传播引起的,纽约市(NYC)是美国爆发最早、规模最大的城市。通过对 MPXV 进行系统地理学和流行病学分析,我们发现至少有 200 种 MPXV 被引入纽约市,其中 84 种导致了继续传播。通过与纽约市的人类免疫缺陷病毒(HIV)进行比较分析,我们发现 MPXV 和 HIV 基因组集群的大小都最符合无标度分布,而且 MPXV 集群中的人更有可能以前接受过 HIV 诊断(几率比=1.58;p=0.012),并且是最近不断扩大的 HIV 传播集群的成员,这表明性接触网络存在重叠。然后,我们建立了 MPXV 通过性接触网络传播的模型,结果表明,在疫情开始时,联系紧密的个体将不成比例地受到感染,从而可能导致性接触网络中联系最紧密的部分耗尽。这种态势解释了纽约市疫情迅速扩大和衰退的原因,也解释了在高危人群中累计发病率估计不到 2%的原因。通过将 MPXV 和 HIV 的基因组流行病学与流行病建模相结合,我们证明 MPXV 的传播动态可以用性传播病原体的一般原理来理解。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Genomic epidemiology reveals 2022 mpox epidemic in New York City governed by heavy-tailed sexual contact networks
The global mpox epidemic in 2022 was likely caused by transmission of mpox virus (MPXV) through sexual contact networks, with New York City (NYC) experiencing the first and largest outbreak in the United States. By performing a phylogeographic and epidemiological analysis of MPXV, we identify at least 200 introductions of MPXV into NYC and 84 leading to onward transmission. Through a comparative analysis with human immunodeficiency virus (HIV) in NYC, we find that both MPXV and HIV genomic cluster sizes are best fit by scale-free distributions and that people in MPXV clusters are more likely to have previously received an HIV diagnosis (odds ratio=1.58; p=0.012) and be a member of a recently growing HIV transmission cluster, indicating overlapping sexual contact networks. We then model the transmission of MPXV through sexual contact networks and show that highly connected individuals would be disproportionately infected at the start of an epidemic, thereby likely resulting in the exhaustion of the most densely connected parts of the sexual network. This dynamic explains the rapid expansion and decline of the NYC outbreak, as well as the estimated cumulative incidence of less than 2% within high-risk populations. By synthesizing the genomic epidemiology of MPXV and HIV with epidemic modeling, we demonstrate that MPXV transmission dynamics can be understood by general principles of sexually transmitted pathogens.
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