Global Analysis of the 2022-2023 Mpox Outbreak: Demographics, Clinical Features, and Risk Factors for Hospitalization

Abstract

Background & aims of the study 

During the 2022-2023 multi-country mpox outbreak, the World Health Organization (WHO) and key stakeholders implemented a global surveillance system to collect aggregated and case-based information on mpox cases. We describe the mpox cases reported through this system from January 2022 to early June 2023. 

 Methods & results 

We analyzed demographic, clinical and transmission characteristics of reported mpox cases and identified risk factors for hospitalization using binary logistic regression.  

As of 11 June 2023, 87,979 mpox cases including 147 related deaths have been reported from 111 countries. The median age of affected individuals was 34 (IQR 29-41) years and most cases (96.2%; 78,150/81,201) were male, most of whom (84.1%; 25,949/30,858) self-identified as men who have sex with men (MSM). Sexual contact was reported as the primary route of transmission (82.0%, 16,435 /20,041). Among cases with available HIV status, 51.9% (16,601/15,360) were living with HIV, and of those with available data, 80.0% (4,078/5,119) were reported to be immunosuppressed. Among cases (n=34,332) where at least one symptom was reported, the most frequently reported symptoms were any rash (80.6%), fever (59.2%), genital rash (44.0%), headache (30.9%) and any lymphadenopathy (29.1%). Among cases with hospitalization information, 3,590 were hospitalized. Factors associated with higher odds of hospitalization included age <5 years (aOR [95% CI]= 1.94.23 [1.20-3.15]) or ≥65 years (aOR= 1.43 [0.98-2.08]); female sex (aOR= 1.64 [1.39-1.94]); living with HIV without immunosuppression  (aOR=1.42 [1.03-1.95]; persons reported as immunosuppressed by their clinician  (aOR= 4.13 [2.20-7.77]); and those with HIV and immunosuppression  (aOR= 1.77 [1.47-2.13]). 

Implications 

The analysis of the WHO global surveillance data yielded key insights for the ongoing mpox outbreak. These have guided the response by emphasizing risk communication for MSM, raising awareness of early disease signs, and highlighting the risk for immunosuppressed individuals, including those with HIV or other conditions. 

Note: This conference abstract was presented at the 9th International Conference on Infectious Disease Dynamics organized by the journal Epidemics. This abstract has not been screened by SSRN for potential for public harm and should not be used to inform any clinical decision making. No competing interests or funding statements have been declared.