The decline of the 2022 Italian mpox epidemic: Role of behavior changes and control strategies

Giorgio Guzzetta, Valentina Marziano, Alessia Mammone, Andrea Siddu, Federica Ferraro, Anna Caraglia, Francesco Maraglino, Giovanni Rezza, Alessandro Vespignani, Ira Longini, Marco Ajelli and Stefano Merler ()
Additional contact information
Giorgio Guzzetta: Bruno Kessler Foundation
Valentina Marziano: Bruno Kessler Foundation
Alessia Mammone: Ministry of Health
Andrea Siddu: Ministry of Health
Federica Ferraro: Ministry of Health
Anna Caraglia: Ministry of Health
Francesco Maraglino: Ministry of Health
Giovanni Rezza: Ministry of Health
Alessandro Vespignani: Northeastern University
Ira Longini: University of Florida
Marco Ajelli: Indiana University School of Public Health
Stefano Merler: Bruno Kessler Foundation

Nature Communications, 2024, vol. 15, issue 1, 1-9

Abstract: Abstract In 2022, a global outbreak of mpox occurred, predominantly impacting men who have sex with men (MSM). The rapid decline of this epidemic is yet to be fully understood. We investigated the Italian outbreak by means of an individual-based mathematical model calibrated to surveillance data. The model accounts for transmission within the MSM sexual contact network, in recreational and sex clubs attended by MSM, and in households. We indicate a strong spontaneous reduction in sexual transmission (61-87%) in affected MSM communities as the possible driving factor for the rapid decline in cases. The MSM sexual contact network was the main responsible for transmission (about 80%), with clubs and households contributing residually. Contact tracing prevented about half of the potential cases, and a higher success rate in tracing contacts could significantly amplify its effectiveness. Notably, immunizing the 23% of MSM with the highest sexual activity (10 or more partners per year) could completely prevent new mpox resurgences. This research underscores the importance of augmenting contact tracing, targeted immunization campaigns of high-risk groups, and fostering reactive behavioral changes as key strategies to manage and prevent the spread of emerging sexually transmitted pathogens like mpox within the MSM community.

Date: 2024
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DOI: 10.1038/s41467-024-46590-4

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