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Peer reviewedOpen accessMonkeypox

Potential determinants of the decline in mpox cases in Belgium: A behavioral, epidemiological and seroprevalence study

International Journal of Infectious Diseases·

Elise De Vos, Liesbeth Van Gestel, Isabel Brosius, Chris Kenyon, Bea Vuylsteke, Irith De Baetselier, Joachim Mariën, Eugene Bangwen, Simon Couvreur, Amaryl Lecompte, Dominique Van Beckhoven, Bart Hoorelbeke, Babs E. Verstrepen, Luca M. Zaeck, Rory D. de Vries, Corine H. Geurts van Kessel, Niel Hens, Kevin K. Ariën, Koen Vercauteren, Marjan Van Esbroek, Christophe Van Dijck, Laurens Liesenborghs

DOI
10.1016/j.ijid.2024.107132
PMID
38942168
PMCID
OpenAlex
W4400061964
Study type
Journal article
Publisher
Elsevier BV
Article type
journal-article
Integrity
current

Why this research matters now

Understanding which factors contributed to the waning of the 2022 mpox epidemic can inform outbreak response strategies and help anticipate future transmission dynamics in similar settings.

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Structured evidence summary

Research question

The study investigates epidemiological, behavioral, and immunological factors that may explain the decline in mpox cases in Belgium after the epidemic peaked in July 2022.

Study design

The authors combined national surveillance data, a prospective registry of mpox patients from the Institute of Tropical Medicine in Antwerp, a behavioral survey among HIV pre-exposure prophylaxis users, and seroprevalence measurements of anti-orthopoxvirus antibodies across four time points in 2022.

Population and setting

The study focused on mpox patients and individuals at greater risk of exposure, specifically HIV pre-exposure prophylaxis users, in Belgium during 2022.

Main findings

Mpox patients diagnosed later in the epidemic reported lower sexual risk behavior, including fewer sexual partners, less sex at mass gatherings, and lower likelihood of belonging to the central sexual network. No substantial changes in sexual behavior were observed among HIV-PrEP users, and anti-orthopoxvirus seroprevalence did not increase notably before national vaccination campaigns began. The changes in immunity and behavior among the at-risk population appear insufficient to explain the epidemic decline, but shifts in the profile of mpox patients may have contributed.

Public-health relevance

Understanding which factors contributed to the waning of the 2022 mpox epidemic can inform outbreak response strategies and help anticipate future transmission dynamics in similar settings.

Important limitations

This summary relies on the supplied single-article abstract and metadata. The original paper is required for decision-grade interpretation of methodology, confounders, selection bias in registry and survey populations, and causal inference regarding the epidemic decline.

GIDS interpretation

The article was classified under Monkeypox and Belgium, making it discoverable through disease-specific and geographic queries. It provides context on behavioral and immunological changes during the 2022 mpox outbreak but does not directly link to active surveillance signals.

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Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

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Evidence relationships

This article has 6 auditable classifier relationships to diseases, places, topics, and study design.

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