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Peer reviewedOpen accessMonkeypox

Dynamics of global mpox epidemics, 1970–2025: a systematic review and meta-analysis of evolving transmissibility and intervention effects

BMJ Global Health·

Yin-Chien Lin, Tzai-Hung Wen, Wei-Liang Shih, Chia-Wei Liao, Sten H Vermund, Chi-Tai Fang

DOI
10.1136/bmjgh-2025-022252
PMID
PMCID
OpenAlex
Study type
Systematic review
Publisher
BMJ
Article type
journal-article
Integrity
current

Why this research matters now

Monitoring progressive changes in viral spread capabilities underscores the importance of timely, balanced resource distribution paired with localized educational initiatives to mitigate future transmission waves.

01

Structured evidence summary

Research question

What trends characterize the reproductive capacity of distinct mpox lineages over several decades, and how do combined public health measures influence infection trajectories?

Study design

A systematic review and meta-analysis aggregating reproduction number calculations and modelling evaluations sourced from major biomedical databases.

Population and setting

Literature documenting worldwide mpox circulation from 1970 to 2025, including regions experiencing historical clade activity and recent subclade expansions.

Main findings

Aggregated reproduction metrics demonstrated statistically significant upward shifts for both primary clades following the appearance of newer genetic variants after 2023. Concurrent implementation of adaptive behaviours and immunization campaigns corresponded with a notable drop in infection counts during the 2022 period, although magnitude differed according to regional rollout speeds and compliance levels.

Public-health relevance

Monitoring progressive changes in viral spread capabilities underscores the importance of timely, balanced resource distribution paired with localized educational initiatives to mitigate future transmission waves.

Important limitations

The pooled estimates exhibit substantial statistical heterogeneity, reflecting differences in local behavioural adaptations and the timing of medical countermeasure deployment across diverse environments.

GIDS interpretation

The manuscript compiles historical and recent epidemiological parameters alongside intervention outcome data, serving as a reference framework for situational awareness rather than an indicator of ongoing field activity.

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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.

03

Evidence relationships

This article has 8 auditable classifier relationships to diseases, places, topics, and study design.

about diseaseaddresses topicaddresses topicaddresses topicevaluates interventionstudied population settingstudies pathogenuses study design