TY - JOUR
T1 - Potential determinants of the decline in mpox cases in Belgium
T2 - A behavioral, epidemiological and seroprevalence study
AU - De Vos, Elise
AU - Van Gestel, Liesbeth
AU - Brosius, Isabel
AU - Kenyon, Chris
AU - Vuylsteke, Bea
AU - De Baetselier, Irith
AU - Mariën, Joachim
AU - Bangwen, Eugene
AU - Couvreur, Simon
AU - Lecompte, Amaryl
AU - Van Beckhoven, Dominique
AU - Hoorelbeke, Bart
AU - Verstrepen, Babs E.
AU - Zaeck, Luca M.
AU - de Vries, Rory D.
AU - Geurts van Kessel, Corine H.
AU - Hens, Niel
AU - Ariën, Kevin K.
AU - Vercauteren, Koen
AU - Van Esbroek, Marjan
AU - Van Dijck, Christophe
AU - Liesenborghs, Laurens
N1 - Publisher Copyright:
© 2024 The Author(s)
PY - 2024/9
Y1 - 2024/9
N2 - Objectives: The 2022 mpox epidemic reached a peak in Belgium and the rest of Europe in July 2022, after which it unexpectedly subsided. This study investigates epidemiological, behavioral, and immunological factors behind the waning of the epidemic in Belgium. Methods: We investigated temporal evolutions in the characteristics and behavior of mpox patients using national surveillance data and data from a prospective registry of mpox patients in the Institute of Tropical Medicine (Antwerp). We studied behavioral changes in the population at risk using a survey among HIV-preexposure prophylaxis (PrEP) users. We determined the seroprevalence of anti-orthopoxvirus antibodies among HIV-PrEP users across four-time points in 2022. Results: Mpox patients diagnosed at the end of the epidemic had less sexual risk behavior compared to those diagnosed earlier: they engaged less in sex at mass events, had fewer sexual partners, and were less likely to belong to the sexual network's central group. Among HIV-PrEP users there were no notable changes in sexual behavior. Anti-orthopoxvirus seroprevalence did not notably increase before the start of national vaccination campaigns. Conclusion: The observed changes in group immunity and behavior in the population at greater risk of exposure to mpox seem unable to explain the waning of the mpox epidemic. A change in the profile of mpox patients might have contributed to the decline in cases.
AB - Objectives: The 2022 mpox epidemic reached a peak in Belgium and the rest of Europe in July 2022, after which it unexpectedly subsided. This study investigates epidemiological, behavioral, and immunological factors behind the waning of the epidemic in Belgium. Methods: We investigated temporal evolutions in the characteristics and behavior of mpox patients using national surveillance data and data from a prospective registry of mpox patients in the Institute of Tropical Medicine (Antwerp). We studied behavioral changes in the population at risk using a survey among HIV-preexposure prophylaxis (PrEP) users. We determined the seroprevalence of anti-orthopoxvirus antibodies among HIV-PrEP users across four-time points in 2022. Results: Mpox patients diagnosed at the end of the epidemic had less sexual risk behavior compared to those diagnosed earlier: they engaged less in sex at mass events, had fewer sexual partners, and were less likely to belong to the sexual network's central group. Among HIV-PrEP users there were no notable changes in sexual behavior. Anti-orthopoxvirus seroprevalence did not notably increase before the start of national vaccination campaigns. Conclusion: The observed changes in group immunity and behavior in the population at greater risk of exposure to mpox seem unable to explain the waning of the mpox epidemic. A change in the profile of mpox patients might have contributed to the decline in cases.
UR - http://www.scopus.com/inward/record.url?scp=85199779101&partnerID=8YFLogxK
U2 - 10.1016/j.ijid.2024.107132
DO - 10.1016/j.ijid.2024.107132
M3 - Article
C2 - 38942168
AN - SCOPUS:85199779101
SN - 1201-9712
VL - 146
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
M1 - 107132
ER -