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

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 EsbroekChristophe Van Dijck, Laurens Liesenborghs

*Corresponding author for this work

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Abstract

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.

Original languageEnglish
Article number107132
JournalInternational Journal of Infectious Diseases
Volume146
DOIs
Publication statusPublished - Sept 2024

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Publisher Copyright:
© 2024 The Author(s)

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