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A global systematic evidence review with meta-analysis of the epidemiological characteristics of the 2022 Mpox outbreaks

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Abstract

Background

In 2022, there were outbreaks of Mpox where the disease is not endemic. We summarized published full-text epidemiological data from the outbreaks.

Methods

A global evidence review (protocol: osf.io/j3kb7) with systematic literature search up to February 09, 2023. We focused on experimental/observational studies of laboratory confirmed Mpox, excluding case reports and case series of < 5 cases. Epidemiological data were pooled using an inverse variance, random-effects model, and pooled estimates presented with associated 95% confidence intervals.

Results

We included 66 studies. Mean incubation period was 7.8 days (6.6–9.0 days, 8 studies: 560 cases), reproductive number 1.8 (1.7–1.9, 6 studies), mean duration from symptom onset to diagnosis 5.8 days (4.8–6.8 days, 4 studies: 982 cases), mean symptom duration 17.5 days (14.7–20.2 days, 3 studies: 292 cases), mean serial interval 8.5 days (7.3–9.9 days, 1 study), hospitalisation 6% (4–9%, 26 studies: 5339 cases), and vaccine effectiveness 78% (65–91%, 3 studies: 953 cases). Highly relevant clinical manifestations were pleomorphic skin lesions 82% (68–94%, 26 studies: 4093 cases), anogenital lesions 64% (51–77%, 9 studies: 10,398 cases), fever 54% (50–57%, 52 studies: 25,992 cases), and lymphadenopathy 51% (46–57%, 42 studies: 17,803 cases), with cases mostly men who have sex with men (MSM). Possibly relevant manifestations were perianal lesions, fatigue, asthenia, myalgia, and headache.

Conclusions

The 2022 Mpox outbreaks presented with sex-related clinical manifestations and were mostly reported among MSM.

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Data availability

All data for this study are presented in the manuscript and as supplementary information.

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Acknowledgements

The authors would like to thank Tyler Ostapyk, MLIS of the University of Manitoba for the peer review of our electronic literature search strategies.

Funding

This study received no specific funding.

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Authors and Affiliations

  1. George & Fay Yee Centre for Healthcare Innovation, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, R3E 0T6, Canada

    George N. Okoli & Ahmed M. Abou-Setta

  2. College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada

    George N. Okoli

  3. Department of Medical Microbiology & Infectious Diseases, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada

    Paul Van Caeseele

  4. Cadham Provincial Laboratory, Winnipeg, MB, Canada

    Paul Van Caeseele

  5. Neil John Maclean Library, University of Manitoba, Winnipeg, MB, Canada

    Nicole Askin

  6. Department of Community Health Sciences, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada

    Ahmed M. Abou-Setta

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  1. George N. Okoli
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  2. Paul Van Caeseele
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  3. Nicole Askin
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  4. Ahmed M. Abou-Setta
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Contributions

Conceptualization (GNO & AMA-S); methodology (GNO, NA, PC & AMA-S); data acquisition (GNO, NA, & AMA-S); formal analysis (GNO); draft manuscript (GNO); manuscript revisions (GNO, NA, PC & AMA-S); guarantor (GNO). The corresponding author (the manuscript’s guarantor) attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.

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Correspondence to George N. Okoli.

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Okoli, G.N., Van Caeseele, P., Askin, N. et al. A global systematic evidence review with meta-analysis of the epidemiological characteristics of the 2022 Mpox outbreaks. Infection (2023). https://doi.org/10.1007/s15010-023-02133-5

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