Quantification of the time-varying epidemic growth rate and of the delays between symptom onset and presenting to healthcare for the mpox epidemic in the UK in 2022.
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
26 08 2024
26 08 2024
Historique:
received:
04
11
2023
accepted:
19
07
2024
medline:
27
8
2024
pubmed:
27
8
2024
entrez:
26
8
2024
Statut:
epublish
Résumé
The mpox epidemic in the UK began in May 2022, with rates of new cases unexpectedly and rapidly declining during August 2022. Interpreting trends in infection requires disentangling the underlying growth rate of cases from the delay from symptom onset to presenting to healthcare. We developed a nowcasting Bayesian method which incorporates time-varying delays (EpiLine) to quantify the changes in the delay from symptom onset to healthcare presentation and the underlying mpox growth rate over the period May-August 2022 in the UK. We show that the mean delay between symptom onset and healthcare presentation for mpox in the UK decreased from 22 days in early May 2022 to 10 days by early June and 8 days in August 2022. When we account for these dynamic delays, the time-varying growth rate declined gradually and continuously in the UK during the May-August 2022 period. Not accounting for varying time delays would have incorrectly characterised the growth rate by a sharp increase followed by a rapid decline in mpox cases. Our results highlight the importance of correctly quantifying the delay between symptom onset to healthcare presentation when characterising the epidemic growth of mpox in the UK. The gradual reduction in the rate of epidemic spread, which pre-dated the vaccine roll-out, is consistent with gradual risk reduction or acquired immunity amongst the highest risk individuals. Our study highlights the need for public health agencies to record the delays from symptom onset to healthcare presentation early in an outbreak.
Identifiants
pubmed: 39187529
doi: 10.1038/s41598-024-68154-8
pii: 10.1038/s41598-024-68154-8
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
19755Informations de copyright
© 2024. The Author(s).
Références
Bunge, E. M. et al. The changing epidemiology of human monkeypox—A potential threat? A systematic review. PLoS Negl. Trop. Dis. 16(2), e0010141. https://doi.org/10.1371/journal.pntd.0010141 (2022).
doi: 10.1371/journal.pntd.0010141
pubmed: 35148313
pmcid: 8870502
UK Government Document, 2022a. Mpox cases confirmed in England. https://www.gov.uk/government/news/monkeypox-cases-confirmed-in-england-latest-updates
Iñigo Martínez, J. et al. Monkeypox outbreak predominantly affecting men who have sex with men, Madrid, Spain, 26 April to 16 June 2022. Euro Surveill. 27(27), 2200471. https://doi.org/10.2807/1560-7917.ES.2022.27.27.2200471 (2022).
doi: 10.2807/1560-7917.ES.2022.27.27.2200471
pubmed: 35801519
pmcid: 9264731
Ward, T., Christie, R., Paton, R. S., Cumming, F. & Overton, C. E. Transmission dynamics of monkeypox in the United Kingdom: Contact tracing study. BMJ 379, e073153. https://doi.org/10.1136/bmj-2022-073153 (2022).
doi: 10.1136/bmj-2022-073153
pubmed: 36323407
pmcid: 9627597
Thornhill, J. P. et al. Monkeypox virus infection in humans across 16 countries—April–June 2022. New Engl. J. Med. 387(8), 679–691. https://doi.org/10.1056/NEJMoa2207323 (2022).
doi: 10.1056/NEJMoa2207323
pubmed: 35866746
Miura, F. et al. Estimated incubation period for monkeypox cases confirmed in the Netherlands, May 2022. Euro Surveill. 27(24), 2200448. https://doi.org/10.2807/1560-7917.ES.2022.27.24.2200448 (2022).
doi: 10.2807/1560-7917.ES.2022.27.24.2200448
pubmed: 35713026
pmcid: 9205160
Brown, K. & Leggat, P. A. Human monkeypox: Current state of knowledge and implications for the future. Trop. Med. Infect. Dis. 1, 8. https://doi.org/10.3390/tropicalmed1010008 (2016).
doi: 10.3390/tropicalmed1010008
pubmed: 30270859
pmcid: 6082047
Vivancos, R. et al. Community transmission of monkeypox in the United Kingdom, April to May 2022. Euro Surveill. 27(22), 2200422. https://doi.org/10.2807/1560-7917.ES.2022.27.22.2200422 (2022).
doi: 10.2807/1560-7917.ES.2022.27.22.2200422
pubmed: 35656834
pmcid: 9164677
Epiline, 2022. https://github.com/BDI-pathogens/EpiLine .
Carpenter, B. et al. Stan: A probabilistic programming language. J. Stat. Softw. 76(1), 1–32. https://doi.org/10.18637/jss.v076.i01 (2017).
doi: 10.18637/jss.v076.i01
pubmed: 36568334
pmcid: 9788645
Brand, S. P. C. et al. The role of vaccination and public awareness in forecasts of Mpox incidence in the United Kingdom. Nat. Commun. 14, 4100. https://doi.org/10.1038/s41467-023-38816-8 (2023).
doi: 10.1038/s41467-023-38816-8
pubmed: 37433797
pmcid: 10336136
UK Government Document, 2022b. Mpox outbreak: vaccination strategy. https://www.gov.uk/guidance/monkeypox-outbreak-vaccination-strategy
UK Government Document, 2022c. Accelerated mpox vaccination rollout in London as UKHSA secure more vaccines. https://www.england.nhs.uk/2022/07/accelerated-monkeypox-vaccination-rollout-in-london-as-ukhsa-secure-more-vaccines/
UKHSA technical report: Investigation into mpox outbreak in England: technical briefing 3. https://www.gov.uk/government/publications/monkeypox-outbreak-technical-briefings/investigation-into-monkeypox-outbreak-in-england-technical-briefing-3#part-4-transmission-dynamics . Accessed November 10, 2022.
van Leeuwen, E., Panovska-Griffiths, J., Elgohari, S., Charlett, A. & Watson, C. The interplay between susceptibility and vaccine effectiveness control the timing and size of an emerging seasonal influenza wave in England. Epidemics 44, 100709. https://doi.org/10.1016/j.epidem.2023.100709 (2023).
doi: 10.1016/j.epidem.2023.100709
pubmed: 37579587
Abbott, S. et al. Estimating the time-varying reproduction number of SARS-CoV-2 using national and subnational case counts. Wellcome Open Res. 5, 112. https://doi.org/10.12688/wellcomeopenres.16006.2 (2020).
doi: 10.12688/wellcomeopenres.16006.2
Höhle, M. & van der Heiden, M. Bayesian nowcasting during the STEC O104:H4 outbreak in Germany, 2011. Biometrics. 70, 993–1002. https://doi.org/10.1111/biom.12194 (2014).
doi: 10.1111/biom.12194
pubmed: 24930473
van de Kassteele, J., Eilers, P. H. C. & Wallinga, J. Nowcasting the number of new symptomatic cases during infectious disease outbreaks using constrained P-spline smoothing. Epidemiology 30(5), 737–745. https://doi.org/10.1097/EDE.0000000000001050 (2019).
doi: 10.1097/EDE.0000000000001050
pubmed: 31205290
pmcid: 6684223
Flaxman, S. et al. Estimating the effects of non-pharmaceutical interventions on COVID-19 in Europe. Nature 584, 257–261. https://doi.org/10.1038/s41586-020-2405-7 (2020).
doi: 10.1038/s41586-020-2405-7
pubmed: 32512579
Ward, T. et al. Understanding the infection severity and epidemiological characteristics of mpox in the UK. Nat. Commun. 15, 2199. https://doi.org/10.1038/s41467-024-45110-8 (2024).
doi: 10.1038/s41467-024-45110-8
pubmed: 38467622
pmcid: 10928097