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Abstract

Background

Locally-acquired mpox cases were rarely reported outside Africa until May 2022, when locally-acquired-mpox cases occurred in various European countries.

Aim

We describe the mpox epidemic in France, including demographic and behavioural changes among a subset of cases, during its course.

Methods

Data were retrieved from the enhanced national surveillance system until 30 September 2022. Laboratory-confirmed cases tested positive for monkeypox virus or orthopoxviruses by PCR; non-laboratory-confirmed cases had clinical symptoms and an epidemiological link to a laboratory-confirmed case. A subset of ≥ 15-year-old male cases, notified until 1 August, was interviewed for epidemiological, clinical and sexual behaviour information. Association of symptom-onset month with quantitative outcomes was evaluated by t- or Wilcoxon tests, and with binary outcomes, by Pearson’s chi-squared or Fisher exact tests.

Results

A total of 4,856 mpox cases were notified, mostly in Île-de-France region (62%; 3,025/4,855). Cases aged ≥ 15 years were predominantly male (97%; 4,668/4,812), with 37 years (range: 15–81) as mean age. Between May and July, among the subset interviewed, mpox cases increased in regions other than Île-de-France, and mean age rose from 35 (range: 21–64) to 38 years (range: 16–75; p = 0.007). Proportions of cases attending men-who-have-sex-with-men (MSM) meeting venues declined from 60% (55/91) to 46% (164/359; p = 0.012); median number of sexual partners decreased from four (interquartile range (IQR): 1–10) to two (IQR: 1–4; p < 0.001).

Conclusion

Changes in cases’ characteristics during the epidemic, could reflect virus spread from people who were more to less behaviourally vulnerable to mpox between May and July, or MSM reducing numbers of sexual partners as recommended.

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2023-12-14
2024-11-21
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2023.28.50.2200923
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References

  1. Roth C. Smallpox and other poxvirus diseases, in Control of communicable diseases manual. D.L. Heymann, Editor. Washington DC: American Public Health Association; 2015. p. 565-9.
  2. Centers for Disease Control and Prevention (CDC). 2022 Mpox. 2023; Atlanta: CDC; 2023.Last update: 2 Feb, 2023. [Accessed 3 Apr 2023]. Available from: https://www.cdc.gov/poxvirus/mpox/if-sick/transmission.html
  3. Miura F, van Ewijk CE, Backer JA, Xiridou M, Franz E, de Coul EO, et al. The incubation period for monkeypox cases confirmed in the Netherlands, May 2022. medRxiv, 2022.
  4. Bunge EM, Hoet B, Chen L, Lienert F, Weidenthaler H, Baer LR, et al. The changing epidemiology of human monkeypox-A potential threat? A systematic review. PLoS Negl Trop Dis. 2022;16(2):e0010141.  https://doi.org/10.1371/journal.pntd.0010141  PMID: 35148313 
  5. Reynolds MG, Yorita KL, Kuehnert MJ, Davidson WB, Huhn GD, Holman RC, et al. Clinical manifestations of human monkeypox influenced by route of infection. J Infect Dis. 2006;194(6):773-80.  https://doi.org/10.1086/505880  PMID: 16941343 
  6. UK Health Security Agency (UKHSA). Monkeypox cases confirmed in England — latest updates. London: UKHSA. Last update: 14 May 2022. [Accessed 27 Sep 2022]. Available from: https://www.gov.uk/government/news/monkeypox-cases-confirmed-in-england-latest-updates
  7. Centers for Disease Control and Prevention (CDC). 2022 Monkeypox Outbreak Global Map. Atlanta: CDC; 2022. Last update: 23 Sep 2022. [Accessed 26 Sep 2022]. Available from: https://www.cdc.gov/poxvirus/monkeypox/response/2022/world-map.html
  8. Santé publique France (SpF). Monkeypox. 2022. Last update: 13 Sep 2022. Saint Maurice: SpF. [Accessed 29 Sep 2022]. Available from: https://www.santepubliquefrance.fr/maladies-et-traumatismes/maladies-transmissibles-de-l-animal-a-l-homme/monkeypox/donnees/#tabs
  9. Philpott D, Hughes CM, Alroy KA, Kerins JL, Pavlick J, Asbel L, et al. , CDC Multinational Monkeypox Response Team. Epidemiologic and Clinical Characteristics of Monkeypox Cases - United States, May 17-July 22, 2022. MMWR Morb Mortal Wkly Rep. 2022;71(32):1018-22.  https://doi.org/10.15585/mmwr.mm7132e3  PMID: 35951487 
  10. Tarín-Vicente EJ, Alemany A, Agud-Dios M, Ubals M, Suñer C, Antón A, et al. Clinical presentation and virological assessment of confirmed human monkeypox virus cases in Spain: a prospective observational cohort study. Lancet. 2022;400(10353):661-9.  https://doi.org/10.1016/S0140-6736(22)01436-2  PMID: 35952705 
  11. Bragazzi NL, Kong JD, Mahroum N, Tsigalou C, Khamisy-Farah R, Converti M, et al. Epidemiological trends and clinical features of the ongoing monkeypox epidemic: A preliminary pooled data analysis and literature review. J Med Virol. 2023;95(1):e27931.  https://doi.org/10.1002/jmv.27931  PMID: 35692117 
  12. Haute Autorité de Santé (HAS). Avis n°2022.0034/SESP du 20 mai 2022 du collège de la Haute Autorité de santé relatif à la vaccination contre le virus Monkeypox. [High Authority of Health advice n°2022.0034/SESP of May 20, 2022 relating to vaccination against mpox virus]. Saint-Denis La Plaine: HAS; 2022.
  13. Le Centre régional d'information et de prévention du sida et pour la santé des jeunes (CRIPS). Sexualité et loi. [Sexuality and law]. 2022. Last update: 26 Sep 2022. [Accessed 5 Oct 2022]. Available from: https://www.lecrips-idf.net/sexualite-loi-france
  14. Li Y, Zhao H, Wilkins K, Hughes C, Damon IK. Real-time PCR assays for the specific detection of monkeypox virus West African and Congo Basin strain DNA. J Virol Methods. 2010;169(1):223-7.  https://doi.org/10.1016/j.jviromet.2010.07.012  PMID: 20643162 
  15. Velter A, Ousseine YM, Duchesne L, Lydie N. Non-use of combination HIV prevention tools and its determinants among men who have sex with men living in France. Infect Dis Now. 2022;52(6):341-8.  https://doi.org/10.1016/j.idnow.2022.06.002  PMID: 35753627 
  16. Danta M, Brown D, Bhagani S, Pybus OG, Sabin CA, Nelson M, et al. , HIV and Acute HCV (HAAC) group. Recent epidemic of acute hepatitis C virus in HIV-positive men who have sex with men linked to high-risk sexual behaviours. AIDS. 2007;21(8):983-91.  https://doi.org/10.1097/QAD.0b013e3281053a0c  PMID: 17457092 
  17. Iñigo Martínez J, Gil Montalbán E, Jiménez Bueno S, Martín Martínez F, Nieto Juliá A, Sánchez Díaz J, et al. Monkeypox outbreak predominantly affecting men who have sex with men, Madrid, Spain, 26 April to 16 June 2022. Euro Surveill. 2022;27(27):2200471.  https://doi.org/10.2807/1560-7917.ES.2022.27.27.2200471  PMID: 35801519 
  18. Au NH, Portillo MT, Marwah A, Thomas-Bachli A, Demarsh PA, Khan K, et al. Potential for monkeypox exportation from West and Central Africa through global travel networks. J Travel Med. 2022;29(6):taac072.  https://doi.org/10.1093/jtm/taac072  PMID: 35642580 
  19. Delaney KP, Sanchez T, Hannah M, Edwards OW, Carpino T, Agnew-Brune C, et al. Strategies Adopted by Gay, Bisexual, and Other Men Who Have Sex with Men to Prevent Monkeypox virus Transmission - United States, August 2022. MMWR Morb Mortal Wkly Rep. 2022;71(35):1126-30.  https://doi.org/10.15585/mmwr.mm7135e1  PMID: 36048582 
  20. Lorente N, Demoulin B, Marcellin F, Dray-Spira R. Spire B et le groupe Vespa2. Comportements sexuels des personnes vivant avec le VIH en France en 2011: premiers résultats de l’enquête ANRS-Vespa2. Bull Epidémiol Hebd. 2013;26-27:307-14.
  21. Thornhill JP, Barkati S, Walmsley S, Rockstroh J, Antinori A, Harrison LB, et al. , SHARE-net Clinical Group. Monkeypox virus infection in humans across 16 countries—April–June 2022. N Engl J Med. 2022;387(8):679-91.  https://doi.org/10.1056/NEJMoa2207323  PMID: 35866746 
  22. León-Figueroa DA, Barboza JJ, Garcia-Vasquez EA, Bonilla-Aldana DK, Diaz-Torres M, Saldaña-Cumpa HM, et al. Epidemiological situation of monkeypox transmission by possible sexual contact: a systematic review. Trop Med Infect Dis. 2022;7(10):267.  https://doi.org/10.3390/tropicalmed7100267  PMID: 36288008 
  23. Vaughan AM, Cenciarelli O, Colombe S, Alves de Sousa L, Fischer N, Gossner CM, et al. A large multi-country outbreak of monkeypox across 41 countries in the WHO European Region, 7 March to 23 August 2022. Euro Surveill. 2022;27(36):2200620.  https://doi.org/10.2807/1560-7917.ES.2022.27.36.2200620  PMID: 36082686 
  24. Lapa D, Carletti F, Mazzotta V, Matusali G, Pinnetti C, Meschi S, et al. , INMI Monkeypox Study Group. Monkeypox virus isolation from a semen sample collected in the early phase of infection in a patient with prolonged seminal viral shedding. Lancet Infect Dis. 2022;22(9):1267-9.  https://doi.org/10.1016/S1473-3099(22)00513-8  PMID: 35931095 
  25. van Ewijk CE, Miura F, van Rijckevorsel G, de Vries HJC, Welkers MRA, van den Berg OE, et al. Monkeypox outbreak in the Netherlands in 2022: public health response, epidemiological and clinical characteristics of the first 1000 cases and protection of the first-generation smallpox vaccine. medRxiv, 2022 . https://doi.org/10.1101/2022.10.20.22281284 
  26. Curran KG, Eberly K, Russell OO, Snyder RE, Phillips EK, Tang EC, et al. , Monkeypox, HIV, and STI Team. HIV and Sexually Transmitted Infections Among Persons with Monkeypox - Eight U.S. Jurisdictions, May 17-July 22, 2022. MMWR Morb Mortal Wkly Rep. 2022;71(36):1141-7.  https://doi.org/10.15585/mmwr.mm7136a1  PMID: 36074735 
  27. AIDES. AIDES Membre de la Coalition Internationale Sida. Variole du Singe: toutes nos recommandations pour réduire les risques 2022. [Mpox: all our recommendations to reduce the risks 2022]. Town: AIDES; 2022. [Accessed 4 Nov 2022]. Available from: https://www.aides.org/fiche-pratique/variole-du-singe-toutes-nos-recommandations-pour-reduire-les-risques
  28. Sida Info Service (SIS-Association). Monkeypox info service. 2022. [Accessed 11 Oct 2022]. Available from: https://www.monkeypox-info-service.fr/
  29. Santé publique France (SpF). Sexosafe. 2022. Saint Maurice: SpF. [Accessed 11 Oct 2022]. Available from: https://www.sexosafe.fr/
  30. Haute Autorité de Santé (HAS). Avis n°2022.0037/AC/SESPEV du 16 juin 2022 du collège de la Haute Autorité de santé relatif à la vaccination des primovaccinés et des populations pédiatriques contre le virus Monkeypox. [High Authority of Health advice n°2022.0037/AC/SESPEV of June 16, 2022 relating to mpox vaccination of populations with a first vaccination and paediatric populations]; 2022. Saint-Denis La Plaine: HAS.
  31. Haute Autorité de Santé (HAS). Avis n°2022.0039/AC/SESPEV du 7 juillet 2022 du collège de la Haute Autorité de santé relatif à la vaccination contre le virus Monkeypox en préexposition des personnes à haut risque d’exposition. [High Authority Health advice relating to Monkeypox vaccination as prophylaxis amongst people at high likelihood of exposure]; 2022. Saint-Denis La Plaine: HAS.
  32. Centre opérationnel de régulation et de réponse aux urgences sanitaires et sociales (CORRUSS). DGS-Urgent. Ministère des solidarités et de la santé (DGS). Paris: CORRUSS; 2022.
Mpox outbreak in France: epidemiological characteristics and sexual behaviour of cases aged 15 years or older, 2022
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Catarina+Krug&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Krug Catarina</a>, <a href="/search?value1=Arnaud+Tarantola&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Tarantola Arnaud</a>, <a href="/search?value1=Emilie+Chazelle&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Chazelle Emilie</a>, <a href="/search?value1=Erica+Foug%C3%A8re&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Fougère Erica</a>, <a href="/search?value1=Annie+Velter&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Velter Annie</a>, <a href="/search?value1=Anne+Guinard&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Guinard Anne</a>, <a href="/search?value1=Yvan+Souares&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Souares Yvan</a>, <a href="/search?value1=Anna+Mercier&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mercier Anna</a>, <a href="/search?value1=C%C3%A9line+Fran%C3%A7ois&option1=author&noRedirect=true" class="nonDisambigAuthorLink">François Céline</a>, <a href="/search?value1=Katia+Hamdad&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hamdad Katia</a>, <a href="/search?value1=Laetitia+Tan-Lhernould&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Tan-Lhernould Laetitia</a>, <a href="/search?value1=Anita+Balestier&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Balestier Anita</a>, <a href="/search?value1=Hana+Lahbib&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lahbib Hana</a>, <a href="/search?value1=Nicolas+Etien&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Etien Nicolas</a>, <a href="/search?value1=Pascale+Bernillon&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bernillon Pascale</a>, <a href="/search?value1=Virginie+De+Lauzun&option1=author&noRedirect=true" class="nonDisambigAuthorLink">De Lauzun Virginie</a>, <a href="/search?value1=Julien+Durand&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Durand Julien</a>, <a href="/search?value1=Myriam+Fayad&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Fayad Myriam</a>, <a href="/search?value1=Investigation+Team&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Investigation Team</a>, <a href="/search?value1=Henriette+De+Valk&option1=author&noRedirect=true" class="nonDisambigAuthorLink">De Valk Henriette</a>, <a href="/search?value1=Fran%C3%A7ois+Beck&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Beck François</a>, <a href="/search?value1=Didier+Che&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Che Didier</a>, <a href="/search?value1=Bruno+Coignard&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Coignard Bruno</a>, <a href="/search?value1=Florence+Lot&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lot Florence</a>, <a href="/search?value1=Alexandra+Mailles&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mailles Alexandra</a></span>. Mpox outbreak in France: epidemiological characteristics and sexual behaviour of cases aged 15 years or older, 2022. <a href="/content/ecdc">Euro Surveill.</a> 2023;28(50):pii=2200923. <a href="https://doi.org/10.2807/1560-7917.ES.2023.28.50.2200923" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2023.28.50.2200923</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 30 Nov 2022;&nbsp;&nbsp; <span class="generated">Accepted</span>: 21 Apr 2023 </span> </p>
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