Serological Evidence of Mpox Virus Infection During Peak Mpox Transmission in New York City, July to August 2022

Preeti Pathela; Michael B Townsend; Erik J Kopping; Jennifer Tang; Terese Navarra; Lalita Priyamvada; William C Carson; S Satheshkumar Panayampalli; Randal C Fowler; Nang Kyaw; Scott Hughes; Kelly Jamison

doi:10.1093/infdis/jiae181

Serological Evidence of Mpox Virus Infection During Peak Mpox Transmission in New York City, July to August 2022

J Infect Dis. 2024 May 13:jiae181. doi: 10.1093/infdis/jiae181. Online ahead of print.

Affiliations

¹ Bureau of Hepatitis, HIV, and STI, New York City Department of Health and Mental Hygiene, Queens, New York, USA.
² Multinational Mpox Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
³ Bureau of the Public Health Laboratory, New York City Department of Health and Mental Hygiene, New York, New York, USA.
⁴ Epidemic Intelligence Service, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
⁵ Bureau of Healthcare and Community Readiness, New York City Department of Health and Mental Hygiene, Queens, New York, USA.

PMID: 38736232
DOI: 10.1093/infdis/jiae181

Abstract

Background: The extent to which infections may have been undetected in an epicenter of the 2022 mpox outbreak is unknown.

Methods: A serosurvey (July and August 2022) assessed the seroprevalence and correlates of mpox infection among a diverse sample of asymptomatic patients with no prior mpox diagnoses and no known histories of smallpox or mpox vaccination. We present seropositivity stratified by participant characteristics collected via survey.

Results: Two-thirds of 419 participants were cismen (281 of 419), of whom 59.1% (166 of 281) reported sex with men (MSM). The sample also included 109 ciswomen and 28 transgender/gender nonconforming/nonbinary individuals. Overall seroprevalence was 6.4% (95% confidence interval [CI], 4.1%-8.8%); 3.7% among ciswomen (95% CI, 1.0%-9.1%), 7.0% among cismen with only ciswomen partners (95% CI, 2.0%-11.9%), and 7.8% among MSM (95% CI, 3.7%-11.9%). There was little variation in seroprevalence by race/ethnicity, age group, HIV status, or number of recent sex partners. No participants who reported close contact with mpox cases were seropositive. Among participants without recent mpox-like symptoms, 6.3% were seropositive (95% CI, 3.6%-9.0%).

Conclusions: Approximately 1 in 15 vaccine-naive people in our study had antibodies to mpox during the height of the NYC outbreak, indicating the presence of asymptomatic infections that could contribute to ongoing transmission.

Keywords: asymptomatic infections; mpox; outbreak; serosurvey; subclinical infections.

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