{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T21:58:27Z","timestamp":1783115907993,"version":"3.54.6"},"reference-count":84,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T00:00:00Z","timestamp":1756166400000},"content-version":"unspecified","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Research and Development Program of China","award":["2021ZD0114104"],"award-info":[{"award-number":["2021ZD0114104"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Glob Health"],"accepted":{"date-parts":[[2025,7,21]]},"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:p>WHO declared mpox a Public Health Emergency of International Concern on 23 July 2022. China experienced the first imported case in September 2022, the first local case in May 2023, indigenous clustered outbreaks in June to August 2023 and finally has achieved routine management since September 2023. We designed a conceptual framework through literature review and theoretical underpinnings according to the risk management theory and Chinese mpox control practice, with the strategy and measures evolution of the mpox control in China over time from the stages of risk preparedness, emergency response and management, to routine report and management. Overall, China proactively takes strategies and measures ranging from risk preparedness to emergency response of imported cases, and finally controls the cross-border importation and local outbreaks of mpox. Notably, risk management was performed in the whole process of mpox response through HIV\/AIDS service system. The imported case in September 2022 did not cause local transmission or aggregated outbreaks. The indigenous cases and clustered outbreaks in June 2023 did not result in three-generation transmission. Since September 2023, less than 100 cases per month and zero aggregated outbreaks were reported nationwide. As of 31 December 2023, the cumulative incidence per million population in China (1.202) was much lower than that in some European and American countries, such as Spain (161.780), Germany (45.633) and the USA (93.340). China has maintained a low mpox incidence rate through early surveillance, mandatory case reporting and prompt treatment. These measures effectively curbed large-scale transmission among high-risk groups. Additionally, the country\u2019s vast population size creates a larger denominator, which may further contribute to the lower observed prevalence. However, China still faces challenges, including low case linkage (&lt;15%), under-reporting due to privacy concerns and unclear infection sources in 94 of 99 aggregated outbreaks. Thus, how to accurately trace infection sources and manage close contacts is a significant obstacle in China. Additionally, how to address stigmatisation and rapidly develop vaccines and medicines remains a problem to be solved in China. In summary, China demonstrates a practical example of mpox risk management, which may provide valuable experience for the other countries and regions with mpox epidemics.<\/jats:p>","DOI":"10.1136\/bmjgh-2025-019279","type":"journal-article","created":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T14:18:59Z","timestamp":1756217939000},"page":"e019279","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Mpox containment strategies in China, 2022\u20132023: from preparedness to legal management"],"prefix":"10.1136","volume":"10","clinical-trial-number":[{"clinical-trial-number":"nct05988203","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3851-507X","authenticated-orcid":false,"given":"Weijing","family":"Shang","sequence":"first","affiliation":[{"name":"School of Public Health, Peking University, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2004-2661","authenticated-orcid":false,"given":"Jun","family":"Yan","sequence":"additional","affiliation":[{"name":"National Disease Control and Prevention Administration, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5785-3309","authenticated-orcid":false,"given":"Hongbin","family":"Zhang","sequence":"additional","affiliation":[{"name":"National Disease Control and Prevention Administration, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7116-0878","authenticated-orcid":false,"given":"Wannian","family":"Liang","sequence":"additional","affiliation":[{"name":"Vanke School of Public Health, Tsinghua University, Beijing 100084, China"},{"name":"Institute for Healthy China, Tsinghua University, Beijing 100084, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1938-9365","authenticated-orcid":false,"given":"Jue","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Public Health, Peking University, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5059-3743","authenticated-orcid":false,"given":"Min","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Public Health, Peking University, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,8,26]]},"reference":[{"key":"2025082607151381000_10.8.e019279.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)00588-3"},{"key":"2025082607151381000_10.8.e019279.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)02075-X"},{"key":"2025082607151381000_10.8.e019279.3","unstructured":"WHO . Global mpox trends. Available: https:\/\/worldhealthorg.shinyapps.io\/mpx_global\/ [Accessed 1 Oct 2024]."},{"key":"2025082607151381000_10.8.e019279.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2207323"},{"key":"2025082607151381000_10.8.e019279.5","unstructured":"WHO . WHO director-general\u2019s statement at the press conference following IHR emergency committee regarding the multi-country outbreak of monkeypox - 23 july 2022. Available: https:\/\/www.who.int\/director-general\/speeches\/detail\/who-director-general-s-statement-on-the-press-conference-following-IHR-emergency-committee-regarding-the-multi--country-outbreak-of-monkeypox--23-july-2022#:~:text=WHO\u2019s%20assessment%20is%20that%20the,remains%20low%20for%20the%20moment [Accessed 30 Sep 2024]."},{"key":"2025082607151381000_10.8.e019279.6","unstructured":"WHO . Director-general declares mpox outbreak a public health emergency of international concern. 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Notice of the issuance of Guidelines for Mpox Diagnostic and Treatment (2022 Edition). Available: https:\/\/www.gov.cn\/zhengce\/zhengceku\/2022-06\/15\/content_5695741.htm [Accessed 9 Dec 2023]."},{"key":"2025082607151381000_10.8.e019279.23","unstructured":"National Health Emergency Response Office, National Health Commision of the People\u2019s Republic of China . Notice of the General Office of the National Health and Wellness Commission on the issuance of the Technical Guidelines for Mpox Prevention and Control (2022 Edition). 2022. 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