{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T17:48:40Z","timestamp":1790444920086,"version":"4.1.0"},"reference-count":43,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T00:00:00Z","timestamp":1736985600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>In May 2022, after the suspension of the mobility restrictions due to the COVID-19 pandemic, the first outbreak of MPOX virus, transmitted from human to human, was detected outside of Africa, affecting mostly sexually active men who have sex with men. Our aim is to report the first outbreak of MPOX in Barcelona city in the period from 5\/2022 to 5\/2023 and the subsequent surge of cases in 8\/2023.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We performed a descriptive study of all notified cases in city residents, obtained through epidemiological surveys. The analyses are presented for the hospitalized cases and the key population of men who have sex with men.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Of 2037 notified cases, 82.6% were confirmed. The cumulative incidence in the general population was 1.03 (95%CI 1.00\u20131.06) per 1000 inhabitants and 2.13 (2.01\u20132.17) per 1000 in men. Men were older than women, with a median age of 37 years (interquartile range 31\u201343). While 84.5% of men reported having sex with partners of the same gender, 70.9% of women only reported sex with partners of the opposite gender. Complications occurred in 4.1% of infected persons, 1.6% required hospitalization, and no deaths were registered. Georeferencing was highly associated with gay venues. Gay, bisexual and other men who have sex with men (GBMSM) accounted for most cases and severe cases, and were associated with attending public sex venues and not providing contact tracing information. Digital and printed prevention campaign materials were developed for GBMSM.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Discussion<\/jats:title>\n<jats:p>The 2022 MPOX outbreak posed a major challenge to surveillance and sexual health services worldwide. With new cases and re-infections on the rise, MPOX may become a regular infection to be incorporated in STI testing and management guidelines. Barcelona has some characteristics that may facilitate the occurrence and spread of emergencies related to sexual health.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0296141","type":"journal-article","created":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T18:40:42Z","timestamp":1737052842000},"page":"e0296141","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["A new STI in the city: MPOX in Barcelona. First outbreak (5\/2022-5\/2023) and subsequent resurgence"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4880-5396","authenticated-orcid":true,"given":"David","family":"Palma","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Montserrat","family":"Guillaumes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6481-452X","authenticated-orcid":true,"given":"Carles","family":"Pericas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"de Andr\u00e9s","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2433-2136","authenticated-orcid":true,"given":"Raquel","family":"Prieto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laia","family":"\u00c1lvarez-Bruned","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas","family":"Ospina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Santi\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Garc\u00eda de Olalla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Rius","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,1,16]]},"reference":[{"key":"pone.0296141.ref001","doi-asserted-by":"crossref","DOI":"10.2807\/1560-7917.ES.2022.27.27.2200471","article-title":"Monkeypox outbreak predominantly affecting men who have sex with men, Madrid, Spain, 26 April to 16 June 2022","volume":"27","author":"J I\u00f1igo Mart\u00ednez","year":"2022","journal-title":"Eurosurveillance"},{"key":"pone.0296141.ref002","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1111\/j.1699-0463.1959.tb00328.x","article-title":"A POX-LIKE DISEASE IN CYNOMOLGUS MONKEYS","volume":"46","author":"P von Magnus","year":"1959","journal-title":"Acta Pathologica Microbiologica Scandinavica"},{"key":"pone.0296141.ref003","doi-asserted-by":"crossref","first-page":"1765","DOI":"10.1086\/498155","article-title":"Reemergence of Monkeypox: Prevalence, Diagnostics, and Countermeasures","volume":"41","author":"RA Weinstein","year":"2005","journal-title":"Clinical Infectious Diseases"},{"key":"pone.0296141.ref004","doi-asserted-by":"crossref","first-page":"e0010141","DOI":"10.1371\/journal.pntd.0010141","article-title":"The changing epidemiology of human monkeypox\u2014A potential threat? 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A systematic review","volume":"97","author":"J Gan","year":"2021","journal-title":"Sex Transm Infect"},{"key":"pone.0296141.ref030","article-title":"Surveillance of Mpox Cases Attending Sexual Health Services in England (SOMASS): design, implementation and initial findings from the SOMASS data collection tool, 2022","author":"Sexual Health Liaison Group U","year":"2023","journal-title":"Sex Transm Infect"},{"key":"pone.0296141.ref031","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1016\/S1473-3099(22)00806-4","article-title":"Clinical features and management of individuals admitted to hospital with monkeypox and associated complications across the UK: a retrospective cohort study","volume":"23","author":"DL Fink","year":"2023","journal-title":"Lancet Infect Dis"},{"key":"pone.0296141.ref032","unstructured":"Pericas C, Prieto R, Llid\u00f3 A, Lug\u00f3n G, Palma D, Sim\u00f3n P, et al. Vigil\u00e0ncia epidemiol\u00f2gica de la infecci\u00f3 pel VIH i la SIDA a Barcelona. 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Barcelona; 2023 Dec."},{"key":"pone.0296141.ref033","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1177\/09564624221148517","article-title":"Dating applications: A double-edged weapon in the current monkeypox outbreak","volume":"34","author":"Y Ortiz-Mart\u00ednez","year":"2023","journal-title":"Int J STD AIDS"},{"key":"pone.0296141.ref034","article-title":"Response Rate, Acceptability and Effectiveness of an Intervention Offering HIV\/STI Testing Via Apps Among Gay, Bisexual, and Other Men Who Have Sex With Men in Barcelona, Spain, from 2016 to 2020","author":"M Alarc\u00f3n Guti\u00e9rrez","year":"2023","journal-title":"AIDS Behav"},{"key":"pone.0296141.ref035","article-title":"Overview of case definitions and contact tracing indications in the 2022 monkeypox outbreak","volume":"31","author":"G Guarducci","year":"2023","journal-title":"Infezioni in Medicina"},{"key":"pone.0296141.ref036","doi-asserted-by":"crossref","DOI":"10.1093\/pnasnexus\/pgad003","article-title":"Optimizing the order of actions in a model of contact tracing","volume":"2","author":"M Meister","year":"2023","journal-title":"PNAS Nexus"},{"key":"pone.0296141.ref037","doi-asserted-by":"crossref","DOI":"10.3389\/fpubh.2023.1178654","article-title":"Variations in national surveillance reporting for Mpox virus: A comparative analysis in 32 countries","volume":"11","author":"DS Panag","year":"2023","journal-title":"Front Public Health"},{"key":"pone.0296141.ref038","doi-asserted-by":"crossref","first-page":"3266","DOI":"10.3390\/ijerph18063266","article-title":"Casual Sex among Men Who Have Sex with Men (MSM) during the Period of Sheltering in Place to Prevent the Spread of COVID-19","volume":"18","author":"AFL de Sousa","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"pone.0296141.ref039","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1016\/j.jiph.2023.04.017","article-title":"A European perspective of phylogenomics, sublineages, geographical distribution, epidemiology, and mutational landscape of mpox virus: Emergence pattern may help to fight the next public health emergency in Europe","volume":"16","author":"C Chakraborty","year":"2023","journal-title":"J Infect Public Health"},{"key":"pone.0296141.ref040","doi-asserted-by":"crossref","first-page":"641","DOI":"10.4269\/ajtmh.22-0596","article-title":"Public Health Challenges in the Context of the Global Spread of Mpox Infections","volume":"108","author":"M Rahi","year":"2023","journal-title":"Am J Trop Med Hyg"},{"key":"pone.0296141.ref041","doi-asserted-by":"crossref","first-page":"5077","DOI":"10.1016\/j.vaccine.2020.04.062","article-title":"Human monkeypox\u2013After 40 years, an unintended consequence of smallpox eradication","volume":"38","author":"K Simpson","year":"2020","journal-title":"Vaccine"},{"key":"pone.0296141.ref042","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1056\/NEJM198703123161106","article-title":"Disseminated Vaccinia in a Military Recruit with Human Immunodeficiency Virus (HIV) Disease","volume":"316","author":"RR Redfield","year":"1987","journal-title":"New England Journal of Medicine"},{"key":"pone.0296141.ref043","article-title":"Mpox vaccination willingness, determinants, and communication needs in gay, bisexual, and other men who have sex with men, in the context of limited vaccine availability in the Netherlands (Dutch Mpox-survey)","volume":"10","author":"NHTM Dukers-Muijrers","year":"2023","journal-title":"Front Public Health"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0296141","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T18:41:05Z","timestamp":1737052865000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0296141"}},"subtitle":[],"editor":[{"given":"Vikash","family":"Jaiswal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,1,16]]},"references-count":43,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,16]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0296141","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,16]]}}}