{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T13:33:28Z","timestamp":1789133608668,"version":"build-2803163510"},"reference-count":43,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T00:00:00Z","timestamp":1736294400000},"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>The 2022 mpox outbreak marked a significant shift in the epidemiology of this zoonotic disease, traditionally confined to Central and West Africa. With over 80 countries reporting cases, this outbreak was characterized by a rapid spread in non-endemic regions, leading to more than 70,000 confirmed cases globally.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Objective<\/jats:title>\n<jats:p>To quantify the cumulative incidence of mpox and identify associated factors of mpox among the Mexican population affiliated by the Mexican Social Security Institute during the 2022\u20132023 outbreak.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Material and methods<\/jats:title>\n<jats:p>A retrospective observational study using a cross-sectional survey to assess the cumulative incidence and factors associated with mpox. The cumulative incidence of laboratory confirmed mpox cases was calculated by dividing the number of confirmed cases by the insured population in the Mexican Social Security Institute as of mid-2022, per 100,000 individuals, this was analyzed by sex, age group, sexual orientation and people living with HIV. Logistic regression analyses were conducted to identify sociodemographic and clinical factors associated with mpox infection.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 2,956 probable cases were reported, with 1,744 (59%) laboratory-confirmed mpox cases. Most confirmed cases were male, with a median age of 32 years. The overall cumulative incidence was 4.05 per 100,000 persons, significantly higher in men and men who have sex with men. Logistic regression revealed that male sex was significantly associated with higher odds of laboratory-confirmed mpox. Age groups 30\u201334, 35\u201339, and 40\u201344 had an elevated risk of infection. Men who have sex with men showed a substantially increased likelihood of mpox, while individuals living with HIV were at higher risk compared to those without HIV. Key clinical predictors included fever, arm rash, and inguinal lymphadenopathy.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The 2022 mpox outbreak revealed significant disparities in infection risk, particularly among men, men who have sex with men, and individuals living with HIV.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0313691","type":"journal-article","created":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T19:30:09Z","timestamp":1736364609000},"page":"e0313691","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Risk factors for human infection with mpox among the Mexican population with social security"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0972-8295","authenticated-orcid":true,"given":"Alfonso","family":"Vallejos Par\u00e1s","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0243-768X","authenticated-orcid":true,"given":"Lumumba","family":"Arriaga Nieto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5314-4786","authenticated-orcid":true,"given":"David Alejandro","family":"Cabrera Gayt\u00e1n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernardo","family":"Cacho D\u00edaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leticia","family":"Jaimes Betancourt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Porfirio Felipe","family":"Hern\u00e1ndez Bautista","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar","family":"Cruz Orozco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9251-7474","authenticated-orcid":true,"given":"Gabriel","family":"Valle Alvarado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Moctezuma Paz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5972-5706","authenticated-orcid":true,"given":"M\u00f3nica Grisel","family":"Rivera Mahey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,1,8]]},"reference":[{"key":"pone.0313691.ref001","article-title":"Smallpox Monkeypox and Other Human Orthopoxvirus 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A systematic review","volume":"16","author":"EM Bunge","year":"2022","journal-title":"PLoS Negl Trop Dis."},{"key":"pone.0313691.ref012","author":"World Health Organization","journal-title":"WHO Director-General declares the ongoing monkeypox outbreak a Public Health Emergency of International Concern [Internet]"},{"key":"pone.0313691.ref013","author":"World Health Organization","year":"2023","journal-title":"2022\u201323 Mpox (Monkeypox) Outbreak: Global Trends [Internet]."},{"issue":"19","key":"pone.0313691.ref014","doi-asserted-by":"crossref","first-page":"1783","DOI":"10.1056\/NEJMra2208860","article-title":"Monkeypox","volume":"387","author":"G Antoine","year":"2022","journal-title":"N Engl J Med"},{"key":"pone.0313691.ref015","article-title":"Monkeypox Virus Infection in Humans across 16 Countries\u2014April\u2013June 2022.","author":"JP Thornhill","year":"2022","journal-title":"N Engl J 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emergency, calls for sustained efforts for long-term management of the disease [Internet]"},{"key":"pone.0313691.ref020","article-title":"The WHO mpox public health emergency of international concern declaration: need for reprioritisation of global public health responses to combat the MPXV Clade I epidemic","author":"SS Lee","year":"2024","journal-title":"Int J Infect Dis"},{"issue":"2","key":"pone.0313691.ref021","volume":"22","author":"M\u00c1G Block","year":"2020","journal-title":"Health Systems in Transition: Mexico Health system review"},{"key":"pone.0313691.ref022","article-title":"The transformation of the Mexican social security institute (IMSS): Progress and challenges.","author":"JAG Anaya","year":"2015"},{"issue":"Suppl_2","key":"pone.0313691.ref023","article-title":"Assessing health system performance: effective coverage at the Mexican Institute of Social Security.","volume":"34","author":"HH Leslie","year":"2019","journal-title":"Health Policy Plan."},{"key":"pone.0313691.ref024","author":"Instituto Mexicano del Seguro Social","year":"2022","journal-title":"Programa Institucional del Seguro Social: Avance y Resultados"},{"key":"pone.0313691.ref025","author":"Instituto Mexicano del Seguro Social","year":"2022","journal-title":"Memoria Estad\u00edstica 2022 [Internet]."},{"key":"pone.0313691.ref026","author":"Secretar\u00eda de Salud","journal-title":"Manual de Procedimientos Estandarizados para la Vigilancia Epidemiol\u00f3gica de Viruela S\u00edmica [Internet]"},{"issue":"3","key":"pone.0313691.ref027","article-title":"Methodological guidance for systematic reviews of observational epidemiological studies reporting prevalence and cumulative incidence data.","volume":"13","author":"Z Munn","year":"2015","journal-title":"JBI Evid Implement."},{"key":"pone.0313691.ref028","author":"Instituto Nacional de Estad\u00edstica y Geograf\u00eda, Consejo Nacional para Prevenir la 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Cambios","year":"2023","journal-title":"Panorama del envejecimiento y tendencias demogr\u00e1ficas en Am\u00e9rica Latina y el Caribe"},{"issue":"48","key":"pone.0313691.ref036","doi-asserted-by":"crossref","DOI":"10.2807\/1560-7917.ES.2022.27.48.2200867","article-title":"Mpox (formerly monkeypox) in women: epidemiological features and clinical characteristics of mpox cases in Spain, April to November 2022.","volume":"27","author":"A Vallejo-Plaza","year":"2022","journal-title":"Eurosurveillance"},{"issue":"5152","key":"pone.0313691.ref037","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.15585\/mmwr.mm715152a1","article-title":"Epidemiologic and Clinical Features of Mpox in Transgender and Gender-Diverse Adults\u2014United States, May\u2013November 2022.","volume":"71","author":"D Blackburn","year":"2022","journal-title":"MMWR Morb Mortal Wkly Rep."},{"issue":"1","key":"pone.0313691.ref038","doi-asserted-by":"crossref","first-page":"e1069","DOI":"10.1002\/hsr2.1069","article-title":"Monkeypox and sex: Sexual orientations and encounters are key factors to consider.","volume":"6","author":"MR Islam","year":"2023","journal-title":"Health Sci Rep."},{"issue":"2","key":"pone.0313691.ref039","first-page":"1","article-title":"Epidemiologic Situation of HIV and Monkeypox Coinfection: A Systematic Review.","volume":"11","author":"B Ortiz-Saavedra","year":"2023","journal-title":"Vaccines (Basel)."},{"issue":"10380","key":"pone.0313691.ref040","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1016\/S0140-6736(23)00273-8","article-title":"Mpox in people with advanced HIV infection: a global case series","volume":"401","author":"O Mitj\u00e0","year":"2023","journal-title":"Lancet"},{"issue":"1","key":"pone.0313691.ref041","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1093\/cid\/ciac622","article-title":"Antivirals With Activity Against Mpox: A Clinically Oriented Review","volume":"76","author":"EA Siegrist","year":"2023","journal-title":"Clin Infect Dis"},{"key":"pone.0313691.ref042","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.ijid.2022.11.020","article-title":"The clinical presentation of monkeypox: a retrospective case-control study of patients with possible or probable monkeypox in a West London cohort","volume":"126","author":"S Rimmer","year":"2023","journal-title":"Int J Infect Dis"},{"key":"pone.0313691.ref043","author":"FS Minhaj","year":"2022","journal-title":"Morbidity and Mortality Weekly Report: Monkeypox Outbreak\u2014Nine States"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0313691","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T19:30:24Z","timestamp":1736364624000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0313691"}},"subtitle":[],"editor":[{"given":"Moises","family":"Leon Juarez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,1,8]]},"references-count":43,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,8]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0313691","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,8]]}}}