{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:20:18Z","timestamp":1790814018901,"version":"4.1.0"},"reference-count":59,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","license":[{"start":{"date-parts":[[2024,3,6]],"date-time":"2024-03-06T00:00:00Z","timestamp":1709683200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,6]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    Incidence of human monkeypox (mpox) has been increasing in West and Central Africa, including in the Democratic Republic of Congo (DRC), where monkeypox virus (MPXV) is endemic. Most estimates of the pathogen\u2019s transmissibility in the DRC are based on data from the 1980s. Amid the global 2022 mpox outbreak, new estimates are needed to characterize the virus\u2019 epidemic potential and inform outbreak control strategies. We used the R package\n                    <jats:italic>vimes<\/jats:italic>\n                    to identify clusters of laboratory-confirmed mpox cases in Tshuapa Province, DRC. Cases with both temporal and spatial data were assigned to clusters based on the disease\u2019s serial interval and spatial kernel. We used the size of the clusters to infer the effective reproduction number,\n                    <jats:italic>\n                      R\n                      <jats:sub>t<\/jats:sub>\n                    <\/jats:italic>\n                    , and the rate of zoonotic spillover of MPXV into the human population. Out of 1,463 confirmed mpox cases reported in Tshuapa Province between 2013 and 2017, 878 had both date of symptom onset and a location with geographic coordinates. Results include an estimated\n                    <jats:italic>\n                      R\n                      <jats:sub>t<\/jats:sub>\n                    <\/jats:italic>\n                    of 0.82 (95% CI: 0.79\u20130.85) and a rate of 132 (95% CI: 122\u2013143) spillovers per year assuming a reporting rate of 25%. This estimate of\n                    <jats:italic>\n                      R\n                      <jats:sub>t<\/jats:sub>\n                    <\/jats:italic>\n                    is larger than most previous estimates. One potential explanation for this result is that\n                    <jats:italic>\n                      R\n                      <jats:sub>t<\/jats:sub>\n                    <\/jats:italic>\n                    could have increased in the DRC over time owing to declining population-level immunity conferred by smallpox vaccination, which was discontinued around 1982.\n                    <jats:italic>\n                      R\n                      <jats:sub>t<\/jats:sub>\n                    <\/jats:italic>\n                    could be overestimated if our assumption of one spillover event per cluster does not hold. Our results are consistent with increased transmissibility of MPXV in Tshuapa Province.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.23-0215","type":"journal-article","created":{"date-parts":[[2024,2,6]],"date-time":"2024-02-06T12:41:57Z","timestamp":1707223317000},"page":"561-568","source":"Crossref","is-referenced-by-count":35,"title":["Updating Reproduction Number Estimates for Mpox in the Democratic Republic of Congo Using Surveillance Data"],"prefix":"10.4269","volume":"110","author":[{"given":"Kelly","family":"Charniga","sequence":"first","affiliation":[{"name":"Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea M.","family":"McCollum","sequence":"additional","affiliation":[{"name":"Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine M.","family":"Hughes","sequence":"additional","affiliation":[{"name":"Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Monroe","sequence":"additional","affiliation":[{"name":"Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joelle","family":"Kabamba","sequence":"additional","affiliation":[{"name":"U.S. Centers for Disease Control and Prevention, Kinshasa, Democratic Republic of Congo;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert Shongo","family":"Lushima","sequence":"additional","affiliation":[{"name":"Ministry of Health, Kinshasa, Democratic Republic of Congo;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toutou","family":"Likafi","sequence":"additional","affiliation":[{"name":"Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice","family":"Nguete","sequence":"additional","affiliation":[{"name":"Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Pukuta","sequence":"additional","affiliation":[{"name":"Institut National de Recherche Biom\u00e9dicale, Kinshasa, Democratic Republic of Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Muyamuna","sequence":"additional","affiliation":[{"name":"Institut National de Recherche Biom\u00e9dicale, Kinshasa, Democratic Republic of Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Jacques","family":"Muyembe Tamfum","sequence":"additional","affiliation":[{"name":"Institut National de Recherche Biom\u00e9dicale, Kinshasa, Democratic Republic of Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stomy","family":"Karhemere","sequence":"additional","affiliation":[{"name":"Institut National de Recherche Biom\u00e9dicale, Kinshasa, Democratic Republic of Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Didine","family":"Kaba","sequence":"additional","affiliation":[{"name":"Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshinori","family":"Nakazawa","sequence":"additional","affiliation":[{"name":"Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Bull World Health Organ","first-page":"593","article-title":"A human infection caused by monkeypox virus in Basankusu Territory, Democratic Republic of the Congo","volume":"46","author":"Ladnyi","year":"1972"},{"key":"b2","year":"2022"},{"key":"b3","series-title":"Clin Infect Dis","first-page":"260","article-title":"Human monkeypox","volume":"58","author":"McCollum","year":"2014"},{"key":"b4","series-title":"PLoS Biol","first-page":"e3001769","article-title":"Urgent need for a non-discriminatory and non-stigmatizing nomenclature for monkeypox 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