{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T19:09:40Z","timestamp":1784920180147,"version":"3.55.0"},"reference-count":62,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,6]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>In July 2022, mpox was declared an international public health emergency because of a surge in cases across Europe and America. This study assessed transmission dynamics and factors associated with hospitalization during the 2022 mpox outbreak in Peru. We performed a cross-sectional study using the Surveillance System of the National Center of Epidemiology, Prevention, and Disease Control (CDC-Peru) data. We estimated the basic reproduction number (R0), effective reproduction number (Rt), and the duration of the outbreak phases. We conducted mathematical modeling of the outbreak and estimated the serial interval. Additionally, we used Poisson regression with robust variance to identify hospitalization factors, using prevalence ratio. Between July and December 2022, 3,677 confirmed cases (96.3% male, mean age 32.6 years) were reported to the CDC-Peru. Of these, 75.0% were men who have sex with men (MSM), 55.6% had HIV infection, and 5.2% were hospitalized. The R0 was 2.37, with an exponential growth phase lasting 7 weeks, and Rt dropped to non-epidemic levels after 14 weeks. The incubation period and recovery period were estimated to be 6 days and 22 days, respectively. The serial interval was 9.3 days. HIV infection increased hospitalization risk. The 2022 mpox outbreak in Peru was characterized by primarily affecting a young MSM population, with a significant proportion being people living with HIV. Hospitalization was associated with HIV coinfection. This outbreak showed exponential growth during the first 7 weeks, followed by a marked deceleration of transmission.<\/jats:p>","DOI":"10.4269\/ajtmh.24-0361","type":"journal-article","created":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T10:59:46Z","timestamp":1747738786000},"page":"387-394","source":"Crossref","is-referenced-by-count":0,"title":["Transmission Dynamics of Mpox in Peru During the 2022 Outbreak"],"prefix":"10.4269","volume":"113","author":[{"given":"M. Gabriela","family":"Soto-Cabezas","sequence":"first","affiliation":[{"name":"Centro Nacional de Epidemiolog\u00eda, Prevenci\u00f3n y Control de Enfermedades, Lima, Per\u00fa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adri\u00e1n","family":"V\u00e1squez-Mej\u00eda","sequence":"additional","affiliation":[{"name":"Centro Nacional de Epidemiolog\u00eda, Prevenci\u00f3n y Control de Enfermedades, Lima, Per\u00fa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha","family":"Calder\u00f3n","sequence":"additional","affiliation":[{"name":"Centro Nacional de Epidemiolog\u00eda, Prevenci\u00f3n y Control de Enfermedades, Lima, Per\u00fa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Reyes-Vega","sequence":"additional","affiliation":[{"name":"Centro Nacional de Epidemiolog\u00eda, Prevenci\u00f3n y Control de Enfermedades, Lima, Per\u00fa;"},{"name":"Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, San Martin de Porres, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yrene I.","family":"Blancas-Blas","sequence":"additional","affiliation":[{"name":"Centro Nacional de Epidemiolog\u00eda, Prevenci\u00f3n y Control de Enfermedades, Lima, Per\u00fa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anderson N.","family":"Soriano-Moreno","sequence":"additional","affiliation":[{"name":"Centro Nacional de Epidemiolog\u00eda, Prevenci\u00f3n y Control de Enfermedades, Lima, Per\u00fa;"},{"name":"Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, San Martin de Porres, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda A.","family":"Vargas","sequence":"additional","affiliation":[{"name":"Centro Nacional de Epidemiolog\u00eda, Prevenci\u00f3n y Control de Enfermedades, Lima, Per\u00fa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kely R.","family":"Meza","sequence":"additional","affiliation":[{"name":"Centro Nacional de Epidemiolog\u00eda, Prevenci\u00f3n y Control de Enfermedades, Lima, Per\u00fa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge R.","family":"Uchuya","sequence":"additional","affiliation":[{"name":"Centro Nacional de Epidemiolog\u00eda, Prevenci\u00f3n y Control de Enfermedades, Lima, Per\u00fa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Castro-Garro","sequence":"additional","affiliation":[{"name":"Centro Nacional de Epidemiolog\u00eda, Prevenci\u00f3n y Control de Enfermedades, Lima, Per\u00fa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Luque-Mamani","sequence":"additional","affiliation":[{"name":"Centro Nacional de Epidemiolog\u00eda, Prevenci\u00f3n y Control de Enfermedades, Lima, Per\u00fa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oswaldo G. E.","family":"Espinoza-Hurtado","sequence":"additional","affiliation":[{"name":"Centro Nacional de Epidemiolog\u00eda, Prevenci\u00f3n y Control de Enfermedades, Lima, Per\u00fa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesar V.","family":"Munayco","sequence":"additional","affiliation":[{"name":"Centro Nacional de Epidemiolog\u00eda, Prevenci\u00f3n y Control de Enfermedades, Lima, Per\u00fa;"},{"name":"Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, San Martin de Porres, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"PLoS Negl Trop Dis","first-page":"e0010141","article-title":"The changing epidemiology of human monkeypox\u2014A potential threat? A systematic review","volume":"16","author":"Bunge","year":"2022"},{"key":"b2","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":"Ladnyj","year":"1972"},{"key":"b3","series-title":"PLoS Negl Trop Dis","first-page":"e0007791","article-title":"A systematic review of the epidemiology of human monkeypox outbreaks and implications for outbreak strategy","volume":"13","author":"Beer","year":"2019"},{"key":"b4","series-title":"J Infect Dis","first-page":"293","article-title":"Human monkeypox: Clinical features of 282 patients","volume":"156","author":"Jezek","year":"1987"},{"key":"b5","series-title":"Emerg Infect Dis","first-page":"934","article-title":"Endemic human monkeypox, Democratic Republic of Congo, 2001\u20132004","volume":"13","author":"Rimoin","year":"2007"},{"key":"b6","series-title":"Lancet Infect Dis","first-page":"872","article-title":"Outbreak of human monkeypox in Nigeria in 2017\u201318: A clinical and epidemiological report","volume":"19","author":"Yinka-Ogunleye","year":"2019"},{"key":"b7","series-title":"Clin Infect Dis Off Dis","first-page":"1742","article-title":"Clinical characteristics of human monkeypox, and risk factors for severe disease","volume":"41","author":"Huhn","year":"2005"},{"key":"b8","series-title":"Clin Infect Dis Off Dis","first-page":"e210","article-title":"Clinical course and outcome of human monkeypox in Nigeria","volume":"71","author":"Ogoina","year":"2020"},{"key":"b9","series-title":"Emerg Infect Dis","first-page":"980","article-title":"Diagnosis of imported monkeypox, Israel, 2018","volume":"25","author":"Erez","year":"2019"},{"key":"b10","series-title":"Eurosurveillance","first-page":"1800509","article-title":"Two cases of monkeypox imported to the United Kingdom, September 2018","volume":"23","author":"Vaughan","year":"2018"},{"key":"b11","series-title":"Emerg Infect Dis","first-page":"1826","article-title":"Imported monkeypox, Singapore","volume":"26","author":"Yong","year":"2020"},{"key":"b12","article-title":"Global Mpox Trends","year":"2025"},{"key":"b13","series-title":"Mpox Outbreak Global Map"},{"key":"b14","series-title":"Minsa Confirma Primer Caso de la Viruela Del Mono en el Per\u00fa"},{"key":"b15","series-title":"Euro Surveill Bull Eur Sur Mal Transm Eur Commun Dis Bull","first-page":"2200471","article-title":"Monkeypox outbreak predominantly affecting men who have sex with men, Madrid, Spain, April 26 to June 16, 2022","volume":"27","author":"I\u00f1igo Mart\u00ednez","year":"2022"},{"key":"b16","series-title":"MMWR Morb Mortal Wkly Rep","first-page":"1018","article-title":"Epidemiologic and clinical characteristics of monkeypox cases\u2014United States, May 17\u2013July 22, 2022","volume":"71","author":"Philpott","year":"2022"},{"key":"b17","series-title":"N Engl J Med","first-page":"679","article-title":"Monkeypox virus infection in humans across 16 countries\u2014April\u2013June 2022","volume":"387","author":"Thornhill","year":"2022"},{"key":"b18","series-title":"Emerg Infect Dis","first-page":"1847","article-title":"Epidemiologic features and control measures during monkeypox outbreak, Spain, June 2022","volume":"28","author":"Su\u00e1rez Rodr\u00edguez","year":"2022"},{"key":"b19","series-title":"HIV Med","first-page":"389","article-title":"Clinical characteristics of monkeypox virus infections among men with and without HIV: A large outbreak cohort in Germany","volume":"24","author":"Hoffmann","year":"2023"},{"key":"b20","series-title":"MMWR Morb Mortal Wkly Rep","first-page":"1141","article-title":"HIV and sexually transmitted infections among persons with monkeypox\u2014Eight U.S. jurisdictions, May 17\u2013July 22, 2022","volume":"71","author":"Curran","year":"2022"},{"key":"b21","series-title":"Lancet Reg Health Am","first-page":"100392","article-title":"Epidemiological and clinical characteristics of patients with human monkeypox infection in Mexico: A nationwide observational study","volume":"17","author":"N\u00fa\u00f1ez","year":"2023"},{"key":"b22","series-title":"MMWR Morb Mortal Wkly Rep","first-page":"1449","article-title":"Epidemiologic features of the monkeypox outbreak and the public health response\u2014United States, May 17\u2013October 6, 2022","volume":"71","author":"Kava","year":"2022"},{"key":"b23","series-title":"Lancet Infect Dis","first-page":"589","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":"Fink","year":"2023"},{"key":"b24","series-title":"BMJ","first-page":"e072410","article-title":"Clinical features and novel presentations of human monkeypox in a central London centre during the 2022 outbreak: Descriptive case series","volume":"378","author":"Patel","year":"2022"},{"key":"b25","series-title":"Br J Dermatol","first-page":"765","article-title":"Monkeypox outbreak in Spain: Clinical and epidemiological findings in a prospective cross-sectional study of 185 cases","volume":"187","author":"Catal\u00e0","year":"2022"},{"key":"b26","series-title":"Dtsch Arzteblatt Int","first-page":"551","article-title":"Monkeypox in Germany","volume":"119","author":"Hoffmann","year":"2022"},{"key":"b27","article-title":"Norma T\u00e9cnica de Salud Para la Vigilancia Epidemiol\u00f3gica de Viruela Del Mono (Viruela S\u00edmica) en el Per\u00fa [Internet]"},{"key":"b28","series-title":"Alerta Epidemiol\u00f3gica. Casos de Viruela Del Mono en Lima y Riesgo de Propagaci\u00f3n a Otras Regiones"},{"key":"b29","series-title":"Norma T\u00e9cnica de Salud Para la Prevenci\u00f3n y Manejo de Pacientes Afectados Por Viruela Del Mono (Viruela S\u00edmica)-Monkeypox"},{"key":"b30","series-title":"HERE Batch Geocoder API\u2014Developer Guide."},{"key":"b31","series-title":"International Encyclopedia of Human Geography","first-page":"111","author":"Yao","year":"2020"},{"key":"b32","series-title":"Spatial Point Patterns: Methodology and Applications with R","first-page":"828","author":"Baddeley","year":"2015"},{"key":"b33","series-title":"Mol Biol Evol","first-page":"232","article-title":"Growth rates made easy","volume":"31","author":"Hall","year":"2014"},{"key":"b34","series-title":"Emerg Infect Dis","first-page":"1912","article-title":"Doubling time of the COVID-19 epidemic by province, China","volume":"26","author":"Muniz-Rodriguez","year":"2020"},{"key":"b35","series-title":"BMC Med Inform Decis Mak","first-page":"147","article-title":"The R0 package: A toolbox to estimate reproduction numbers for epidemic outbreaks","volume":"12","author":"Obadia","year":"2012"},{"key":"b36","series-title":"Clin Microbiol Infect Off Infect","first-page":"1653.e1","article-title":"Estimation of local transmissibility in the early phase of the monkeypox epidemic in 2022","volume":"28","author":"Kwok","year":"2022"},{"key":"b37","series-title":"PloS One","first-page":"e2185","article-title":"Real time Bayesian estimation of the epidemic potential of emerging infectious diseases","volume":"3","author":"Bettencourt","year":"2008"},{"key":"b38","series-title":"F1000Res","first-page":"139","article-title":"Epidemic curves made easy using the R package incidence","volume":"8","author":"Kamvar","year":"2019"},{"key":"b39","series-title":"Math Biosci Eng","first-page":"761","article-title":"A SEIR model for control of infectious diseases with constraints","volume":"11","author":"Biswas","year":"2014"},{"key":"b40","series-title":"PeerJ Comput Sci","first-page":"e623","article-title":"The coefficient of determination R-squared is more informative than SMAPE, MAE, MAPE, MSE, and RMSE in regression analysis evaluation","volume":"7","author":"Chicco","year":"2021"},{"key":"b41","series-title":"Chaos Solitons Fractals","first-page":"109948","article-title":"Forecasting the cumulative number of confirmed cases of COVID-19 in Italy, UK, and USA using fractional nonlinear grey Bernoulli model","volume":"138","author":"\u015eahin","year":"2020"},{"key":"b42","series-title":"Genomics Inform","first-page":"e22","article-title":"Mathematical modeling of the impact of Omicron variant on the COVID-19 situation in South Korea","volume":"20","author":"Oh","year":"2022"},{"key":"b43","series-title":"Emerg Infect Dis","first-page":"818","article-title":"Serial interval and incubation period estimates of monkeypox virus infection in 12 jurisdictions, United States, May\u2013August 2022","volume":"29","author":"Madewell","year":"2023"},{"key":"b44","series-title":"BMC Med Res Methodol","first-page":"21","article-title":"Alternatives for logistic regression in cross-sectional studies: An empirical comparison of models that directly estimate the prevalence ratio","volume":"3","author":"Barros","year":"2003"},{"key":"b45","series-title":"Front Vet Sci","first-page":"193","article-title":"Odds ratio or prevalence ratio? An overview of reported statistical methods and appropriateness of interpretations in cross-sectional studies with dichotomous outcomes in veterinary medicine","volume":"4","author":"Martinez","year":"2017"},{"key":"b46","series-title":"Int J Med Inform","first-page":"10","article-title":"Comparison of variable selection methods for clinical predictive modeling","volume":"116","author":"Sanchez-Pinto","year":"2018"},{"key":"b47","series-title":"AIDS Lond Aids","first-page":"1509","article-title":"Estimating per-act HIV transmission risk: A systematic review","volume":"28","author":"Patel","year":"2014"},{"key":"b48","series-title":"UKHSA Latest Findings into Monkeypox Outbreak"},{"key":"b49","series-title":"PAHO\/WHO Mpox in Americas Region Dashboard"},{"key":"b50","series-title":"Int J STD AIDS","first-page":"87","article-title":"Behaviorally bisexual men as a bridge population for HIV and sexually transmitted infections? Evidence from a national probability survey","volume":"20","author":"Mercer","year":"2009"},{"key":"b51","series-title":"AIDS Lond Aids","first-page":"1031","article-title":"How many HIV infections cross the bisexual bridge? An estimate from the United States","volume":"11","author":"Kahn","year":"1997"},{"key":"b52","series-title":"Int J Public Health","first-page":"687","article-title":"Married men who have sex with men: The bridge to HIV prevention in Mumbai, India","volume":"55","author":"Setia","year":"2010"},{"key":"b53","series-title":"Emerg Infect Dis","first-page":"2078","article-title":"Early estimates of monkeypox incubation period, generation time, and reproduction number, Italy, May\u2013June 2022","volume":"28","author":"Guzzetta","year":"2022"},{"key":"b54","series-title":"J Med Virol","first-page":"e28270","article-title":"Early estimation of basic reproduction number R0 in Europe","volume":"95","author":"Branda","year":"2023"},{"key":"b55","series-title":"Open Forum Infect Dis","first-page":"ofac501","article-title":"Transmission potential of human monkeypox in mass gatherings","volume":"9","author":"Sypsa","year":"2022"},{"key":"b56","series-title":"Infect Dis Model","first-page":"338","article-title":"Early transmission dynamics of COVID-19 in a southern hemisphere setting: Lima, Peru: February 29\u2013March 30, 2020","volume":"5","author":"Munayco","year":"2020"},{"key":"b57","series-title":"Int J Environ Res Public Health","first-page":"11613","article-title":"Reliability of early estimates of the basic reproduction number of COVID-19: A systematic review and meta-analysis","volume":"19","author":"Dhungel","year":"2022"},{"key":"b58","series-title":"Nat Commun","first-page":"4100","article-title":"The role of vaccination and public awareness in forecasts of mpox incidence in the United Kingdom","volume":"14","author":"Brand","year":"2023"},{"key":"b59","series-title":"BMJ","first-page":"e073153","article-title":"Transmission dynamics of monkeypox in the United Kingdom: Contact tracing study","volume":"379","author":"Ward","year":"2022"},{"key":"b60","series-title":"J Med Virol","first-page":"e27931","article-title":"Epidemiological trends and clinical features of the ongoing monkeypox epidemic: A preliminary pooled data analysis and literature review","volume":"95","author":"Bragazzi","year":"2023"},{"key":"b61","series-title":"AIDS","first-page":"105","article-title":"Mpox severity and associated hospitalizations among people with HIV and related immunosuppression in Brazil","volume":"38","author":"Silva","year":"2024"},{"key":"b62","series-title":"Lancet Global Health","first-page":"e1012","article-title":"Description of the first global outbreak of mpox: An analysis of global surveillance data","volume":"11","author":"Laurenson-Schafer","year":"2023"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/113\/2\/article-p387.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/113\/2\/article-p387.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/113\/2\/article-p387.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T18:58:24Z","timestamp":1784919504000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/113\/2\/article-p387.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,6]]},"references-count":62,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.24-0361","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,6]]}}}