Background During the 2022 global mpox outbreak, the cumulative number of countries reporting their first imported case quickly rose in the early phase, but the importation rate subsequently slowed down, leaving many countries reporting no cases by the 2022 year-end. Methods We developed a mathematical model of international dissemination of mpox infections incorporating sexual networks and global mobility data. We used this model to characterize the mpox importation patterns observed in 2022 and to discuss the potential of further international spread. Results Our proposed model better explained the observed importation patterns than models not assuming heterogeneity in sexual contacts. Estimated importation hazards decreased in most countries, surpassing the global case count decline, suggesting a reduced per-case risk of importation. We assessed each country's potential to export mpox cases until the end of an epidemic, identifying countries capable of contributing to the future international spread. Conclusions The accumulation of immunity among high-risk individuals over highly heterogeneous sexual networks may have contributed to the slowdown in the rate of mpox importations. Nevertheless, the existence of countries with the potential to contribute to the global spread of mpox highlights the importance of equitable resource access to prevent the global resurgence of mpox.

中文翻译：

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2022 年男男性行为者之间沉重的性接触网络推动了猴痘输入风险的动态格局


背景在 2022 年全球猴痘疫情期间，报告首例输入病例的国家累计数量在早期迅速上升，但随后输入率放缓，导致许多国家在 2022 年底前没有报告病例。方法 我们开发了一个 mpox 感染国际传播的数学模型，其中包含性网络和全球流动性数据。我们使用此模型来描述 2022 年观察到的猴痘输入模式，并讨论进一步国际传播的可能性。结果我们提出的模型比不假设性接触异质性的模型更好地解释了观察到的输入模式。大多数国家/地区的估计输入风险有所下降，超过了全球病例数的下降幅度，这表明每例输入风险降低。我们评估了每个国家在疫情结束前输出猴痘病例的可能性，确定了能够促进未来国际传播的国家。结论 高危个体对高度异质性网络的免疫力积累可能导致 mpox 输入速度的放缓。然而，存在可能导致 mpox 全球传播的国家凸显了公平获取资源以防止 mpox 在全球卷土重来的重要性。