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. 2023 Mar;28(12):2200772.
doi: 10.2807/1560-7917.ES.2023.28.12.2200772.

Mpox outbreak in the Netherlands, 2022: public health response, characteristics of the first 1,000 cases and protection of the first-generation smallpox vaccine

Catharina E van Ewijk  1   2 , Fuminari Miura  1   3 , Gini van Rijckevorsel  1   4 , Henry Jc de Vries  5   6   7   8 , Matthijs Ra Welkers  4   9 , Oda E van den Berg  1 , Ingrid Hm Friesema  1 , Patrick R van den Berg  1 , Thomas Dalhuisen  1 , Jacco Wallinga  1   10 , Diederik Brandwagt  1 , Brigitte Agl van Cleef  1   4 , Harry Vennema  1 , Bettie Voordouw  1 , Marion Koopmans  11 , Annemiek A van der Eijk  11 , Corien M Swaan  1 , Margreet Jm Te Wierik  1 , Tjalling Leenstra  1 , Eline Op de Coul  1 , Eelco Franz  1 ; Dutch Mpox Response Team  1   10   11   2   3   4   5   6   7   8   9 ; Members of the Dutch Mpox Response Team
Collaborators, Affiliations

Mpox outbreak in the Netherlands, 2022: public health response, characteristics of the first 1,000 cases and protection of the first-generation smallpox vaccine

Catharina E van Ewijk et al. Euro Surveill. 2023 Mar.

Abstract

In early May 2022, a global outbreak of mpox started among persons without travel history to regions known to be enzootic for monkeypox virus (MPXV). On 8 August 2022, the Netherlands reported its 1,000th mpox case, representing a cumulative incidence of 55 per million population, one of the highest cumulative incidences worldwide. We describe characteristics of the first 1,000 mpox cases in the Netherlands, reported between 20 May and 8 August 2022, within the context of the public health response. These cases were predominantly men who have sex with men aged 31-45 years. The vast majority of infections were acquired through sexual contact with casual partners in private or recreational settings including LGBTQIA+ venues in the Netherlands. This indicates that, although some larger upsurges occurred from point-source and/or travel-related events, the outbreak was mainly characterised by sustained transmission within the Netherlands. In addition, we estimated the protective effect of first-generation smallpox vaccine against moderate/severe mpox and found a vaccine effectiveness of 58% (95% CI: 17-78%), suggesting moderate protection against moderate/severe mpox symptoms on top of any possible protection by this vaccine against MPXV infection and disease. Communication with and supporting the at-risk population in following mitigation measures remains essential.

Keywords: MSM; Mpox; outbreak; the Netherlands; zoonoses.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure
Figure
Laboratory-confirmed mpox cases by date of symptom onset, the Netherlands, 20 May–1 August 2022 (n = 894), and nowcast of confirmed cases by date of onset until 1 August
See this image and copyright information in PMC

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