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Case Reports
. 2023 Dec;28(50):2200923.
doi: 10.2807/1560-7917.ES.2023.28.50.2200923.

Mpox outbreak in France: epidemiological characteristics and sexual behaviour of cases aged 15 years or older, 2022

Catarina Krug  1   2   3 , Arnaud Tarantola  1   3 , Emilie Chazelle  1   3 , Erica Fougère  1 , Annie Velter  1   4 , Anne Guinard  1 , Yvan Souares  1 , Anna Mercier  1 , Céline François  1 , Katia Hamdad  1 , Laetitia Tan-Lhernould  1 , Anita Balestier  1 , Hana Lahbib  1 , Nicolas Etien  1 , Pascale Bernillon  1 , Virginie De Lauzun  1 , Julien Durand  1 , Myriam Fayad  1 ; Investigation Team  5 ; Henriette De Valk  1 , François Beck  1   6 , Didier Che  1 , Bruno Coignard  1 , Florence Lot  1   7 , Alexandra Mailles  1   7 ; Investigation Team (alphabetically)
Collaborators, Affiliations
Case Reports

Mpox outbreak in France: epidemiological characteristics and sexual behaviour of cases aged 15 years or older, 2022

Catarina Krug et al. Euro Surveill. 2023 Dec.

Abstract

BackgroundLocally-acquired mpox cases were rarely reported outside Africa until May 2022, when locally-acquired-mpox cases occurred in various European countries.AimWe describe the mpox epidemic in France, including demographic and behavioural changes among a subset of cases, during its course.MethodsData were retrieved from the enhanced national surveillance system until 30 September 2022. Laboratory-confirmed cases tested positive for monkeypox virus or orthopoxviruses by PCR; non-laboratory-confirmed cases had clinical symptoms and an epidemiological link to a laboratory-confirmed case. A subset of ≥ 15-year-old male cases, notified until 1 August, was interviewed for epidemiological, clinical and sexual behaviour information. Association of symptom-onset month with quantitative outcomes was evaluated by t- or Wilcoxon tests, and with binary outcomes, by Pearson's chi-squared or Fisher exact tests.ResultsA total of 4,856 mpox cases were notified, mostly in Île-de-France region (62%; 3,025/4,855). Cases aged ≥ 15 years were predominantly male (97%; 4,668/4,812), with 37 years (range: 15-81) as mean age. Between May and July, among the subset interviewed, mpox cases increased in regions other than Île-de-France, and mean age rose from 35 (range: 21-64) to 38 years (range: 16-75; p = 0.007). Proportions of cases attending men-who-have-sex-with-men (MSM) meeting venues declined from 60% (55/91) to 46% (164/359; p = 0.012); median number of sexual partners decreased from four (interquartile range (IQR): 1-10) to two (IQR: 1-4; p < 0.001).ConclusionChanges in cases' characteristics during the epidemic, could reflect virus spread from people who were more to less behaviourally vulnerable to mpox between May and July, or MSM reducing numbers of sexual partners as recommended.

Keywords: France; Monkeypox; Mpox; Orthopoxvirus; Outbreak; Sexual and Gender Minorities; Sexual behaviour.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Confirmeda (in grey bars and blue dashed line, n = 2,950) and non-laboratory-confirmedb (in black bars and blue full line, n = 684) mpox cases by day of symptom onset, France, 7 May–25 September 2022c
Figure 2
Figure 2
Evolution of (A) mean age, with range, of male mpox cases (n = 2,216) and (B) median number, with interquartile range, of sexual partners of male mpox cases (n = 1,449), by cases’ month of symptom onset, France, 7 May–31 July 2022
Figure 3
Figure 3
Evolution by month of symptom onset of (A−I) epidemiological characteristics and (J) PrEP use of male mpox cases, or (K−L) sexual behaviours among the subset of men who have sex with men, France, 7 May–31 July 2022 (n = 2,216)
See this image and copyright information in PMC

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