Uncovering the impact of infection routes on within-host MPXV dynamics: Insights from a mathematical modeling study.

The unprecedented mpox outbreak in non-endemic regions during 2022-2023, which has seen a recent resurgence in late 2023-2024, poses a significant public health threat. Despite its global spread, the viral dynamics of mpox infection and the specific characteristics driving these outbreaks remain ins...

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Main Authors: Qi Deng, Woldegebriel Assefa Woldegerima, Wenjing Zhang, Ali Asgary, Jude Dzevela Kong, Sarah Flicker, Nicholas H Ogden, James Orbinski, Nicola Luigi Bragazzi, Jianhong Wu
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-05-01
Series:PLoS Computational Biology
Online Access:https://doi.org/10.1371/journal.pcbi.1013073
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author Qi Deng
Woldegebriel Assefa Woldegerima
Wenjing Zhang
Ali Asgary
Jude Dzevela Kong
Sarah Flicker
Nicholas H Ogden
James Orbinski
Nicola Luigi Bragazzi
Jianhong Wu
author_facet Qi Deng
Woldegebriel Assefa Woldegerima
Wenjing Zhang
Ali Asgary
Jude Dzevela Kong
Sarah Flicker
Nicholas H Ogden
James Orbinski
Nicola Luigi Bragazzi
Jianhong Wu
author_sort Qi Deng
collection DOAJ
description The unprecedented mpox outbreak in non-endemic regions during 2022-2023, which has seen a recent resurgence in late 2023-2024, poses a significant public health threat. Despite its global spread, the viral dynamics of mpox infection and the specific characteristics driving these outbreaks remain insufficiently explored. We develop mathematical models to examine the interactions between host immune responses and the virus across three distinct infection routes (intravenous, intradermal, and intrarectal). The models are calibrated using viral load data from macaques infected through each of these three infection routes. Subsequently, we calculate the infectiousness of each infected macaque, finding that the proportion of presymptomatic infectiousness is highest in those infected via sexual contact, followed by skin-to-skin contact. These observations demonstrate that close contact during sexual activity is a significant route of viral transmission, with presymptomatic spread playing a crucial role in the 2022-2023 multi-country outbreak and potentially also in the 2023-2024 multi-source outbreak. Leveraging model predictions and infectiousness data, we assess the impact of antiviral drugs on interventions against mpox infection. Model simulations suggest that early administration of antiviral drugs can reduce peak viral loads, even in individuals with compromised immunity, particularly in cases of infection through skin-to-skin and sexual contact. These results underscore the importance of initiating antiviral treatment as early as possible for mpox-infected patients with compromised immune systems, such as those who are HIV-positive.
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spelling doaj-art-b7f4efb68c8c4b4e93b6f3f6da6c10d92025-08-20T03:13:29ZengPublic Library of Science (PLoS)PLoS Computational Biology1553-734X1553-73582025-05-01215e101307310.1371/journal.pcbi.1013073Uncovering the impact of infection routes on within-host MPXV dynamics: Insights from a mathematical modeling study.Qi DengWoldegebriel Assefa WoldegerimaWenjing ZhangAli AsgaryJude Dzevela KongSarah FlickerNicholas H OgdenJames OrbinskiNicola Luigi BragazziJianhong WuThe unprecedented mpox outbreak in non-endemic regions during 2022-2023, which has seen a recent resurgence in late 2023-2024, poses a significant public health threat. Despite its global spread, the viral dynamics of mpox infection and the specific characteristics driving these outbreaks remain insufficiently explored. We develop mathematical models to examine the interactions between host immune responses and the virus across three distinct infection routes (intravenous, intradermal, and intrarectal). The models are calibrated using viral load data from macaques infected through each of these three infection routes. Subsequently, we calculate the infectiousness of each infected macaque, finding that the proportion of presymptomatic infectiousness is highest in those infected via sexual contact, followed by skin-to-skin contact. These observations demonstrate that close contact during sexual activity is a significant route of viral transmission, with presymptomatic spread playing a crucial role in the 2022-2023 multi-country outbreak and potentially also in the 2023-2024 multi-source outbreak. Leveraging model predictions and infectiousness data, we assess the impact of antiviral drugs on interventions against mpox infection. Model simulations suggest that early administration of antiviral drugs can reduce peak viral loads, even in individuals with compromised immunity, particularly in cases of infection through skin-to-skin and sexual contact. These results underscore the importance of initiating antiviral treatment as early as possible for mpox-infected patients with compromised immune systems, such as those who are HIV-positive.https://doi.org/10.1371/journal.pcbi.1013073
spellingShingle Qi Deng
Woldegebriel Assefa Woldegerima
Wenjing Zhang
Ali Asgary
Jude Dzevela Kong
Sarah Flicker
Nicholas H Ogden
James Orbinski
Nicola Luigi Bragazzi
Jianhong Wu
Uncovering the impact of infection routes on within-host MPXV dynamics: Insights from a mathematical modeling study.
PLoS Computational Biology
title Uncovering the impact of infection routes on within-host MPXV dynamics: Insights from a mathematical modeling study.
title_full Uncovering the impact of infection routes on within-host MPXV dynamics: Insights from a mathematical modeling study.
title_fullStr Uncovering the impact of infection routes on within-host MPXV dynamics: Insights from a mathematical modeling study.
title_full_unstemmed Uncovering the impact of infection routes on within-host MPXV dynamics: Insights from a mathematical modeling study.
title_short Uncovering the impact of infection routes on within-host MPXV dynamics: Insights from a mathematical modeling study.
title_sort uncovering the impact of infection routes on within host mpxv dynamics insights from a mathematical modeling study
url https://doi.org/10.1371/journal.pcbi.1013073
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