Monkeypox virus infections in low-risk groups during the 2022-23 global outbreak: An analysis of the WHO global report.

Introduction: In the 2022-23 Mpox outbreak, cases also occurred in children, adolescents, and adults aged 50 years and older, for whom the risk of transmission is low and whose epidemiological characteristics are less known, compared to high-risk groups such as young adults. Here we describe the epidemiological characteristics of Mpox in children, adolescents and adults aged 50 years and older in the global Mpox outbreak. Methods: A retrospective study on laboratory-confirmed surveillance data of Mpox cases reported to World Health Organization (WHO) was conducted. Case data from WHO's 2022-23 Mpox Outbreak: Global Trends from 1 January 2022 to 1 September 2023 was used for our analysis. We included cases reported by WHO with data on age (children [range, 0 to 9 years], adolescents [range, 10 to 17 years], adults 50 to 59 years, and adults 60 years and older), gender, WHO region, hospital admission, and intensive care unit admission. Results: Until September 01, 2023, data from 89,752 cases of Mpox have been reported to WHO. Of all the reported cases, 1124 (1.3%), 6296 (7.0%) and 1501 (1.6%) were children and adolescents, adults aged 50-59 years, and adults aged 60 years or older, respectively, and the proportion varied among WHO regions. There was a high proportion of cases among population aged 0-17 years, adolescents (256 [66.3%]) from the region of the Americas and girls aged 0-9 years [127 (46.7%)] from the African region. Men aged 50-59 years (3495 [57.2%] vs. 2553 [41.8%] cases from the region of the Americas and the European region, respectively) and men aged 60-69 years (639 [60.0%] vs. 607 [48.4%] from the region of the Americas and the European region) were most affected, compared to other age groups and women. Among children, adolescents, and adults aged 50 years or older, a low proportion of cases developed some complications and required hospital admission, and some cases were admitted to the intensive care unit. Conclusions: Epidemiological evidence of Mpox in these low-risk groups highlights the risk of wider community transmission. Therefore, while efforts continue to control the global outbreak of Mpox in high-risk groups, it is also necessary to ensure that these low-risk groups have access to timely health care and vaccination.