Evidence map›Paper›PMID 42050447›Full record

SynthesisBMC infectious diseases2026

Secondary attack rates after mpox exposure in multiple settings during the 2022-2024 pandemic: a systematic review.

Aiman El-Saed, Sarah Al-Fayez, Kholod AlAmeer, Mohammed Al Zunitan, Fatmah Othman, Fayssal Farahat, Tom Fletcher, Tochi Okwor, Hibak Mahamed, Hannah Hamilton Hurwitz and 3 more

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Aiman El-SaedInfection Prevention and Control Department, King Abdulaziz Medical City, P.O. Box 22490, Riyadh, 11426, Saudi Arabia.
Sarah Al-FayezInfection Prevention and Control Department, King Abdulaziz Medical City, P.O. Box 22490, Riyadh, 11426, Saudi Arabia.
Kholod AlAmeerInfection Prevention and Control Department, King Abdulaziz Medical City, P.O. Box 22490, Riyadh, 11426, Saudi Arabia.
Mohammed Al ZunitanInfection Prevention and Control Department, King Abdulaziz Medical City, P.O. Box 22490, Riyadh, 11426, Saudi Arabia.
Fatmah OthmanKing Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Fayssal FarahatInfection Prevention and Control Department, King Abdulaziz Medical City, P.O. Box 22490, Riyadh, 11426, Saudi Arabia.
Tom FletcherDepartment of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
Tochi OkworThe Nigeria Centre for Disease Control (NCDC), Abuja, Nigeria.
Hibak MahamedWorld Health Organization, Geneva, Switzerland.
Hannah Hamilton HurwitzWorld Health Organization, Geneva, Switzerland.
Victoria WilletWorld Health Organization, Geneva, Switzerland.
Majid M AlshamraniInfection Prevention and Control Department, King Abdulaziz Medical City, P.O. Box 22490, Riyadh, 11426, Saudi Arabia. dr_shomrani@yahoo.com.
April BallerWorld Health Organization, Geneva, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEstimating secondary attack rates is essential for assessing the spread potential of mpox during an outbreak. The objective of the study was to assess secondary attack rates after mpox exposure in multiple settings worldwide.

methodsA systematic review was conducted for studies published between May 2022 and September 2024 and reporting mpox exposure data. The levels and types of exposure were defined as per the study description.

resultsA total of 62 studies including 8712 mpox exposures were included. Out of 8712 exposures, 239 were associated with mpox infection (secondary attack rate of 2.74%). The rates were highest in household setting (4.02%), intermediate in congregate/community setting (2.50%), and lowest in healthcare setting (0.81%). The rates were highest in the African region (8.00%), intermediate in the European region (4.23%), and lowest in the American region (1.10%). Clade data were available in 17 (27.42%) studies; mainly clade IIb (15 studies) and to less extent clades Ia and Ib (one study each). Secondary attack rates were higher among individuals reporting sexual contact (11.35%) compared with non-sexual contact (1.34%, p < 0.001). Non-sexual contact exposures (83.17%) were more frequent (p < 0.001) than sexual contact exposures (13.66%, p < 0.001).

conclusionsThe overall mpox secondary attack rate in the published data from the 2022-2024 multi-country outbreak is relatively low (< 3%). While exposures involving non-sexual contact were more prevalent in all settings, sexual contact was responsible for the majority of secondary infections in household and congregate/community settings. The findings may guide mpox preventive and control activities in different settings. CLINICAL TRIAL: Not applicable.

Indexed as

Mpox, MonkeypoxPandemicsHumansCladeExposureMpoxSecondary attack rateSystematic review

Identifiers

PMID42050447
PMCPMC13274034

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.