Modelling the effectiveness of an isolation strategy for managing mpox outbreaks with variable infectiousness profiles.
Jeong, Yong Dam Hart, William S Thompson, Robin N Ishikane, Masahiro Nishiyama, Takara Park, Hyeongki Iwamoto, Noriko Sakurai, Ayana Suzuki, Michiyo Aihara, Kazuyuki
Jeong, Yong Dam
Hart, William S
Thompson, Robin N
Ishikane, Masahiro
Nishiyama, Takara
Park, Hyeongki
Iwamoto, Noriko
Sakurai, Ayana
Suzuki, Michiyo
Aihara, Kazuyuki
Series / Report no.
Open Access
Type
Journal Article
Article
Article
Language
en
Date of publication
2024-08-26
Year of publication
Research Projects
Organizational Units
Journal Issue
Title
Modelling the effectiveness of an isolation strategy for managing mpox outbreaks with variable infectiousness profiles.
Translated Title
Published in
Nat Commun 2024; 15(1):7112
Abstract
The global outbreak of mpox in 2022 and subsequent sporadic outbreaks in 2023 highlighted the importance of nonpharmaceutical interventions such as case isolation. Individual variations in viral shedding dynamics may lead to either premature ending of isolation for infectious individuals, or unnecessarily prolonged isolation for those who are no longer infectious. Here, we developed a modeling framework to characterize heterogeneous mpox infectiousness profiles - specifically, when infected individuals cease to be infectious - based on viral load data. We examined the potential effectiveness of three different isolation rules: a symptom-based rule (the current guideline in many countries) and rules permitting individuals to stop isolating after either a fixed duration or following tests that indicate that they are no longer likely to be infectious. Our analysis suggests that the duration of viral shedding ranges from 23 to 50 days between individuals. The risk of infected individuals ending isolation too early was estimated to be 8.8% (95% CI: 6.7-10.5) after symptom clearance and 5.4% (95% CI: 4.1-6.7) after 3 weeks of isolation. While these results suggest that the current standard practice for ending isolation is effective, we found that unnecessary isolation following the infectious period could be reduced by adopting a testing-based rule.