Modelling the effectiveness of an isolation strategy for managing mpox outbreaks with variable infectiousness profiles

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.

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Publication Details

Journal
Nature Communications
Published
2024-08-26
DOI
https://doi.org/10.1038/s41467-024-51143-w
Citations
10
Primary Topic
Poxvirus research and outbreaks
Type
article
Field-Weighted Citation Impact
2.94

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article

Modelling the effectiveness of an isolation strategy for managing mpox outbreaks with variable infectiousness profiles

Hyeongki Park, Jacco Wallinga, Robin N. Thompson, Noriko Iwamoto et al.
10 citations
Nature Communications
Poxvirus research and outbreaks
2.94
article

Modelling the effectiveness of an isolation strategy for managing mpox outbreaks with variable infectiousness profiles

Hyeongki Park, Jacco Wallinga, Robin N. Thompson, Noriko Iwamoto, William S. Hart, Eline Op de Coul, Yong Dam Jeong, Masahiro Ishikane, Kazuyuki Aihara, Fuminari Miura, Takara Nishiyama, Shingo Iwami, Norio Ohmagari, Koichi Watashi, Ayana Sakurai, Michiyo Suzuki
article en
10 citations

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.

Nature CommunicationsVol. 15(1)
Kyushu University (JP), Kyoto University (JP), Leiden University Medical Center (NL), University of Oxford (GB), National Institute of Infectious Diseases (JP), National Center for Global Health and Medicine (JP), RIKEN Center for Sustainable Resource Science (JP), National Institute for Public Health and the Environment (NL), Japan Bio Products (Japan) (JP), Japanese Foundation For Cancer Research (JP), Ehime University (JP), Pusan National University (KR), Nagoya University (JP), The University of Tokyo (JP)
Japan Agency for Medical Research and Development, National Research Foundation, Ministry of Education, Culture, Sports, Science and Technology, National Research Foundation of Korea, Secom Science and Technology Foundation, University of Tokyo, Ministry of Science and ICT, South Korea, Japan Society for the Promotion of Science, Core Research for Evolutional Science and Technology, JST-Mirai Program, Moonshot Research and Development Program
Partnerships for the goals
Openalex Percentile: Top 9%
Poxvirus research and outbreaks
2.94
DOIOpen Access PDFOpenAlex
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