Routes of transmission of mpox by virus clade and geographic distribution: A systematic review

Majid M. Alshamrani; Aiman El-Saed; Sarah Al-Fayez; Kholod AlAmeer; Mohammed Al Zunitan; Mohammed Abalkhail; Fatmah Othman; Fayssal Farahat; Syed Nazeer; Wafaa Al Nasser; Maher Alharbi; Tom Fletcher; Tochi Okwor; Hibak Mahamed; Hannah Hamilton Hurwitz; Victoria Willet; April Baller

doi:10.1016/j.jiph.2025.102985

Routes of transmission of mpox by virus clade and geographic distribution: A systematic review

Majid M. Alshamrani, Aiman El-Saed, Sarah Al-Fayez, Kholod AlAmeer, Mohammed Al Zunitan, Mohammed Abalkhail, Fatmah Othman, Fayssal Farahat, Syed Nazeer, Wafaa Al Nasser, Maher Alharbi, Tom Fletcher, Tochi Okwor, Hibak Mahamed, Hannah Hamilton Hurwitz, Victoria Willet, April Baller

Clinical Sciences

Research output: Contribution to journal › Review article › peer-review

Abstract

Mpox epidemiology has experienced a dramatic change in recent years with a marked shift in transmission dynamics. The objective was to assess the route of transmission of mpox by virus clade and geographic distribution. A systematic review of studies with transmission data published between September 2022 and September 2024 was conducted. A total 222 studies including 45,553 mpox patients were included. Approximately 93.0 % of the patients were males and 98.6 % were adults. Approximately 89.1 % were men who have sex with men, 5.3 % were heterosexual men, and 5.5 % were heterosexual women. Approximately 95.3 % reported sexual contact (65.1 % confirmed and 30.3 % suspected), 2.9 % close non-sexual contact, and 1.8 % multiple/other routes (not including inhalation). Sexual contact represented > 90 % of transmission in all regions but African region. Most studies reported clade data showed clade IIb with a similar transmission pattern as described above. This can support the formulation of infection prevention and control recommendations.

Original language	English
Article number	102985
Journal	Journal of Infection and Public Health
Volume	18
Issue number	12
DOIs	https://doi.org/10.1016/j.jiph.2025.102985
Publication status	Published - 14 Oct 2025

Keywords

Geography
Mpox
Route of transmission
Sexual contact
Systematic review
Virus clade

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Alshamrani, M. M., El-Saed, A., Al-Fayez, S., AlAmeer, K., Al Zunitan, M., Abalkhail, M., Othman, F., Farahat, F., Nazeer, S., Al Nasser, W., Alharbi, M., Fletcher, T., Okwor, T., Mahamed, H., Hamilton Hurwitz, H., Willet, V., & Baller, A. (2025). Routes of transmission of mpox by virus clade and geographic distribution: A systematic review. Journal of Infection and Public Health, 18(12), Article 102985. https://doi.org/10.1016/j.jiph.2025.102985

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title = "Routes of transmission of mpox by virus clade and geographic distribution: A systematic review",

abstract = "Mpox epidemiology has experienced a dramatic change in recent years with a marked shift in transmission dynamics. The objective was to assess the route of transmission of mpox by virus clade and geographic distribution. A systematic review of studies with transmission data published between September 2022 and September 2024 was conducted. A total 222 studies including 45,553 mpox patients were included. Approximately 93.0 \% of the patients were males and 98.6 \% were adults. Approximately 89.1 \% were men who have sex with men, 5.3 \% were heterosexual men, and 5.5 \% were heterosexual women. Approximately 95.3 \% reported sexual contact (65.1 \% confirmed and 30.3 \% suspected), 2.9 \% close non-sexual contact, and 1.8 \% multiple/other routes (not including inhalation). Sexual contact represented > 90 \% of transmission in all regions but African region. Most studies reported clade data showed clade IIb with a similar transmission pattern as described above. This can support the formulation of infection prevention and control recommendations.",

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author = "Alshamrani, \{Majid M.\} and Aiman El-Saed and Sarah Al-Fayez and Kholod AlAmeer and \{Al Zunitan\}, Mohammed and Mohammed Abalkhail and Fatmah Othman and Fayssal Farahat and Syed Nazeer and \{Al Nasser\}, Wafaa and Maher Alharbi and Tom Fletcher and Tochi Okwor and Hibak Mahamed and \{Hamilton Hurwitz\}, Hannah and Victoria Willet and April Baller",

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Alshamrani, MM, El-Saed, A, Al-Fayez, S, AlAmeer, K, Al Zunitan, M, Abalkhail, M, Othman, F, Farahat, F, Nazeer, S, Al Nasser, W, Alharbi, M, Fletcher, T, Okwor, T, Mahamed, H, Hamilton Hurwitz, H, Willet, V & Baller, A 2025, 'Routes of transmission of mpox by virus clade and geographic distribution: A systematic review', Journal of Infection and Public Health, vol. 18, no. 12, 102985. https://doi.org/10.1016/j.jiph.2025.102985

TY - JOUR

T1 - Routes of transmission of mpox by virus clade and geographic distribution: A systematic review

AU - Alshamrani, Majid M.

AU - El-Saed, Aiman

AU - Al-Fayez, Sarah

AU - AlAmeer, Kholod

AU - Al Zunitan, Mohammed

AU - Abalkhail, Mohammed

AU - Othman, Fatmah

AU - Farahat, Fayssal

AU - Nazeer, Syed

AU - Al Nasser, Wafaa

AU - Alharbi, Maher

AU - Fletcher, Tom

AU - Okwor, Tochi

AU - Mahamed, Hibak

AU - Hamilton Hurwitz, Hannah

AU - Willet, Victoria

AU - Baller, April

PY - 2025/10/14

Y1 - 2025/10/14

N2 - Mpox epidemiology has experienced a dramatic change in recent years with a marked shift in transmission dynamics. The objective was to assess the route of transmission of mpox by virus clade and geographic distribution. A systematic review of studies with transmission data published between September 2022 and September 2024 was conducted. A total 222 studies including 45,553 mpox patients were included. Approximately 93.0 % of the patients were males and 98.6 % were adults. Approximately 89.1 % were men who have sex with men, 5.3 % were heterosexual men, and 5.5 % were heterosexual women. Approximately 95.3 % reported sexual contact (65.1 % confirmed and 30.3 % suspected), 2.9 % close non-sexual contact, and 1.8 % multiple/other routes (not including inhalation). Sexual contact represented > 90 % of transmission in all regions but African region. Most studies reported clade data showed clade IIb with a similar transmission pattern as described above. This can support the formulation of infection prevention and control recommendations.

AB - Mpox epidemiology has experienced a dramatic change in recent years with a marked shift in transmission dynamics. The objective was to assess the route of transmission of mpox by virus clade and geographic distribution. A systematic review of studies with transmission data published between September 2022 and September 2024 was conducted. A total 222 studies including 45,553 mpox patients were included. Approximately 93.0 % of the patients were males and 98.6 % were adults. Approximately 89.1 % were men who have sex with men, 5.3 % were heterosexual men, and 5.5 % were heterosexual women. Approximately 95.3 % reported sexual contact (65.1 % confirmed and 30.3 % suspected), 2.9 % close non-sexual contact, and 1.8 % multiple/other routes (not including inhalation). Sexual contact represented > 90 % of transmission in all regions but African region. Most studies reported clade data showed clade IIb with a similar transmission pattern as described above. This can support the formulation of infection prevention and control recommendations.

KW - Geography

KW - Mpox

KW - Route of transmission

KW - Sexual contact

KW - Systematic review

KW - Virus clade

U2 - 10.1016/j.jiph.2025.102985

DO - 10.1016/j.jiph.2025.102985

M3 - Review article

AN - SCOPUS:105018624666

SN - 1876-0341

VL - 18

JO - Journal of Infection and Public Health

JF - Journal of Infection and Public Health

IS - 12

M1 - 102985

ER -

Routes of transmission of mpox by virus clade and geographic distribution: A systematic review

Abstract

Keywords

UN SDGs

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