Though the surge in Sierra Leone has received much of the attention, cases are also rising in two other countries in West Africa: Ghana and Liberia.
The test the US Centers for Disease Control and Prevention uses to identify clade I mpox cases is 'most likely not reliable' for detection of the substrain identified in the study, the authors say.
Another mpox study today showed that dose-sparing vaccine administration of the Jynneos vaccine appeared to have worked.
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Cases so far this year are triple the same period last year, and the WHO said more outbreak resources are needed, including access to vaccines.
Only 1 of 109 mpox cases was tied to workplace exposure, likely from a sharps injury.
The step paves the way for the vaccine to be given at a broader range of sites, including doctors offices and pharmacies.
Swedish and Dutch studies find, however, that antibody levels remain high in people who had previously had smallpox vaccines.
Mpox spread is occurring alongside a refugee crisis, internal violence, and a host of other disease outbreaks.
By the end of November 2022, Florida had recorded 2,845 confirmed or probable mpox cases.
For women, the estimated sample case hospitalization risk was 18%, compared with 5% for men, but the authors noted 'considerable' uncertainty because of the small number of cases in women.
The epi investigation revealed that many of the patients were young women involved in sex work.
The authors found strong evidence of viral circulation before initial case detection in each affected world region.
The most common symptom throughout the study period was rash, followed by enlarged lymph nodes.
