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Abstract

Background

Since May 2022, an mpox outbreak affecting primarily men who have sex with men (MSM) has occurred in numerous non-endemic countries worldwide. As MSM frequently reported multiple sexual encounters in this outbreak, reliably determining the time of infection is difficult; consequently, estimation of the incubation period is challenging.

Aim

We aimed to provide valid and precise estimates of the incubation period distribution of mpox by using cases associated with early outbreak settings where infection likely occurred.

Methods

Colleagues in European countries were invited to provide information on exposure intervals and date of symptom onset for mpox cases who attended a fetish festival in Antwerp, Belgium, a gay pride festival in Gran Canaria, Spain or a particular club in Berlin, Germany, where early mpox outbreaks occurred. Cases of these outbreaks were pooled; doubly censored models using the log-normal, Weibull and Gamma distributions were fitted to estimate the incubation period distribution.

Results

We included data on 122 laboratory-confirmed cases from 10 European countries. Depending on the distribution used, the median incubation period ranged between 8 and 9 days, with 5th and 95th percentiles ranging from 2 to 3 and from 20 to 23 days, respectively. The shortest interval that included 50% of incubation periods spanned 8 days (4–11 days).

Conclusion

Current public health management of close contacts should consider that in approximately 5% of cases, the incubation period exceeds the commonly used monitoring period of 21 days.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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A corrected article has been published for this content:
Erratum for Euro Surveill. 2023;28(27)
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2023-07-06
2024-04-28
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2023.28.27.2200806
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Estimated incubation period distributions of mpox using cases from two international European festivals and outbreaks in a club in Berlin, May to June 2022
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Sarah+E+McFarland&option1=author&noRedirect=true" class="nonDisambigAuthorLink">McFarland Sarah E</a>, <a href="/search?value1=Ulrich+Marcus&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Marcus Ulrich</a>, <a href="/search?value1=Lukas+Hemmers&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hemmers Lukas</a>, <a href="/search?value1=Fuminari+Miura&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Miura Fuminari</a>, <a href="/search?value1=Jes%C3%BAs+I%C3%B1igo+Mart%C3%ADnez&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Iñigo Martínez Jesús</a>, <a href="/search?value1=Fernando+Mart%C3%ADn+Mart%C3%ADnez&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Martínez Fernando Martín</a>, <a href="/search?value1=Elisa+Gil+Montalb%C3%A1n&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Montalbán Elisa Gil</a>, <a href="/search?value1=Emilie+Chazelle&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Chazelle Emilie</a>, <a href="/search?value1=Alexandra+Mailles&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mailles Alexandra</a>, <a href="/search?value1=Yassoungo+Silue&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Silue Yassoungo</a>, <a href="/search?value1=Na%C3%AFma+Hammami&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hammami Naïma</a>, <a href="/search?value1=Amaryl+Lecompte&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lecompte Amaryl</a>, <a href="/search?value1=Nicolas+Ledent&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ledent Nicolas</a>, <a href="/search?value1=Wim+Vanden+Berghe&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Vanden Berghe Wim</a>, <a href="/search?value1=Laurens+Liesenborghs&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Liesenborghs Laurens</a>, <a href="/search?value1=Dorien+Van+den+Bossche&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Van den Bossche Dorien</a>, <a href="/search?value1=Paul+R+Cleary&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Cleary Paul R</a>, <a href="/search?value1=Jacco+Wallinga&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Wallinga Jacco</a>, <a href="/search?value1=Eve+P+Robinson&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Robinson Eve P</a>, <a href="/search?value1=Tone+Bjordal+Johansen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Johansen Tone Bjordal</a>, <a href="/search?value1=Antra+Bormane&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bormane Antra</a>, <a href="/search?value1=Tanya+Melillo&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Melillo Tanya</a>, <a href="/search?value1=Cornelia+Seidl&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Seidl Cornelia</a>, <a href="/search?value1=Liza+Coyer&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Coyer Liza</a>, <a href="/search?value1=Ronja+Boberg&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Boberg Ronja</a>, <a href="/search?value1=Annette+Jurke&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Jurke Annette</a>, <a href="/search?value1=Dirk+Werber&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Werber Dirk</a>, <a href="/search?value1=Alexander+Bartel&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bartel Alexander</a></span>. Estimated incubation period distributions of mpox using cases from two international European festivals and outbreaks in a club in Berlin, May to June 2022. <a href="/content/ecdc">Euro Surveill.</a> 2023;28(27):pii=2200806. <a href="https://doi.org/10.2807/1560-7917.ES.2023.28.27.2200806" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2023.28.27.2200806</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 05 Oct 2022;&nbsp;&nbsp; <span class="generated">Accepted</span>: 13 Jan 2023 </span> </p>
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