The World Health Organization declared mpox a public health emergency of international concern in July 2022. To investigate global mpox transmission and population-level changes associated with controlling spread, we built phylogeographic and phylodynamic models to analyze MPXV genomes from five global regions together with air traffic and epidemiological data. Our models reveal community transmission prior to detection, changes in case reporting throughout the epidemic, and a large degree of transmission heterogeneity. We find that viral introductions played a limited role in prolonging spread after initial dissemination, suggesting that travel bans would have had only a minor impact. We find that mpox transmission in North America began declining before more than 10% of high-risk individuals in the USA had vaccine-induced immunity. Our findings highlight the importance of broader routine specimen screening surveillance for emerging infectious diseases and of joint integration of genomic and epidemiological information for early outbreak control.

中文翻译：

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未发现的扩散和广泛的本地传播推动了 2022 年的 MPOX 流行

世界卫生组织于 2022 年 7 月宣布 MPX 为国际关注的突发公共卫生事件。为了调查全球 MPOX 传播以及与控制传播相关的人口水平变化，我们建立了系统发育地理学和系统动力学模型，以分析来自全球五个地区以及空中交通的 MPXV 基因组和流行病学数据。我们的模型揭示了检测前的社区传播、整个流行病期间病例报告的变化以及很大程度的传播异质性。我们发现，病毒引入在最初传播后延长传播时间方面发挥的作用有限，这表明旅行禁令只会产生很小的影响。我们发现，在美国超过 10% 的高危人群获得疫苗诱导免疫力之前，北美的 MPOX 传播就开始下降。我们的研究结果强调了对新出现的传染病进行更广泛的常规标本筛查监测以及联合整合基因组和流行病学信息对早期疫情控制的重要性。