Objective To analyse the transmission dynamics of the monkeypox outbreak in the UK, declared a Public Health Emergency of International Concern in July 2022. Design Contact tracing study, linking data on case-contact pairs and on probable exposure dates. Setting Case questionnaires from the UK Health Security Agency (UKHSA), United Kingdom. Participants 2746 people with polymerase chain reaction confirmed monkeypox virus in the UK between 6 May and 1 August 2022. Main outcome measures The incubation period and serial interval of a monkeypox infection using two bayesian time delay models—one corrected for interval censoring (ICC—interval censoring corrected) and one corrected for interval censoring, right truncation, and epidemic phase bias (ICRTC—interval censoring right truncation corrected). Growth rates of cases by reporting date, when monkeypox virus was confirmed and reported to UKHSA, were estimated using generalised additive models. Results The mean age of participants was 37.8 years and 95% reported being gay, bisexual, and other men who have sex with men (1160 out of 1213 reporting). The mean incubation period was estimated to be 7.6 days (95% credible interval 6.5 to 9.9) using the ICC model and 7.8 days (6.6 to 9.2) using the ICRTC model. The estimated mean serial interval was 8.0 days (95% credible interval 6.5 to 9.8) using the ICC model and 9.5 days (7.4 to 12.3) using the ICRTC model. Although the mean serial interval was longer than the incubation period for both models, short serial intervals were more common than short incubation periods, with the 25th centile and the median of the serial interval shorter than the incubation period. For the ICC and ICRTC models, the corresponding estimates ranged from 1.8 days (95% credible interval 1.5 to 1.8) to 1.6 days (1.4 to 1.6) shorter at the 25th centile and 1.6 days (1.5 to 1.7) to 0.8 days (0.3 to 1.2) shorter at the median. 10 out of 13 linked patients had documented pre-symptomatic transmission. Doubling times of cases declined from 9.07 days (95% confidence interval 12.63 to 7.08) on the 6 May, when the first case of monkeypox was reported in the UK, to a halving time of 29 days (95% confidence interval 38.02 to 23.44) on 1 August. Conclusions Analysis of the instantaneous growth rate of monkeypox incidence indicates that the epidemic peaked in the UK as of 9 July and then started to decline. Short serial intervals were more common than short incubation periods suggesting considerable pre-symptomatic transmission, which was validated through linked patient level records. For patients who could be linked through personally identifiable data, four days was the maximum time that transmission was detected before symptoms manifested. An isolation period of 16 to 23 days would be required to detect 95% of people with a potential infection. The 95th centile of the serial interval was between 23 and 41 days, suggesting long infectious periods. An application can be made to the UK Health Security Agency. Data requests can be made to the Office for Data Release () and by contacting DataAccess@ukhsa.gov.uk. All requests to access data are reviewed by the Office for Data Release and are subject to strict confidentiality provisions in line with the requirements of: the common law duty of confidentiality, data protection legislation (including the General Data Protection Regulation), Caldicott principles, the Information Commissioner’s statutory data sharing code of practice, and the national data opt-out programme. The trace results for the shape and scale parameter from the from the Markov chain Monte Carlo sampler and the model code can be found here: .

中文翻译：

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英国猴痘的传播动态：接触者追踪研究


目的 分析 2022 年 7 月宣布为国际关注的突发公共卫生事件的英国猴痘疫情的传播动态。设计接触者追踪研究，将病例-接触者对和可能接触日期的数据联系起来。来自英国英国健康安全局 (UKHSA) 的案例调查问卷。 2022 年 5 月 6 日至 8 月 1 日期间，2746 名患有聚合酶链反应的参与者在英国确诊了猴痘病毒。 主要结果指标 使用两种贝叶斯时间延迟模型（其中一个针对间隔审查进行校正）来衡量猴痘感染的潜伏期和系列间隔删失校正）和一个校正区间删失、右截断和流行病阶段偏差的校正（ICRTC——区间删失右截断校正）。使用广义累加模型估计了按报告日期（猴痘病毒被确认并向 UKHSA 报告）的病例增长率。结果 参与者的平均年龄为 37.8 岁，95% 的人报告为同性恋、双性恋和其他男男性行为者（1213 名报告中的 1160 名）。使用 ICC 模型估计平均潜伏期为 7.6 天（95% 可信区间为 6.5 至 9.9），使用 ICRTC 模型估计为 7.8 天（6.6 至 9.2）。使用 ICC 模型估计的平均序列间隔为 8.0 天（95% 可信间隔为 6.5 至 9.8），使用 ICRTC 模型为 9.5 天（7.4 至 12.3）。尽管两个模型的平均序列间隔都长于潜伏期，但短序列间隔比短潜伏期更常见，其中 25 个百分位数和序列间隔中位数比潜伏期短。对于 ICC 和 ICRTC 模型，相应的估计范围为 1.8 天（95% 可信区间 1.5 至 1.8）到 1。第 25 个百分位处缩短 6 天（1.4 至 1.6），中位处缩短 1.6 天（1.5 至 1.7）至 0.8 天（0.3 至 1.2）。 13 名相关患者中有 10 名已记录有症状前传播。病例倍增时间从 5 月 6 日英国报告首例猴痘病例时的 9.07 天（95% 置信区间 12.63 至 7.08）下降到减半时间 29 天（95% 置信区间 38.02 至 23.44） 8 月 1 日。结论 对猴痘发病率瞬时增长率的分析表明，英国疫情于 7 月 9 日达到顶峰，然后开始下降。短的连续间隔比短的潜伏期更常见，表明有相当多的症状前传播，这一点通过链接的患者水平记录得到了验证。对于可以通过个人身份数据联系起来的患者来说，四天是在症状出现之前检测到传播的最长时间。需要 16 至 23 天的隔离期才能检测出 95% 的潜在感染者。系列间隔的第 95 个百分位在 23 至 41 天之间，表明传染期较长。可以向英国健康安全局提出申请。可以向数据发布办公室 (Office for Data Release) 提出数据请求，也可以联系 DataAccess@ukhsa.gov.uk。所有访问数据的请求均由数据发布办公室审核，并遵守严格的保密规定，符合以下要求：普通法保密义务、数据保护立法（包括《通用数据保护条例》）、卡迪科特原则、信息专员的法定数据共享行为准则和国家数据选择退出计划。 来自马尔可夫链蒙特卡罗采样器的形状和尺度参数的跟踪结果以及模型代码可以在此处找到：。