RESUMO
BackgroundIn 2022 and 2023, a global outbreak of mpox affected mostly gay, bisexual and other men having sex with men (GBMSM). Outbreak control in the Netherlands included isolation, quarantine, post-exposure prophylaxis vaccination and primary preventive vaccination (PPV).AimWe describe the course of the outbreak, the vaccination programme, vaccine effectiveness (VE) of full vaccination against symptomatic disease, and trends in behaviour to generate hypotheses about factors that influenced the outbreak's decline.MethodsIn this observational study, we collected data from public health services on notified cases, number of PPV invitations and PPV doses administered. We calculated PPV uptake and coverage. Trends in behavioural data of GBMSM visiting sexual health centres were analysed for all consultations in 2022. We estimated VE using the screening method.ResultsUntil 31 December 2023, 1,294 mpox cases were reported. The outbreak peaked in early July 2022 and then declined sharply. PPV started on 25 July 2022; in total 29,851 doses were administered, 45.8% received at least one dose, 35.4% were fully vaccinated. The estimated VE was 68.2% (95% CI 4.3-89.5%). We did not observe an evident decrease in high-risk behaviour.DiscussionIt is unlikely that PPV was a driver of the outbreak's decline, as incidence started to decline well before the start of the PPV programme. The possible impact of behavioural change could not be demonstrated with the available indicators, however, the data had limitations, hampering interpretation. We hypothesise that infection-induced immunity in high-risk groups was an important factor explaining the decline.
Assuntos
Surtos de Doenças , Homossexualidade Masculina , Vacinação , Humanos , Países Baixos/epidemiologia , Masculino , Homossexualidade Masculina/estatística & dados numéricos , Adulto , Vacinação/estatística & dados numéricos , Pessoa de Meia-Idade , Adulto Jovem , Profilaxia Pós-Exposição , Infecções Sexualmente Transmissíveis/epidemiologia , Infecções Sexualmente Transmissíveis/prevenção & controle , Feminino , Minorias Sexuais e de Gênero/estatística & dados numéricos , Adolescente , Quarentena , Programas de Imunização , Comportamento Sexual/estatística & dados numéricosRESUMO
Since May 2022, an international monkeypox (MPX) outbreak has been ongoing in more than 50 countries. While most cases are men who have sex with men, transmission is not restricted to this population. In this report, we describe the case of a male child younger than 10 years with MPX in the Netherlands. Despite thorough source tracing, a likely source of infection has not been identified. No secondary cases were identified in close contacts.
Assuntos
Mpox , Criança , Humanos , Masculino , Mpox/diagnóstico , Mpox/epidemiologia , Monkeypox virus , Países Baixos/epidemiologiaRESUMO
Since 2015, outbreaks of hepatitis A among men who have sex with men (MSM) have been reported worldwide. To examine the impact of these MSM outbreaks in the Netherlands, we combined notification and epidemiological data with sequence analysis. Our results show the hazards of outbreaks within risk-groups spilling over into the largely susceptible general population. One third of the outbreak-related hepatitis A virus genotypes were detected in non-MSM cases.
Assuntos
Surtos de Doenças/estatística & dados numéricos , Vírus da Hepatite A Humana/genética , Hepatite A/epidemiologia , Homossexualidade Masculina/estatística & dados numéricos , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , DNA Viral/genética , Notificação de Doenças/estatística & dados numéricos , Feminino , Infecções por HIV/epidemiologia , Hepatite A/diagnóstico , Hepatite A/transmissão , Vírus da Hepatite A Humana/classificação , Vírus da Hepatite A Humana/isolamento & purificação , Humanos , Incidência , Lactente , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Análise de Sequência de DNA , Estudos Soroepidemiológicos , Adulto JovemRESUMO
Between July 2016 and February 2017, 48 male cases of hepatitis A were notified in the Netherlands. Of these, 17 identified as men who have sex with men (MSM). Ten of the 13 cases for whom sequencing information was available, were infected with a strain linked with the EuroPride that took place in Amsterdam in 2016. This strain is identical to a strain that has been causing a large outbreak among MSM in Taiwan.
