Epidemiology of Mpox 

during the Current OutbreakSascha Ellington, PhD, MSPHEpidemiology Task Force2022 Multinational Mpox Response Centers for Disease Control and Prevention February 22, 2023
Epidemiology of the Current Outbr
2022-2023 Spread of Mpox in U.S

• The first U.S. case was confirmed in 

May 2022.

• At first, spread was associated with 

international travel.

• More than 30,000 U.S. cases have been 

reported; new cases are declining.

• Most cases have been in gay, bisexual, 

& other men who have sex with men.

• Cases have also been reported in men 

who do not have sex with men, cisgender and transgender women, transgender men, gender-diverse people, children, and teens.

Data as of February 8, 2023
U.S. Mpox Case Trends as of Febr

2023 
Mpox cases reported to CDC by age an

sex/gender

Data as of February 8, 2023

Median Min 

34 < 1 

Sex / Gender

* Cases Percent

Cisgender men 28,010 95.1%Cisgender women 854 2.9%Transgender men 76 0.3%Transgender women 266 0.9%Another sex/gender 235 0.8%Missing gender 728 -*Sex/Gender is available for 97.6% of cases
Mpox cases reported to CDC by race a

ethnicity

Data as of February 8, 2023

Race / Ethnicity*+ Count Percent

Black or African American 9,331 33.1%Hispanic or Latino 8,773 31.1%White 8,258 29.3%Asian 789 2.8%Other Race 690 2.4%Multiple Races 151 0.5%American Indian or Alaska Native (AI/AN) 111 0.4%Native Hawaiian or Other Pacific Islander(NH/OPI)

68 0.2%

Missing 1,998 -*All cases reporting Hispanic ethnicity are classified into 

the Hispanic or Latino category

+Race/Ethnicity available for 93.4% of cases
Clinical Characteristics of Mpox C

Reported to CDC as February 9, 20

Characteristic Percentage

HIV Status*HIV Positive 53%HIV Negative 47%Rash location**

Genitals or perianal area 65%Trunk or limbs 62%Head, face, mouth 54%Palms or soles of feet 24%

Hospitalized Yes 7.7%No 92%*HIV status available for 9,039 (30%) of mpox cases**Rash location available for 14,902 (49%) of mpox cases

32 mpox assodeaths (0.1% cases) reporteU.S. 
Detection and transmission of mp

during the current outbreak 

https://www.cdc.gov/poxvirus/monkeypox/about/science-behind-transmission.html

• Spread primarily through sexual or close intimate contact • Other routes of transmission have been reported 

 Household transmission  Injury with contaminated sharp instrument in clinical setting Piercing and tattooing Perinatal transmission 

• Some people can spread mpox virus to others 1-4 days before symptom on

(i.e. pre-symptomatic transmission)

• No evidence that people who are infected but never develop symptoms can 
Detection and transmission of mp

during the current outbreak 

Mpox Virus in Human Samples and Implications for TransmissionExposure source Mpox virus DNA detected by PCR

Replication-competent virus detected/isolated

Epidemiosource of 

Skin Yes Yes YesOropharynx and saliva Yes* Yes YesAnorectum Yes Yes Yes†Semen Yes* Yes InsufficieUrine/urethra Yes Yes InsufficieConjunctivae or ocular fluid Yes Yes InsufficieBlood/plasma/serum Yes Insufficient data InsufficieFeces Yes Insufficient data InsufficieVagina Yes Insufficient data InsufficieBreastmilk Insufficient data Insufficient data InsufficieContaminated sharp‡ Insufficient data Insufficient data Yes

* DNA has been detected at Ct values <35 in recovered patients more than 30 days after illness onset in an upper respiratory tract swab, saliva, and semen.† The preponderance of existing data support exposure to anorectal and vulvovaginal tissues and fluids as capable of transmitting infection; however, it is difficult with current evidence to 

from other concomitant exposures (see text).‡ Includes body modification with piercings and tattooing.

https://www.cdc.gov/poxvirus/monkeypox/about/science-behind-transmission.html
Mpox cases among men reported to C

sexual contact history

Data as of February 8, 2023

MMSC* among Men** Cases PercentMen, recent MMSC 14,143 75.4%Men, no recent MMSC 4,612 24.6%Missing 9,331 -*MMSC= male-male sexual contact**Sexual contact history and gender available for 66.8% of cases among men
Epidemiology of Mpox in Less Affected Populations 
Mpox in Cisgender Women in the 

States, May 11–November 7, 2022

Source: http://dx.doi.org/10.15585/mmwr.mm7201a2

Characteristic

Percentage among Cisgender women (n=769)

AgeMedian (Range) 32 (15–89)Race and ethnicityBlack, non-Hispanic 44%White, non-Hispanic 25%Hispanic or Latino 23%HIV Status*HIV positive 8%HIV negative 92%Recent sexual or close intimate partner** 71%*HIV status available for 173 (22%) cisgender women**Defined as within last 3 weeks; data available for 463 (60%) cisgender women

2.7% reporwere cisge
Mpox in Pregnant and Recently P

People in the U.S.• From May 11-November 7, 2022, 21 cases of mpox reported to CDC occurred i

people and 2 reported cases occurred in people who were recently pregnant (wdelivery)

• Among those with exposure data (n=12): 9 with sexual contact and 3 with house• Similar signs and symptoms of mpox as those in non-pregnant people

 4 cases with genital lesions during pregnancy

• Tecovirimat provided to 48% of people with mpox during pregnancy with no adv

reported

• None received post-exposure prophylaxis with JYNNEO

S

• Outcomes 

 Four hospitalizations for mpox indications. All discharged while still pregnant. No pregnant patients required intensive care, intubation, or unplanned delivery 3 pregnancy outcomes: 2 uncomplicated live births (no transmission to the infant); 1 first trimeste

abortion

 Two recently pregnant persons experienced symptoms within 3 days of delivery and their newbor

lesions within a week 

Source: http://dx.doi.org/10.15585/mmwr.mm7201a2
Mpox in Transgender and Gender-D

Adults — United States, May 17–Nov

2022

Source: http://dx.doi.org/10.15585/mmwr.mm715152a1

Characteristic

Percetransdiver

AgeMedian (Range) 32 (1Race and ethnicityBlack, non-Hispanic 28%White, non-Hispanic 28%Hispanic or Latino 37%HIV StatusHIV positive 48%HIV negative 52%Recent sexual or close intimate partner 84%*HIV status available for 166 (36%) transgender and gend**Defined as within last 3 weeks; data available for 378 (diverse adults 

43%

15%

42%

Transgender womenTransgender menGender-diverse persons

Gender identity of transgender and gender-diverse adults with mpox (n=466)

96% of gender-diverse adults were assigned male sex at birth.
Epidemiologic Characteristics of Pediat

in the U.S., May 17–September 24, 202Source: http://dx.doi.org/10.15585/mmwr.mm7144a4

Characteristic

% by age gro

0–4 5–12 

(n = 16) (n = 12

SexMale 75% 50% Female 25% 50% Race or ethnicityBlack, non-Hispanic 44% 42% Hispanic or Latino 31% 42% White, non-Hispanic 19% 17% Asian, non-Hispanic — — American Indian or Alaska Native, non-Hispanic — — Native Hawaiian or other Pacific Islander, non-Hispanic 6% — Other, non-Hispanic — — Exposure setting and routeSexual contact — — Household contact 93% 100% Other 7% — 
Vaccine Administration 
Total JYNNEOS Vaccine Doses Adm

and Reported to CDC by week

Data as of February 7, 2023

0

20,00040,00060,00080,000

100,000120,000

5/22-5/28

5/29-6/4

6/5-6/11

6/12-6/18

6/19-6/25

6/26-7/2

7/3-7/9

7/10-7/16

7/17-7/23

7/24-7/30

7/31-8/6

8/7-8/13

8/14-8/20

8/21-8/27

8/28-9/3

9/4-9/10

9/11-9/17

9/18-9/24

9/25-10/1

10/2-10/8

10/9-10/15

10/16-10/22

10/23-10/29

10/30-11/5

11/6-11/12

11/13-11/19

11/20-11/26

11/27-12/3

12/4-12/10

12/11-12/17

Doses administered

First dosesSecond doses

1,185,907 doses administered and reported to CDC since May 20
Mpox Cases and Vaccine Recipients b

and Ethnicity*Race and ethnicity available for 93% of mpox cases reported **Based on 1st dose; Data as of February 9, 2023; race and ethnicity available for 91% of first doses administered 

33%

13%

31%

22%

29%

52%

2.8%

7.3%

2.4%

3.6%

0.5%

2.7% 0.4%

0.4%

0.2% 0.3%

0%

10%20%30%40%50%60%70%80%90%

100%

Mpox Cases (N=28,171*) Mpox Vaccine Recipients** (N=704,728)