Monkeypox, Biology, Outcome, Transmission and Epidemiology -Prospective Follow-up of High-risk Contacts

Study Overview
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Brief Summary
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With the MBOTE-CONTACT study, a detailed follow-up study of high-risk contacts of mpox patients will be done. The MBOTE-CONTACT study will be nested in the NIH-Funded PALM-007 clinical trial (NCT05559099) and the MBOTE project on mpox transmission. The study will take place in Maniema Province, Democratic Republic of Congo (DRC). Participants will be recruited among high-risk contacts of mpox patients included in the PALM-007 trial. Consenting contacts will be either followed daily at the central study site or visited weekly by an outreach team in the community. They will be examined daily for signs and symptoms and asked to provide daily saliva and weekly blood samples for polymerase chain reaction (PCR) and/or serology. If participants develop mpox, they are offered treatment and enrollment in the PALM-007 trial.

Official Title
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Mpox, Biology, Outcome, Transmission and Epidemiology - Prospective Follow-up of High-risk Contacts

Conditions
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Mpox

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ▪ Be a high-risk contact of a laboratory-confirmed mpox case, with high-risk defined as having at least one the following types of exposure: living in the same household as an mpox patient having had sexual contact or intercourse with an mpox patient sleeping in the same room as an mpox patient sharing a meal with an mpox patient children: having played together Last exposure to the mpox index case of less than 14 days ago Patients of any age and gender (children aged < 10 years are excluded from venous blood sampling) Patient or culturally acceptable representative is willing and able to give informed consent for participation in the study Exclusion Criteria: Having previously been diagnosed with mpox in the last 3 months Inability or unwillingness to comply with the proposed follow-up schedule
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Study human-to-human transmission of Mpox virus (MPXV) by determining the secondary attack rate (SAR) among high-risk contacts of index patients. | Proportion of high-risk contacts with a positive MPXV PCR on any sample within 21 days after inclusion. | 21 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| To determine the rate of seroconversion amongst high-risk contacts of index patients. | The proportion of high-risk contacts with seroconversion for mpox antibodies on day 21 compared to baseline. | 21 days | 
| To estimate the extent of asymptomatic shedding of MPXV. | PCR positivity in any sample (blood, saliva) among participants who do not have any symptoms at the moment of sampling, but develop symptoms later during follow-up. | 21 days | 
| To estimate the extent of presymptomatic shedding of MPXV. | PCR positivity in any sample (blood, saliva) among participants who do not have any symptoms at the moment of sampling, but develop symptoms later during follow-up. | 21 days | 
| To estimate the duration between start of viral shedding and the appearance of prodromal symptoms. | Time between PCR positivity in any sample and appearance of systemic symptoms: either adenopathy, fever or dysphagia. | 21 days | 
| To estimate the incubation period of MPXV. | Time from last exposure to first PCR positivity. Time from last exposure to appearance of any symptom. Time from last exposure to appearance of skin lesions. | 21 days | 
| To characterize the clinical presentation of symptomatic secondary cases. | Frequency, timing and type of signs and symptoms observed among participants with a positive PCR. | 21 days | 
| To evaluate risk factors for infection and/or symptomatic disease. | Number of contacts with positive PCR on any sample AND/OR symptomatic disease and one of the following factors: Different types of contact with the index case Exposure to the same animal reservoir as the index case Being vaccinated against mpox Sociodemographic factors | 21 days | 
| To evaluate the protective effect of previous small pox vaccinations against infection and/or symptomatic disease. | number of previous vaccinate contacts positive PCR on any sample AND/OR symptomatic disease. | 21 days | 
| To estimate the duration between start of viral shedding and the appearance of skin symptoms. | Time between PCR positivity in any sample and appearance of skin lesions. | 21 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Monkeypox