A Review of Epidemiological Modeling Studies on Monkeypox
Issued Date
2026-05-15
Resource Type
ISSN
20967071
Scopus ID
2-s2.0-105039849864
Journal Title
China Cdc Weekly
Volume
8
Issue
20
Start Page
587
End Page
596
Rights Holder(s)
SCOPUS
Bibliographic Citation
China Cdc Weekly Vol.8 No.20 (2026) , 587-596
Suggested Citation
Li J., Luo Q., Beltran E., Chen Q., Perez S., Frutos R., Su Y., Liu Z., Rui J., Chen T., Luo K., Zhao Z. A Review of Epidemiological Modeling Studies on Monkeypox. China Cdc Weekly Vol.8 No.20 (2026) , 587-596. 596. doi:10.46234/ccdcw2026.097 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/117040
Title
A Review of Epidemiological Modeling Studies on Monkeypox
Author's Affiliation
University of Southampton
University of Liverpool
Xiamen University
Université Côte d'Azur
Universitas Airlangga
Faculty of Medicine Ramathibodi Hospital, Mahidol University
UK Health Security Agency
Interactions Hôtes-Vecteurs-Parasites-Environnement Dans les Maladies Tropicales Négligées dues aux Trypanosomatides (INTERTRYP)
Hunan Provincial Center for Disease Control and Prevention
University of Aix-Marseilles I
CentralSouthUniversity
University of Liverpool
Xiamen University
Université Côte d'Azur
Universitas Airlangga
Faculty of Medicine Ramathibodi Hospital, Mahidol University
UK Health Security Agency
Interactions Hôtes-Vecteurs-Parasites-Environnement Dans les Maladies Tropicales Négligées dues aux Trypanosomatides (INTERTRYP)
Hunan Provincial Center for Disease Control and Prevention
University of Aix-Marseilles I
CentralSouthUniversity
Corresponding Author(s)
Other Contributor(s)
Abstract
Between 2022 and 2025, nearly 130,000 confirmed monkeypox (mpox) cases, including over 280 deaths, were reported to the World Health Organization (WHO) from 130 countries and territories, prompting the WHO to declare it a public health emergency of international concern on two occasions. Hence, to enable a scientific approach to prevention and control, transmission dynamics through mathematical modeling must be elucidated. Through a comprehensive literature review on the modeling of mpox transmission dynamics, this study indicates that existing research primarily extends the susceptible-infectious-recovered (SIR) modeling framework and largely focuses on the 2022 global outbreak. The analysis revealed significant variations in mpox virulence, particularly dependent on the subtypes, and variations according to the descending order of clades: Ib>Ia>IIa>IIb. Interpersonal transmission capacity was notably higher for clade II than for clade I, highlighting geographical disparities, with the highest transmission capacity in the Americas, moderate in Europe and Oceania, and the lowest in Asia. In contrast, Africa maintained consistently low but non-declining transmission levels. Furthermore, the study confirmed significant co-infection patterns between mpox and sexually transmitted diseases, such as Human Immunodeficiency Virus (HIV) and syphilis, along with evidence of synergistic transmission interactions among multiple pathogens. This study provides crucial modeling evidence for mpox regulation. By quantifying high-risk populations, evaluating intervention effectiveness, and identifying the risks associated with subtypes and geographic areas, this study offers a comprehensive reference for understanding the interface between model complexity and practical application. These advancements have enhanced the strategic focus and precision of public health responses during outbreaks.Monkeypox (mpox) is a zoonotic infectious disease caused by the monkeypox virus (MPXV), with clinical manifestations similar to those of smallpox but with lower incidence and mortality (1). MPXV is classified into clades I (formerly the Central African or Congo Basin clade, subdivided into Ia and Ib) and II (formerly the West African clade, subdivided into IIa and IIb). Transmission occurs via direct contact with infectious lesions, body fluids, respiratory droplets, or contaminated fomites (2). From 1970 to 2017, mpox was endemic primarily in Central and West Africa, predominantly via animal-to-human transmission. Sporadic cases in non-endemic regions were largely related to travel or animal importation (3−4). However, human-to-human transmission has increased following the 2017 Nigerian outbreak (5). In May 2022, a large global outbreak occurred, spreading primarily through sexual contact networks (6), with cases reported among men who have sex with men (MSM). The epidemiological modeling framework for mpox has evolved over the decades, with research on transmission dynamics among humans and between humans and animals, forming a relatively complete theoretical system. This study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines (7). The literature search covered the China National Knowledge Infrastructure (CNKI), Web of Science, and PubMed for the period spanning 3 years following the global spread of mpox in 2022 (2022–2025). The focus was on the literature employing mathematical modeling methods to study the transmission dynamics models of orthopoxvirus (mpox) among humans or between humans and animals. The searches were conducted on December 25, 2025, using keywords including "mpox," "Ia/Ib/IIa/IIb," "dynamic" and "model." "Monkeypox" was also included as a keyword for the 2022 publications to account for the WHO nomenclature change in November 2022. This study did not include gray literature, and all analyses were based on published peer-reviewed academic literature. No geographic or language restrictions were applied. The systematic search yielded 11,824 relevant records. After deduplication, 5,479 duplicate records were removed. The remaining records were independently screened by two reviewers in a two-round process and discrepancies were resolved by consensus. The first round, based on title and abstract review assessing the application of mathematical compartmental models, identified 122 articles for full-text assessment. During the second round of full-text screening, 39 articles that did not analyze the epidemic transmission potential and 4 dissertations were excluded. Ultimately, 79 studies were included in the systematic review of compartmental structures, parameter settings, and dynamic characteristics of the models (Figure 1).