Serological Evidence of Mpox Virus Infection During Peak Mpox Transmission in New York City, July to August 2022

Abstract

Abstract Background The extent to which infections may have been undetected in an epicenter of the 2022 mpox outbreak is unknown. Methods A serosurvey (July and August 2022) assessed the seroprevalence and correlates of mpox infection among a diverse sample of asymptomatic patients with no prior mpox diagnoses and no known histories of smallpox or mpox vaccination. We present seropositivity stratified by participant characteristics collected via survey. Results Two-thirds of 419 participants were cismen (281 of 419), of whom 59.1% (166 of 281) reported sex with men (MSM). The sample also included 109 ciswomen and 28 transgender/gender nonconforming/nonbinary individuals. Overall seroprevalence was 6.4% (95% confidence interval [CI], 4.1%–8.8%); 3.7% among ciswomen (95% CI, 1.0%–9.1%), 7.0% among cismen with only ciswomen partners (95% CI, 2.0%–11.9%), and 7.8% among MSM (95% CI, 3.7%–11.9%). There was little variation in seroprevalence by race/ethnicity, age group, HIV status, or number of recent sex partners. No participants who reported close contact with mpox cases were seropositive. Among participants without recent mpox-like symptoms, 6.3% were seropositive (95% CI, 3.6%–9.0%). Conclusions Approximately 1 in 15 vaccine-naive people in our study had antibodies to mpox during the height of the NYC outbreak, indicating the presence of asymptomatic infections that could contribute to ongoing transmission.