Monkeypox: A review of epidemiological modelling studies and how modelling has led to mechanistic insight

Human monkeypox virus (mpox) is a viral zoonosis belonging to the Orthopoxvirus genus of the Poxviridae family that presents with similar symptoms as seen previously in human smallpox patients. mpox is a growing concern internationally with over 80000 cases in non-endemic countries as of December 2022. In this review, we briefly cover the history and origins of mpox and describe its basic virology, noting key differences in mpox viral fitness traits pre and post-2022. We then summarize and critique current knowledge from epidemiological mathematical models, within-host models, and between-host transmission models. We distinguish between models that focus on immunity from vaccination, as well as geography, climatic variables, and animal models. We report various epidemiological parameters, such as the reproduction number R0, in a condensed format for ease of comparison between studies. We focus specifically on how mathematical modelling studies have led to novel mechanistic insight into Monkeypox transmission and pathogenesis. As mpox continues to emerge and is predicted to continue to form subsequent peaks in many historically non-endemic countries, mpox mathematical modelling studies can provide rapid actionable insight into viral dynamics to guide public health measures and mitigation strategies.