4.7 Article

Estimating the undetected infections in the Monkeypox outbreak

Journal

JOURNAL OF MEDICAL VIROLOGY
Volume 95, Issue 1, Pages -

Publisher

WILEY
DOI: 10.1002/jmv.28099

Keywords

asymptomatic cases; capture-recapture methods; incidence indicators; Monkeypox

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This study aims to estimate the true number of Monkeypox infections in the most affected countries, including both detected and undetected cases. By using a data-driven approach and analyzing the cumulative distribution of weekly cases, the study proposes a lower bound estimator to provide reliable estimates. The findings show that the proportion of undetected cases is relevant in all countries, and the estimated true number of infections in some countries could be more than three times the observed cases.
While the number of detected Monkeypox infections are widely available, an understanding of the extent of undetected cases is urgently needed for an effective tackling of its spread. The aim of this study is to estimate the true number of Monkeypox (detected and undetected) infections in most affected countries. The question being asked is: How many cases have actually occurred? We propose a lower bound estimator for the true number of Monkeypox cases. The estimator is data-driven and can be easily computed from the cumulative distributions of weekly cases. We focused on the ratio of the total estimated cases to the observed cases on July 31, 2022: The proportion of undetected cases was relevant in all countries, with countries whose estimated true number of infections could be more than three times the observed one. We provided a practical contribution to the understanding of the current Monkeypox wave and reliable estimates on how many undetected cases are going around in several countries, where the epidemic spreads differently.

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