New study highlights positive impact of community efforts to combat mpox outbreak in Ireland

Ireland's national mpox crisis team led by MPOWER was praised for successfully controlling the outbreak with risk communication and community engagement. 

Photo of MPOWER team standing in front of progress Pride flag mural, the MPOX study referenced their work in containing the outbreak

A new study published in the Irish Medical Journal (IMJ) offers a comprehensive description of the mpox outbreak in Ireland in 2022 and the response. It demonstrates that Ireland was very successful in controlling the spread, largely thanks to the efforts of community groups like MPOWER.

The study, conducted by the Health Protection Surveillance Centre (HPSC), the Health Service Executive (HSE) and HIV Ireland, reports that there were 229 mpox cases in Ireland between May 2022 and May 2023, with 98.7% of those cases in men. Case numbers peaked in July to August 2022, and declined steadily in early 2023.

The study additionally shows that Ireland’s recorded mpox cases were generally mild, with no ICU admissions or deaths.

The median number of sexual partners for those infected was two in the 21 days before contracting mpox, but one person reported having 75 sexual partners in that time frame. While this detail has been the focal point of some headlines, Adam Shanley, MPOWER Programme Manager, and co-author of the IMJ paper notes that this should not be the main takeaway of the study.

Shanley said: “RTÉ choosing to pick one data point to inflame stigma towards a minority community is not the standard of reporting I, and most people in Ireland, would expect from the national broadcaster. The news story should be the extensive work that our colleagues across the HSE put into responding to mpox as they come off the back of the crippling impact of the COVID pandemic.

“It is well documented internationally that in tandem with vaccination, the efforts of the gay community to organise, inform, and support one another during the mpox outbreak had a significant impact on controlling further spread – that’s the story.”

He added: “I think it is important that we remind our community that by coming forward for testing and vaccination during the mpox outbreak and by speaking openly and honestly with public health teams, we took part in important acts of community care. As a community, let’s continue to reject shame and hold each other up in moments of collective need.”

The HSE similarly responded to the study, saying: “Working in partnership with the affected community has been vital to the response to the emergence of mpox. This collaborative and peer-led approach ensured the delivery of key messaging intended to be informative but not stigmatising. It was recognised as an example of best practice for risk communication and community engagement on mpox by ECDC and the WHO.”

The World Health Organization (WHO) first identified mpox (formerly called monkeypox) as a public health emergency in 2022 when 53,000 cases were detected in 75 countries. Early data confirmed that most cases were found among unvaccinated gay, bisexual and other men who have sex with men.

After the first known cases were recorded in May 2022, roughly 90,000 cases were confirmed and 152 deaths were reported worldwide. People affected ranged in age from 16 to 68, with nearly half (46%) aged between 18 and 34.

After initial virus cases were detected in the UK and Portugal, Ireland assembled a national crisis management team to raise awareness about mpox and promote the vaccine programme.

Initially, mpox was designated as a High Consequence Infectious Disease (HCID). Contact tracing was implemented and contacts were recommended to quarantine for 21 days, but as understanding of the severity and transmission risks improved, this guidance was modified.

The Sexual Health Crisis Pregnancy Programme (SHCPP) and HSE Communications, Gay Health Network and MPOWER worked together to create community posters, social media messaging, and outreach activities. This collaborative effort earned praise for being “informative but not stigmatising”.

The vaccination efforts and community engagement campaign led by MPOWER were very successful in controlling the outbreak. Over 5,300 people at risk of infection were fully vaccinated in the country, with more than 11,000 doses of the vaccine administered.

WHO praised Ireland for its efforts in educating affected populations about symptoms and testing. The approach was recognised as best practice for risk communication and community engagement.

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