D uring the 2022 global mpox outbreak, asymp- tomatic monkeypox virus (MPXV) infections or unrecognized mpox cases were reported among men who have sex with men (MSM) (1-4). Asymptomatic cases were diagnosed by using PCR on anorectal, pharyngeal, urine, and pooled samples, but the prevalence of asymptomatic infections varied by country. A recent meta-analysis reported the prevalence of asymptomatic MPXV infections worldwide (5), but limited cohort sizes have hindered precise estimations. Understanding the extent to which asymptomatic infections contribute to MPXV transmission is crucial for an effective public health response (6,7). In addition, further clarification on the how prevalence of asymptomatic infections affect mpox epidemics is needed.
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Mizushima et al. (2023) studied this question.
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