Driving effect of multiplex factors on Mpox in global high-risk region, implication for Mpox based on one health concept

Mpox is an ongoing viral zoonotic disease epidemic worldwide. Being different from conventional animal-to-human transmission, the present outbreak is mainly caused by human-to-human transmission of Mpox virus, putting forward the risk of worldwide epidemic. The current spatial distribution characteristics and risk area prediction are urgently needed for preparedness for prevention and control of the disease based on the One Health strategy. In the present study, the global outbreak point of Mpox virus were collected and used to predict potential global risk of Mpox virus with ecological niche model constructed with a combination of eco-geographical, anthropoid, meteorological, and host variables. The results showed that human factors are the key to the risk and prevalence of Mpox. The risk map indicated that Mpox may affect extensive areas worldwide. Europe and North America have the highest risk of Mpox. Although most areas have never recorded Mpox before, there are some high-risk areas in Asia. Our findings highlight population density is the most important contributing factor for high-risk area. Many large cities with dense populations, developed transportation, and high migration rate in the world, are in high risks. At present, the spread of Mpox is highly valued in the world and strict prevention and control measures have been taken. However, under the influence of human factors, Mpox has the potential of a global pandemic. The risk area prediction and main risk factors provide key information for targeted preparedness for prevention and control of Mpox outbreak and avoiding potential global epidemic through the One Health approach.