World Health Organization. Mpox. 2024 Aug 26 [cited 2025 Jun 4]. https://www.who.int/news-room/fact-sheets/detail/mpox
Satapathy P, Mohanty P, Manna S, Shamim MA, Rao PP, Aggarwal AK, et al. Potentially asymptomatic infection of monkeypox virus: a systematic review and meta-analysis. Vaccines (Basel). 2022;10:2083. DOIPubMedGoogle Scholar
de Vries HJ, Götz HM, Bruisten S, van der Eijk AA, Prins M, Oude Munnink BB, et al. Mpox outbreak among men who have sex with men in Amsterdam and Rotterdam, the Netherlands: no evidence for undetected transmission prior to May 2022, a retrospective study. Euro Surveill. 2023;28:2200869. DOIPubMedGoogle Scholar
Grabmeier-Pfistershammer K, Skorepa C, Breuer M, Masood M, Chromy D, Strassl R. No evidence of asymptomatic monkeypox infection in a highly sexually active MSM population in Austria. HIV Med. 2024;25:150–3. DOIPubMedGoogle Scholar
Pestel J, Matthews H, Schmiedel S, Hüfner A, Jordan S, Scheiter RL, et al. Screening for monkeypox infection in asymptomatic high-risk-behaviour men having sex with men (MSM). Infect Dis Rep. 2022;14:794–7. DOIPubMedGoogle Scholar
Rossotti R, Calzavara D, Cernuschi M, D’Amico F, De Bona A, Repossi R, et al. Detection of asymptomatic mpox carriers among high-risk men who have sex with men: a prospective analysis. Pathogens. 2023;12:798. DOIPubMedGoogle Scholar
Thomassen SE, von Schreeb S, Kirkby NS, Pinholt M, Lebech AM, Kronborg G, et al. Prospective screening for monkeypox infection among users of HIV pre-exposure prophylaxis in Denmark. Int J STD AIDS. 2024;35:374–8. DOIPubMedGoogle Scholar
Van Dijck C, De Baetselier I, Kenyon C, Liesenborghs L, Vercauteren K, Van Esbroeck M; ITM Monkeypox Study Group. Mpox screening in high-risk populations finds no asymptomatic cases. Lancet Microbe. 2023;4:e132–3. DOIPubMedGoogle Scholar
Pitt-Kendall R, Foster C, Rayment M, Orzechowska B, Mammadov R, Soni S, et al. Retrospective testing for mpox virus in routine STI screens from men who have sex with men in England, August-October 2022. Sex Transm Infect. 2023;99:548–51. DOIPubMedGoogle Scholar
Ferré VM, Bachelard A, Zaidi M, Armand-Lefevre L, Descamps D, Charpentier C, et al. Detection of monkeypox virus in anorectal swabs from asymptomatic men who have sex with men in a sexually transmitted infection screening program in Paris, France. Ann Intern Med. 2022;175:1491–2. DOIPubMedGoogle Scholar
De Baetselier I, Van Dijck C, Kenyon C, Coppens J, Michiels J, de Block T, et al.; ITM Monkeypox study group. Retrospective detection of asymptomatic monkeypox virus infections among male sexual health clinic attendees in Belgium. Nat Med. 2022;28:2288–92. DOIPubMedGoogle Scholar
Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al. Cochrane handbook for systematic reviews of interventions version 6.5. 2024 Aug [cited 2025 Jun 4]. https://www.cochrane.org/authors/handbooks-and-manuals/handbook
Riley RD, Higgins JP, Deeks JJ. Interpretation of random effects meta-analyses. BMJ. 2011;342(feb10 2):d549. DOIPubMedGoogle Scholar
Balduzzi S, Rücker G, Schwarzer G. How to perform a meta-analysis with R: a practical tutorial. Evid Based Ment Health. 2019;22:153–60. DOIPubMedGoogle Scholar
Viechtbauer W. Conducting meta-analyses in R with the metafor package. J Stat Softw. 2010;36:1–48. DOIGoogle Scholar
Agustí C, Martínez-Riveros H, Hernández-Rodríguez À, Casañ C, Díaz Y, Alonso L, et al. Self-sampling monkeypox virus testing in high-risk populations, asymptomatic or with unrecognized Mpox, in Spain. Nat Commun. 2023;14:5998. DOIPubMedGoogle Scholar
Brosius I, Van Dijck C, Coppens J, Vandenhove L, Bangwen E, Vanroye F, et al.; ITM MPOX Study Group. Presymptomatic viral shedding in high-risk mpox contacts: a prospective cohort study. J Med Virol. 2023;95:e28769. DOIPubMedGoogle Scholar
Contag CA, Renfro ZT, Lu J, Shen S, Karan A, Solis D, et al. Prevalence of Mpox (Monkeypox) in patients undergoing STI screening in northern California, April–September 2022. J Clin Virol. 2023;164:105493. DOIPubMedGoogle Scholar
Golden MR, Soge OO, Mills M, Berzkalns A, Cannon C, Ramchandani M, et al. Asymptomatic and subclinical mpox: an association with modified vaccinia Ankara vaccine. Sex Transm Dis. 2024;51:342–7. DOIPubMedGoogle Scholar
Hampel B, Farnham A, Lamothe-Molina PJ, Capelli C, Schibler M, Ustero Alonso P, et al. Low prevalence of asymptomatic mpox in populations at high risk. Lancet Microbe. 2023;4:e856. DOIPubMedGoogle Scholar
Koppe U, Jansen K, Schmidt AJ, Weber C, Schulze H, Kulis-Horn RK, et al. Clinically inapparent mpox virus (MPXV) infections among clients of three anonymous Community Based Voluntary Counselling and Testing centres in Berlin, Germany, 2022-2023. BMC Infect Dis. 2024;24:613. DOIPubMedGoogle Scholar
Mizushima D, Shintani Y, Takano M, Shiojiri D, Ando N, Aoki T, et al. Prevalence of asymptomatic mpox among men who have sex with men, Japan, January–March 2023. Emerg Infect Dis. 2023;29:1872–6. DOIPubMedGoogle Scholar
Ogale YP, Baird N, Townsend MB, Berry I, Griffin I, Lee M, et al. DC Mpox Response Project Team. DC Mpox Response Project Team. Evidence of mpox virus infection among persons without characteristic lesions or rash presenting for first dose of JYNNEOS vaccine—District of Columbia, August 2022. Clin Infect Dis. 2023;77:298–302. DOIPubMedGoogle Scholar
Centers for Disease Control and Prevention. JYNNEOS vaccine effectiveness. 2024 Aug 27 [cited 2025 Jun 4]. https://www.cdc.gov/mpox/data-research/vaccines/index.html
Farrar JL, Lewis NM, Houck K, Canning M, Fothergill A, Payne AB, et al.; Mpox Cases in Vaccinated Persons Team. Demographic and clinical characteristics of mpox in persons who had previously received 1 dose of JYNNEOS vaccine and in unvaccinated persons—29 U.S. jurisdictions, May 22–September 3, 2022. Am J Transplant. 2023;23:298–303. DOIPubMedGoogle Scholar
World Health Organization. Testing for mpox: individuals and communities. 2023 Dec 11 [cited 2025 Jun 4]. https://www.who.int/news-room/questions-and-answers/item/testing-for-mpox–individuals-and-communities
Granskog L, Saadeh K, Snyder R, Tang EC, Lo T, Quint J, et al. Effectiveness of JYNNEOS vaccination in preventing lesion dissemination among individuals with confirmed mpox infection. Open Forum Infect Dis. 2025;12(Suppl 1):ofae631.074. DOIGoogle Scholar
Coppens J, Vanroye F, Brosius I, Liesenborghs L, van Henten S, Vanbaelen T, et al.; ITM MPX study group. Alternative sampling specimens for the molecular detection of mpox (formerly monkeypox) virus. J Clin Virol. 2023;159:105372. DOIPubMedGoogle Scholar
MedlinePlus. Asymptomatic. 2024 Oct 9 [cited 2025 Jun 4]. https://medlineplus.gov/ency/article/002217.htm
Shaikh N, Swali P, Houben RMGJ. Asymptomatic but infectious—the silent driver of pathogen transmission. A pragmatic review. Epidemics. 2023;44:100704. DOIPubMedGoogle Scholar
Espinoza B, Marathe M, Swarup S, Thakur M. Asymptomatic individuals can increase the final epidemic size under adaptive human behavior. Sci Rep. 2021;11:19744. DOIPubMedGoogle Scholar
Sberna G, Specchiarello E, Mija C, Carletti F, Belladonna S, Girardi E, et al. Measurement of the infection and integrity of monkeypox virus: a new method using PMAxx-ddPCR. Int J Mol Sci. 2025;26:1195. DOIPubMedGoogle Scholar
Snyder RE, Saadeh K, Tang EC, Johnson KA, Holland SN, Quint J, et al. Sexual exposures associated with mpox infection: California, November 2022 to June 2023. J Infect Dis. 2024;229(Supplement_2):S188–96. DOIPubMedGoogle Scholar
Liu Y, Funk S, Flasche S. Centre for Mathematical Modelling of Infectious Diseases nCoV Working Group. The contribution of pre-symptomatic infection to the transmission dynamics of COVID-2019. Wellcome Open Res. 2020;5:58. DOIPubMedGoogle Scholar
Pollock AM, Lancaster J. Asymptomatic transmission of covid-19. BMJ. 2020;371:m4851. DOIGoogle Scholar
Sayampanathan AA, Heng CS, Pin PH, Pang J, Leong TY, Lee VJ. Infectivity of asymptomatic versus symptomatic COVID-19. Lancet. 2021;397:93–4. DOIPubMedGoogle Scholar
Alvi MI, Kliner M, Welfare W, Gordon NC, Thomas S, Padfield S, et al. Case series of the first five human infections with monkeypox virus clade Ib and report on the public health response, United Kingdom, October to November 2024. Euro Surveill. 2025;30:2500131. DOIPubMedGoogle Scholar
Centers for Disease Control and Prevention. Ongoing clade II mpox global outbreak. 2025 [cited 2025 Jun 4]. https://www.cdc.gov/mpox/outbreaks/2022/index-1.html






