Talk:2023–2024 mpox epidemic

Map needs updating

The text says there are now cases in several East African countries, but the map doesn't show that. TooManyFingers (talk) 00:06, 16 August 2024 (UTC)

That's right: Burundi, Rwanda and Kenya have all confirmed at least one case, but don't feature on the map.

Is anybody able to fix it? I'm not too familiar with Commons' tools, unfortunately... Oltrepier (talk) 13:33, 16 August 2024 (UTC)

Ivory Coast needs to be included, as well. Oltrepier (talk) 19:56, 16 August 2024 (UTC)

@Oltrepier Yes a number of countries were missing. looks like @Bondegezou removed it, which makes sense if no one is regularly updating. I'm not familiar with how to update maps, but it's a visually important tool for an outbreak of this nature. Anyone able and willing should go back to edits, reinstate the map, and update *daily.* Maldives have two new cases today. At least one country has been added per day for just about each day in the past 7 days. Phew. Non-pegasus (talk) 12:58, 22 August 2024 (UTC)

Agreed TheTopazRuby (talk) 02:54, 25 August 2024 (UTC)

The Newsweek report on mpox in wastewater

Er, are we sure this Newsweek report about the presence of the mpox virus in wastewater in some American states is accurate enough, given previous concerns about the magazine? Oltrepier (talk) 13:59, 16 August 2024 (UTC)

No. The virus in question is clade II, not the subgroup that is responsible for the epidemic in Africa. elijahpepe@wikipedia (he/him) 14:54, 16 August 2024 (UTC)

@ElijahPepe: Thank you for double-checking it: I'm going to remove that bit now. So, I think we shouldn't include information about newly-reported cases in Portugal, either, since the DGS confirmed that they all belong to clade IIb, right? --Oltrepier (talk) 15:18, 16 August 2024 (UTC)

Semi-protected edit request on 16 August 2024

capitalize mpox and epidemic for God's sake EtalonOr (talk) 15:07, 16 August 2024 (UTC)

 Not done: If I understand you correctly, article titles do not use title case. See WP:TITLECASE for more information on that. — BerryForPerpetuity (talk) 15:11, 16 August 2024 (UTC)

Issues with an Sfn footnote

Hello everyone! Yesterday, I've added one more report at the bottom of the article, and then used a shortened footnote to include it as a reference throughout the page. However, it seems like the wikilink doesn't work, in contrast to the other two existing footnotes...

Does anyone know what I got wrong? Oltrepier (talk) 08:27, 17 August 2024 (UTC)

My bad, I forgot to clarify that the reference I added is a bulletin by the WHO, which is hosted on ReliefWeb. Oltrepier (talk) 08:29, 17 August 2024 (UTC)

{{sfn}}'s wikilink requires {{cite xxx}}'s |ref= set to the same {{harvid}}. 142.113.140.146 (talk) 21:15, 17 August 2024 (UTC)

Thank you, I'll try to fix it as soon as possible! Oltrepier (talk) 08:08, 18 August 2024 (UTC)

@Oltrepier: No need to worry; got it all fixed for you! :) TheTechnician27 (Talk page) 20:48, 18 August 2024 (UTC)

@TheTechnician27 Thank you so much! : ) Oltrepier (talk) 07:46, 19 August 2024 (UTC)

Re: Infobox

Why does the number of confirmed cases differ from the infections? Viriditas (talk) 09:18, 19 August 2024 (UTC)

@Viriditas Sorry, I think it's my bad... When I updated the casualties table by adding the latest WHO report I could find three days ago, the total amount of reported cases turned out to be slightly lower than the previous number.

By the way, I genuinely wish the agency had a section where data is updated in real time on their site, but I guess it's very difficult to create one in this early phase of the outbreak. Oltrepier (talk) 12:52, 19 August 2024 (UTC)

Do we include any strain, or just Clade Ib?

Are we only including cases of Clade Ib? Because some countries have reported cases of other strains and aren't included in the article. Benpiano800 (talk) 01:12, 20 August 2024 (UTC)

@Benpiano800 Good question, to be honest! I guess we're mainly focusing on clade Ib, since it now appears to be the most infectious strain (especially in Central Africa). Obviously, though, we're still in an early phase of the outbreak, so it's very hard to retrieve complete data about these kinds of information, especially because some of the countries affected don't even have enough resources to perform testing and sequencing as swiftly as they'd liked to.

But anyway, I agree clade Ib remains the main focus here, and that's why I decided to leave out the most recent cases recorded in Portugal, as the DGS explicitly confirmed that they all belonged to clade IIb. Pakistan doesn't seem to be affected by the new strain, either, whereas we're still waiting for more details from Taiwan and the Philippines.

This is just my guess, though, because it's definitely a tricky task! Oltrepier (talk) 10:28, 20 August 2024 (UTC)

I think there are two outbreaks overlapping here. Or possibly more.

• In endemic areas (mainly DRC) outbreaks historically have been frequent and short-lived, caused by contact with infected wildlife. See Mpox in the Democratic Republic of the Congo
• There is an ongoing global outbreak of Clade IIb which was once a PHEIC but is now sputtering along at a low level, mainly affecting MSM and mainly spread via sexual transmission. Reports of Clade II mpox are probably (but not guaranteed) part of this outbreak.
• Finally, this outbreak of clade Ib which has broken out of the endemic zone. It appears to be more transmissible than previous strains but as yet there are no reliable sources who can tell us how, and how easily, transmission is occutting.

Suggestion - add a couple of extra columns to the Casualties table, and distinguish between cases of Clade I versus Clade II.

Bob (talk) 17:01, 20 August 2024 (UTC)

The Philippines is case is clade II.Hariboneagle927 (talk) 04:47, 21 August 2024 (UTC)

I've removed the Pakistani and Filipino rows from the table as they're not clade Ib. I did that before seeing the discussion here! I don't think having a separate column for clade II cases would help. I'll add some explanatory text somewhere to the article. Bondegezou (talk) 09:27, 21 August 2024 (UTC)

I've moved Pakistan and the Philippines to a separate section. The map needs updating with them being removed too. Bondegezou (talk) 09:36, 21 August 2024 (UTC)

I agree with @Bondegezou here: as @Robertpedley correctly pointed out, the current outbreak is likely caused by several strains overlapping, but the data about casualties are so sparse and fragmented that we'll have quite a hard time keeping the table at the top of the page updated with the latest numbers and references available, let alone trying to distinguish clade Ib cases from clade II ones... Oltrepier (talk) 09:38, 21 August 2024 (UTC)

The main problem I see with only focusing on clade Ib right now is that tests need to be run for it to determine which clade of mpox is being observed. Nonetheless, right now, we're in a weird half-state where we expressly exclude those cases which are explicitly confirmed to be clade II, but we also include cases that seemingly have not been confirmed to be clade Ib while adding a footnote stating how many have been confirmed. Given good, up-to-date information on clade Ib cases, I would agree with this proposal. But this is going to be extremely messy if we only include clade Ib, because we're either going to have to only look at confirmed clade Ib cases, or we're going to have to assume that every single mpox case not explicitly confirmed as clade IIb is clade Ib, which itself is highly misleading. To be honest, I'm really not sure what can be done with this. If we mix clade Ib and clade IIb, then we overemphasize how bad the much more serious clade Ib epidemic currenlty is. If we only report explicitly confirmed clade Ib cases, then we deemphasize how serious it is, as the ratio of confirmed clade Ib cases to actual ones is likely to be miniscule.

I think right now, the best idea I can come up with is to list any known cases, but to highlight countries whose only known cases are clade IIb in the list. I'm going to do that now as WP:BOLD, and I'd appreciate any feedback. TheTechnician27 (Talk page) 13:59, 22 August 2024 (UTC)

Okay, after trying to untangle this mess, I definitely think we should bring back the map with all mpox cases, but for those countries which are only reporting clade IIb, it should e.g. have stripes to denote that. I'll get to work on that. TheTechnician27 (Talk page) 15:29, 22 August 2024 (UTC)

I disagree with that, the article states the strain is lb, and this particular epidemic is only lb (2023-2024) TheTopazRuby (talk) 02:49, 25 August 2024 (UTC)

I think this will work for now. Benpiano800 (talk) 16:11, 22 August 2024 (UTC)

Can we have three shadings? Clade I confirmed, only clade II, cases undetermined. Bondegezou (talk) 21:25, 23 August 2024 (UTC)

From my understanding, mpox is endemic. Clade Ib is not, as a novel subgroup. Mentioning that clade II is present in the U.S. may be useful, but it should not be a secondary focus of the article. elijahpepe@wikipedia (he/him) 01:32, 24 August 2024 (UTC)

@ElijahPepe: I think the current article strikes a good balance, wherein we focus solely on clade Ib in the map, the lead, and the first table but maintain a secondary table for countries with clades Ia and IIb. The main problems I see with failing to mention countries with clade IIb and Ia are that 1) it subtly implies that all of the cases are clade Ib despite the fact that there's definitely intermingling within countries that have identified Ib, 2) it means it's a lot easier for confusion to arise when an editor wants to come and add a IIb country because they mistakenly believe it's Ib, 3) it clarifies to the reader what countries with mpox have not yet identified clade Ib (especially because there's often misinformation that circulates such as Pakistan allegedly having clade Ib), 4) there has been a surge in IIb cases (e.g. Australia last year had 26 and this year 306), and 5) readers will absolutely be coming here hoping for an all-around view of the current state of mpox, not just clade Ib. It's also simply not true in a lot of these countries that clade IIb mpox is endemic (or at least detectably so); for a lot of them, they're detecting their first cases in quite a long time just this month. TheTechnician27 (Talk page) 03:59, 24 August 2024 (UTC)

I disagree because this article is talking about the 2023-2024 epidemic (clade lb) I would suggest making a different article if you want to only talk about monkeypox during 2024 TheTopazRuby (talk) 02:51, 25 August 2024 (UTC)

I mean obviously we should only include clade lb, this article clearly states the dates of clade lb TheTopazRuby (talk) 02:48, 25 August 2024 (UTC)

Rolling "laboratory confirmed" directly into the casualties table?

Unless this is a style unique to medical topics that I am not aware of (which is entirely possible), wouldn't it be better to add the numbers of cases/deaths that have been confirmed in laboratories directly to the columns for cases/deaths as Cases number (lab confirmed cases number) and Deaths number (lab confirmed deaths number) instead of having them as separate notes for each country? Yvan Part (talk) 11:21, 21 August 2024 (UTC)

@Yvan Part That could be nice, to be honest!

I admit I added those footnotes just to keep the table in a reasonable shape, but I don't know whether it meets the criteria for medical topics or not... Oltrepier (talk) 17:31, 21 August 2024 (UTC)

Done for now. I decided to make it into header notes to avoid taking too much space but if there is a better alternative, feel free to change it. New laboratory confirmed cases or deaths numbers can just be added in parentheses. Yvan Part (talk) 18:14, 23 August 2024 (UTC)

Double outbreak?

As I've monitored the mpox epidemic so far I've noticed that it seems that we have two epidemics go on at once!

I wonder if we could add a section for Clade I cases and a section for Clade II cases so that we can report both at the same time. NuestroBrasil (talk) 12:20, 21 August 2024 (UTC)

Have a look at Talk:2023–2024_mpox_epidemic#Do_we_include_any_strain,_or_just_Clade_Ib? above. The clade II cases are the remnants of the 2022-3 outbreak that has its own article, with this article being about the newer, Ib outbreak. I think that works, keep the focus here on the Ib outbreak. Bondegezou (talk) 12:59, 21 August 2024 (UTC)

Agreed TheTopazRuby (talk) 02:52, 25 August 2024 (UTC)

Thailand

Not quite yet, but results are pending to see if a new case is Clade 1b and consequently if Thailand will show up on the map. TheTechnician27 (Talk page) 22:38, 21 August 2024 (UTC)

Map

@Bondegezou: Which problems did you find with the map? I can get them addressed promptly and have the map back up. Edit: never mind. I see where you spoke about them on Nice4What's talk page.TheTechnician27 (Talk page) 13:22, 22 August 2024 (UTC)

Further to my comments there, I think we can exclude Indonesia too. The text in the article suggests those were all clade II cases. Bondegezou (talk) 13:46, 22 August 2024 (UTC)

I've updated the map so that Clade II cases are shown in a distinct color, do you think it is good to add back? Chaotic Enby (talk · contribs) 14:11, 22 August 2024 (UTC)

@Chaotic Enby: After doing quite a bit of research, the majority of the countries on the table do not actually have confirmed clade Ib cases yet. In all likelihood, I think the best option would be to use something like stripes for the countries which don't have confirmed clade Ib cases yet. This is definitely a bit of a cluster right now, but I'm willing to put in the work to sort this all out as best I can. TheTechnician27 (Talk page) 15:37, 22 August 2024 (UTC)

Thanks a lot! Good luck if you want to take this on! Chaotic Enby (talk · contribs) 16:17, 22 August 2024 (UTC)

Clade II differentiation not showing up on mobile

Same applies for the "Timeline" page for this event, which has teal not showing up on the mobile page. Could any other people on their phones confirm? 2A02:8012:C76B:0:AC2B:E6C1:B854:C301 (talk) 20:10, 22 August 2024 (UTC)

Yeah, this is ostensibly some sort of glitch with how MediaWiki renders SVG files. At any rate, the current map system no longer includes non-clade IB-positive countries at all and consequently has no stripes, so this shouldn't be an issue going forward. TheTechnician27 (Talk page) 03:44, 23 August 2024 (UTC)

Map

After I saw both statistics I'd recommend making the countries with clade II or IIb cases and also nations with unspecified clade cases to be colored red, to make them stand out, because as of now it seems we have a outbreak of clade I and Ib but also larger II and IIb cases. NuestroBrasil (talk) 12:13, 23 August 2024 (UTC)

Having done this song and dance yesterday with trying to include clade IIb, I don't think we should be including clade IIb on the map at this point (as best as I understand it, clade IIb is the only one circulating; clade IIa has been MIA for a couple years at least now). For starters, the crux of this epidemic (and the reason why the WHO declared it a PHEIC) is the cross-border spread of clade Ib, so I think marking a ton of countries with clade IIb (or clade Ia) would just swamp the arguably more significant portion of the map. So it would simultaneously misinform casual readers about the extent of the clade Ib spread while also taking focus away from the main area of focus of the global health community. Moreover, we have clade IIb on the table, which already is definitely very incomplete (I'm trying to work on it to make it more complete), and I split the table for the same reason: clades IIb and to a lesser extent Ia were just completely swamping information about clade Ib. TheTechnician27 (Talk page) 19:11, 23 August 2024 (UTC)

Terminology - Ib and IIb, or 1b and 2b?

We're using both versions - Arabic numerals (1, 2) and Roman numerals (I, II). In fact the very first sentence of this article contains one of each.

It doesn't help that many of our sources are inconsistent. Recent articles by WHO, Lancet, BBC and gov.uk have contained both systems, though not in the same article I think.

Leaning towards Ib are:- ECDC, CEPI, UNICEF, USA today, NYT, CDC, Nature, FDA

Favouring 1b are:- Washington Post, Reuters, CIDRAP, Institut Pasteur, Reliefweb

Interestingly, London School of Hygiene & Tropical Medicine (who ought to know about these things) use both systems inconsistently in this article.

Should we aim to be more consistent?Bob (talk) 17:21, 24 August 2024 (UTC)

We definitely should be internally consistent, although I'm not sure which one would be preferable. If I had to choose, I'd pick I and II, as they seem to be more in use overall. Chaotic Enby (talk · contribs) 10:01, 25 August 2024 (UTC)

Good background reading about origins and evolution of current epidemics

I found this very comprehensive and helpful [| Confused about the mpox outbreaks? Here’s what’s spreading, where, and why ]

Bob (talk) 17:23, 24 August 2024 (UTC)

Shut down any and all traveling

WP:Soapbox ⸺(Random)staplers 23:38, 24 August 2024 (UTC)
Us americans aren't about to die from ANOTHER outbreak 97.81.148.159 (talk) 21:50, 24 August 2024 (UTC)