Simulating a potential mpox outbreak: Implications for control in non-endemic settings.

We construct a model for mpox outbreaks in low and middle-income countries where the disease is non-endemic, using India as an example. We simulate potential outbreak scenarios using BharatSim, a flexible agent-based simulation framework. The spread of mpox is modelled as being driven primarily through sexual contacts within a subnetwork of men who have sex with men (MSM), embedded within a larger network representing their household and workplace contacts. Our model allows for disease spread through this expanded network, including the possibility of heterosexual transmission. We quantify the outbreak size, the dynamics of infection within and outside the MSM subnetwork, and the implications of vaccination and prophylactic measures for curtailing disease spread. These results should inform planning and policy measures for mpox control in generic LMIC settings.