Sexual Exposures Associated With Mpox Infection: California, November 2022 to June 2023.

BACKGROUND: Exposures associated with mpox infection remain imperfectly understood. METHODS: We conducted a case-control study enrolling participants who received molecular tests for mpox/orthopoxvirus in California from November 2022 through June 2023. We collected data on behaviors during a 21-day risk period before symptom onset or testing among mpox case patients and test-negative controls. RESULTS: Thirteen of 54 case patients (24.1%) and 5 of 117 controls (4.3%) reported sexual exposure to individuals they identified as potential mpox case patients ("index contacts"; odds ratio [OR], 7.7 [95% confidence interval (CI), 2.5-19.3] relative to individuals who did not report exposure to potential mpox case patients). Among these participants, 10 of 13 case patients (76.9%) and 2 of 5 controls (40.0%) reported that their index contacts were not experiencing symptoms visible to participants during sex (OR, 14.9 [95% CI, 3.6-101.8]). Only 3 of 54 case patients (5.6%) reported exposure to symptomatic index contacts. Case patients reported more anal/vaginal sex partners than did controls (adjusted OR, 2.2 [95% CI, 1.0-4.8] for 2-3 partners and 3.8 [1.7-8.8] for ≥4 partners). Male case patients with penile lesions more commonly reported insertive anal/vaginal sex than those without penile lesions (adjusted OR, 9.3 [95% CI, 1.6-54.8]). Case patients with anorectal lesions more commonly reported receptive anal sex than those without anorectal lesions (adjusted OR, 14.4 [95% CI, 1.0-207.3]). CONCLUSIONS: Sexual exposure to contacts known or suspected to have experienced mpox was associated with increased risk of infection, often when index contacts lacked apparent symptoms. Exposure to more sex partners, including those whom participants did not identify as index contacts, was associated with increased risk of infection in a site-specific manner. While participants' assessment of symptoms in partners may be imperfect, these findings suggest that individuals without visibly prominent mpox symptoms transmit infection.

Uptake of funded influenza vaccines in young Australian children in 2018; parental characteristics, information seeking and attitudes.

OBJECTIVE: Infants and children under 5-years are at an increased risk of complications from influenza. We aimed to evaluate characteristics associated with uptake of Australian state and territory funded influenza vaccine programs in 2018 for children aged 6-months to 5-years. MATERIALS AND METHODS: A national online survey of 1002 Australian parents with at least one child aged between 6-months and 5-years (response rate 29.9%). A 23-item online questionnaire asked parents about health service use, 2017 and 2018 influenza vaccine uptake, and routine childhood vaccine status for their youngest child. Parents were also asked a range of questions about their demographics, sources of vaccine information, and beliefs and attitudes towards immunisation. RESULTS: A total of 1002 parents completed the questionnaire and 52.9% of children aged 6-months to 5-years in our sample were immunised against influenza in 2018; representing a significant increase from 2017. Knowing the vaccine was free for their child, and being influenced by a pharmacist increased the likelihood that their child received the influenza vaccine. Not receiving an influenza vaccine recommendation from a health care provider significantly reduced the likelihood of immunisation. Some parents were worried about the safety of the influenza vaccine for their child (36.4%), while 26.5% of parents agreed that you can catch influenza from the vaccine. CONCLUSIONS: Uptake of influenza vaccine for Australian children aged 6-months to 5-years increased significantly in 2018. Continuing efforts to build parents' trust in childhood influenza vaccination are still required. Increasing opportunities for health care providers to recommend vaccination will lead to further improvements in uptake for young children.