Fig. 1: Stratification of mpox virus infections.

a Results of K-means clustering of mpox cases based on viral load at symptom onset, area under the viral load curve (AUC), i.e., the total amount of virus shed over time, and duration of viral shedding using estimated individual parameters. Data points indicate individuals and are colored based on the group that each individual is in. Principal component analysis (PCA) was used to visualize the clusters in two dimensions. Groups 1 and 2 comprise 71 and 19 mpox cases, respectively. b Stratified viral load data points measured in lesion samples. The cross represents data points where the viral load was below the limit of detection. c Reconstructed individual viral load trajectories in each group. The horizontal dashed line means the assumed infectiousness threshold. d Comparison between groups of: viral load at symptom onset (left panel); duration of viral shedding (middle panel); and area under viral load curve (right panel), respectively. The box-and-whisker plots show the medians (50th percentile; bold lines), interquartile ranges (25th and 75th percentiles; boxes), and 2.5th to 97.5th percentile ranges (whiskers). The sizes of Group 1 and Group 2 are 71 and 19 cases, respectively. Using the two-sided Mann–Whitney test, statistically significant differences between the two groups were found for viral load at symptom onset (\({p}\,{\mbox{value}}=5.7\times {10}^{-10}\)), duration of viral shedding (\({p}\,{\mbox{value}}=2.1\times {10}^{-9}\)), and area under viral load curve (\({p}\,{\mbox{value}}=4.6\times {10}^{-11}\)). Group 1 and Group 2 represent cases with low and high risk of transmission, respectively. e Viral clearance in each group. Probability of detectable virus after symptom onset for each group (left panel). The solid lines and shaded regions indicate means and 95% confidence intervals, respectively. The dashed lines and dotted lines stand for probabilities at 3 and 4 weeks after symptom onset, respectively. Bar plots represent the probabilities for 3 weeks (right upper panel) and 4 weeks (right lower panel) after symptom onset, respectively. The centers and error bars indicate means and 95% confidence intervals, respectively. Note that the estimated probabilities are based on 100 independent simulations.