The prediction market focuses on whether there will be 10 or more confirmed cases of monkeypox (mpox) in the United States during 2024. Based on current CDC data and public health surveillance, mpox cases have remained relatively low in 2023-2024, with effective vaccination programs and public health measures helping to contain outbreaks. However, there are ongoing concerns about Clade I infections, particularly given recent cases in the Democratic Republic of Congo and the potential for international spread. The market currently shows strong conviction (96.4%) that cases will remain below 10 in 2024, reflecting the success of containment efforts and vaccination campaigns targeting high-risk populations. However, key risk factors include low vaccination rates among eligible individuals, potential for travel-related cases, and the higher transmissibility of Clade I strains.

Background and Current Status

Current Case Trends

• CDC data shows mpox cases have declined significantly since the 2022 outbreak
• Recent surveillance indicates sporadic clusters but no major outbreaks
• Los Angeles County experienced a small resurgence in May-August 2023 with 56 cases

Vaccination Status

• Only ~29% of eligible individuals have received full vaccination
• JYNNEOS vaccine available and recommended for high-risk populations
• Low vaccination uptake remains a concern for public health officials

Analysis of Potential Outcomes

Scenario 1: Under 10 Cases (96.4%)

Supporting Factors:

• Effective public health response infrastructure
• Continued vaccination availability
• Enhanced surveillance and early detection
• Lower current baseline of cases

Risks:

• Low vaccination rates could enable outbreaks
• Travel-related introduction of Clade I
• Potential for asymptomatic spread

Scenario 2: 10+ Cases (3.6%)

Supporting Factors:

• Emergence of Clade I cases in DRC
• Historical patterns of disease resurgence
• Ongoing transmission in high-risk networks
• Large unvaccinated susceptible population

Key Factors to Watch

1. International Developments

• Clade I cases in endemic regions
• Travel-related transmission
• Global vaccination efforts

2. Domestic Health Measures

• Vaccination uptake rates
• Surveillance system effectiveness
• Public health response capacity

3. Community Factors

• Behavior patterns in high-risk groups
• Access to healthcare and testing
• Community awareness and education

Recent Developments

• CDC advisory highlighting ongoing circulation of mpox
• Concerns about Clade I transmission in DRC
• Enhanced surveillance recommendations for healthcare providers
• Continued emphasis on vaccination for at-risk populations