Abstract
Research assessing the trend in online search activity on monkeypox (mpox) and the correlation with the mpox epidemic at the global and national level is scarce. The trend of online search activity and the time-lag correlations between it and daily new mpox cases were estimated by using segmented interrupted time-series analysis and Spearman correlation coefficient (rs), respectively. We found that after the declaration of a Public Health Emergency of International Concern (PHEIC), the proportion of countries or territories with increasing changes in online search activity was lowest in Africa (8.16%, 4/49), and a downward trend in online search activity was highest in North America (8/31, 25.81%). The time-lag effect of global online search activity on daily new cases was significant (rs = 0.24). There were eight countries or territories with significant time-lag effect; the top three countries or territories were Brazil (rs = 0.46), United States (rs = 0.24), and Canada (rs = 0.24). Interest behavior in mpox was insufficient, even after the declaration of PHEIC, especially in Africa and North America. Online search activity could be used as an early indicator of the outbreak of mpox at the global level and in epidemic countries.