Clinical features and novel presentations of human monkeypox in a central London centre during the 2022 outbreak : descriptive case series

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OBJECTIVE: To characterise the clinical features of monkeypox infection in humans.

DESIGN: Descriptive case series.

SETTING: A regional high consequences infectious disease centre with associated primary and secondary care referrals, and affiliated sexual health centres in south London between May and July 2022.

PARTICIPANTS: 197 patients with polymerase chain reaction confirmed monkeypox infection.

RESULTS: The median age of participants was 38 years. All 197 participants were men, and 196 identified as gay, bisexual, or other men who have sex with men. All presented with mucocutaneous lesions, most commonly on the genitals (n=111 participants, 56.3%) or in the perianal area (n=82, 41.6%). 170 (86.3%) participants reported systemic illness. The most common systemic symptoms were fever (n=122, 61.9%), lymphadenopathy (114, 57.9%), and myalgia (n=62, 31.5%). 102/166 (61.5%) developed systemic features before the onset of mucocutaneous manifestations and 64 (38.5%) after (n=4 unknown). 27 (13.7%) presented exclusively with mucocutaneous manifestations without systemic features. 71 (36.0%) reported rectal pain, 33 (16.8%) sore throat, and 31 (15.7%) penile oedema. 27 (13.7%) had oral lesions and 9 (4.6%) had tonsillar signs. 70/195 (35.9%) participants had concomitant HIV infection. 56 (31.5%) of those screened for sexually transmitted infections had a concomitant sexually transmitted infection. Overall, 20 (10.2%) participants were admitted to hospital for the management of symptoms, most commonly rectal pain and penile swelling.

CONCLUSIONS: These findings confirm the ongoing unprecedented community transmission of monkeypox virus among gay, bisexual, and other men who have sex with men seen in the UK and many other non-endemic countries. A variable temporal association was observed between mucocutaneous and systemic features, suggesting a new clinical course to the disease. New clinical presentations of monkeypox infection were identified, including rectal pain and penile oedema. These presentations should be included in public health messaging to aid early diagnosis and reduce onward transmission.

Errataetall:

CommentIn: BMJ. 2022 Aug 10;378:o1990. - PMID 35948354

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:378

Enthalten in:

BMJ (Clinical research ed.) - 378(2022) vom: 28. Juli, Seite e072410

Sprache:

Englisch

Beteiligte Personen:

Patel, Aatish [VerfasserIn]
Bilinska, Julia [VerfasserIn]
Tam, Jerry C H [VerfasserIn]
Da Silva Fontoura, Dayana [VerfasserIn]
Mason, Claire Y [VerfasserIn]
Daunt, Anna [VerfasserIn]
Snell, Luke B [VerfasserIn]
Murphy, Jamie [VerfasserIn]
Potter, Jack [VerfasserIn]
Tuudah, Cecilia [VerfasserIn]
Sundramoorthi, Rohan [VerfasserIn]
Abeywickrema, Movin [VerfasserIn]
Pley, Caitlin [VerfasserIn]
Naidu, Vasanth [VerfasserIn]
Nebbia, Gaia [VerfasserIn]
Aarons, Emma [VerfasserIn]
Botgros, Alina [VerfasserIn]
Douthwaite, Sam T [VerfasserIn]
van Nispen Tot Pannerden, Claire [VerfasserIn]
Winslow, Helen [VerfasserIn]
Brown, Aisling [VerfasserIn]
Chilton, Daniella [VerfasserIn]
Nori, Achyuta [VerfasserIn]

Links:

Volltext

Themen:

Case Reports
Journal Article

Anmerkungen:

Date Completed 01.08.2022

Date Revised 13.12.2023

published: Electronic

CommentIn: BMJ. 2022 Aug 10;378:o1990. - PMID 35948354

Citation Status MEDLINE

doi:

10.1136/bmj-2022-072410

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM344218392