Researchers from Imperial College London recently published a comprehensive case series on monkeypox. For this purpose, 528 infections were examined that had been diagnosed between April 27th and June 24th in 16 countries. Overall, 98 percent of homosexual or bisexual men were affected. The average age was 38 years, the scientists report in the journal “NEJM”.
According to the publication, the virus was transmitted during sexual activity in 95 percent of cases. However, other transmission routes are also possible, for example via droplets or contact with the characteristic skin lesions. “It is important to emphasize that monkeypox is not a classic sexually transmitted disease (STI), it can be transmitted through any type of close contact,” says study author Dr. John P. Thornhill in a statement from Queen Mary University of London.
Symptoms differ in sick people
Patients’ symptoms were not always distinctive: 95 percent had skin lesions, with the majority (64 percent) having fewer than 10 lesions. 73 percent had lesions on the anus and genitals, with almost 10 percent of patients experiencing only a single lesion. The latter is similar to the symptoms of other sexually transmitted diseases, which is why they are easy to confuse, the authors emphasize. Medical professionals should also consider monkeypox if they have these symptoms in high-risk individuals.
Patients also commonly had fever (62 percent), drowsiness (41 percent), muscle pain (31 percent), and headache (27 percent). Thirteen percent of patients had to be hospitalized, some because of severe pain in the anus and rectum, severe sore throat, difficulty swallowing or eye lesions. There were three serious complications: one patient developed epiglottitis (inflammation of the back of the throat) and two developed myocarditis (inflammation of the heart muscle).
The European epidemic agency ECDC had already pointed out in a report on July 8 that the current monkeypox outbreak is presenting the disease with a spectrum of symptoms that differs from previous monkeypox outbreaks in endemic countries. Asymptomatic or subclinical courses also occur. The latter should be confirmed and the relevance to the transmission checked, ECDC says. Asymptomatic infections would make containing the outbreak particularly difficult. The current case series does not provide any information on this – only infected people who had sought medical treatment for symptoms were included.
Those: DOI 10.1056/NEJMoa2207323