New symptoms of monkeypox: lethargy and headaches

Concomitant sexually transmitted infections were reported in 29 percent of the people who were studied.

Fever, lethargy, myalgia, or headache are the other symptoms caused by monkey poxaccording to a study in which the CIBERINFEC research group has participated in the University Hospital of La Paz (Madrid) and which has been published in ‘The New England Journal of Medicine’.

Since the identification in 1970 of the virus monkeypox in humans, sporadic outbreaks have been described in certain African regions where it is endemic. But since May 2022, a unprecedented increase in the number of cases that have already been identified in more than 50 countries on different continents.

In addition to this change in its distribution, the virus is showing a different spectrum in terms of clinical presentation and affected population. In order to try to better characterize the current outbreak and thus better define its transmission, associated risk factors, clinical evolution and complications, this study has been carried out in which 528 infections diagnosed between April 27 and on June 24, 2022, at 43 centers in 16 countries.

Most of them (98 percent of those infected) were gay or bisexual men, white (75 percent), and 41 percent were infected with the human immunodeficiency virus (HIV); the mean age was 38 years. Most infections occurred through sexual activity (95 percent of cases).

Regarding clinical manifestations, almost all patients (95%) had a rash (64% had 10 lesions), 73% had anogenital lesions, and 41% had mucosal lesions. The rash was associated with fever (62 percent), lethargy (41 percent), myalgia (31 percent), and headache (27 percent); lymphadenopathy was also common (in 56 percent).

Concomitant sexually transmitted infections

Likewise, the concomitant sexually transmitted infections they were recorded in 109 of 377 people (29 percent) who were studied. Among those in whom a clear exposure might be identified (23 subjects), the median incubation time for infection was 7 days (range 3 to 20). Monkeypox virus DNA was identified in seminal fluid from 29 of 32 people tested.

Antiviral treatment was given to 5 percent of people overall, and 70 (13 percent) required hospitalization primarily for pain control (mainly severe anorectal pain, 21 people), soft tissue superinfection (18), pharyngitis limiting oral intake (5), eye injuries (2), acute kidney injury (2); myocarditis (2) and for infection control (13). No deaths were reported.

“It has been shown how monkeypox is behaving in the current outbreak, with a variety of clinical findings, both dermatological and systemic, and transmitted mainly following sexual contact. The fact that cases have been simultaneously identified outside the areas where monkeypox has traditionally been endemichighlights the need to identify and diagnose cases early as a critical measure to contain the spread of this disease in the community,” the researchers said.

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