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Review
. 2023 Jan;95(1):e27931.
doi: 10.1002/jmv.27931. Epub 2022 Jun 17.

Epidemiological trends and clinical features of the ongoing monkeypox epidemic: A preliminary pooled data analysis and literature review

Nicola L Bragazzi  1 , Jude D Kong  1 , Naim Mahroum  2 , Christina Tsigalou  3 , Rola Khamisy-Farah  4   5 , Manlio Converti  6 , Jianhong Wu  1
Affiliations
Review

Epidemiological trends and clinical features of the ongoing monkeypox epidemic: A preliminary pooled data analysis and literature review

Nicola L Bragazzi et al. J Med Virol. 2023 Jan.

Abstract

An emerging outbreak of monkeypox infection is quickly spreading worldwide, being currently reported in more than 30 countries, with slightly less than 1000 cases. In the present preliminary report, we collected and synthesized early data concerning epidemiological trends and clinical features of the ongoing outbreak and we compared them with those of previous outbreaks. Data were pooled from six clusters in Italy, Australia, the Czech Republic, Portugal, and the United Kingdom, totaling 124 cases (for 35 of which it was possible to retrieve detailed information). The ongoing epidemic differs from previous outbreaks in terms of age (54.29% of individuals in their thirties), sex/gender (most cases being males), risk factors, and transmission route, with sexual transmission being highly likely. Also, the clinical presentation is atypical and unusual, being characterized by anogenital lesions and rashes that relatively spare the face and extremities. The most prevalent sign/symptom reported was fever (in 54.29% of cases) followed by inguinal lymphadenopathy (45.71%) and exanthema (40.00%). Asthenia, fatigue, and headache were described in 22.86% and 25.71% of the subjects, respectively. Myalgia was present in 17.14% of the cases. Both genital and anal lesions (ulcers and vesicles) were reported in 31.43% of the cases. Finally, cervical lymphadenopathy was described in 11.43% of the sample, while the least commonly reported symptoms were diarrhea and axillary lymphadenopathy (5.71% of the case series for both symptoms). Some preliminary risk factors can be identified (being a young male, having sex with other men, engaging in risky behaviors and activities, including condomless sex, human immunodeficiency virus positivity (54.29% of the sample analyzed), and a story of previous sexually transmitted infections, including syphilis). On the other hand, being fully virally suppressed and undetectable may protect against a more severe infectious course. However, further research in the field is urgently needed.

Keywords: emerging pathogen; monkeypox; outbreak; pooled data analysis.

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References

REFERENCES

    1. von Magnus P, Andersen EK, Petersen KB, Birch-Andersen A. A pox-like disease in cynomolgus monkeys. Acta Pathol Microbiol Scand. 1959;46:156-176. doi:10.1111/j.1699-0463.1959.tb00328.x
    1. Bunge EM, Hoet B, Chen L, et al. The changing epidemiology of human monkeypox-a potential threat? A systematic review. PLoS Negl Trop Dis. 2022;16(2):e0010141. doi:10.1371/journal.pntd.0010141
    1. Nakazawa Y, Mauldin MR, Emerson GL, et al. A phylogeographic investigation of African monkeypox. Viruses. 2015;7(4):2168-2184. doi:10.3390/v7042168
    1. Mwanbal PT, Tshioko KF, Moudi A, et al. Human monkeypox in Kasai Oriental, Zaire (1996-1997). Euro Surveill. 1997;2(5):33-35. doi:10.2807/esm.02.05.00161-en
    1. Centers for Disease Control and Prevention (CDC). Human monkeypox-Kasai Oriental, Democratic Republic of Congo, February 1996-October 1997. MMWR Morb Mortal Wkly Rep. 1997;46(49):1168-1171.

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