Understanding the Epidemiology of Monkeypox Virus to Prevent Future Outbreaks

Abstract

Monkeypox (Mpox) is an infectious disease caused by the Mpox virus belonging to the Orthopoxvirus genus in the Poxviridae family and has been declared by the WHO as a global health emergency owing to its rapid spread during 2022 and 2023. All patients diagnosed with Mpox who were confirmed by PCR between July 2022 and April 2023 were included in this study. In total, 405 patients in whom clade 2 was identified were included. Notably, 99% of included patients were men, with 82% of them aged 20-39 years. Furthermore, 71% were men who had sex with men, and 34% were HIV carriers. Regarding the morphology of the lesions, approximately 63% presented with papulonecrotic rash, which sometimes alternated with pustules depending on the stage they were in. All patients presented with systemic symptoms. Five patients required hospital admission, one of whom died, and presented with HIV and severe immunosuppression. Clinical findings suggest that contact during sexual intercourse is the most likely transmission mechanism and genital involvement is the most frequent clinical form. HIV was the primary comorbidity. Genital lesions were common, especially in vulnerable populations such as those who engage in high-risk sexual behaviors.

Keywords: HIV; MSM; genital ulcers; monkeypox.

Figure 1

Rash and lesions at different stages in a man who has sex with men.

Figure 2

Multiple pseudopustules, some were crater-shaped with erosive centers.

Figure 3

Regular circular ulcer with a white peripheral border, and purplish red central bottom.

Figure 4

Lesion at inoculation site. Confluent ulcers with an associated depressed necrotic center.

Figure 5

An umbilicated pustule on the dorsal surface of the penis.

Figure 6

Papulonecrotic lesions and ulcerations with extensive necrosis in a patient with HIV.

Figure 7

Several ulcerated lesions were observed on the penis in this patient VIH + and MSM.