Epidemiological and clinical characteristics of patients with monkeypox in the GeoSentinel Network: a cross-sectional study
Kristina M Angelo, Teresa Smith, Daniel Camprubí, Leire Balerdi-Sarasola, Marta Díaz‐Menéndez, Guillermo Servera-Negre, Sapha Barkati, Alexandre Duvignaud, Kristina L B Huber, Arpita Chakravarti, Emmanuel Bottieau, Christina Greenaway, Martin P. Grobusch, Diogo Mendes Pedro, Hilmir Ásgeirsson, Corneliu Petru Popescu, Charlotte Martin, Carmelo Licitra, Albie de Frey, Eli Schwartz, Michael Beadsworth, Susana Lloveras, Carsten Schade Larsen, Sarah Anne J. Guagliardo, Florence Whitehill, Ralph Huits, Davidson H. Hamer, Phyllis E. Kozarsky, Michael Libman, Lucille Blumberg, H. Chaussade, Arnaud Desclaux, Éric Florence, Simin Aysel Florescu, Hedvig Glans, Marielle Glynn, Abraham Goorhuis, Marina B. Klein, Denis Malvy, Andrea M. McCollum, José Muñóz, Duc T. Nguyen, Laura A.S. Quilter, Camilla Rothe, Patrick Soentjens, Camille Tumiotto, Jef Vanhamel
Abstract
BACKGROUND: The early epidemiology of the 2022 monkeypox epidemic in non-endemic countries differs substantially from the epidemiology previously reported from endemic countries. We aimed to describe the epidemiological and clinical characteristics among individuals with confirmed cases of monkeypox infection. METHODS: and higher, patients with one sexual partner or ten or more sexual partners, and patients with or without a previous smallpox vaccination. FINDINGS: (range 36-1659; IQR 500-885). Of 219 patients for whom data were available, 216 (99%) reported sexual or close intimate contact in the 21 days before symptom onset; MSM reported a median of three partners (IQR 1-8). Of 195 patients for whom data were available, 78 (40%) reported close contact with someone who had confirmed monkeypox. Overall, 30 (13%) of 226 patients were admitted to hospital; 16 (53%) of whom had severe illness, defined as hospital admission for clinical care rather than infection control. No deaths were reported. Compared with patients without HIV, patients with HIV were more likely to have diarrhoea (p=0·002), perianal rash or lesions (p=0·03), and a higher rash burden (median rash burden score 9 [IQR 6-21] for patients with HIV vs median rash burden score 6 [IQR 3-14] for patients without HIV; p<0·0001), but no differences were identified in the proportion of men who had severe illness by HIV status. INTERPRETATION: Clinical manifestations of monkeypox infection differed by HIV status. Recommendations should be expanded to include pre-exposure monkeypox vaccination of groups at high risk of infection who plan to engage in sexual or close intimate contact. FUNDING: US Centers for Disease Control and Prevention, International Society of Travel Medicine.