Monkeypox virus, seldom reported outside African until now,
https://www.nejm.org/doi/full/10.1056/NEJMoa2207323?emp=marcom&utm_source=nejmlist&utm_medium=email&utm_campaign=aomev2&utm_content=version-a&ssotoken=U2FsdGVkX19dsxXEVZT5ggLZ3zieDxejeViMkwTigM4Q7ECfBTJmfTXUrKWkbZ3up0jDhhQjYR6OydzgkC%2F1LL8S5l7OuFDLsP2LiBwfKJ3ymNN4hp0Z%2FNASEYMuetIqeQIQ9ETL8BABCQut7e8xEQeWPlduFdyPMYgAugUePHtSEs5rFR%2BGWfFOCIPZs9Wb7aJf%2FyzhvvLSrzqDKmNt4Q%3D%3D&cid=DM1289135_Notable_Articles_Engaged&bid=1085207852
Endemic in Africa
Cases now worldwide
METHODS
Formed an international collaborative group,
international case series, presentation, clinical course, outcomes of PCR confirmed infections
RESULTS
We report 528 infections diagnosed between
April 27 to June 24, 2022
Cases, 528, at 43 sites in 16 countries
98% in gay or bisexual men, 7
5% were White,
41% had HIV
median age 38
Transmission suspected to have occurred through sexual activity
95% of cases
Presentation in this series
95% rash
(with 64% having less than 10 lesions)
73% anogenital lesions
41% had mucosal lesions
(with 54 having a single genital lesion)
Common systemic features preceding the rash
fever (62%)
lethargy (41%)
myalgia (31%)
headache (27%)
lymphadenopathy (56%)
Concomitant sexually transmitted infections
109 of 377 (29%)
Among the 23 people with a clear exposure history
median incubation period, 7 days (range, 3 to 20)
Monkeypox virus DNA
Detected in 29 of the 32 (in whom seminal fluid was analyzed)
Management
Antiviral treatment given to 5% of cases
70 (13%) were hospitalized
Mostly for pain management
severe anorectal pain (21)
soft-tissue superinfection (18)
pharyngitis limiting oral intake (5)
eye lesions (2)
acute kidney injury (2)
myocarditis (2)
infection-control purposes (13)
No deaths were reported
CONCLUSIONS
Monkeypox manifested with a variety of dermatologic and systemic clinical findings.
Need for rapid identification and diagnosis of cases to contain further community spread.
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