Bragazzi Nicola L, Kong Jude D, Mahroum Naim, Tsigalou Christina, Khamisy-Farah Rola, Converti Manlio, Wu Jianhong
Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, Ontario, Canada.
Department of Internal Medicine, International School of Medicine, Istanbul Medipol University, Istanbul, Turkey.
J Med Virol. 2023 Jan;95(1):e27931. doi: 10.1002/jmv.27931. Epub 2022 Jun 17.
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.
猴痘感染的新一轮疫情正在全球迅速蔓延，目前已有30多个国家报告了疫情，病例数略少于1000例。在本初步报告中，我们收集并综合了有关此次疫情流行趋势和临床特征的早期数据，并将其与以往疫情的数据进行了比较。数据来自意大利、澳大利亚、捷克共和国、葡萄牙和英国的六个群组，共计124例（其中35例可获取详细信息）。此次疫情在年龄（30多岁的个体占54.29%）、性别（大多数病例为男性）、危险因素和传播途径方面与以往疫情不同，性传播的可能性很大。此外，临床表现不典型且异常，其特征是肛门生殖器病变和皮疹，面部和四肢相对较少受累。报告的最常见体征/症状是发热（54.29%的病例），其次是腹股沟淋巴结病（45.71%）和皮疹（40.00%）。分别有22.86%和25.71%的受试者出现乏力、疲劳和头痛。17.14%的病例出现肌痛。31.43%的病例报告有生殖器和肛门病变（溃疡和水疱）。最后，11.43%的样本出现颈部淋巴结病，而报告最少的症状是腹泻和腋窝淋巴结病（两种症状在病例系列中均占5.71%）。可以确定一些初步的危险因素（年轻男性、与其他男性发生性行为、从事包括无保护性行为在内的危险行为和活动、人类免疫缺陷病毒阳性（分析样本中的54.29%）以及既往有包括梅毒在内的性传播感染病史）。另一方面，病毒得到充分抑制且检测不到可能预防更严重的感染病程。然而，该领域迫切需要进一步研究。
