Centro Sandoval/Hospital Clínico San Carlos, IdISSC.
Laboratorio de Arbovirus y Enfermedades Víricas importadas, Centro Nacional de Microbiología. Instituto de Salud Carlos III; CIBERINFEC.
J Infect. 2022 Oct;85(4):412-417. doi: 10.1016/j.jinf.2022.07.005. Epub 2022 Jul 10.
Monkeypox is the most prevalent Orthopoxvirus zoonosis infection since the eradication of smallpox. The current multi-country outbreak involves five WHO regions affecting mainly Europe. Accurate clinical and virological aspects of the disease outside endemic areas are needed.
We performed an observational study of cases diagnosed in Madrid (Spain) (May/June 2022). Confirmation from vesicular lesions swabs, Orthopoxvirus real-time PCR, sequencing, phylogenetic analysis, and direct detection by Electron microscopy was performed. In addition, a structured epidemiological questionnaire was completed systematically to gather sociodemographic, clinical, and behavioral data from all confirmed cases.
We extracted data from 48 patients, all cisgender men. The median age was 35 years (IQR 29 - 44), and 87.5% were MSM. The most prevalent symptoms were the presence of vesicular-umbilicated and pseudo-pustular skin lesions (93.8%), asthenia (66.6%), and fever (52.1%). In addition, the location of the lesions in the genital or perianal area was related to the role in sexual intercourse (p<0.001). Sequencing analysis indicated the virus circulating in Spain belongs to the western African clade. Like the other European cases in the outbreak, the Spanish isolates are a direct descendant of viruses previously detected in Nigeria, the UK, Singapore, and Israel in 2017-2018.
Monkeypox is an emerging infectious disease in Europe where community transmission is reported, mainly in MSM. The first symptom was skin lesions instead of classical fever and rash. The disease follows a self-limited course, and there have been no cases with a serious presentation or severe complications.
自天花根除以来，猴痘是最常见的正痘病毒人畜共患病感染。目前，这一多国暴发涉及五个世卫组织区域，主要影响欧洲。需要了解流行地区以外疾病的准确临床和病毒学方面。
我们对马德里（西班牙）（2022 年 5 月/6 月）诊断的病例进行了观察性研究。对来自疱疹病变拭子的猴痘病毒进行了实时 PCR、测序、系统发育分析和电子显微镜直接检测。此外，还通过系统地完成了一份结构化的流行病学调查问卷，从所有确诊病例中收集社会人口统计学、临床和行为数据。
我们从 48 例患者中提取数据，均为顺性别男性。中位年龄为 35 岁（IQR 29-44），87.5%为男男性接触者。最常见的症状是出现疱疹-脐状和假脓疱性皮肤病变（93.8%）、乏力（66.6%）和发热（52.1%）。此外，病变位于生殖器或肛周区域与性接触的角色有关（p<0.001）。测序分析表明，在西班牙流行的病毒属于西非分支。与暴发期间其他欧洲病例一样，西班牙分离株是 2017-2018 年尼日利亚、英国、新加坡和以色列之前检测到的病毒的直系后代。
猴痘是一种在欧洲出现的新发传染病，有社区传播报告，主要发生在男男性接触者中。最初的症状是皮肤病变，而不是典型的发热和皮疹。疾病呈自限性，没有严重表现或严重并发症的病例。
