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2022 年 5 月 17 日至 7 月 22 日美国猴痘病例的流行病学和临床特征。

Epidemiologic and Clinical Characteristics of Monkeypox Cases - United States, May 17-July 22, 2022.

出版信息

MMWR Morb Mortal Wkly Rep. 2022 Aug 12;71(32):1018-1022. doi: 10.15585/mmwr.mm7132e3.

Abstract

Monkeypox, a zoonotic infection caused by an orthopoxvirus, is endemic in parts of Africa. On August 4, 2022, the U.S. Department of Health and Human Services declared the U.S. monkeypox outbreak, which began on May 17, to be a public health emergency (1,2). After detection of the first U.S. monkeypox case), CDC and health departments implemented enhanced monkeypox case detection and reporting. Among 2,891 cases reported in the United States through July 22 by 43 states, Puerto Rico, and the District of Columbia (DC), CDC received case report forms for 1,195 (41%) cases by July 27. Among these, 99% of cases were among men; among men with available information, 94% reported male-to-male sexual or close intimate contact during the 3 weeks before symptom onset. Among the 88% of cases with available data, 41% were among non-Hispanic White (White) persons, 28% among Hispanic or Latino (Hispanic) persons, and 26% among non-Hispanic Black or African American (Black) persons. Forty-two percent of persons with monkeypox with available data did not report the typical prodrome as their first symptom, and 46% reported one or more genital lesions during their illness; 41% had HIV infection. Data suggest that widespread community transmission of monkeypox has disproportionately affected gay, bisexual, and other men who have sex with men and racial and ethnic minority groups. Compared with historical reports of monkeypox in areas with endemic disease, currently reported outbreak-associated cases are less likely to have a prodrome and more likely to have genital involvement. CDC and other federal, state, and local agencies have implemented response efforts to expand testing, treatment, and vaccination. Public health efforts should prioritize gay, bisexual, and other men who have sex with men, who are currently disproportionately affected, for prevention and testing, while addressing equity, minimizing stigma, and maintaining vigilance for transmission in other populations. Clinicians should test patients with rash consistent with monkeypox, regardless of whether the rash is disseminated or was preceded by prodrome. Likewise, although most cases to date have occurred among gay, bisexual, and other men who have sex with men, any patient with rash consistent with monkeypox should be considered for testing. CDC is continually evaluating new evidence and tailoring response strategies as information on changing case demographics, clinical characteristics, transmission, and vaccine effectiveness become available..

摘要

猴痘是一种由正痘病毒引起的人畜共患病,在非洲部分地区流行。2022 年 8 月 4 日,美国卫生与公众服务部宣布,自 5 月 17 日开始的美国猴痘疫情为公共卫生紧急事件(1,2)。在美国首例猴痘病例检测到后(),疾病预防控制中心和卫生部门加强了猴痘病例的检测和报告。在美国,截至 7 月 22 日,43 个州、波多黎各和美属维尔京群岛共报告了 2891 例病例,疾病预防控制中心截至 7 月 27 日收到了 1195 例(41%)病例的病例报告表。其中,99%的病例为男性;在有信息可查的男性中,94%的人在症状出现前的 3 周内有男男性行为或密切的性接触。在 88%有数据可查的病例中,41%为非西班牙裔白人(白人),28%为西班牙裔或拉丁裔(西班牙裔),26%为非西班牙裔黑人或非洲裔美国人(黑人)。42%有数据可查的猴痘患者的首发症状并非典型的前驱症状,46%的患者在发病期间出现一个或多个生殖器损伤;41%的患者感染了 HIV。数据表明,猴痘在社区的广泛传播已不成比例地影响到男同性恋者、双性恋者和其他与男性发生性关系的男性以及种族和少数民族群体。与在流行地区的猴痘的历史报告相比,目前报告的与疫情相关的病例较少出现前驱症状,更有可能出现生殖器受累。疾病预防控制中心和其他联邦、州和地方机构已实施应对措施,以扩大检测、治疗和疫苗接种。公共卫生工作应优先考虑男同性恋者、双性恋者和其他与男性发生性关系的男性,这些人目前受到不成比例的影响,以进行预防和检测,同时解决公平问题,减少污名化,并保持警惕其他人群中的传播。临床医生应检测皮疹与猴痘一致的患者,无论皮疹是否扩散或是否有前驱症状。同样,尽管迄今为止大多数病例发生在男同性恋者、双性恋者和其他与男性发生性关系的男性中,但任何皮疹与猴痘一致的患者都应考虑进行检测。疾病预防控制中心正在不断评估新的证据,并根据病例人口统计学、临床特征、传播和疫苗有效性变化的信息,调整应对策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b727/9400536/bc76d6752941/mm7132e3-F.jpg

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