Centers for Disease Control and Prevention, and the Department of Gynecology and Obstetrics, Emory University, Atlanta, Georgia.
Obstet Gynecol. 2022 Sep 1;140(3):391-397. doi: 10.1097/AOG.0000000000004909. Epub 2022 Jul 11.
Since May 2022, more than 6,900 cases of monkeypox virus infection have been reported in 52 countries. The World Health Organization is planning to rename the virus and its clades to reduce stigma. As of July 5, 2022, 556 cases have been reported in 33 U.S. states and the District of Columbia. The initial cases were travel-associated; however, person-to-person transmission is now occurring domestically. Close, sustained skin-to-skin contact, including during sexual activity, appears to be the primary mode of transmission. The risk of widespread community transmission remains low; however, rapid identification of monkeypox virus infection and isolation of affected individuals is critical to prevent further transmission. Most but not all cases have occurred in males; some infections have started with anogenital lesions and can be mistaken for common sexually transmitted infections. To facilitate rapid, accurate diagnosis of monkeypox virus infection, obstetrician-gynecologists (ob-gyns) in the United States should ask about recent travel history and new ulcers or lesions and perform a thorough visual inspection of skin and mucosal sites (oral, genital, perianal area) in patients presenting with new rash. Obstetrician-gynecologists should become familiar with the appearance of monkeypox lesions and know whom to call to report a suspected case, how and when to test for monkeypox virus, and how to counsel patients. In the event of a suspected case, ob-gyns should follow infection-control guidelines to prevent transmission and make recommendations to prevent further community spread. This article outlines the diagnosis, prevention, and treatment of monkeypox virus infection, monkeypox virus infection during pregnancy, and implications for practicing ob-gyns in the United States.
自 2022 年 5 月以来，52 个国家报告了超过 6900 例猴痘病毒感染病例。世界卫生组织正在计划重新命名该病毒及其分支，以减少污名化。截至 2022 年 7 月 5 日，美国 33 个州和哥伦比亚特区已报告 556 例病例。最初的病例与旅行有关；然而，现在正在国内发生人际传播。密切、持续的皮肤对皮肤接触，包括在性行为期间，似乎是主要的传播方式。广泛的社区传播风险仍然较低；然而，快速识别猴痘病毒感染并隔离受影响的个体对于防止进一步传播至关重要。大多数但不是所有病例都发生在男性身上；一些感染始于生殖器溃疡，可能被误认为是常见的性传播感染。为了促进猴痘病毒感染的快速、准确诊断，美国的妇产科医生（ob-gyns）应该询问最近的旅行史以及新的溃疡或病变，并对出现新皮疹的患者进行皮肤和粘膜部位（口腔、生殖器、肛门周围区域）的彻底目视检查。妇产科医生应该熟悉猴痘病变的外观，并知道向谁报告疑似病例，如何以及何时进行猴痘病毒检测，以及如何为患者提供咨询。如果怀疑有疑似病例，ob-gyns 应遵循感染控制指南以防止传播，并提出建议以防止进一步的社区传播。本文概述了猴痘病毒感染、猴痘病毒感染怀孕期间的诊断、预防和治疗，以及对美国妇产科医生的影响。
