Núñez Isaac, García-Grimshaw Miguel, Ceballos-Liceaga Santa E, Toledo-Salinas Carla, Carbajal-Sandoval Guillermo, Sosa-Laso Luisa, García-Rodríguez Gabriel, Cortés-Alcalá Ricardo, Torre Alethse de la, Fragoso-Saavedra Sergio, Quintero-Villegas Alejandro, López-Gatell Hugo, Reyes-Terán Gustavo, Valdés-Ferrer Sergio Iván
Department of Medical Education, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, 14080, Mexico.
Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, 14080, Mexico.
Lancet Reg Health Am. 2023 Jan;17:100392. doi: 10.1016/j.lana.2022.100392. Epub 2022 Nov 10.
Human monkeypox, a zoonosis historically endemic to West and South Africa, has led to a worldwide outbreak driven by human-to-human transmission resulting in an international public health emergency. Endemic and outbreak monkeypox cases may differ in their affected populations, clinical features, and outcomes. Thus, profiling cases of the current monkeypox outbreak worldwide is crucial.
We performed a nationwide observational surveillance-based study from May 24 to September 5, 2022. Patients that met the operational clinical definition of monkeypox or symptomatic close contacts of confirmed cases were tested by real-time polymerase chain reaction. Clinical data were collected with a standardized case-report form. We report epidemiologic, sociodemographic, and clinical characteristics of confirmed cases.
Five-hundred and sixty-five human monkeypox confirmed cases were analysed; 97.2% were men, of whom 59.5% identified as men who have sex with men, and 54.5% had human immunodeficiency virus infection. The median age was 34 years. All patients but one had rash (99.8%), 78.9% had fever, and 47.8% reported myalgia. The anogenital area was the most commonly affected one by rash (49.6%), and proctitis occurred in 6.2% of patients. Six patients required hospitalization, of which one died due to causes unrelated to monkeypox.
The 2022 monkeypox outbreak in Mexico is mainly driven by middle-aged men who have sex with men, of which a large proportion are persons who live with human immunodeficiency virus infection. Clinical features such as the high proportion of anogenital lesions suggest sexual contact is a pivotal transmission mechanism in this outbreak.
This research was supported by grant A1-S-18342 from Consejo Nacional de Ciencia y Tecnología (CONACyT), Mexico (to S.I.V.-F.).
人类猴痘是一种历史上在西非和南非流行的人畜共患病，现已导致由人际传播引发的全球疫情，构成国际公共卫生紧急事件。地方性和疫情性猴痘病例在受影响人群、临床特征和结果方面可能存在差异。因此，对当前全球猴痘疫情病例进行剖析至关重要。
我们于2022年5月24日至9月5日开展了一项基于全国观察性监测的研究。符合猴痘操作临床定义的患者或确诊病例的有症状密切接触者通过实时聚合酶链反应进行检测。临床数据通过标准化病例报告表收集。我们报告确诊病例的流行病学、社会人口学和临床特征。
分析了565例人类猴痘确诊病例；97.2%为男性，其中59.5%为男男性行为者，54.5%感染了人类免疫缺陷病毒。中位年龄为34岁。除1例患者外，所有患者均出现皮疹（99.8%），78.9%发热，47.8%报告有肌痛。皮疹最常累及肛门生殖器区域（49.6%），6.2%的患者发生直肠炎。6例患者需要住院治疗，其中1例因与猴痘无关的原因死亡。
2022年墨西哥的猴痘疫情主要由中年男男性行为者推动，其中很大一部分是感染了人类免疫缺陷病毒的人群。肛门生殖器病变比例高之类的临床特征表明性接触是此次疫情的关键传播机制。
本研究由墨西哥国家科学技术委员会（CONACyT）授予的A1-S-18342号资助（授予S.I.V.-F.）。
