George & Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, Canada.
College of Pharmacy, University of Manitoba, Winnipeg, Canada.
Infect Dis (Lond). 2023 Jul;55(7):490-508. doi: 10.1080/23744235.2023.2214609. Epub 2023 May 18.
In 2022, there were outbreaks of Mpox where the disease is not endemic. We summarised and compared the findings from published observational studies on the clinical presentation and epidemiology of the 2022 and previous outbreaks of Mpox.
We registered a review protocol with the Open Science Framework (osf.io/j3kb7). We searched MEDLINE, Embase, CENTRAL, CINAHL and Scopus databases, and relevant websites up to August 30, 2022. Retrieved literature citations were screened for eligibility, and summary clinical presentation and epidemiological data from the included studies were pooled, when possible, using an inverse variance, random-effects model.
Seventy-nine studies met the eligibility. Irrespective of outbreak, fever, headache, myalgia, lymphadenopathy, pleomorphic skin lesions, oral lesions, and sore throat were potentially highly relevant Mpox manifestations, while conjunctivitis, cough, and possibly reactivation of varicella zoster virus may be part of the clinical presentation. The mean incubation period for the 2022 outbreaks was 7.4 d (6.4-8.4 d, 64.2%; 4 studies: 270 cases) and for previous outbreaks, 12.9 d (10.4-15.5 d; one study: 31 cases), < .001. None of the male cases from previous outbreaks was reported to have sex with men (MSM) whereas almost all reported male cases from the 2022 outbreak were MSM. Concomitant sexually transmitted infections and perianal lesions were reported only among male cases from the 2022 outbreak, with the cases mostly presenting with genital lesions.
The 2022 Mpox outbreaks appear to be mostly among MSM and have a lower incubation period compared with previous outbreaks.Key messages79 studies met the review's inclusion criteria.The 2022 Mpox outbreaks appear to have shorter incubation period compared with previous outbreaks.Established clinical presentation of Mpox includes fever, headache, myalgia, lymphadenopathy, pleomorphic skin lesions, oral lesions, and sore throat.Almost all reported cases from the 2022 Mpox outbreaks were men who had sex with men (MSM).Concomitant sexually transmitted infections and perianal lesions were only reported among cases from the 2022 Mpox outbreaks.A significantly higher proportion of Mpox cases from the 2022 outbreaks had genital lesions compared with cases from previous outbreaks.The 2022 Mpox outbreaks appear to be mostly among MSM.
2022 年出现了猴痘疫情，这些疫情并非地方性流行。我们总结和比较了已发表的关于 2022 年和以往猴痘疫情的临床特征和流行病学的观察性研究结果。
我们在开放科学框架（osf.io/j3kb7）上注册了一份综述方案。我们检索了 MEDLINE、Embase、CENTRAL、CINAHL 和 Scopus 数据库以及截至 2022 年 8 月 30 日的相关网站。对检索到的文献进行了筛选，以确定其是否符合纳入标准，并对纳入研究的综合临床特征和流行病学数据进行了汇总，如果可能的话，使用方差倒数、随机效应模型进行汇总。
79 项研究符合纳入标准。无论疫情是否地方性流行，发热、头痛、肌痛、淋巴结病、多形性皮肤损伤、口腔损伤和咽痛可能是猴痘的高度相关表现，而结膜炎、咳嗽和可能的水痘带状疱疹病毒再激活可能是临床表现的一部分。2022 年疫情的平均潜伏期为 7.4d（6.4-8.4d，64.2%；4 项研究：270 例），以往疫情的潜伏期为 12.9d（10.4-15.5d；一项研究：31 例），<0.001。以往疫情中没有报告男性病例有男男性行为，而 2022 年疫情中几乎所有报告的男性病例都是男男性行为者。只有 2022 年疫情中的男性病例报告同时存在性传播感染和肛周损伤，且这些病例大多表现为生殖器损伤。
与以往疫情相比，2022 年猴痘疫情似乎主要发生在男男性行为者中，潜伏期较短。猴痘的既定临床特征包括发热、头痛、肌痛、淋巴结病、多形性皮肤损伤、口腔损伤和咽痛。2022 年猴痘疫情报告的几乎所有病例都是男男性行为者。只有 2022 年猴痘疫情中的病例报告同时存在性传播感染和肛周损伤，且这些病例大多表现为生殖器损伤。与以往疫情相比，2022 年疫情中猴痘病例生殖器损伤的比例明显更高。2022 年猴痘疫情似乎主要发生在男男性行为者中。
