Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA.
Stanford University School of Medicine, Stanford, CA, USA.
J Clin Virol. 2023 Jul;164:105493. doi: 10.1016/j.jcv.2023.105493. Epub 2023 May 15.
Despite the sharp increase in mpox (formerly monkeypox) incidence and the wide geographic spread of mpox during the 2022 outbreak, the community prevalence of infection remains poorly characterized. This study is a retrospective epidemiologic survey to estimate mpox prevalence.
Samples obtained for sexually transmitted infection (STI) testing from April to September 2022 in the public hospital and clinic system of San Mateo County, California were screened for mpox virus (MPXV) using polymerase chain reaction.
16/1,848 samples from 11/1,645 individuals were positive for MPXV by qPCR. 4/11 individuals with positive MPXV testing were cisgender women, 2 of whom were pregnant at the time of sample collection. Both deliveries were complicated by chorioamnionitis. Anorectal and oropharyngeal samples were the most likely to be positive for MPXV (4/60 anorectal samples and 4/66 oropharyngeal samples compared with 5/1,264 urine samples and 3/445 vaginal samples).
Our study is one of the first epidemiologic surveys for MPXV infection outside of sexual health/STI clinic settings. Relatively high rates of MPXV from oropharyngeal and anorectal samples reinforces the importance of MPXV testing at various anatomic sites, particularly if patients are presenting with non-lesional symptoms (pharyngitis, proctitis). However, the United States Food and Drug Administration (FDA) has not yet authorized non-lesional MPXV testing. The identification of MPXV in women in our cohort suggests that the rates of mpox in women may have previously been underestimated and highlights the risk of pregnancy complications associated with mpox.
尽管 2022 年猴痘（以前称为猴痘）发病率急剧上升，且猴痘广泛传播，但社区感染率仍知之甚少。本研究是一项回顾性流行病学调查，旨在估计猴痘的流行率。
加利福尼亚州圣马特奥县公立医院和诊所系统于 2022 年 4 月至 9 月期间，对用于性传播感染（STI）检测的样本进行了猴痘病毒（MPXV）聚合酶链反应（PCR）检测。
11 名个体的 16/1848 份样本通过 qPCR 检测出 MPXV 呈阳性。11 名 MPXV 检测呈阳性的个体中，有 4 名为顺性别女性，其中 2 名在样本采集时怀孕。两次分娩均并发绒毛膜羊膜炎。肛直肠和口咽样本最有可能检测出 MPXV 阳性（4/60 份肛直肠样本和 4/66 份口咽样本，而 5/1264 份尿液样本和 3/445 份阴道样本中仅为阳性）。
我们的研究是在性健康/STI 诊所环境之外进行的首例 MPXV 感染的流行病学调查之一。肛直肠和口咽样本中相对较高的 MPXV 阳性率，强调了在不同解剖部位进行 MPXV 检测的重要性，尤其是如果患者出现无皮损症状（咽炎、直肠炎）时。然而，美国食品和药物管理局（FDA）尚未授权非皮损 MPXV 检测。我们队列中女性发现的 MPXV 表明，女性的猴痘发病率以前可能被低估，且突出了与猴痘相关的妊娠并发症风险。
