Department of Infectious Diseases, Collegium Medicum, Cardinal Stefan Wyszyński University, Warsaw, Poland.
Hospital for Infectious Diseases, Warsaw, Poland.
J Med Virol. 2023 Oct;95(10):e29172. doi: 10.1002/jmv.29172.
Mpox has become the most significant orthopoxviral infection among humans. Since May 2022, there has been a multicountry outbreak of mpox across six continents. Retrospective observational cohort study of 94 patients with probable or confirmed mpox of whom 86.2% were hospitalized in Hospital for Infectious Diseases in Warsaw, Poland between May 16 and October 30, 2022. Most patients were young (median age: 31, IQR: 25-43 years), predominantly (88.3%) Polish men who have sex with men exposed most commonly in Poland (82.7%), Spain (6.2%), or Germany (4.9%). The median observed mpox incubation period was 7 (IQR: 4-8) days with the median hospitalization time of 7 (range: 2-24, IQR: 5-11) days. History of sexually transmitted infections (STIs) was common in the group (previous syphilis or hepatitis C virus in 33.3% and 17.3%, respectively, 6.2% of early syphilis or gonorrhea). A significant proportion (n = 43, 45.7%) of mpox cases were people with human immunodeficiency virus (HIV), all except one were on stable and virologically effective (88.4% with HIV viral load <50 copies/mL) antiretroviral treatment. Chemsex was reported in 34.6% of hospitalized cases, more commonly among people with HIV (48.5% vs. 25.0%, p = 0.029). None of the mpox infected patients presented with advanced HIV infection. Despite the fact that 6.3% of cases presented with >50 skin lesions the course of the disease was self-limited with no severe cases or deaths. There were no significant clinical or laboratory differences or complication rates between patients with and without HIV coinfection. Epidemiological and clinical characteristics of mpox in Poland are similar to other countries, but there were no targeted, population oriented interventions or vaccination programs. Mpox diagnosis provided an opportunity to screen and diagnose other STIs. As Central European populations, including refugees from Ukraine, are largely unvaccinated against mpox access to preventive vaccinations and antiviral therapy should be maximized.
猴痘已成为人类中最重要的正痘病毒感染。自 2022 年 5 月以来，六大洲发生了多起猴痘跨国疫情。这是一项回顾性观察性队列研究，纳入了 94 例疑似或确诊的猴痘患者，这些患者于 2022 年 5 月 16 日至 10 月 30 日期间在波兰华沙传染病医院住院。大多数患者为年轻人（中位数年龄：31 岁，IQR：25-43 岁），主要为波兰男男性行为者（88.3%），最常见的暴露地点是波兰（82.7%）、西班牙（6.2%）或德国（4.9%）。中位观察到的猴痘潜伏期为 7 天（IQR：4-8 天），中位住院时间为 7 天（范围：2-24 天，IQR：5-11 天）。该组中常见性传播感染（STI）史（既往梅毒或丙型肝炎病毒分别为 33.3%和 17.3%，早期梅毒或淋病为 6.2%）。很大比例（n=43，45.7%）的猴痘病例为人类免疫缺陷病毒（HIV）感染者，除 1 例外，所有 HIV 感染者均接受稳定且有效的抗病毒治疗（88.4%的 HIV 病毒载量<50 拷贝/mL）。34.6%住院患者报告有 Chemsex，HIV 感染者更为常见（48.5%比 25.0%，p=0.029）。感染猴痘的患者均未出现晚期 HIV 感染。尽管 6.3%的病例出现了>50 个皮肤损伤，但疾病呈自限性，无严重病例或死亡。HIV 合并感染患者与无 HIV 合并感染患者之间的临床和实验室特征或并发症发生率无显著差异。波兰的猴痘流行病学和临床特征与其他国家相似，但没有针对特定人群的干预措施或疫苗接种计划。猴痘诊断为筛查和诊断其他性传播感染提供了机会。由于包括乌克兰难民在内的中欧人群对猴痘疫苗的接种率普遍较低，应最大限度地获得预防接种和抗病毒治疗。
