Dashler Gaby, Faryar Kiran, Stanford Kimberly A, Dyal Jonathan W, Doerning Robert C, Schechter-Perkins Elissa M, Wilson Jason W, May Larissa S, Duber Herbert C, Hsieh Yu-Hsiang, Rothman Richard E, Hansoti Bhakti
Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Department of Emergency Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.
J Am Coll Emerg Physicians Open. 2025 Jun 28;6(4):100212. doi: 10.1016/j.acepjo.2025.100212. eCollection 2025 Aug.
Despite many emergency departments (EDs) managing patients with possible mpox, individual institution reports have been limited, making it challenging to understand demographic trends and service needs. We established a data repository of ED patients with mpox to inform epidemiologic trends and future practice.
This national multicenter retrospective chart review included patients aged ≥ 18 years presenting to 8 EDs across the United States during the mpox outbreak (June 2022 to January 2023) with laboratory-confirmed mpox. Data were collected on demographic variables and clinical characteristics from each participating site, representing the northeast, midwest, south, and west regions.
A total of 270 patients were included in the cohort; most were men (264, 98%) and relatively young (median age: 34 years; IQR: 28-41). Patients commonly presented with skin lesions (253, 94%), fever or flu-like symptoms (152, 56%), and rectal pain (70, 26%). More than half (141/270, 52%) of individuals had a known diagnosis of HIV. Among those tested for sexually transmitted infection (STI) coinfection, 36% (51/143) had positive syphilis serology (not all diagnoses could be confirmed by clinical history), followed by gonorrhea 7% (9/128) and chlamydia 7% (8/122).
Similar to the COVID-19 pandemic, EDs played a critical role in the mpox response. High coinfection rates with STIs highlight the need for routine coinfection testing. Multisite data collection identified key trends, emphasizing the value of surveillance networks for outbreak response.
尽管许多急诊科在管理可能感染猴痘的患者，但各机构的单独报告有限，这使得了解人口统计学趋势和服务需求具有挑战性。我们建立了一个猴痘急诊科患者数据存储库，以了解流行病学趋势和指导未来实践。
这项全国多中心回顾性病历审查纳入了在猴痘疫情期间（2022年6月至2023年1月）前往美国8家急诊科就诊且实验室确诊为猴痘的≥18岁患者。从每个参与站点收集了人口统计学变量和临床特征数据，这些站点代表了东北部、中西部、南部和西部地区。
该队列共纳入270例患者；大多数为男性（264例，98%）且相对年轻（中位年龄：34岁；四分位间距：28 - 41岁）。患者常见症状为皮肤病变（253例，94%）、发热或流感样症状（152例，56%）以及直肠疼痛（70例，26%）。超过一半（141/270，52%）的患者已知感染艾滋病毒。在接受性传播感染（STI）合并感染检测的患者中，36%（51/143）梅毒血清学呈阳性（并非所有诊断都能通过临床病史确诊），其次是淋病7%（9/128）和衣原体感染7%（8/122）。
与新冠疫情类似，急诊科在猴痘应对中发挥了关键作用。性传播感染的高合并感染率凸显了进行常规合并感染检测的必要性。多站点数据收集确定了关键趋势，强调了监测网络在疫情应对中的价值。
