lancet-header

Preprints with The Lancet is part of SSRN´s First Look, a place where journals identify content of interest prior to publication. Authors have opted in at submission to The Lancet family of journals to post their preprints on Preprints with The Lancet. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These preprints are early stage research papers that have not been peer-reviewed. The findings should not be used for clinical or public health decision making and should not be presented to a lay audience without highlighting that they are preliminary and have not been peer-reviewed. For more information on this collaboration, see the comments published in The Lancet about the trial period, and our decision to make this a permanent offering, or visit The Lancet´s FAQ page, and for any feedback please contact preprints@lancet.com.

Epidemiological Characteristics and Clinical Features of Confirmed Human Monkeypox Virus Cases in Individuals Attending a Sexual Health Centre in London, United Kingdom

14 Pages Posted: 1 Jun 2022

See all articles by Nicolo Girometti

Nicolo Girometti

Government of the United Kingdom - Department of HIV/GUM

Ruth Byrne

Government of the United Kingdom - Department of HIV/GUM

Margherita Bracchi

Government of the United Kingdom - Department of HIV/GUM

Joseph Heskin

Government of the United Kingdom - Department of HIV/GUM

Alan McOwan

Government of the United Kingdom - Department of HIV/GUM

Victoria Tittle

Government of the United Kingdom - Department of HIV/GUM

Keerti Gedela

Government of the United Kingdom - Department of HIV/GUM

Christopher Scott

Government of the United Kingdom - Department of HIV/GUM

Sheel Patel

Government of the United Kingdom - Department of HIV/GUM

Jesal Gohil

Government of the United Kingdom - Department of HIV/GUM

Diarmuid Nugent

Government of the United Kingdom - Department of HIV/GUM

Tara Suchak

Government of the United Kingdom - Department of HIV/GUM

Molly Dickinson

Government of the United Kingdom - Department of HIV/GUM

Margaret Feeney

Government of the United Kingdom - Department of HIV/GUM

Borja Mora-Peris

Imperial College London - Imperial College Healthcare NHS Trust; Government of the United Kingdom - Department of HIV/GUM; Imperial College London - Section of Virology

Katrina Stegmann

Government of the United Kingdom - Department of HIV/GUM

Gary Davies

Government of the United Kingdom - Department of HIV/GUM

Luke SP Moore

Government of the United Kingdom - Department of HIV/GUM

Nabeela Mughal

Government of the United Kingdom - Department of HIV/GUM

David Asboe

Government of the United Kingdom - Department of HIV/GUM

Marta Boffito

Government of the United Kingdom - Department of HIV/GUM

Rachael Jones

Government of the United Kingdom - Department of HIV/GUM

Gary Whitlock

Government of the United Kingdom - Department of HIV/GUM

More...

Abstract

Background: Human monkeypox virus (MPXV) cases in UK have been mainly due to imported infections from West Africa. UK and several other countries are now reporting increasing number of cases in individuals with no apparent epidemiological links to areas where the virus is endemic.

Methods: We report the clinical and epidemiological features of patients with confirmed MPVX infection via MPXV viral PCR detection who attended open-access sexual health clinics in London, UK. We report hospitalization rates and concurrent STI rates and we describe our response to the outbreak.

Results: MPXV infection was confirmed in 54 individuals, all identifying as men who have sex with men (MSM), with a median age of 41 years (IQR 34-45years), 70% of white ethnicity, 48% UK-born, 24% living with HIV. Overall, 67% reported fatigue or lethargy, 57% fever, 18% none of the classic prodromal symptoms. All presented with skin lesions, 94% were anogenital, 89% were multiple, 72% had skin lesions affecting 1-2 anatomical sites, 55% had lymphadenopathy. One in four had a concurrent STI. In total, 11% required hospitalization, mainly due to localized cellulitis requiring antibiotic treatment and analgesia.

Conclusion/Interpretation: Autochthonous community MPXV chain transmission is currently seen in MSM in the UK. High rates of concomitant STIs and frequent anogenital symptoms are suggestive of transmission through local inoculation during close skin to skin or mucosal contact, such as sexual contact. Additional resources are required to support sexual health services in the management of this condition. A review of the case-definition and better understanding of viral transmission routes are needed to shape infection control policies and contact tracing.

Funding: None to declare.

Declaration of Interest: None to declare.

Ethical Approval: The data collection was approved by the Chelsea and Westminster Hospital NHS Foundation Trust clinical governance committee as a service evaluation.

Keywords: Orthopoxvirus, vesicular rash, monkeypox virus, outbreak, MSM

Suggested Citation

Girometti, Nicolo and Byrne, Ruth and Bracchi, Margherita and Heskin, Joseph and McOwan, Alan and Tittle, Victoria and Gedela, Keerti and Scott, Christopher and Patel, Sheel and Gohil, Jesal and Nugent, Diarmuid and Suchak, Tara and Dickinson, Molly and Feeney, Margaret and Mora-Peris, Borja and Stegmann, Katrina and Davies, Gary and Moore, Luke SP and Mughal, Nabeela and Asboe, David and Boffito, Marta and Jones, Rachael and Whitlock, Gary, Epidemiological Characteristics and Clinical Features of Confirmed Human Monkeypox Virus Cases in Individuals Attending a Sexual Health Centre in London, United Kingdom. Available at SSRN: https://ssrn.com/abstract=4125251 or http://dx.doi.org/10.2139/ssrn.4125251

Nicolo Girometti (Contact Author)

Government of the United Kingdom - Department of HIV/GUM ( email )

United Kingdom

Ruth Byrne

Government of the United Kingdom - Department of HIV/GUM ( email )

Margherita Bracchi

Government of the United Kingdom - Department of HIV/GUM ( email )

Joseph Heskin

Government of the United Kingdom - Department of HIV/GUM ( email )

Alan McOwan

Government of the United Kingdom - Department of HIV/GUM ( email )

Victoria Tittle

Government of the United Kingdom - Department of HIV/GUM ( email )

Keerti Gedela

Government of the United Kingdom - Department of HIV/GUM ( email )

Christopher Scott

Government of the United Kingdom - Department of HIV/GUM

Sheel Patel

Government of the United Kingdom - Department of HIV/GUM ( email )

Jesal Gohil

Government of the United Kingdom - Department of HIV/GUM ( email )

Diarmuid Nugent

Government of the United Kingdom - Department of HIV/GUM ( email )

Tara Suchak

Government of the United Kingdom - Department of HIV/GUM ( email )

Molly Dickinson

Government of the United Kingdom - Department of HIV/GUM ( email )

Margaret Feeney

Government of the United Kingdom - Department of HIV/GUM ( email )

Borja Mora-Peris

Imperial College London - Imperial College Healthcare NHS Trust ( email )

Praed St
London
United Kingdom

Government of the United Kingdom - Department of HIV/GUM ( email )

Imperial College London - Section of Virology ( email )

Katrina Stegmann

Government of the United Kingdom - Department of HIV/GUM ( email )

Gary Davies

Government of the United Kingdom - Department of HIV/GUM ( email )

Luke SP Moore

Government of the United Kingdom - Department of HIV/GUM

Nabeela Mughal

Government of the United Kingdom - Department of HIV/GUM ( email )

David Asboe

Government of the United Kingdom - Department of HIV/GUM ( email )

Marta Boffito

Government of the United Kingdom - Department of HIV/GUM ( email )

Rachael Jones

Government of the United Kingdom - Department of HIV/GUM ( email )

Gary Whitlock

Government of the United Kingdom - Department of HIV/GUM ( email )