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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
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
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