Largest monkeypox study to date highlights new symptoms

Many people infected in the international outbreak of monkeypox have had a single lesion or ulcer in their mouth or genitals, a departure from the typical symptoms of the virus that may lead doctors to misdiagnose monkeypox as another sexually transmitted infection (STI). ).

This is one of the main fast food from New England Journal of Medicine‘s (NEJMIt’s) a new international study of the current outbreak, the largest case study on the virus.

“This global case series has enabled clinicians from 16 countries to share their extensive clinical experience and many clinical images to help other clinicians in places with fewer cases. We have shown that current international case definitions need to be expanded to add symptoms that are , of Queen Mary University of London, in a university press release:

13% required hospitalization

The study included clinical observations of 528 confirmed infections at 43 sites from April 27 to June 24 this year. The median incubation period is 7 days in this outbreak, and the median case patient age was 38. No deaths occurred, but 70 patients (13%) required hospitalization.

In the study, the authors involved several patients who present to clinics and hospitals to manage pain or difficulty swallowing. Individual anal ulcers have been recorded in several cases. One in 10 people had only one skin lesion in the genital area, and 15% had anal and/or rectal pain, a symptom not usually seen in other monkeypox outbreaks.

A total of 98% of the documented cases were in gay or bisexual men, and while monkeypox is not considered an STD, per se, the authors said 95% of the documented transmissions occurred during sexual relations. Seventy-five percent of patients with the condition are white, and 41 percent have HIV.

The study authors also reported that semen samples collected showed significant amounts of the virus, but said more research needs to be done to understand whether semen can actually transmit the virus.

Symptoms vary according to sexual practice

In a second study, published as Lancet Prior to printing, similar conclusions were drawn based on clinical presentations of 181 cases of monkeypox in Spain.

In that group, 91.7% of patients were men who have sex with men (MSM), and detailed sexual history showed that those who reported anal intercourse had longer incubation periods (8 vs 6 days) and a higher rate of systemic symptoms than pre-existing rashes. (62.0% vs. 27.6%) and more frequently with proctitis (32.9% vs. 6.9%) of MSM who did not engage in this type of sexual practice.

The authors concluded that, “because of the diversity of clinical presentations, clinicians should have a low threshold for disease suspicion.” This report, unlike NEJM Study, not peer-reviewed.

The CDC eases use of Tpoxx

After several media outlets reported that doctors were filling out papers for 3 to 4 hours to prescribe the antiviral Tpoxx to monkeypox patients, the Centers for Disease Control and Prevention (CDC) announced other plans to streamline access to the drug, which must be obtained from the strategy. It is nationally stocked and approved only for use in smallpox cases.

Photographs and samples from case patients are no longer needed, and paperwork has been reduced to four forms, which can be returned to the CDC after treatment is prescribed.

In a statement about the change to protocols, the Infectious Diseases Association of America (IDSA) said: “Reducing paperwork and other documentation required to obtain treatment is welcome news, and we expect it to speed access to treatment. However, more work remains to simplify and expand Access to treatment and data collection for more information on the use of tekovirimat.”

The Centers for Disease Control and Prevention is reporting 270 cases of monkeypox today from 46 states, bringing the national total to 2,593.

In other US news, the White House released its research priorities for monkeypox. They include further understanding of transmission, modeling, prediction, and vaccine efficacy and the development of new diagnoses – among others.

Madrid reports monkeypox in infants

After yesterday’s report of monkeypox in a child from Amsterdam, a baby boy from Madrid was diagnosed with the virus.

Officials said the 7-month-old baby contracted the virus at home. both of his parents are afflicted; The child and the parents are isolated at home with a mild illness.

Today, the European Medicines Agency has finally approved a monkeypox vaccine as an additional indication for the Imphanix (Jynneos in the US) vaccine in the Scandinavian state of Bavaria.

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