Clinical features and management of individuals admitted to hospital with monkeypox and associated complications across the UK: a retrospective cohort study

Beynon, W.J.G.; Heskin, Jospeh; Beard, Katie; Dunning, Jake; Fink, Douglas; Milligan, Iain; Luintel, Akish; Rodger, Alison; Bhagani, Sanjay; Lamb, Lucy; Moores, Rachel; Lee, Simon F K; Brown, Colin; Hopkins, Susan; Mepham, Stephen; Warren, Simon; Molloy, Aoife; Cropley, Ian; Kew, Alex; Karunaharan, Natasha; Scobie, Antonia; Hart, Jennifer; Irish, Dianne; Haque, Tanzina; Jalal, Hamid; Smith, Robin; Mack, Damien; Barber, Tristan; Burns, Fiona; Miller, R.; Hamlyn, Eleanor; Simoes, Pedro; Athan, Breda; Abrahamsen, Jennifer; Joyce, Jessica; Taylor, Caroline; Reddecliffe, Sally; Miller, Chloe; Reeve, Brooke; Kingston, Hugh; Crocker-Buqué, Tim; Massie, Nicolas; Dhariwal, Ankush; Jayakumar, Angelina; Hammond, R. H.; Bramley, Alexandra; Kanitkar, Tanmay; Maynard-Smith, Laura; Gil, Eliza; O'Connor, Cavan; Cocker, Derek; Spicer, Wendy; Lanzman, Marisa; Thacker, Meera; Anorson, Zoe O; Patel, Dharmesh; Williams, Alan; Houlihan, Catherine; Wakerley, Dominic; Gordon, Claire N; Callaby, Helen; Bailey, Daniel J.; Furneaux, Jenna; Bown, Abbie M; Truelove, Elizabeth J; Killip, Marian J.; Jackson, David A.; Beetar-King, Tracy L B; Arnold, Ulrike M V; Strachan, Rhea M; Jones, Matthew B.; Matthew, Hannah J; Osborne, Jane C; Rampling, Tommy; Vipond, Richard; Gibney, Barry; Owen, Jodie; Bond, Helena; Beynon, W. M.; Hunter, Michael; McCorry, Louise; Emerson, Carol; Quah, S P; Todd, Suzanne; McCarty, Emma; Walker, Eoin; Feeney, Susan; Curran, Tanya; Li, Kathy; Mullan, JD; Jackson, Kate; Nelson, Peter S.; Lewis, K. W.; McNicol, Mark; Pratt, Marcus; Smith, Anna; Vos, Erin; Alsalemee, Fahad; Leary, Daniel O; Canny, John; McGinnity, Katherine; Culbert, Carly; McDowell, Conor; McQuillan, Cathy; Jeong, Eunjin; Glass, Lynsey; Dyche, Jessica; McClean, Paula; Stewart, Rebecca; Ursolino, Harold; Perry, Melissa J.; McCormick, Hannah; Lim, Eleanor; Gkrania‐Klotsas, Effrossyni; Bracchi, Margherita; Heskin, Joseph; Brown, Nicklas; Juniper, Thomas; Dalla-Pria, Alessia; Mackie, Nicola; Winston, Alan; Cooke, Graham; Nelson, Mark; Kilbride, Emer; Elbishi, Ala; Kerrigan, William; Silva, Joshua; Gohil, Jesal; Payagala, Sasha; Walters, Yasmin; Smith, Joanna; Goodfellow, Jonathan; Lyons, Kitty; Tung, Hsiu; Henderson, Merle; Peres, Edu; Carvalho, Taiana Silva; Joly, Antoine; Dickinson, Molly; Moore, Luke; Mughal, Nabeela; Hughes, Stephen H.; Chitlangia, Shrada; Viramgana, Priyanka; Byrne, Ruth; Randell, Paul; Strangis, Luigi; Poveda, Nicola; Bovey, Deborah; Richardson, Poppy; Heaslip, Vivian; Higgs, Chris; Boffito, Marta; Girometti, Nicolò; Whitlock, Gary; Tittle, Victoria; Jones, Robin L.; Rayment, Michael; Scott, Christopher; Asboe, David; Pond, Marcus; Muir, David; Rathish, Balram; O’Hara, Geraldine; Abeywickrema, Movin; Bailey, Sarah-Lou; Boyd, Sara E.; Fontoura, Dayana Da Silva; Daunt, Anna; Mason, Claire Y; Murphy, Jamie; Naidu, Vasanth V; Patel, Aatish; Pley, Caitlin; Redmore, Ethan; Sharrocks, Katherine; Snell, Luke B; Sundramoorthi, Rohan; Tam, Jerry C. 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A.; Ajayi, Medinat; Baltazar, Abigail; Sharella, Davis; Hersi, Nasra; Nguyen, Thuy D.; Timbo, Rugiatu; Jalloh, Ismail; Bryan, Susan R; Clarke, Patricia; Kerr, Marcia; Amedu, Fidelis; BohoBonaba, Maria; Haque, Sarah; Howson, Michelle; Tambilawan, Norbai; Estay, Soledad Yupanqui; Bangura, Hawanatu; Gideon, Tseday; Jerome-oboh, Damilola; Tetteh, Linda; Nwagu, Chioma; Agbaglah, Viwoalo; Narag, Nona; Zaveri, Mahima; Luanaigh, Maedhbh Ni; Keane, Peggy; Peters, Joanna R; Rimmer, Stephanie; Abbara, Aula; Mora-Peris, Borja; Dosekun, Olamide; Garvey, Lucy; Bolland, Mhairi; Stafford, Adam; Saleh, Dina; Sheridan, Rhianna; Davies, Ella; Sun, Kristi; Gilchrist, Mark; Kukadia, Priti; Embrahimsa, Muhammed; Chiu, Christopher; Butler, Michael; Patel, Kinjal; Taylor, L. 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M.; Richards, Lauren; Cummings, Mary-Ann; Gillan, Emily; Peers, Rebecca; Tickle, Amy; Keating, Grace; Chinyanda, Tendi; Sanchez, Mav; Harrison, Daniel J.; Hoyle,; Metcalfe, Benjamin; Taylor, Jennifer; Johnson, Nicky; Kelle, Neil; McDowell, Kirsty; Richardson, Ian; Saguidan, Monette; Farmer, Nicky; Gillespie, Angella; Willoughby, Shay; Parker, Samantha; Avulan, Shamseena; Arif, Shazia; Marshall, Suzanne; Carlisle, D; Rezaeian, Mohsen; Booth, Angela; Watts, Joanne; Tremarco, Lauren; Jeyanayagam, Priyanga; Ubochi, Odinaka; Vagianos, Daniel; Richardson, M. I.; Jarvis, Anthony P.; Gow, Kyra; Walmsley, Jade; O'keefe, Adam; Smielewska, Anna; Hopkins, Mark; Balane, Fatima; Bradley, Sarah; Corrah, Tumena; Daquiz, Venus; Dugan, Christopher; Elliot, J. M.; Foley, Fiona; Friday, Dawn; Gamit, May; Garner, David M.; Gokani, Karishma; Liu, John; Joseph, Deepa; Khan, Nuzhath; Mamuyac, Cherifer; McGregor, Alastair; McSorley, John; Parris, Victoria; Rubinstein, Luciana; Rycroft, Julian Anthony; Salinas, Kelcy; Salinas, Jason; Sebatian, Jency; Smith, Melanie; Garcia, Marina Tejero; Ume, Uchenna; Vicentine, Margarete; Wallis, Gabriel; Sturdy, Ann; Whittington, Ashley; Jacobs, Nathan; Johnson, Leann; Bonington, Alec; Uriel, Alison; Ustianowski, Andrew; Dancsó, Balázs; Hogan, Celia; Halsema, Clare van; Vilar, F Javier; Devine, Karen Dragon; Ajdukiewicz, Katherine Mb; Rajendran, Rajesh; Ghosh, Subrata; Riste, Michael; Machin, Nicholas; Babu, Chitra; Ahmad, Shazaad; Obeng, Dorcas; Dave, Farnaz; Conolley, Gavin; Thompson, Joseph R.; Tickell‐Painter, Maya; Chakravorty, Prasun; Pringle, Rachel; Zafar, Mohammad R; Lawrence, Sarah; Sanchez-Gonzalez, Amada; Fernández, Cristina; Goodwin, Lynsey; Carey, David J.; Howarth-Maddison, Molly; Moody, Samuel; Upton, Rebecca; Apthorp, Christina; Murray, Charlotte; Salthouse, Kirstie; Nadeem, Sabah; Ridley, Grant; White, Francesca; Brown, Andrew; Lawless, Michael; Mohamed, Mohamed; Mulligan, Robert F.; Belfield, Amy; Brolly, Jacob; Calderón, M. J.; Cheveau, James; Cullinan, Milo; Garrad, Sophie; Griffiths, W. R.; Ireland, Aidan; Ireland, Peter T.; Milne, Charlotte; Nwajiugo, Paul; Quartey, John; Ghavami-Kia, Bijan; Duncan, Chris; Evans, Adam; Hunter, Ewan; Price, Ashley B.; Schmid, Matthias; Schwab, Uli; Taha, Yusri; Payne, Brendan AI; Elliott, Ivo A M; Crowe, Stewart; Woodrow, Charles J.; Karageorgopoulos, Drosos E.; Davis, Peter J.; Lord, Emily; Bannister, Oliver J; Dagens, Andrew; Harrison, Thomas; Cole, Joby; Tunbridge, Anne; Choudry, Saher; Telfer, Adam; Jhibril, Ihsan; Atta, Syed N; Stone, Ben; Evans, Cariad; Ankcorn, Mike; Akili, Suha; Yavuz, M. Hakan; Goodall, Vicky; Farrow, Sam; Mountford, Georgina; Cusack, Tomas-Paul; Beard, Kate; Sutton, Julian; Clark, Tristan; Mason, Annette; Vickers, Mike; Macallan, Derek C.; Bicanic, Tihana; Houston, Angela; Pope, Cassie F.; Tan, N J; Ward, Christopher; Jones, Imogen; Banerjee, Rishi; Cohen, Jonathan; Clercq, Marieke Emonts-le; Porter, David A.; Riordan, Andrew; Sinha, Ruchi; Whittaker, Elizabeth

doi:10.1016/s1473-3099(22)00806-4

Cited by 51 publications

(39 citation statements)

References 21 publications

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“…Thus, Mpox virus was also designated as a sexually transmitted disease [23] . In a study from the United Kingdom, rectal or perianal pain resulted in the hospitalization of 44 (28%) of 156 Mpox cases and 38 (24%) were treated with tecovirimat [24] . Tecovirimat was the most commonly used antiviral with no major safety concerns [25] .…”

Section: Discussionmentioning

confidence: 99%

Clinical features and outcome of human Mpox (Monkeypox) in Saudi Arabia: An observational study of travel-related cases

Assiri

Al‐Tawfiq

Jokhdar

et al. 2023

Journal of Infection and Public Health

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Section: Discussionmentioning

confidence: 99%

Clinical features and outcome of human Mpox (Monkeypox) in Saudi Arabia: An observational study of travel-related cases

Assiri

Al‐Tawfiq

Jokhdar

et al. 2023

Journal of Infection and Public Health

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“…The proportion of HIV-infected people among mpox cases was 39%, significantly higher than in the general population and correlated with the frequently reported sexual risk behaviour in the observed patient population. Since the likelihood of a concomitant STD is up to 30% in mpox patients [ 22 , 25 ], patients presenting with mpox infection should be offered a screening for STDs including HIV. Conversely, mpox should be especially considered as a differential diagnosis in HIV-positive individuals presenting with skin/mucosal lesions or associated symptoms.…”

Section: Discussionmentioning

confidence: 99%

Mpox outbreak 2022: an overview of all cases reported to the Cologne Health Department

Kröger¹,

Lehmann²,

Treutlein³

et al. 2023

Infection

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PurposeThe worldwide mpox outbreak starting in May 2022 marks the occurrence of another previously atypical infectious disease in Europe. This study's objective was to present a comprehensive overview based on the gathered data and to illustrate the approach of the Cologne Health Department to contain the mpox outbreak. Methods In this retrospective observational study, 368 individuals reported to the Cologne Health Department as PCRpositive for mpox were included. Data were collected in structured telephone interviews and digitally processed. ResultsThe first mpox case in Cologne was recorded on May 24, 2022. The local outbreak lasted approximately 4 months and reached its peak in July. The last reported case in Cologne occurred on September 17. Transmissions mostly occurred through sexual contacts (67.4%) or other close physical contacts (4.6%) between men, but also through fomites, in the context of events or occasionally in the work environment. In 21.5% of cases, no route of infection could be determined. The mean incubation period was 8.2 days. Clinically, mpox infections usually presented with skin and/or mucosal lesions accompanied by general symptoms. In 74.8% of cases, a prodromal stage was absent. Initially, the rash often had an unspecific appearance, but in the further clinical course, it usually passed through the typical stages. Most infections resolved spontaneously under home care. In 3.5% of cases, however, inpatient hospitalisation was required. Infected persons with a previous smallpox vaccination had 0.43 times the odds of unvaccinated persons to be affected by lesions in 3 or more body regions and 0.30 times the odds to develop lesions in all 5 body regions. Previous vaccination statistically reduced the total duration of symptoms by 2.0 days. Conclusions The mpox outbreak 2022 in Cologne primarily affected men who have sex with men and have reported recent sexual encounters. The observed average incubation period was shorter than initially assumed. Mucosal involvement and associated symptoms occur in a relevant number of cases and can lead to more severe clinical courses. Previous smallpox vaccination was statistically significantly associated with milder courses of mpox. In the case of an unclear rash or symptoms suggesting mucosal involvement, mpox should be considered as a differential diagnosis. An equally rapid and wellorchestrated public health response are crucial for infection control.

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“…Benites-Zapata y col. [20] en un estudio reciente de metaanálisis que incluyó 19 artículos en 1958 pacientes describieron que las manifestaciones clínicas más frecuentes fueron: erupción cutánea en el 93 % (IC 95 % 80-100 %), fiebre en el 72 % (IC 95 % 30-99 %), prurito en el 65 % (IC 95 % 47-81 %) y adenopatía en el 62 % (IC 95 % 47-76 %), el 35 % (IC 95 % 14-59 %) fueron hospitalizados y sólo el 4 % (IC 95 % 1-9 %) tuvieron desenlaces fatales. Un estudio más reciente, publicado por Fink y col [21] enfocado en posibles complicaciones, describe que en 156 individuos hospitalizados por MPOX, 57 % tuvieron dolor severo, 58 % infección secundaria bacteriana, 10 requirieron cirugía, y hubo dos casos de encefalitis.…”

Section: Discussionunclassified

Viruela del mono (MPOX) en paciente varón heterosexual VIH negativo

2023

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Se presenta el caso de un paciente varón de 28 años, heterosexual, con VIH negativo que desarrolló erupción cutánea intensa caracterizada por la presencia de vesículas, pústulas y pápulas umbilicadas confluentes en el pene y región púbica con escasa diseminación en el resto del cuerpo, sin adenopatía ni manifestaciones sistémicas, cuatro días después de haber tenido relaciones sexuales con una prostituta aparentemente sana. El hisopado de las lesiones dérmicas revelaron la presencia de ADN del virus MPOX por PCR en tiempo real. Las pruebas inmunológicas fueron las siguientes: ELISA cuarta generación para VIH y Western Blot negativas, anticuerpos IgM para herpes simplex1=1.2 U/ml, anticuerpos IgM para herpes simplex2=1.9 U/ml, anticuerpos IgM para varicela zoster=0.5 S/CO, FTA-ABS (IgM)=negativo. Se resalta la intensidad de las lesiones cutáneas en el pene y la necesidad de realizar pruebas para descarte de MPOX en prostitutas.

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Clinical features and management of individuals admitted to hospital with monkeypox and associated complications across the UK: a retrospective cohort study

Cited by 51 publications

References 21 publications

Clinical features and outcome of human Mpox (Monkeypox) in Saudi Arabia: An observational study of travel-related cases

Clinical features and outcome of human Mpox (Monkeypox) in Saudi Arabia: An observational study of travel-related cases

Mpox outbreak 2022: an overview of all cases reported to the Cologne Health Department

Viruela del mono (MPOX) en paciente varón heterosexual VIH negativo

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