Epidemiologic Features and Control Measures during Monkeypox Outbreak, Spain, June 2022

Abstract

During June 2022, Spain was one of the countries most affected worldwide by a multicountry monkeypox outbreak with chains of transmission without identified links to disease-endemic countries. We provide epidemiologic features of cases reported in Spain and the coordinated measures taken to respond to this outbreak.

Monkeypox

“… 73 During the 2022 outbreak, the mean incubation period generally spans 7–10 days after exposure. 32 , 34 , 106 , 107 The shorter incubation period could be due to the direct viral inoculation through sexual transmission.…”

Global monkeypox case hospitalisation rates: A rapid systematic review and meta-analysis

“…Many of the studies in 2022 specifically document sexual activity, where the majority of reported cases occur among individuals who identify as gay or MSM. 2 , 27 , 28 , 29 , 44 , 47 , 48 When treatments were specified, the most often used pharmaceuticals were antibiotics but more recent documents indicate the use of antivirals (e.g., tecovirimat). 27 , 28 , 29 , 41 Five of the studies explicitly documented an initial spillover event followed by human-to-human transmission.…”

“…(2022) 2 Portugal Clade II Retrospective April–May 2022 Median age 33 years (range 22–51 years); all male; 18/19 MSM Suspected, probable, and confirmed Human to human Not specified 27 3 0 Low Rodriguez et al. (2022) 48 Spain Clade II Retrospective May–July 2022 Median age 37; 98.9% male; 290 reported MSM, 6 reported heterosexual out of 332 reporting sexual contact Confirmed Human to human Not specified 530 30 0 Low Tarín-Vicente et al. (2022) 49 Spain Clade II Retrospective May–June 2022 37 years (IQR, 31–42); 97% (175/181) male; 92% gay, bisexual, MSM Confirmed Human to human Treatment not specified for proctitis, tonsillitis, and bacterial skin abscess (38.7% required treatment) 181 2 0 Low Thornhill et al.…”

Mpox (formerly monkeypox) in women: epidemiological features and clinical characteristics of mpox cases in Spain, April to November 2022

“…The General Director of WHO declared mpox a Public Health Emergency of International Concern (PHEIC) [ 3 ] on 23 July 2022. Human-to-human transmission in the context of this PHEIC has primarily been related to close and direct physical contact with skin lesions, crusts or certain body fluids of an infected person, especially in the context of sexual relations, but uncertainties about modes of transmission and the potential impact on general population remain [ 4 - 6 ].…”

“…Most cases in Spain and other countries have occurred in men who have sex with men (MSM) [ 6 ]. However, cases in other population groups, such as women, have also been identified.…”