The current outbreak of monkeypox differs significantly from prior outbreaks in endemic regions, according to a study published today in The BMJ.
Between May and July of 2022, 197 monkeypox cases were confirmed at an infectious disease centre in London.
When it comes to rectal pain and penile oedema (swelling), some of the frequent symptoms they describe differs from those reported in past outbreaks.
Patients with these symptoms should be evaluated for monkeypox infection, according to the study. They also recommend “ongoing review or inpatient management” for people with confirmed monkeypox infection and large penile lesions or significant rectal pain.
There were 2,137 confirmed cases of monkeypox in the UK as of July 18, 2022, according to government records. There were 2,050 of them in the United Kingdom, with 73% of them residing in the capital city of London.
The study’s 197 participants were all men (with an average age of 38 years), and 196 of those men identified as gay, bisexual, or as having sex with other men.
Lesions on the skin or mucosa of all patients were found in the genitals or perianal area, most frequently on the genitals.
The vast majority of patients (86 percent) described their condition as being systemic in nature (affecting the entire body). Swollen lymph nodes (58 percent), fever (62 percent), and muscle aches and pains (56 percent) were the most frequent systemic symptoms (32 percent ).
According to previous studies, systemic symptoms appear before skin lesions, but in this study patients with mucocutaneous lesions did not develop systemic symptoms until after the start of skin symptoms occurred in 38% of patients.
Recessive abdominal discomfort was experienced by 71 individuals, sore throats by 33, penile oedema by 31, and oral lesions by 27, swollen tonsils by 22, and rectal pain by nine.
Previously, single lesions and swollen tonsils were not known to be characteristic symptoms of monkeypox infection and may be confused for other illnesses, according to the scientists.
One in three people who participated in this study was HIV positive, and one in three people examined for sexually transmitted illnesses was infected as well.
Among the participants, 20 (or 10 percent) were hospitalised to treat various symptoms, the most common of which were rectal pain and penile swelling. However, there were no deaths and no patients necessitating severe hospitalizations.
This suggests that monkeypox is still being transmitted in the UK, but only one participant had recently been to an endemic area, and only a quarter of patients had known contact with someone with proven monkeypox illness.
Although the findings are observational and may be subject to clinical variability, the authors recognise that they are based on a single center’s results.
These findings, however, support the ongoing unparalleled community spread of monkeypox virus among gay, bisexual, and other men who have sex with men in the United Kingdom and many other non-endemic nations.
“Understanding these findings will have substantial consequences for contact tracing, public health guidance, and ongoing infection control and isolation efforts.”
Research on infection control and isolation is essential, as is the development of new diagnostics, therapies and preventive measures.