The researchers recommend that clinicians consider the possibility of monkeypox infection in patients with these symptoms.
A new study, published in The BMJhas identified important differences in the symptoms of monkey pox between the current outbreak and previous outbreaks in endemic regions, something the researchers hope the results will help doctors detect infections earlier.
The conclusions are based on 197 cases of monkey pox confirmed at an infectious disease center in London (UK) between May and July 2022. Some of the common symptoms they describe, such as rectal pain and the swelling of the penis (edema), differ from those described in previous outbreaks.
For this reason, the researchers recommend that doctors consider the possibility of an infection by monkey pox in patients with these symptoms. And they say that those with infection by monkey pox confirmed with extensive penile lesions or severe rectal pain “should be considered for continued review or treatment in hospital.”
The 197 participants in this study were men (mean age 38 years), of whom 196 identified as homosexual, bisexual, or other men who have sex with men. All the patients presented skin lesions or in the mucous membraneswith more frenquency on the genitals or in the perianal area.
The majority (86%) of patients reported a systemic disease (which affected the whole body). The most common systemic symptoms were fever (62%), swollen lymph nodes (58%), and muscle aches (32%).
And in contrast to existing case reports suggesting that systemic symptoms precede cutaneous lesions, 38% of patients developed systemic symptoms after the appearance of mucocutaneous lesions, while 14% presented lesions without systemic features.
A total of 71 patients reported rectal pain, 33 sore throat Y 31 edema of peniswhile 27 had oral lesions, 22 had a solitary lesion and 9 had swollen tonsils.
The authors note that solitary lesions and swollen tonsils they were not previously known to be typical features of monkeypox infection, and could be confused with other conditions.
Just over a third (36%) of the participants also had an HIV infection and 32% of those tested for sexually transmitted infections had a sexually transmitted infection.
In all, 20 (10%) of the participants were admitted to hospital for treatment of symptoms, mostly rectal pain and penile swelling. However, no deaths were recorded and no patient required intensive hospital care.
Only one participant had recently traveled to an endemic region, confirming ongoing transmission within the UK, and only a quarter of the patients had known contact with someone with confirmed infection. monkey poxwhich raises the possibility of transmission by people with no or very few symptoms.
The authors acknowledge some limitations, such as the observational nature of the results, the possible variability of clinical records, and the fact that data is limited to a single center. However, they state that these findings confirm the current unprecedented community transmission of the virus. monkey pox among gay, bisexual, and other men who have sex with men that is seen in the UK and many other non-endemic countries.
“Understanding these findings will have important implications for contact tracing, public health advice, and ongoing infection control and isolation measures,” the researchers stress, calling for further study to inform policy. control and isolation of infection and guide the development of new diagnoses, treatments and preventive measures.