Sexual closeness reason for 95% of monkeypox cases

Sexual closeness reason for 95% of monkeypox cases

Sydney: Researchers from 16 countries across the world have said that sexual closeness is the most likely route of transmission in 95% of monkeypox cases.

Nevertheless, the disease can also be transmitted through any close physical contact, large respiratory droplets and through clothing and other surfaces, they said at Queen Mary University of London.

In the study, the team reported 528 infections diagnosed between April 27 and June 24, 2022, at 43 sites in 16 countries. The findings, published in the New England Journal of Medicine (NEJM), showed 95% the persons presented with a rash (with 64 per cent having less than 10 lesions), 73% cent had anogenital lesions, and 41% had mucosal lesions (with 54 having a single genital lesion).

Overall, 98 per cent of the persons with infection were gay or bisexual men, 75% were white, and 41% had human immunodeficiency virus infection. Common systemic features preceding the rash included fever (62%), lethargy (41%), myalgia (31%), and headache (27%); lymphadenopathy -- swelling of lymph nodes -- was also common (reported in 56%). Concomitant sexually transmitted infections were reported in 109 of 377 persons (29%) who were tested.

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In some people, anal and oral symptoms have led to people being admitted to hospital for management of pain and difficulties swallowing. It's important that these new clinical symptoms be recognised and healthcare professionals be educated on how to identify and manage the disease - misdiagnosis can slow detection and thus hinder efforts to control the spread of the virus, the team said.

“We have shown that the current international case definitions need to be expanded to add symptoms that are not currently included, such as sores in the mouth, on the anal mucosa and single ulcers. These particular symptoms can be severe and have led to hospital admissions so it is important to make a diagnosis,” said Chloe Orkin, Professor of HIV Medicine at QMUL.

These findings will improve future diagnosis, help to slow the spread of infection and help the international community prioritise the limited global supply of monkeypox vaccines and treatments to communities most at risk, the researchers said.