Higher prevalence of genital and anal skin lesions observed, along with lower fatigue and fever compared to previous outbreaks
In a recent study published in The Lancet Infectious Diseases, researchers from the Chelsea & Westminster Hospital NHS Foundation Trust have shed light on the distinct features of new monkeypox cases. The study focused on 54 patients who visited sexual health clinics in London and were diagnosed with monkeypox during a 12-day period in May 2022. The findings indicate a higher prevalence of skin lesions in the genital and anal area among these patients, along with lower levels of fatigue and fever compared to previous outbreaks.
Monkeypox, a rare viral disease, has been spreading across 51 countries worldwide, with Europe experiencing the majority of cases. The United Kingdom, in particular, has reported the highest number of cases on the continent, with 1,235 individuals affected so far.
Of the patients involved in the study, all except two were unaware of any contact with a known monkeypox case or travel to sub-Saharan Africa. However, many had recently visited other European countries. Notably, all patients identified as men who have sex with men, with a significant number reporting multiple new sexual partners in the weeks leading up to their monkeypox diagnosis.
Skin lesions were a common symptom among the patients, with 94 percent of them experiencing at least one lesion in the genital or perianal area. Furthermore, a quarter of the patients tested positive for sexually transmitted infections such as gonorrhea or chlamydia simultaneously with their monkeypox infection. This suggests that the virus may be transmitted through close skin-to-skin contact, particularly during sexual activity.
Dr. Ruth Byrne from the Chelsea & Westminster Hospital NHS Foundation Trust emphasized the importance of raising awareness about monkeypox symptoms among sexual health clinicians and patients. Misdiagnosis could hinder proper intervention and prevention of further transmission, as monkeypox can present similarly to common sexually transmitted infections like herpes or syphilis.
The study also revealed variations in the clinical features of this patient cohort compared to previous cases. A smaller proportion of patients reported feelings of weakness, fatigue, and fever compared to earlier outbreaks. Additionally, 18 percent of patients did not exhibit any early symptoms before the onset of skin lesions.
The researchers predict that sexual health clinics may witness additional monkeypox cases in the future due to the high prevalence of genital skin lesions and concurrent sexually transmitted infections among patients. However, they caution that their findings may not be representative of the overall outbreak and emphasize the need for continued vigilance and targeted health promotion to affected groups.