A new study published today in The BMJ found significant differences in monkeypox symptoms between the present outbreak and earlier outbreaks in endemic areas.

New research published today in The BMJ compares the current outbreak of monkeypox to prior endemic outbreaks.

The conclusions are based on 197 confirmed cases of monkeypox recorded between May and July 2022 at an infectious disease center in London.

They describe a variety of common symptoms, some of which are distinct from those recorded in past outbreaks of the disease. These symptoms include rectal pain and penile enlargement (oedema).

Therefore, the researchers advise clinicians to take monkeypox infection into account in individuals exhibiting similar symptoms. Additionally, they advise that individuals with large penile lesions or significant rectal pain associated with a confirmed monkeypox infection “should be considered for ongoing review or inpatient management.”

As of July 18, 2022, there were 2,137 confirmed cases of monkeypox in the UK, according to government statistics. There were 2,050 in England, with nearly three-quarters (73 percent) in London.

The average age of the 197 men in this study was 38, and 196 of them said they were gay, bisexual, or other men who have sex with other men.

All of the patients had lesions on their skin or mucous membranes when they arrived, most frequently on the genital or in the perianal region.

The majority of patients (86%) reported having a systemic disease (affecting the entire body). Fever (62 percent), enlarged lymph nodes (58 percent), and aches and pains in the muscles were the most prevalent systemic symptoms (32 percent ).

And contrary to previous case reports indicating that systemic symptoms precede skin lesions, 38 percent of patients developed systemic symptoms following the onset of mucocutaneous lesions, while 14 percent presented with lesions devoid of systemic signs.

71 patients in all experienced rectal pain, 33 sore throats, 31 penile oedema, 27 oral lesions, 22 solitary lesions, and 9 enlarged tonsils.

The authors add that solitary lesions and swollen tonsils were not previously recognized as characteristic symptoms of monkeypox infection and could be confused with other diseases.

A little more than a third (36%) of individuals also had HIV infection, and 32% of those evaluated for sexually transmitted illnesses were infected with one.

Overall, 20 (10%) of the people who took part were taken to the hospital to treat their symptoms, which were mostly rectal pain and penile swelling. There were no recorded fatalities, though, and no individuals needed acute medical care.

Only one participant had recently visited an area where the disease was endemic, confirming ongoing transmission within the UK. Additionally, only one-fourth of patients had contact with someone who had been diagnosed with monkeypox, raising the possibility that those with no or minimal symptoms could also spread the disease.

The authors acknowledge many limitations, including the observational nature of the findings, the inherent variability of clinical record keeping, and the fact that the data are restricted to a single center.

But they assert that these discoveries support the ongoing, previously unrecognized community transmission of the monkeypox virus among gay, bisexual, and other males who have sex with men, as has been observed in the UK and many other non-endemic nations.

“Understanding these findings,” according to the authors, “will have major implications for contact tracing, public health advice, and ongoing infection control and isolation measures.” 

They also want more research to be done so that infection control and isolation policies can be improved and new tests, treatments, and preventive measures can be made.

Image Credit: Getty

You were reading: Monkeypox Symptoms Have Changed A Lot: These Are New Signs – Study