Monkeypox Virus Infection in Humans across 16 Countries — April–June 2022

作者：John Thornhill, Sapha Barkati, Sharon Walmsley, Juergen Rockstroh, Andrea Antinori, Luke B. Harrison, Romain Palich, Achyuta Nori, Iain Reeves, Maximillian S. Habibi, Vanessa Apea, Christoph Boesecke, Linos Vandekerckhove, Michal Yakubovsky, Elena Sendagorta, José Luís Blanco, Éric Florence, Davide Moschese, Fernando Maltêz, Abraham Goorhuis, Valérie Pourcher, Pascal Migaud, Sebastian Noé, Claire Pintado, Fabrizio Maggi, Ann‐Brit Eg Hansen, Christian Hoffmann, Jezer I. Lezama, Cristina Mussini, AnnaMaria Cattelan, Keletso Makofane, Darrell H. S. Tan, Silvia Nozza, Johannes Nemeth, Marina B. Klein, Chloe Orkin · 发表于：New England Journal of Medicine · 年份：2022 · DOI：10.1056/nejmoa2207323 · 被引用次数：2214 · 研究领域：Poxvirus research and outbreaks、Cervical Cancer and HPV Research、Viral Infections and Outbreaks Research

BACKGROUND: Before April 2022, monkeypox virus infection in humans was seldom reported outside African regions where it is endemic. Currently, cases are occurring worldwide. Transmission, risk factors, clinical presentation, and outcomes of infection are poorly defined. METHODS: We formed an international collaborative group of clinicians who contributed to an international case series to describe the presentation, clinical course, and outcomes of polymerase-chain-reaction-confirmed monkeypox virus infections. RESULTS: We report 528 infections diagnosed between April 27 and June 24, 2022, at 43 sites in 16 countries. Overall, 98% of the persons with infection were gay or bisexual men, 75% were White, and 41% had human immunodeficiency virus infection; the median age was 38 years. Transmission was suspected to have occurred through sexual activity in 95% of the persons with infection. In this case series, 95% of the persons presented with a rash (with 64% having ≤10 lesions), 73% had anogenital lesions, and 41% had mucosal lesions (with 54 having a single genital lesion). Common systemic features preceding the rash included fever (62%), lethargy (41%), myalgia (31%), and headache (27%); lymphadenopathy was also common (reported in 56%). Concomitant sexually transmitted infections were reported in 109 of 377 persons (29%) who were tested. Among the 23 persons with a clear exposure history, the median incubation period was 7 days (range, 3 to 20). Monkeypox virus DNA was detecte...