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Epidemiological and clinical characteristics of patients with monkeypox in the GeoSentinel Network: a cross-sectional study

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dc.contributor.authorAngelo, Kristina M.
dc.contributor.authorSmith, Teresa
dc.contributor.authorCamprubí-Ferrer, Daniel
dc.contributor.authorBalerdi-Sarasola, Leire
dc.contributor.authorDíaz Menéndez, Marta
dc.contributor.authorServera-Negre, Guillermo
dc.contributor.authorBarkati, Sapha
dc.contributor.authorDuvignaud, Alexandre
dc.contributor.authorHuber, Kristina L. B.
dc.contributor.authorChakravarti, Arpita
dc.contributor.authorBottieau, Emmanuel
dc.contributor.authorGreenaway, Christina
dc.contributor.authorGrobusch, Martin P.
dc.contributor.authorPedro, Diogo
dc.contributor.authorAsgeirsson, Hilmir
dc.contributor.authorPopescu, Corneliu Petru
dc.contributor.authorMartin, Charlotte
dc.contributor.authorLicitra, Carmelo
dc.contributor.authorde Frey, Albie
dc.contributor.authorSchwartz, Eli
dc.contributor.authorBeadsworth, Michael
dc.contributor.authorLloveras, Susana
dc.contributor.authorLarsen, Carsten S.
dc.contributor.authorGuagliardo, Sarah Anne J.
dc.contributor.authorWhitehill, Florence
dc.contributor.authorHuits, Ralph
dc.contributor.authorHamer, Davidson H.
dc.contributor.authorKozarsky, Phyllis
dc.contributor.authorLibman, Michael
dc.contributor.authorBlumberg, Lucille
dc.contributor.authorChaussade, Hélène
dc.contributor.authorDesclaux, Arnaud
dc.contributor.authorFlorence, Eric
dc.contributor.authorAysel Florescu, Simin
dc.contributor.authorGlans, Hedvig
dc.contributor.authorGlynn, Marielle
dc.contributor.authorGoorhuis, Abraham
dc.contributor.authorKlein, Marina
dc.contributor.authorMalvy, Denis
dc.contributor.authorMcCollum, Andrea
dc.contributor.authorMuñoz, José
dc.contributor.authorNguyen, Duc
dc.contributor.authorQuilter, Laura
dc.contributor.authorRothe, Camilla
dc.contributor.authorSoentjens, Patrick
dc.contributor.authorTumiotto, Camille
dc.contributor.authorVanhamel, Jef
dc.date.accessioned2023-02-02T12:15:48Z
dc.date.available2023-02-02T12:15:48Z
dc.date.issued2023
dc.description© 2022 Elsevier Ltd. All rights reserved.pt_PT
dc.description.abstractBackground: The early epidemiology of the 2022 monkeypox epidemic in non-endemic countries differs substantially from the epidemiology previously reported from endemic countries. We aimed to describe the epidemiological and clinical characteristics among individuals with confirmed cases of monkeypox infection. Methods: We descriptively analysed data for patients with confirmed monkeypox who were included in the GeoSentinel global clinical-care-based surveillance system between May 1 and July 1 2022, across 71 clinical sites in 29 countries. Data collected included demographics, travel history including mass gathering attendance, smallpox vaccination history, social history, sexual history, monkeypox exposure history, medical history, clinical presentation, physical examination, testing results, treatment, and outcomes. We did descriptive analyses of epidemiology and subanalyses of patients with and without HIV, patients with CD4 counts of less than 500 cells per mm3 or 500 cells per mm3 and higher, patients with one sexual partner or ten or more sexual partners, and patients with or without a previous smallpox vaccination. Findings: 226 cases were reported at 18 sites in 15 countries. Of 211 men for whom data were available, 208 (99%) were gay, bisexual, or men who have sex with men (MSM) with a median age of 37 years (range 18-68; IQR 32-43). Of 209 patients for whom HIV status was known, 92 (44%) men had HIV infection with a median CD4 count of 713 cells per mm3 (range 36-1659; IQR 500-885). Of 219 patients for whom data were available, 216 (99%) reported sexual or close intimate contact in the 21 days before symptom onset; MSM reported a median of three partners (IQR 1-8). Of 195 patients for whom data were available, 78 (40%) reported close contact with someone who had confirmed monkeypox. Overall, 30 (13%) of 226 patients were admitted to hospital; 16 (53%) of whom had severe illness, defined as hospital admission for clinical care rather than infection control. No deaths were reported. Compared with patients without HIV, patients with HIV were more likely to have diarrhoea (p=0·002), perianal rash or lesions (p=0·03), and a higher rash burden (median rash burden score 9 [IQR 6-21] for patients with HIV vs median rash burden score 6 [IQR 3-14] for patients without HIV; p<0·0001), but no differences were identified in the proportion of men who had severe illness by HIV status. Interpretation: Clinical manifestations of monkeypox infection differed by HIV status. Recommendations should be expanded to include pre-exposure monkeypox vaccination of groups at high risk of infection who plan to engage in sexual or close intimate contact.pt_PT
dc.description.sponsorshipUS Centers for Disease Control and Prevention, International Society of Travel Medicinept_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationLancet Infect Dis. 2023 Feb;23(2):196-206pt_PT
dc.identifier.doi10.1016/S1473-3099(22)00651-Xpt_PT
dc.identifier.eissn1474-4457
dc.identifier.issn1473-3099
dc.identifier.urihttp://hdl.handle.net/10451/56118
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.relation.publisherversionhttps://www.sciencedirect.com/journal/the-lancet-infectious-diseasespt_PT
dc.titleEpidemiological and clinical characteristics of patients with monkeypox in the GeoSentinel Network: a cross-sectional studypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage206pt_PT
oaire.citation.issue2pt_PT
oaire.citation.startPage196pt_PT
oaire.citation.titleThe Lancet Infectious Diseasespt_PT
oaire.citation.volume23pt_PT
person.familyNameFreire Leitão Duarte Mendes Pedro
person.givenNameDiogo Miguel
person.identifier.ciencia-id8B1F-4D7E-52CD
person.identifier.orcid0000-0002-4923-2940
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication5e692303-0446-4c4d-a887-ab82c7dc0186
relation.isAuthorOfPublication.latestForDiscovery5e692303-0446-4c4d-a887-ab82c7dc0186

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