Monkeypox outbreak in Spain: clinical and epidemiological findings in a prospective cross-sectional study of 185 cases

被引：205

作者：

Catala, Alba ^{[1
]}

Clavo-Escribano, Petunia ^{[2
]}

Riera-Monroig, Josep ^{[1
]}

Martin-Ezquerra, Gemma ^{[3
]}

Fernandez-Gonzalez, Pablo ^{[4
]}

Revelles-Penas, Leonor ^{[2
,5
]}

Simon-Gozalbo, Ana ^{[6
]}

Jose Rodriguez-Cuadrado, Francisco ^{[7
]}

Guilera Castells, Vanessa ^{[8
]}

de la Torre Gomar, Francisco Javier ^{[9
]}

Comunion-Artieda, Alicia ^{[10
]}

de Fuertes de Vega, Laura ^{[11
]}

Luis Blanco, Jose ^{[12
]}

Puig, Susana ^{[13
]}

Maria Garcia-Minarro, Angela ^{[14
]}

Benito, Esther Fiz ^{[15
]}

Munoz-Santos, Carlos ^{[16
]}

Bosco Repiso-Jimenez, Juan ^{[17
]}

Lopez Llunell, Cristina ^{[18
]}

Ceballos-Rodriguez, Carmen ^{[11
]}

Garcia Rodriguez, Victor ^{[19
]}

Castano Fernandez, Juan Luis ^{[7
]}

Sanchez-Gutierrez, Irene ^{[7
]}

Calvo-Lopez, Ricardo ^{[20
]}

Berna-Rico, Emilio ^{[4
]}

De Nicolas-Ruanes, Belen ^{[4
]}

Corella Vicente, Francesca ^{[21
]}

Tarin Vicente, Eloy Jose ^{[22
]}

de la Fernandez de la Fuente, Laura ^{[23
]}

Riera-Marti, Nuria ^{[24
]}

Angel Descalzo-Gallego, Miguel ^{[25
]}

Grau-Perez, Merce ^{[7
,25
]}

Garcia-Doval, Ignacio ^{[25
,26
]}

Fuertes, Irene ^{[1
]}

机构：

[1] Hosp Clin Barcelona, Dermatol Dept, Sexually Transmitted Dis Clin, Barcelona, Spain

[2] Hosp Clin San Carlos, Ctr Sandoval, Dermatol Dept, Madrid, Spain

[3] Hosp Mar, Dermatol Dept, Sexually Transmitted Dis Clin, Barcelona, Spain

[4] Hosp Ramon & Cajal, Dermatol Dept, Madrid, Spain

[5] Complejo Asistencial Univ Salamanca, Dermatol Dept, Salamanca, Spain

[6] Hosp Univ Infanta Leonor, Dermatol Dept, Madrid, Spain

[7] Hosp Univ Puerta de Hierro Majadahonda, Dermatol Dept, Madrid, Spain

[8] Hosp Clin Barcelona, STDs Program, Barcelona, Spain

[9] Hosp Univ San Cecilio, Dermatol Dept, Granada, Spain

[10] Ctr Diagnost Montesa, Madrid, Spain

[11] Hosp Univ Fdn Jimenez Diaz, Dermatol Dept, Madrid, Spain

[12] Hosp Clin Barcelona, Infect Dis & AIDS Unit, Barcelona, Spain

[13] Hosp Clin Barcelona, Dermatol Dept, Barcelona, Spain

[14] Hosp Univ Gran Canaria Dr Negrin, Las Palmas Gran Canaria, Spain

[15] Hosp La Paz, Dermatol Dept, Madrid, Spain

[16] Hosp Gen Granollers, Dermatol Dept, Barcelona, Spain

[17] Hosp Costa del Sol, Dermatol Dept, Marbella, Spain

[18] Consorci Cor Sanitaria Parc Tauli, Dermatol, Barcelona, Spain

[19] Hosp Univ Sagrat Cor, Dermatol Dept, Grp Quironsalud, Barcelona, Spain

[20] Hosp Univ A Coruna, Emergency Dept, La Coruna, Spain

[21] Hosp Univ Mutua de Terrassa, Dermatol Dept, Barcelona, Spain

[22] Hosp 12 Octubre, Dermatol Dept, Madrid, Spain

[23] Hosp Univ Fuenlabrada, Dermatol Dept, Madrid, Spain

[24] Hosp Univ Parc Tauli, Dermatol Dept, Barcelona, Spain

[25] Fdn Piel Sana Acad Espanola Dermatol & Venereol, Res Unit, Madrid, Spain

[26] Complexo Hosp Univ Vigo, Dermatol Dept, Vigo, Spain

来源：

BRITISH JOURNAL OF DERMATOLOGY | 2022年 / 187卷 / 05期

关键词：

RISK-FACTORS;

D O I：

10.1111/bjd.21790

中图分类号：

R75 [皮肤病学与性病学];

学科分类号：

100206 ;

摘要：

Background Since May 2022, a new outbreak of monkeypox has been reported in several countries, including Spain. The clinical and epidemiological characteristics of the cases in this outbreak may differ from those in earlier reports. Objectives To document the clinical and epidemiological characteristics of cases of monkeypox in the current outbreak. Methods We conducted a prospective cross-sectional study in multiple medical facilities in Spain to describe the cases of monkeypox in the 2022 outbreak. Results In total, 185 patients were included. Most cases started with primarily localized homogeneous papules, not pustules, in the probable area of inoculation, which could be cutaneous or mucous, including single lesions. Generalized small pustules appeared later in some of them. Heterogeneous lesions occurred during this generalized phase. All patients had systemic symptoms. Less common lesions included mucosal ulcers (including pharyngeal ulcers and proctitis) and monkeypox whitlows. Four patients were hospitalized, none died. Smallpox vaccination and well-controlled HIV disease were not associated with markers of severity. Contact during sex is the most likely mechanism of transmission. In this outbreak, cases have been described in men who have sex with men and are strongly associated with high-risk sexual behaviours. Seventy-six per cent of the patients had other sexually transmitted diseases upon screening. Conclusions The clinical findings in this outbreak differ from previous findings and highly suggest contact transmission and initiation at the entry site. The characterization of the epidemiology of this outbreak has implications for control.

引用

页码：765 / 772

页数：8

共 20 条

[1] Case 24-2022: A 31-Year-Old Man with Perianal and Penile Ulcers, Rectal Pain, and Rash [J].

Basgoz, Nesli ;

Brown, Catherine M. ;

Smole, Sandra C. ;

Madoff, Lawrence C. ;

Biddinger, Paul D. ;

Baugh, Joshua J. ;

Shenoy, Erica S. .

NEW ENGLAND JOURNAL OF MEDICINE, 2022, 387 (06) :547-556

[2] Monkeypox virus: histologic, immunohistochemical and electron-microscopic findings [J].

Bayer-Garner, IB .

JOURNAL OF CUTANEOUS PATHOLOGY, 2005, 32 (01) :28-34

[3] Human Monkeypox: Current State of Knowledge and Implications for the Future [J].

Brown, Katy ;

Leggat, Peter A. .

TROPICAL MEDICINE AND INFECTIOUS DISEASE, 2016, 1 (01)

[4] The changing epidemiology of human monkeypox-A potential threat? A systematic review [J].

Bunge, Eveline M. ;

Hoet, Bernard ;

Chen, Liddy ;

Lienert, Florian ;

Weidenthaler, Heinz ;

Baer, Lorraine R. ;

Steffen, Robert .

PLOS NEGLECTED TROPICAL DISEASES, 2022, 16 (02)

[5]

Centers for Disease Control and Prevention, MONK US CAS OUTBR

[6]

Centers for Disease Control and Prevention, MONK CLIN FAQS

[7] Ongoing monkeypox virus outbreak, Portugal, 29 April to 23 May 2022 [J].

Duque, Mariana Perez ;

Ribeiro, Sofia ;

Martins, Joao Vieira ;

Casaca, Pedro ;

Leite, Pedro Pinto ;

Tavares, Margarida ;

Mansinho, Kamal ;

Duque, Luis Miguel ;

Fernandes, Candida ;

Cordeiro, Rita ;

Borrego, Maria Jose ;

Pelerito, Ana ;

de Carvalho, Isabel Lopes ;

Nuncio, Sofia ;

Manageiro, Vera ;

Minetti, Corrado ;

Machado, Jorge ;

Haussig, Joana M. ;

Croci, Roberto ;

Spiteri, Gianfranco ;

Casal, Ana Sofia ;

Mendes, Diana ;

Souto, Tiago ;

Pocinho, Sara ;

Fernandes, Teresa ;

Firme, Ana ;

Vasconcelos, Paula ;

Freitas, Graca .

EUROSURVEILLANCE, 2022, 27 (22)

[8]

European Centre for Disease Prevention and Control, FACTSH HLTH PROF MON

[9]

European Centre for Disease Prevention and Control, 2022, MONK MULT OUTBR SIT

[10] Classification of the cutaneous manifestations of COVID-19: a rapid prospective nationwide consensus study in Spain with 375 cases [J].

Galvan Casas, C. ;

Catala, A. ;

Carretero Hernandez, G. ;

Rodriguez-Jimenez, P. ;

Fernandez-Nieto, D. ;

Rodriguez-Villa Lario, A. ;

Navarro Fernandez, I. ;

Ruiz-Villaverde, R. ;

Falkenhain-Lopez, D. ;

Llamas Velasco, M. ;

Garcia-Gavin, J. ;

Baniandres, O. ;

Gonzalez-Cruz, C. ;

Morillas-Lahuerta, V. ;

Cubiro, X. ;

Figueras Nart, I. ;

Selda-Enriquez, G. ;

Romani, J. ;

Fusta-Novell, X. ;

Melian-Olivera, A. ;

Roncero Riesco, M. ;

Burgos-Blasco, P. ;

Sola Ortigosa, J. ;

Feito Rodriguez, M. ;

Garcia-Doval, I. .

BRITISH JOURNAL OF DERMATOLOGY, 2020, 183 (01) :71-77

← 1 2 →