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Monkeypox patients in the UK have very different symptoms to those seen in previous outbreaks, according to researchers in London, raising concerns that cases are being missed.
Patients reported less fever and tiredness and more skin lesions in their genital and anal areas than is normally seen in monkeypox, the study of 54 patients at London sexual health clinics in May this year found.
Monkeypox, a generally relatively mild viral disease that is endemic in several West and Central African countries, has caused more than 5,000 cases and one death outside those areas, mainly in Europe, since early May.
Cases have also increased in countries where it usually spreads, according to the World Health Organization.
The research, published in The Lancet Infectious Diseases Journal, follows suggestions from public health agencies such as the US Centers for Disease Control and Prevention that the outbreak, which is spreading primarily among men who have sex with men, it presents unusually.
The authors, from several institutions including Chelsea & Westminster Hospital NHS Foundation Trust, said case definitions need to be reviewed to avoid being overlooked, particularly as monkeypox can “mimic” other sexually transmitted infections (STIs). such as herpes and syphilis.
The study also found that a quarter of monkeypox patients were HIV positive and a quarter had another STI.
Monkeypox spreads through close contact, and researchers are working to establish whether it can also be transmitted through semen, the classic definition of sexual transmission.
David Heymann, an infectious disease epidemiologist and WHO adviser on the outbreak, said it was important to control the spread without stigmatizing those affected.
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