Dataset Information

Human Monkeypox without Viral Prodrome or Sexual Exposure, California, USA, 2022.

ABSTRACT: We report human monkeypox in a man who returned to the United States from the United Kingdom and reported no sexual contact. He had vesicular and pustular skin lesions but no anogenital involvement. The potential modes of transmission may have implications for the risk of spread and for epidemic control.

SUBMITTER: Karan A

PROVIDER: S-EPMC9514362 | biostudies-literature | 2022 Oct

REPOSITORIES: biostudies-literature

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Publications

Human Monkeypox without Viral Prodrome or Sexual Exposure, California, USA, 2022.

Karan Abraar A Styczynski Ashley R AR Huang ChunHong C Sahoo Malaya K MK Srinivasan Krithika K Pinsky Benjamin A BA Salinas Jorge L JL

Emerging infectious diseases 20220816 10

We report human monkeypox in a man who returned to the United States from the United Kingdom and reported no sexual contact. He had vesicular and pustular skin lesions but no anogenital involvement. The potential modes of transmission may have implications for the risk of spread and for epidemic control. ...[more]

PMID: 35971952

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Project description:BackgroundExposures associated with mpox infection remain imperfectly understood.MethodsWe conducted a case-control study enrolling participants who received molecular tests for mpox/orthopoxvirus in California from November 2022 through June 2023. We collected data on behaviors during a 21-day risk period before symptom onset or testing among mpox case patients and test-negative controls.ResultsThirteen of 54 case patients (24.1%) and 5 of 117 controls (4.3%) reported sexual exposure to individuals they identified as potential mpox case patients ("index contacts"; odds ratio [OR], 7.7 [95% confidence interval (CI), 2.5-19.3] relative to individuals who did not report exposure to potential mpox case patients). Among these participants, 10 of 13 case patients (76.9%) and 2 of 5 controls (40.0%) reported that their index contacts were not experiencing symptoms visible to participants during sex (OR, 14.9 [95% CI, 3.6-101.8]). Only 3 of 54 case patients (5.6%) reported exposure to symptomatic index contacts. Case patients reported more anal/vaginal sex partners than did controls (adjusted OR, 2.2 [95% CI, 1.0-4.8] for 2-3 partners and 3.8 [1.7-8.8] for ≥4 partners). Male case patients with penile lesions more commonly reported insertive anal/vaginal sex than those without penile lesions (adjusted OR, 9.3 [95% CI, 1.6-54.8]). Case patients with anorectal lesions more commonly reported receptive anal sex than those without anorectal lesions (adjusted OR, 14.4 [95% CI, 1.0-207.3]).ConclusionsSexual exposure to contacts known or suspected to have experienced mpox was associated with increased risk of infection, often when index contacts lacked apparent symptoms. Exposure to more sex partners, including those whom participants did not identify as index contacts, was associated with increased risk of infection in a site-specific manner. While participants' assessment of symptoms in partners may be imperfect, these findings suggest that individuals without visibly prominent mpox symptoms transmit infection.

Dataset Information

Human Monkeypox without Viral Prodrome or Sexual Exposure, California, USA, 2022.

Publications

Human Monkeypox without Viral Prodrome or Sexual Exposure, California, USA, 2022.

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