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Monkeypox outbreak in Madrid (Spain): Clinical and virological aspects
Eva Orviz1, Anabel Negredo2, Oskar Ayerdi1
1Centro Sandoval/Hospital Clínico San Carlos, IdISSC.
The Journal of Infection
|July 13, 2022
Summary
The 2022 monkeypox outbreak in Spain primarily affected cisgender men, with skin lesions being the most common symptom. The circulating virus belongs to the western African clade, with no severe cases reported.
Area of Science:
- Virology
- Epidemiology
- Dermatology
Background:
- Monkeypox (Mpox) is a significant Orthopoxvirus zoonotic infection, particularly relevant following the eradication of smallpox.
- The ongoing multi-country Mpox outbreak has a substantial presence in Europe, necessitating detailed clinical and virological data from non-endemic regions.
- Understanding the characteristics of Mpox outside its endemic areas is crucial for public health response.
Purpose of the Study:
- To describe the clinical and virological features of monkeypox cases diagnosed in Madrid, Spain, during the 2022 outbreak.
- To analyze the sociodemographic, clinical, and behavioral data of confirmed Mpox patients.
- To determine the phylogenetic origin of the Mpox virus circulating in Spain.
Main Methods:
- An observational study was conducted on 48 patients diagnosed with Mpox in Madrid between May and June 2022.
- Viral confirmation involved real-time PCR on vesicular lesion swabs, alongside sequencing, phylogenetic analysis, and electron microscopy.
- Sociodemographic, clinical, and behavioral data were systematically collected using a structured epidemiological questionnaire.
Main Results:
- All 48 confirmed cases were cisgender men, with a median age of 35 years; 87.5% identified as men who have sex with men (MSM).
- The predominant symptoms included vesicular-umbilicated and pseudo-pustular skin lesions (93.8%), asthenia (66.6%), and fever (52.1%).
- Sequencing confirmed the circulating virus belongs to the western African clade, directly descended from strains detected in Nigeria, the UK, Singapore, and Israel between 2017-2018.
Conclusions:
- Monkeypox is an emerging infectious disease in Europe, with community transmission predominantly observed among MSM.
- The initial symptom in this cohort was typically skin lesions, differing from the classical fever and rash presentation.
- The disease course was self-limited, with no severe presentations or complications observed in the studied patients.
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