Monkeypox in Germany

Many cases of monkeypox have been reported across Europe from early May 2022 onward. Initial publications suggest that nearly all of the affected persons to date have been men who have sex with men (MSM).

To characterize the German cases, an anonymous questionnaire was sent via the mailing lists of the German AIDS Society (Deutsche AIDS-Gesellschaft, DAIG) and the German Association of Outpatient Physicians for Infectious Diseases and HIV Medicine (Deutsche Arbeitsgemeinschaft ambulant tätiger Ärztinnen und Ärzte für Infektionskrankheiten und HIV-Medizin e.V., DAGNAE).

301 PCR-verified cases had been registered as of 23 June 2022. All of the affected persons were MSM, including 141 (46.7%) with HIV infection and 135 (44.7%) with pre-exposure prophylaxis (PrEP). The great majority of skin lesions were in the anal and genital areas. The most common general symptoms were fever, headache, limb pain, and, often, painfully swollen lymph nodes. Most infections to date have taken a relatively mild course: 5.0% of the patients were hospitalized, and none died. A high frequency of sexually transmitted infections (STI) was noted: only 41.0% of the patients had not been given a diagnosis of an STI in the six months before their monkeypox infection.

Monkeypox seems to be establishing itself as a new type of STI among MSM. In view of the rising case numbers, there is a need for a rapid information and vaccination campaign in the population at risk. Heightened alertness among phy - sicians is needed as well.