Mpox Surveillance Based on Rash Characteristics - 13 Emergency Departments, United States, June-December 2023

Area of Science:

• Epidemiology
• Infectious Diseases
• Public Health

Background:

• A global mpox outbreak occurred in 2022, predominantly affecting gay, bisexual men who have sex with men (GBMSM).
• Continued surveillance is crucial to detect reemergence and identify cases in non-GBMSM populations.
• Emergency departments (EDs) serve as critical points for identifying infectious disease outbreaks.

Purpose of the Study:

• To assess mpox prevalence in U.S. emergency department patients presenting with compatible rashes.
• To investigate potential mpox reemergence and cases among non-GBMSM individuals.
• To characterize demographic and risk factors associated with mpox diagnoses.

Main Methods:

• Prospective surveillance of patients aged ≥3 months with mpox-compatible rashes.
• Data collection included demographics, medical history, and illness characteristics via questionnaires and EHRs.
• Polymerase chain reaction (PCR) testing of lesions for monkeypox virus.

Main Results:

• 196 patients were enrolled; 1.5% prevalence of mpox was detected.
• All confirmed mpox cases were among GBMSM, unvaccinated, HIV-negative individuals who met partners via dating apps.
• No mpox cases were identified in women, children, or unhoused persons.

Conclusions:

• Clinicians must maintain vigilance for mpox, especially in GBMSM populations.
• Education on risk-reducing behaviors and JYNNEOS vaccination is vital for prevention.
• Current surveillance data suggest limited spread beyond the primary at-risk group in this cohort.