Clinical and Epidemiological Characteristics of Mpox Cases Identified Through Case-based Surveillance in India, July
Serin Kuriakose1, Rajesh Kumar Gupta1, Anuj Kumar1
1Epidemic Intelligence Service, Department of Epidemiology, National Centre for Disease Control, New Delhi, India.
Background:
Of the 43 mpox cases reported by the WHO in South East Asia between January 2022 and March 2023, 24 (56%) were from India.
Objectives:
We describe the clinical and epidemiological profile of cases identified through India's hospital case-based surveillance.
Materials And Methods:
We identified mpox cases as a positive result for mpox virus polymerase-chain-reaction assay, reported through surveillance from July 1, 2022 to January 7, 2023. Cases and clinicians were interviewed, and data were abstracted from the medical records. We conducted contact tracing among family, close social networks, and healthcare personnel staff for the first 17 cases. We collected the data on sociodemographics, clinical findings, and behavior, and described data using summary statistics.
Results:
We identified 24 laboratory-confirmed cases (42% females, median age 30 years, range 22-38), including one death (case fatality rate 4.2%). We collected clinical and behavioural data from 21 of 24 cases. All had rashes with vesicles and genital lesions; 7 (33%) reported genital lesions as the first symptom; and 3 (13%) reported complications. Among the 21 cases, all were sexually active, none self-identified as men having sex with men (MSM), and 6 (29%) reported multiple sex partners. We identified 51 contacts of the first 17 reported cases, none reported symptoms suggestive of mpox.
Conclusion:
The clinical and behavioral characteristics of mpox cases in India are consistent with the global 2022 outbreak, with the exception that no cases in India reported MSM. Most were sexually active young adult economic migrants and developed genital lesions.
Insights
Mpox cases in India, primarily among young adult economic migrants, showed clinical features similar to the global outbreak but with no reported cases among men who have sex with men (MSM). Genital lesions were a common initial symptom.
Area of Science:
- Epidemiology
- Infectious Diseases
- Public Health
Background:
- India reported 24 of 43 mpox cases in South East Asia between January 2022 and March 2023.
- Mpox (monkeypox) virus transmission and clinical presentation require ongoing surveillance.
Purpose of the Study:
- To describe the clinical and epidemiological profile of mpox cases in India.
- To inform public health strategies for mpox control.
Main Methods:
- Laboratory-confirmed mpox cases were identified via polymerase-chain-reaction assay.
- Data were collected through interviews with cases and clinicians, and medical record abstraction.
- Contact tracing was performed for initial cases, with data summarized using descriptive statistics.
Main Results:
- Twenty-four laboratory-confirmed mpox cases were identified, with a median age of 30 years and a case fatality rate of 4.2%.
- All cases presented with rashes and genital lesions; 33% reported genital lesions as the initial symptom.
- Among sexually active cases, none identified as men having sex with men (MSM), and 29% reported multiple partners.
Conclusions:
- Mpox cases in India share similarities with the global 2022 outbreak, notably the prevalence of genital lesions.
- A key difference observed was the absence of reported cases among MSM in India.
- The study highlights mpox presentation in young adult economic migrants, emphasizing the need for tailored public health messaging.
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