Orkin’s study, which came out Thursday in the New England Journal of Medicine, found that 528 people with monkeypox in 16 countries between April and June had rashes (occurring 95 percent of the time).
About 73 percent of people with monkeypox had lesions on their anogenital area, while about 10 percent had only one lesion. Most of the monkeypox in this outbreak has been spread through sexual contact, which is why 98 percent of the people who agreed to be in the study were gay or bisexual men.
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Some Patients Had Trouble Swallowing, or Going To The Toilet
Orkin said that the cases ranged from being very mild to being so painful that the people couldn’t use the toilet or swallow.
“People didn’t just have skin problems,” she said, which is different from how the virus has been described in the past. “They were also having problems inside their mouths and anuses. And sometimes these problems were so bad that people had to go to the hospital because they were in so much pain.”
People with monkeypox had fevers (in 62 percent of cases), lethargy (in 41 percent of cases), muscle aches (in 31 percent of cases), and headaches (in 31 percent of cases) before they got a rash (27 percent ). Most of the 70 people who were hospitalized because of the study had severe anorectal pain (21 people), skin infections (18 people), and trouble swallowing (11 people) (five patients).
Early treatment is important not only because it can help keep the virus under control, but also because antiviral treatments work best when given early in the course of an infection.
“It is easy to miss,” said Orkin. “And it does look like they missed it.”
During a phone call with the Infectious Diseases Society of America last week, Dr. Lilian Abbo from the University of Miami talked about how frustrating it was that some South Florida patients had to see multiple doctors before they were finally given a positive monkeypox diagnosis.
So far, the Centers for Disease Control and Prevention have found at least 2,323 cases of monkeypox in the United States. The World Health Organization says that monkeypox is found in at least 50 countries around the world.
Clinicians aren’t sure if the monkeypox that’s going around now is really a different kind of virus than what they’ve seen before, or if the different ways the virus is showing up now just show how it’s being passed from person to person (through the skin to skin touching during sexual contact.)
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Even though monkeypox DNA was found in the sperm of some of the people in this study, it’s still not clear what this might mean for how this virus could be spread sexually.
Dr. Lawrence Purpura, an infectious disease expert at Columbia University Irving Medical Center, said, “You can find viruses in sperm, but that doesn’t mean it’s a threat to public health.”
Purpura, who was not involved in this research but has studied viruses in sperm like Ebola and COVID, said, “Just finding a virus doesn’t immediately raise the red flags that we should be worried about sexual transmission at this point, but it does, I think, give enough reason to really study it, and study it quickly, to figure out if that is a potential risk.”
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