Epidemiologic and Clinical Characteristics of Monkeypox Cases — United States, May 17–July 22, 2022

Details

• Personal Author:
  Philpott, David ; Hughes, Christine M. ; Alroy, Karen A. ; Kerins, Janna L. ; Pavlick, Jessica ; Asbel, Lenore ; Crawley, Addie ; Newman, Alexandra P. ; Spencer, Hillary ; Feldpausch, Amanda ; Cogswell, Kelly ; Davis, Kenneth R. ; Chen, Jinlene ; Henderson, Tiffany ; Murphy, Katherine ; Barnes, Meghan ; Hopkins, Brandi ; Fill, Mary-Margaret A. ; Mangla, Anil T. ; Perella, Dana ; Barnes, Arti ; Hughes, Scott ; Griffith, Jayne ; Berns, Abby L. ; Milroy, Lauren ; Blake, Haley ; Sievers, Maria M. ; Marzan-Rodriguez, Melissa ; Tori, Marco ; Black, Stephanie R. ; Kopping, Erik ; Ruberto, Irene ; Maxted, Angela ; Sharma, Anuj ; Tarter, Kara ; Jones, Sydney A. ; White, Brooklyn ; Chatelain, Ryan ; Russo, Mia ; Gillani, Sarah ; Bornstein, Ethan ; White, Stephen L. ; Johnson, Shannon A. ; Ortega, Emma ; Saathoff-Huber, Lori ; Syed, Anam ; Wills, Aprielle ; Anderson, Bridget J. ; Oster, Alexandra M. ; Christie, Athalia ; McQuiston, Jennifer ; McCollum, Andrea M. ; Rao, Agam K. ; Negrón, María E.
• Corporate Authors:
  CDC Multinational Monkeypox Response Team. ; Centers for Disease Control and Prevention (U.S.). Epidemic Intelligence Service. ; CDC Monkeypox Response. ; New York (N.Y.). Department of Health and Mental Hygiene. ; Chicago (Ill.). Department of Public Health. ; Georgia. Department of Health. ; Philadelphia. Department of Public Health. ; New York. State Department of Health. ; Oregon. Department of Health. ; Texas. Department of State Health Services. ; Maryland. Department of Health. ; Michigan. Department of Health and Human Services. ; Louisiana. Department of Health. ; Colorado. Department of Public Health and Environment. ; Massachusetts. Department of Public Health. ; Tennessee. Department of Health. ; District of Columbia. Department of Health. ; Illinois. Department of Public Health. ; Minnesota. Department of Health. ; Rhode Island. Department of Health. ; Indiana. State Department of Health. ; Southern Nevada Health District, Las Vegas, Nevada ; New Mexico. Department of Health. ; Puerto Rico Department of Health. ; South Carolina. Department of Health and Environmental Control. ; Centers for Disease Control and Prevention (U.S.). Laboratory Leadership Service. ; Arizona. Department of Health Services. ; Wisconsin. Department of Health Services. ; Ohio. Department of Health. ; Connecticut. Department of Public Health. ; Centers for Disease Control and Prevention (U.S.). Career Epidemiology Field Officer Training Program. ; Missouri. Department of Health and Senior Services. ; Salt Lake County Health Department, Salt Lake City, Utah. ; Pennsylvania. Department of Health.
• Description:
  What is already known about this topic? A global monkeypox outbreak began in 2022.
  
  What is added by this report? Among U.S. monkeypox cases with available data, 99% occurred in men, 94% of whom reported recent male-to-male sexual or close intimate contact; racial and ethnic minority groups appear to be disproportionately affected. Clinical presentations differed from typical monkeypox, with fewer persons experiencing prodrome and more experiencing genital rashes.
  
  What are the implications for public health practice? Public health efforts should prioritize gay, bisexual, and other men who have sex with men, who are currently disproportionately affected, for prevention and testing, address equity, and minimize stigma, while maintaining vigilance for transmission in other populations. Clinicians should test persons with rash consistent with monkeypox, regardless of whether the rash is disseminated or was preceded by prodrome
  
  Monkeypox, a zoonotic infection caused by an orthopoxvirus, is endemic in parts of Africa. On August 4, 2022, the U.S. Department of Health and Human Services declared the U.S. monkeypox outbreak, which began on May 17, to be a public health emergency (1,2). After detection of the first U.S. monkeypox case), CDC and health departments implemented enhanced monkeypox case detection and reporting. Among 2,891 cases reported in the United States through July 22 by 43 states, Puerto Rico, and the District of Columbia (DC), CDC received case report forms for 1,195 (41%) cases by July 27. Among these, 99% of cases were among men; among men with available information, 94% reported male-to-male sexual or close intimate contact during the 3 weeks before symptom onset. Among the 88% of cases with available data, 41% were among non-Hispanic White (White) persons, 28% among Hispanic or Latino (Hispanic) persons, and 26% among non-Hispanic Black or African American (Black) persons. Forty-two percent of persons with monkeypox with available data did not report the typical prodrome as their first symptom, and 46% reported one or more genital lesions during their illness; 41% had HIV infection. Data suggest that widespread community transmission of monkeypox has disproportionately affected gay, bisexual, and other men who have sex with men and racial and ethnic minority groups. Compared with historical reports of monkeypox in areas with endemic disease, currently reported outbreak-associated cases are less likely to have a prodrome and more likely to have genital involvement. CDC and other federal, state, and local agencies have implemented response efforts to expand testing, treatment, and vaccination. Public health efforts should prioritize gay, bisexual, and other men who have sex with men, who are currently disproportionately affected, for prevention and testing, while addressing equity, minimizing stigma, and maintaining vigilance for transmission in other populations. Clinicians should test patients with rash consistent with monkeypox,† regardless of whether the rash is disseminated or was preceded by prodrome. Likewise, although most cases to date have occurred among gay, bisexual, and other men who have sex with men, any patient with rash consistent with monkeypox should be considered for testing. CDC is continually evaluating new evidence and tailoring response strategies as information on changing case demographics, clinical characteristics, transmission, and vaccine effectiveness become available.
  
  Suggested citation for this article: Philpott D, Hughes CM, Alroy KA, et al. Epidemiologic and Clinical Characteristics of Monkeypox Cases — United States, May 17–July 22, 2022. MMWR Morb Mortal Wkly Rep. ePub: 5 August 2022
  
  mm7132e3.htm?s_cid=mm7132e3_w
  
  mm7132e3-H.pdf
  
  
• Subjects:
  Mpox (monkeypox)
• Source:
  MMWR: Morbidity and Mortality Weekly Report 2022; v. 71 Early Release
• Series:
  Weekly Report: Morbidity and Mortality Weekly Report (MMWR)
• ISSN:
  0149-2195 (print) ; 1545-861X (digital)
• Document Type:
  Journal Article
• Place as Subject:
  United States
• Pages in Document:
  6 pdf pages
• Volume:
  71
• Collection(s):
  Morbidity and Mortality Weekly Report (MMWR)
• Main Document Checksum:
  urn:sha-512:7f1d36d0ed2c326be0013dca8e8ffa45b01f501fb172e4fc58b21457bc7976546c013a344e97816a00b4316649c3fb404f1b6abe4cbd7259693abe2df225039d
• Download URL:
  https://stacks.cdc.gov/view/cdc/119938/cdc_119938_DS1.pdf
• File Type:
  [PDF - 370.61 KB ]