Top 5 Takeaways:

1. Demographics and Risk Behaviors: Among 719 mpox patients in NYC, 97.9% were men, predominantly identifying as gay or queer (78.7%), or bisexual (5.6%). A significant proportion reported intimate or sexual contact with men, which appears to have been a key risk factor.
2. Symptomatology: Prodromal symptoms were noted in 38.1% of cases. Notably, 45.1% reported proctitis or rectal symptoms, with a majority not observing perianal skin lesions. Ophthalmic manifestations were seen in 6.2% of patients.
3. Diagnostic Delays and Treatment: The median time from symptom onset to diagnosis was 5 days. Tecovirimat was administered to 14.0% of patients, and 4.9% required hospitalization.
4. Importance of Anorectal Swabs: Over two-thirds of patients with rectal symptoms lacked perianal lesions, suggesting the potential utility of anorectal swabs in diagnosis, despite current protocols focusing on swabbing skin lesions.
5. Data Completeness and Public Health Implications: Data on gender, race, ethnicity, and sexual orientation were over 80% complete, aiding public health outreach. The study’s findings can inform public health messaging and clinical management strategies.

Original Article Author and Citation

Corresponding Author

Nang Thu Thu Kyaw

Suggested Citation

Kyaw NT, Kipperman N, Alroy KA, et al. Notes from the Field: Clinical and Epidemiologic Characteristics of Mpox Cases from the Initial Phase of the Outbreak — New York City, May 19–July 15, 2022. MMWR Morb Mortal Wkly Rep 2022;71:1631–1633.

Summary

This MMWR article presents a detailed analysis of the clinical and epidemiologic characteristics of mpox cases in New York City during the initial phase of the 2022 outbreak. The study involved 719 patients, predominantly men and those identifying as gay or queer. A significant number reported intimate or sexual contact with men, highlighting a key risk behavior in this outbreak.

Methods

The study analyzed case investigation data for NYC residents diagnosed with mpox from May 19 to July 15, 2022. Interviews with patients and information from medical care providers formed the basis of data collection, adhering to CDC policy and applicable federal law.

Discussion

The report underscores the diverse clinical presentations of mpox, including the notable occurrence of proctitis or rectal symptoms without perianal skin lesions and ophthalmic involvement. These findings are crucial for clinical management and diagnostic strategies, particularly the potential role of anorectal swabs in diagnosis.

Conclusion

The study’s insights are instrumental in guiding public health messaging and clinical management of mpox. It highlights the need for further research, particularly on the use of anorectal swabs for early diagnosis. The report also acknowledges limitations, including missing data and evolving epidemiology, which may affect the generalizability of findings.

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