Mpox across countries from Central and Eastern Europe - 2022 outbreak

• Published in: Travel Medicine and Infectious Disease
• Main Authors: Irina Ianache, Agata Skrzat-Klapaczynska, David Jilich, Lukas Fleischhans, Ivana Gmizic, Jovan Ranin, Antonios Papadopoulos, Konstantinos Protopapas, Velida Mulabdic, Botond Lakatos, Eva Livia Nagy, Josip Begovac, Tiberiu Holban, Dilek Yildiz Sevgi, Alma Cicic, Nina Yancheva, Lubomir Sojak, Nino Rukhadze, Justyna Kowalska, Cristiana Oprea
• Format: Article in Journal/Newspaper
• Language: English
• Published: Elsevier 2024
• Subjects: mpox; HIV; Central and Eastern Europe; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1016/j.tmaid.2024.102719; https://doaj.org/article/b7a02dd00dc043769b4c9343ace59ad7

Background: The aim of the study was to assess socio-demographical characteristics, clinical presentation, and outcomes in patients diagnosed with mpox. Methods: A survey on patients diagnosed with mpox was performed in 14 countries from Central and Eastern Europe. Data was compared according to HIV status and country of origin (EU vs. non-EU). Mpox diagnosis was confirmed by RT-PCR from oropharyngeal swabs, skin lesions, and other body fluids. Results: Out of 154 patients confirmed with mpox in 2022, 99.3% were males, with a median age (years) of 35 (IQR 30–39), 90.2% MSM and 48.7% PLWH. Compared to HIV-negative subjects, PLWH had more frequent high-risk behaviours:chemsex (p = 0.015), group sex (p = 0.027), and a history of sexually transmitted infections (STIs) (p = 0.004). Persons from EU were more often PLWH (p = 0.042), MSM (p < 0.0001), had multiple sexual partners (p = 0.025), practiced chemsex (p = 0.008) or group-sex (p = 0.005) and had more often history of STIs (p < 0.0001). The median CD4 cell count/mL at mpox diagnosis was 713 (IQR 486–996) and 73.5% had undetectable HIV VL. The commonest clinical features were fever (108 cases), lymphadenopathy (78), and vesiculo-pustular rash: penile (76), perianal (48), limbs (67). Fifty-one (31%) persons were hospitalized due to complications or epidemiological reasons. Three patients received tecovirimat or cidofovir. The outcome was favorable for all patients, including 4 with severe forms. Conclusions: Mpox was diagnosed predominantly in young MSM, with high-risk behaviors and history of STIs. Effective contact tracing and vaccination are important strategic pillars to control mpox outbreaks.