The Evolving Monkeypox Outbreak Amongst Homosexual and Bisexual Transmission: A Systematic Review

Authors

  • Hanny Nilasari University of Indonesia
  • Monica Trifitriana Sriwijaya University
  • Ratrisha Anadya Padjadjaran University
  • Levina Ameline Diponegoro University
  • Dian Pratiwi Bogor Agricultural Institute

Keywords:

Monkeypox, Homosexuals, MSM, STI, Systematic review

Abstract

Background: Monkeypox is a viral zoonotic disease. It has evolved into human-to-human transmissionwith similar characteristics to smallpox. In contrast with the previous endemic outbreak, this 2022multinational outbreak found numerous data of different skin lesions, predilections and populations. Furthermore, recent findings regarding monkeypox revealed the possibility of sexual transmission. Objective:   As a basis for future monkeypox diagnosis guidelines, providing comprehensive data on the symptoms, predilections, age at presentation, previous history of sexual activities, comorbidities, range of incubation period from the time of sexual activity until the symptoms occured, as criteria for diagnosis of sexual transmitted disease. Method: We performed a comprehensive search on a topic that assesses the outbreak of monkeypoxdisease in 2022 regarding the route of transmission from inception up until September 2022. Result: There were 1310 patients from 10 studies who had monkeypox disease in 2022. Patients were mostly found in European countries, with averaging in their 30s, and were 99,54 % male. Vesiculopustular lesions and ulcers with central umbilication appeared prior to prodromal signs were characteristic.Approximately 90% were transmitted during sexual intercourse and in homosexual group (MSM / Menwho have sex with men), and 5-10% between bisexuals. Approximately 40,84% cases also had HIV as a comorbid disease and 15,42% have concurrent or history of sexually transmitted infection (STI) includingsyphilis, gonorrhea, chlamydia, herpes simplex, mixed, and other STIs. Conclusion: Homosexual and bisexual populations are the most high risk populations in the 2022 outbreak of monkeypox disease. The epidemiology, clinical manifestation, and type of skin lesion were different from the previous outbreak. The findings in this review may supplement information to furtherestablish clinical guidelines on the new presentation of monkeypox disease. Further large-scale studies are necessary to further describe and verify the data with higher levels of evidence.

Author Biographies

Hanny Nilasari, University of Indonesia

Department Dermatology and Venereology, Faculty of Medicine University of Indonesia

Ratrisha Anadya, Padjadjaran University

Faculty of Medicine, Padjadjaran University, West Java, Indonesia

Levina Ameline, Diponegoro University

Faculty of Medicine, Diponegoro University, Central Java, Indonesia

Dian Pratiwi, Bogor Agricultural Institute

Faculty of Animal Biomedical Sciences, Bogor Agricultural Institute, Indonesia

References

Alakunle E, Moens U, Nchinda G, Okeke MI. Monkeypox Virus in Nigeria: Infection Biology, Epidemiology, and Evolution. 2020;29.

Vaughan A, Aarons E, Astbury J. Two cases of monkeypox imported to the United Kingdom, September 2018. Eurosurveillance [Internet]. 2018 Sep 9 [cited 2022 Aug 18]; Available from: /pmc/articles/PMC6157091/

Taylor L. Monkeypox: WHO declares a public health emergency of international concern. Available from: Available from: http://dx.doi.org/10.1136/bmj.o1874

The Indonesian Ministry of Health. Kasus Monkepox Pertama di Indonesia Terkonfirmasi [Internet]. Sehat Negeriku. [cited 2022 Sep 8]. Available from: URL: https://sehatnegeriku.kemkes.go.id/baca/rilis-media/20220820/3140968/kasus-monkeypox-p ertama-di-indonesia-terkonfirmasi-2/

Moore J, Rathish B, Zahra F. Monkeypox. StatPearls. 2022 Jul 16 [cited 2022 Aug 18]; Available from: https://www.ncbi.nlm.nih.gov/books/NBK574519/

Antinori A, Mazzotta V, Vita S, Carletti F, Tacconi D, Lapini LE, et al. Epidemiological, clinical and virological characteristics of four cases of monkeypox support transmission through sexual contact, Italy, May 2022. Eurosurveillance [Internet]. 2022 Jun 2 [cited 2022 Aug 14];27(22). Available from: https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2022.27.22.2200421

Girometti N, Byrne R, Bracchi M, Heskin J, McOwan A, Tittle V, et al. Demographic and clinical characteristics of confirmed human monkeypox virus cases in individuals attending a sexual health centre in London, UK: an observational analysis. Lancet Infect Dis [Internet]. 2022 Jul [cited 2022 Aug 14];S147330992200411X. Available from: https://linkinghub.elsevier.com/retrieve/pii/S147330992200411X

Hammerschlag Y, MacLeod G, Papadakis G, Adan Sanchez A, Druce J, Taiaroa G, et al. Monkeypox infection presenting as genital rash, Australia, May 2022. Eurosurveillance [Internet]. 2022 Jun 2 [cited 2022 Aug 14];27(22). Available from: https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2022.27.22.2200411

Thornhill JP, Barkati S, Walmsley S, Rockstroh J, Antinori A, Harrison LB, et al. Monkeypox Virus Infection in Humans across 16 Countries — April–June 2022. N Engl J Med [Internet]. 2022 Jul 21 [cited 2022 Aug 14];NEJMoa2207323. Available from: http://www.nejm.org/doi/10.1056/NEJMoa2207323

Irith D, Christophe V, Kenyon C, Coppens J, Dorien V, Hilde S, et al. Asymptomatic monkeypox virus infections among male sexual health clinic attendees in Belgium. 2022.

Jang YR, Lee M, Shin H, Kim JW, Choi M min, Kim YM, et al. The First Case of Monkeypox in the Republic of Korea. J Korean Med Sci [Internet]. 2022 [cited 2022 Aug 14];37(27):e224. Available from: https://jkms.org/DOIx.php?id=10.3346/jkms.2022.37.e224

Iñigo Martínez J, Gil Montalbán E, Jiménez Bueno S, Martín Martínez F, Nieto Juliá A, Sánchez Díaz J, et al. Monkeypox outbreak predominantly affecting men who have sex with men, Madrid, Spain, 26 April to 16 June 2022. Eurosurveillance [Internet]. 2022 Jul 7 [cited

Aug 14];27(27). Available from: https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2022.27.27.2200471

Peiró-Mestres A, Fuertes I, Camprubí-Ferrer D, Marcos MÁ, Vilella A, Navarro M, et al. Frequent detection of monkeypox virus DNA in saliva, semen, and other clinical samples from 12 patients, Barcelona, Spain, May to June 2022. Eurosurveillance [Internet]. 2022 Jul

[cited 2022 Aug 14];27(28). Available from: https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2022.27.28.2200503

Patel A, Bilinska J, Tam JCH, Da Silva Fontoura D, Mason CY, Daunt A, et al. Clinical features and novel presentations of human monkeypox in a central London centre during the 2022 outbreak: descriptive case series. BMJ [Internet]. 2022 Jul 28 [cited 2022 Aug 14];e072410. Available from: https://www.bmj.com/lookup/doi/10.1136/bmj-2022-072410

Ortiz-Martínez Y, Rodríguez-Morales AJ, Franco-Paredes C, Chastain DB, Gharamti AA, Vargas Barahona L, et al. Monkeypox – a description of the clinical progression of skin lesions: a case report from Colorado, USA. Ther Adv Infect Dis [Internet]. 2022 Jan [cited 2022 Aug 14];9:204993612211177. Available from: http://journals.sagepub.com/doi/10.1177/20499361221117726

De Baetselier I, Van Dijck C, Kenyon C, Coppens J, Michiels J, de Block T, et al. Retrospective detection of asymptomatic monkeypox virus infections among male sexual health clinic attendees in Belgium. Nat Med. 2022.

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Published

2024-05-06

How to Cite

1.
Nilasari H, Trifitriana M, Anadya R, Ameline L, Pratiwi D. The Evolving Monkeypox Outbreak Amongst Homosexual and Bisexual Transmission: A Systematic Review. J Pak Assoc Dermatol [Internet]. 2024May6 [cited 2024May22];34(1):243-54. Available from: https://jpad.com.pk/index.php/jpad/article/view/2502

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Review Articles