In one week, the health service registered 67 new cases of monkeypox, and in 2024 there will already be 334 cases (Castilla-La Mancha, Society)

The Ministry of Health published this Wednesday an update on the epidemiological situation of monkeypox cases, which shows an increase of 67 cases compared to the previous report published on August 19, reaching 334 cases in 2024 compared to the 323 cases that were recorded last year for the whole of 2023.

The new update, with data up to August 26, includes a total of 8,178 confirmed cases of mpox infection since the outbreak began in April 2022 in 17 autonomous communities. Specifically, since the publication of the previous report on August 19, cases of mpox infection in Spain have increased by 20 percent, although all of them still belong to the old variant that was already present in Spain.

The autonomous communities that have registered the highest number of cases of oppox are: the Community of Madrid (144 cases), where 118 cases were registered the previous week; Andalusia (79), the same as the previous week; and Catalonia (54), where 23 cases were registered the previous week. However, according to data collected by the Ministry of Health, there are still four autonomous communities that have not registered cases of smallpox, namely: Aragon, Asturias, Navarre and La Rioja.

Of the 334 cases reported in 2024, 318 (95.2%) had a symptom onset date. Most were men (98.1%), with ages ranging from 6 to 76 years, with a median of 37 years. 63.5 percent of cases were aged 30 to 49 years, and 48.1 percent of cases were born in Spain.

In August 2024, 18 cases were reported, with symptom onset dates between 5 and 19 August. The autonomous communities reporting cases that month were Madrid (11 cases), Castilla-La Mancha (2 cases), Andalusia (1 case), Catalonia (1 case), Cantabria (1 case), Castilla y León (1 case) and Murcia (1 case).

In total, 238 cases (74.8%) had some systemic symptoms (fever, asthenia, sore throat, muscle pain or headache) throughout the clinical process, with fever being the most common (186 cases, 58.5%); localized lymphadenopathy was observed in 154 cases (48.4%). The rash was located in the anogenital region in 238 cases (74.8%), in the orobuccal region in 53 cases (16.7%) and in other localizations in 171 cases (53.8%).

In addition, 32 patients (11.4% of 280 cases for which information is available) experienced complications throughout the clinical process: secondary bacterial infection (13 cases), oral ulcer (7 cases), corneal infection (4 cases), myocarditis (1 case), proctitis (1 case) and 6 cases with other complications. There were 15 hospitalizations (4.7%).

All were men, with an average age of 34 years.

Regarding vaccination, 283 cases (89%) were unvaccinated or their vaccination status was unknown, 31 cases (9.8%) were vaccinated against smallpox in the current outbreak, and four cases (1.3%) were vaccinated against smallpox in childhood. Of the 31 cases vaccinated with smallpox vaccine, 8 (25.8%) received a single dose, 20 (64.5%) received two doses, and in 3 cases (9.7%) the number of doses was unknown.

SHOW CHARACTERISTICS

In terms of exposure characteristics, of the 274 cases for which information is available, 49 (17.9%) reported close contact with a probable or confirmed case. Forty cases reported travel within 21 days prior to the date of symptom onset, although only nine were classified as imported cases.

For seven imported cases, travel destination information is available (Morocco (2 cases), Andorra (1 case), Czech Republic (1 case), Hungary (1 case), Serbia (1 case), and the United States (1 case)). A family outbreak was detected involving three family members. None of them required hospitalization.

The most likely mechanism of transmission was due to close contact in the context of sexual relations in 257 cases (80.8%), in 13 cases it was due to close contact in a non-sexual context (4.1%) and in 48 cases this information was not available (15.1%). Regarding the sexual orientation of the victims, excluding minors, 246 cases (77.6%) were men who had sex with other men, nine cases (2.8%) were heterosexual men, four cases (1.3%) were heterosexual women and in 58 cases (18.3%) the information was not available.