Characteristics of 86 individuals with mpox diagnosed at Copenhagen University Hospital.

INTRODUCTION: Since the beginning of the mpox (previously called monkeypox) outbreak in 2022, almost half of cases in Denmark have been diagnosed at the Department of Infectious Diseases, Copenhagen University Hospital - Amager and Hvidovre Hospital. This article describes the patient cohort seen at the Department with a view to increasing knowledge of mpox among colleagues who are most likely to identify future cases. METHODS: A retrospective observational study reporting patient characteristics, coinfections, clinical presentation and diagnostic delay among mpox cases diagnosed at the department between 23 May 2022 and 8 February 2023. Furthermore, a case report of a patient hospitalised with severe rectal pain is presented to highlight anorectal symptoms. RESULTS: A total of 86 patients were diagnosed with mpox, all were men who have sex with men, with a median age of 39 years. Twenty-six patients (31%) took HIV pre-exposure prophylaxis, and 20 patients (24%) were people living with HIV. All patients (100%) presented with lesions, most frequently on or around the genitals. Twenty-nine patients (35%) had anorectal discomfort or pain. Seven patients (10%) had chlamydia, 19 (26%) gonorrhoea and two (5%) syphilis. In 13 cases (15%), mpox was not suspected at the first medical consultation, mainly because symptoms were attributed to a gonorrhoeal coinfection. Five patients (6%) were hospitalised for a median of three days. CONCLUSION: As mpox may become endemic in Denmark, clinicians should remain aware of its symptoms and the risk of coinfection with sexually transmitted infections. FUNDING: None. TRIAL REGISTRATION: Not relevant.

Tuberculosis screening among newly arrived asylum seekers in Denmark.

BACKGROUND: Tuberculosis (TB) screening programmes among asylum seekers tend to focus on chest radiography (CXR) for early diagnosis, whereas knowledge on sputum examination is limited. We evaluated active TB screening using CXR and sputum culture among asylum seekers arriving in Denmark. In addition, we assessed the coverage of a voluntary health assessment. METHODS: Between 1 February 2017 and 31 March 2019, all newly arrived asylum seekers in Denmark ≥ 18 years from TB high-incidence countries or risk groups, who attended a voluntary general health assessment, were offered active TB screening with CXR and spot sputum examination. Sputum samples were examined by culture and smear microscopy. RESULTS: Coverage of the general health assessment was 65.1%. Among 1,154 referred for active TB screening, 923 (80.0%) attended. Of these, 854 were screened by CXR and one case of active TB was identified equivalent to a yield of 0.12%. Sputum samples were collected from 758 and one M. tuberculosis culture-positive TB case (also identified by CXR) was identified, equivalent to a yield of 0.13%. No cases were found by sputum culture screening only. In addition, screening found three cases of malignant disease. CONCLUSION: We suggest that TB screening should focus on asylum seekers from TB high-incidence countries. Furthermore, early health assessments should be of high priority to ensure migrant health.