[Outbreak of monkeypox in the Canary Islands from may 15 to june 6, 2022]. / Estudio descriptivo del brote de viruela del simio en las Islas Canarias, mayo a octubre de 2022.

OBJECTIVE: Since May 2022, non-endemic countries reported the appearance of non-imported cases of monkeypox (Mpox). Spain was one of the most affected countries. The objective of the study was to describe the clinical-epidemiological characteristics of the first confirmed cases of Mpox in the Canary Islands and the main difficulties in contact tracing. METHODS: Retrospective observational descriptive study with confirmed cases of Mpox and their close contacts in the Autonomous Community of the Canary Islands. We conducted a descriptive analysis, using frequencies and percentages for qualitative variables, and median (interquartile range) for quantitative variables. RESULTS: One hundred and seventy-seven cases of Mpox were reported in the Canary Islands, with a median age of 39 years (32.8-48.3); 46.6% were HIV seropositive, and 6.8% were foreign. The most frequent clinical symptom was anogenital rash (68.8%), and at pustules stage (61.4%). One hundred and three declared risky sexual behaviors. Only fifty-three (30%) collaborated in the identification of close contacts. There were difficulties in: establishing communication with the cases, communicating the isolation measures, requesting tests, and due to delayed sample processing. CONCLUSIONS: Most common clinical symptom at diagnosis is anogenital rash in pustule stage. Most of the cases report risky sexual relations. The main barriers in contact tracing are the difficulty in contacting cases, the lack of identification data and the lack of experience of health professionals regarding Mpox.

OBJETIVO: Desde mayo de 2022, países no endémicos notificaron la aparición de casos no importados de viruela del simio (Mpox), siendo España uno de los más afectados. El objetivo del estudio fue describir las características clínico-epidemiológicas de los casos confirmados de Mpox en las Islas Canarias y las principales dificultades en el rastreo de contactos. METODOS: Se realizó un estudio retrospectivo observacional descriptivo con casos confirmados de Mpox y sus contactos estrechos en la Comunidad Autónoma de Canarias. Se realizó un análisis descriptivo, indicando frecuencias y porcentajes para variables cualitativas y mediana (rango intercuartílico) para cuantitativas. RESULTADOS: Se notificaron ciento setenta y siete casos de Mpox en las Islas Canarias, con una mediana de edad de 39 años (32,8-48,3), un 46,6% de seropositivos por VIH, y un 6,8% de extranjeros. La manifestación clínica más frecuente fue exantema anogenital (68,8 %), y en estadio de pústulas (61,4%). Ciento tres declararon conductas sexuales de riesgo. Solo cincuenta y tres (30%) colaboraron en la identificación de contactos estrechos. Se produjeron dificultades al establecer comunicación con los casos, al comunicar las medidas de aislamiento, en la solicitud de pruebas y, finalmente, debido al procesamiento de muestras con retraso. CONCLUSIONES: La manifestación clínica más frecuente al diagnóstico es el exantema anogenital en estadio de pústulas. La mayoría de los casos reportan relaciones sexuales de riesgo. Las principales barreras en el rastreo de contactos resultan la dificultad para contactar con los casos, la falta de datos de identificación y la inexperiencia de los profesionales sanitarios en relación con Mpox.

Atypical presentation of sexually-transmitted monkeypox lesions.

BACKGROUND: Typically, skin lesions caused by monkeypox (MPX) begin as a monomorphic exanthema with centrifugal distribution, and can be found at different sequential stages in different regions of the body. The aim of this study is to present an atypical case of MPX infection that simultaneously presented exanthema at three stages of evolution in the same location. METHODS: This is a descriptive study of a confirmed case of MPX by detection of the virus genome in clinical sample by polymerase chain reaction. RESULTS: We describe a 40-year-old male patient with an unusual clinical presentation. One week after having multiple risky MSM sexual intercourses, the patient developed skin eruption on the penis. During the following 10 days, he progressively developed new lesions on the same area. These lesions simultaneously showed different stages of evolution (vesicles, pustules and crust). CONCLUSIONS: Contrary to expected clinical presentation of the disease, the patient developed lesions at different stages in the same location. Attending physicians must be aware of atypical initial presentation and evolution of the lesions, and conduct a comprehensive epidemiological survey.