In 2022, a global mpox outbreak occurred, primarily affecting gay and bisexual men who have sex with men (GBMSM). To screen for mpox's reemergence and investigate potentially unsuspected cases among non-GBMSM, prospective surveillance of patients aged ≥3 months with an mpox-compatible rash (vesicular, pustular, ulcerated, or crusted) was conducted at 13 U.S. emergency departments (EDs) during June-December 2023. Demographic, historical, and illness characteristics were collected using questionnaires and electronic health records. Lesions were tested for monkeypox virus using polymerase chain reaction. Among 196 enrolled persons, the median age was 37.5 years (IQR = 21.0-53.5 years); 39 (19.9%) were aged <16 years, and 108 (55.1%) were male. Among all enrollees, 13 (6.6%) were GBMSM. Overall, approximately one half (46.4%) and one quarter (23.5%) of enrolled persons were non-Hispanic White and non-Hispanic Black or African American, respectively, and 38.8% reported Hispanic or Latino (Hispanic) ethnicity. Unstable housing was reported by 21 (10.7%) enrollees, and 24 (12.2%) lacked health insurance. The prevalence of mpox among ED patients evaluated for an mpox-compatible rash was 1.5% (95% CI = 0.3%-4.4%); all persons with a confirmed mpox diagnosis identified as GBMSM and reported being HIV-negative, not being vaccinated against mpox, and having engaged in sex with one or more partners met through smartphone dating applications. No cases were identified among women, children, or unhoused persons. Clinicians should remain vigilant for mpox and educate persons at risk for mpox about modifying behaviors that increase risk and the importance of receiving 2 appropriately spaced doses of JYNNEOS vaccine to prevent mpox.

中文翻译：

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基于皮疹特征的猴痘监测 - 美国 13 个急诊科，2023 年 6 月至 12 月。


2022 年，全球爆发了猴痘疫情，主要影响男同性恋和双性恋男男性行为者 （GBMSM）。为了筛查 mpox 的再次出现并调查非 GBMSM 中可能未被怀疑的病例，2023 年 6 月至 12 月期间，美国 13 个急诊科 （ED） 对 ≥3 个月龄的 mpox 相容性皮疹（水泡、脓疱、溃疡或结痂）患者进行了前瞻性监测。使用问卷和电子健康记录收集人口统计学、病史和疾病特征。使用聚合酶链反应检测病灶是否感染猴痘病毒。在 196 名登记人员中，中位年龄为 37.5 岁 （IQR = 21.0-53.5 岁）;39 例 （19.9%） 年龄 <16 岁，108 例 （55.1%） 为男性。在所有入组者中，13 名 （6.6%） 是 GBMSM。总体而言，大约一半 （46.4%） 和四分之一 （23.5%） 的登记人员分别是非西班牙裔白人和非西班牙裔黑人或非裔美国人，38.8% 的人报告了西班牙裔或拉丁裔（西班牙裔）。21 名 （10.7%） 参保者报告了不稳定的住房，24 名 （12.2%） 缺乏健康保险。在评估为 mpox 相容皮疹的 ED 患者中，mpox 的患病率为 1.5% （95% CI = 0.3%-4.4%）;所有确诊 mpox 的人都被确定为 GBMSM 并报告为 HIV 阴性，未接种 mpox 疫苗，并且与通过智能手机约会应用程序认识的一个或多个伴侣发生性关系。在妇女、儿童或无家可归者中未发现病例。临床医生应保持对 mpox 的警惕，并教育有 mpox 风险的人如何改变增加风险的行为，以及接种 2 剂适当间隔的 JYNNEOS 疫苗预防 mpox 的重要性。