(The Lancet) Human monkeypox virus is spreading in Europe and the USA among individuals who have not travelled to endemic areas.
1 On July 23, 2022, monkeypox was declared a Public Health Emergency of International Concern by WHO Director-General Tedros Adhanom Ghebreyesus.
2 Human-to-human transmission of monkeypox virus usually occurs through close contact with the lesions, body fluids, and respiratory droplets of infected people or animals.
Two men who have sex with men attended Pitié-Salpêtrière Hospital, Paris, France, on June 10, 2022 (appendix). One man (referred to as patient 1 going forward) is Latino, aged 44 years, and lives with HIV with undetectable viral loads on antiretrovirals; the second man (patient 2) is White, aged 27 years, and HIV-negative. The men are non-exclusive partners living in the same household. They each signed a consent form for the use of their clinical and biological data, and for the publication of anonymised photographs. The men had presented with anal ulceration 6 days after sex with other partners. In patient 1, anal ulceration was followed by a vesiculopustular rash on the face, ears, and legs; in patient 2, on the legs and back. In both cases, rash was associated with asthenia, headaches, and fever 4 days later (figure A, B).
12 days after symptom onset, their male Italian greyhound, aged 4 years and with no previous medical disorders, presented with mucocutaneous lesions, including abdomen pustules and a thin anal ulceration (figure C, D; appendix). The dog tested positive for monkeypox virus by use of a PCR protocol adapted from Li and colleagues
In endemic countries, only wild animals (rodents and primates) have been found to carry monkeypox virus.
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