As cases of monkeypox continue to increase in the United States and abroad, infectious disease specialists are particularly closely monitoring one group of women.
So far, the overwhelming majority of cases of viral disease have been reported in men who have sex with men. But recently, authorities have learned about a small number of cases of women — indicating that the outbreak may be widespread.
Researchers closely monitor the proportion of female cases to “assess whether the outbreak is moving away” from a network of men who have sex with men, most of whom have been identified in the first case. .. briefing From the UK Health Security Agency (UKHSA).
“There is insufficient evidence to support changes in transmission dynamics,” the agency said. “But as the proportion of female cases has increased in recent weeks, this trend needs to be carefully monitored.”
With the worldwide cooperation of researchers and clinicians, 528 cases of monkeypox have recently been reported in 16 countries, but not women.
Since collecting data for that study The study group ended in June and confirmed female cases, said study co-author John P. Thornhill, MD, a sexual health consultant. HIV Senior Clinical Lecturer at Barts Health NHS Trust and Queen Mary University of London.
“Women’s cases have certainly been reported, but are now much less common,” Thornhill said. Medscape Medical News..
Infections in women were outliers at the time of their current outbreak, but can be severe when they do occur. Some women in the United Kingdom were hospitalized with severe symptoms.
According to July 21, a similar pattern was seen in New York City, with only one woman out of 639 cases. report From the city health agency.
Researcher recently published Guidance on monkeypox for ob / gyns, Perinatal Medicine SubspecialistWhen Pregnant or lactating person In anticipation of the possibility of more cases in women.
Centers for Disease Control and Prevention (CDC) advice If necessary, monkeypox “pregnant, recently pregnant, and lactating people should be treated first.”
One of the monkeypox vaccines, Jynneos, is ideally within 4 days of exposure, based on confirmed or likely contact with pregnant or lactating individuals, or cases. Can be provided to those who are eligible for vaccination. Some people at high risk of exposure, such as laboratory workers, may be vaccinated preemptively.
According to the CDC, another vaccine, ACAM2000, is contraindicated in pregnant or lactating people.
Transmission dynamics
Investigators have not yet identified a substantial spread of monkeypox beyond men who have sex with men, but infections have been reported among household contacts, including women and children.
Most early infections currently occurring occurred during sexual activity.But monkeypox Can spread According to the CDC, through close contact with skin lesions and body fluids, and perhaps through contact with contaminated items such as clothing and linen. It can also spread from mother to child in the womb.
Infected pets are also known to spread the disease. Multi-state monkeypox that occurred in the United States in 2003 Linked Prairie dogs as pets Childcare and school settings.. That year, 55% of 71 cases occurred in female patients.
More tests for men, higher positive rates
Since May, men have been tested for monkeypox more than women in the UK, with 3467 men and 447 women. Among those tested, the positive rate was much higher in men than in women, 54% vs. 2.2%, respectively.
As of July 20, about 0.65% of UK cases of known gender were women. Two weeks ago, about 0.4% were women.
According to the UKHSA, a total of 13 cases of monkeypox in the UK were women, and 4 had serious symptoms requiring hospitalization.
World wide, More than 16,000 monkeypox cases According to the World Health Organization, it has been reported.The agency said that Will change the name of the illness To reduce stigma.
Monkeypox and pregnancy
Denise J. Jamieson, MD, MPH of Emory University in Atlanta, Georgia, said Ob / gyms are often “at the forefront in identifying people with infections.” Jamison co-authored “Introduction to Monkeypox Virus for Obstetricians and Gynecologists”. Released on July 11 of Obstetrics and gynecology..
“Obstetricians need to know which infections are prevalent and what’s happening in the community,” she said.
In the case of monkeypox, “no one knows how widespread this will be,” Jamison said.
“The first cases of monkeypox in the current outbreak occurred primarily, but not limited to, among men having sex with men. Increased infection in this group is facilitated and complex by sexual activity. It can spread through sexual networks, “said Thornhill. “As the outbreak continues, more monkeypox infections are likely to be seen outside the group.”
“People who work in sexual health should have high suspicion indicators in all individuals with genital and oral ulcers and in all individuals with proctitis,” he added.
Chloe M. Orkin, MD, a professor of HIV medicine at Queen Mary University of London, said the chain of infections at home was short, usually a few, during previous monkeypox outbreaks. Orkin oversees the Sexual Health and HIV All East Research (SHARE) Collaborative, which has worked on the editing of international case series.
Monkeypox is transmitted primarily among men who have sex with men, but not all identities are gay, and there may be women and non-binary partners, Orkin said.
“Clinicians should keep this in mind when examining a person,” she said.
