Monkeypox Virus Outbreak 2022: Key Epidemiologic, Clinical, Diagnostic, and Prevention Considerations.
Jeffrey Kwong, Katherine C McNabb, Joachim G Voss and 3 others
PMID 37099022WHAT IT FOUND
Monkeypox lesions can appear on mucosal surfaces without external signs, causing pain in the rectum, urethra, or vagina.
Forty-two percent of initial US cases lacked prodromal fever or fatigue. Nurses should screen for concurrent STIs and assess pain intensity independently of visible skin lesion severity.
Key findings
01Patients may present with painful sensations in the rectum, urethra, vagina, or oral pharynx without any external lesions, and 42% of initial US cases lacked prodromal symptoms like fever.
02The severity of visible skin lesions does not reliably reflect symptom intensity, as internal lesions can cause severe pain despite limited external findings.
03Nearly 30% of documented cases in the current outbreak had a co-occurring sexually transmitted infection diagnosis.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a narrative review, not a systematic review, so it does not report a formal search strategy or risk of bias assessment. The data reflects the evolving situation in mid-2022, and guidance may have changed since publication. Evidence on specific treatments like tecovirimat is based on smallpox approvals and limited monkeypox data rather than large randomized trials. The review notes that knowledge of true incidence and transmission modes, particularly asymptomatic spread, remains limited.
Declared interests
The publication types indicate research support from the U.S. National Institutes of Health and non-U.S. government sources. No specific financial conflicts of interest for the authors are detailed in the provided text.
The easy way to misread this
Do not assume a patient is free of monkeypox because they lack fever or visible external skin lesions. Internal mucosal lesions can cause severe pain and shedding, and 42% of early cases had no prodromal symptoms.