An emerging outbreak of monkeypox infection is quickly spreading worldwide, being currently reported in more than 30 countries, with slightly less than 1000 cases. In the present preliminary report, we collected and synthesized early data concerning epidemiological trends and clinical features of the ongoing outbreak and we compared them with those of previous outbreaks. Data were pooled from six clusters in Italy, Australia, the Czech Republic, Portugal, and the United Kingdom, totaling 124 cases (for 35 of which it was possible to retrieve detailed information). The ongoing epidemic differs from previous outbreaks in terms of age (54.29% of individuals in their thirties), sex/gender (most cases being males), risk factors, and transmission route, with sexual transmission being highly likely. Also, the clinical presentation is atypical and unusual, being characterized by anogenital lesions and rashes that relatively spare the face and extremities. The most prevalent sign/symptom reported was fever (in 54.29% of cases) followed by inguinal lymphadenopathy (45.71%) and exanthema (40.00%). Asthenia, fatigue, and headache were described in 22.86% and 25.71% of the subjects, respectively. Myalgia was present in 17.14% of the cases. Both genital and anal lesions (ulcers and vesicles) were reported in 31.43% of the cases. Finally, cervical lymphadenopathy was described in 11.43% of the sample, while the least commonly reported symptoms were diarrhea and axillary lymphadenopathy (5.71% of the case series for both symptoms). Some preliminary risk factors can be identified (being a young male, having sex with other men, engaging in risky behaviors and activities, including condomless sex, human immunodeficiency virus positivity (54.29% of the sample analyzed), and a story of previous sexually transmitted infections, including syphilis). On the other hand, being fully virally suppressed and undetectable may protect against a more severe infectious course. However, further research in the field is urgently needed.

An outbreak of monkeypox, a rare zoonotic disease caused by an orthopoxvirus, is currently ongoing and has spread so far to more than 20 countries, mostly affecting Europe, the Americas, Australia, and Israel, with more than 400 confirmed cases (https://bnonews. com/monkeypox/), becoming the largest monkeypox epidemic outside of western and central Africa, where it is endemic in eleven countries. 1 In the UK, where the first monkeypox case was reported on May 7, 2022, in a traveler returning from Nigeria, the National "Health Security Agency" (UKHSA) has reported that "a notable proportion of early cases detected have been in gay and bisexual men and so UKHSA is urging this community in particular to be alert" (https://www.gov.uk/government/news/monkeypox-casesconfirmed-in-england-latest-updates). Moreover, the "European Centre for Disease Prevention and Control" (ECDC) has stated that "the majority of cases have been in young men, many self-identifying as men who have sex with men (MSM)" (https://www.ecdc.europa.eu/ en/news-events/epidemiological-update-monkeypox-outbreak).These statements have been promptly relaunched by media and social networks, some of which have morbidly covered some events and festivals, like the "Gay Pride Maspalomas (Gran Canaria) 2022", held from May 5 to May 15, 2002, in Maspalomas, Great Canary (Spain), where about 80 000 people met from across the European

The present study indicated, for the first time, a significant correlation between HP infection and inflammation on the basis of NLR, a simple and reliable indicator of inflammation. Furthermore, there is an increase in NLR as the severity of gastritis with HP increases. This elevated ratio gets normalized with treatment.