Clinical and Epidemiological Characteristics of the 2022 Mpox Outbreak in Spain (CEME-22 Study)

Abstract

Background We conducted a multicentric national study (SEIMC-CEME-22), to describe the clinical and epidemiological profile of the Mpox outbreak in Spain, including the management of the disease. Methods Retrospective national observational study conducted by SEIMC and Foundation SEIMC-GESIDA. We included patients with a confirmed Mpox diagnosis before 13th July 2022, and attended at the Spanish health network (the early phase of the outbreak). Epidemiological, clinical and therapeutic data were collected. Results 1,472 patients from 52 centers were included. 99% of them were cis-gender men, middle-aged. 98.6% were residents in Spain. Main suspected route of transmission was sexual exposure, primarily among MSM. Occupational exposure was reported in 6 individuals. Immunosuppression was present in 40% of patients, mainly due to HIV. Only 6.5% of patients had been vaccinated against orthopoxvirus. Virus sequencing was performed in 147 individuals (all of them B.1 lineage). Rash was the most frequent symptom (95.7%), followed by fever (48.2%), adenopathies (44.4%) myalgias (20.7%), proctitis (17%) and headache (14.7%). Simultaneously diagnosed STI included syphilis (129), gonococcal infection (91), HIV (67), chlamydiasis (56), hepatitis B (14) and hepatitis C (11). No therapy was used in 479 individuals (33%). Symptomatic therapies and antibiotics were used in 50% cases. Most used therapy were systemic corticoids (90 patients), tecovirimat (6) and cidofovir (13). Smallpox immunoglobulins were used in one patient. Fifty-eight patients were hospitalized. One patient died. Conclusions Mpox outbreak in Spain affected primarily middle-aged men who were sexually active and showed a high rate of HIV infection. A range of heterogeneous therapeutics options were performed.