{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T13:04:48Z","timestamp":1784034288553,"version":"3.55.0"},"reference-count":19,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,5,27]],"date-time":"2023-05-27T00:00:00Z","timestamp":1685145600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In May 2022, an outbreak of mpox (monkeypox) in men\u2010who\u2010have\u2010sex\u2010with\u2010men (MSM) emerged and quickly affected over 100 countries. In the early stages of the outbreak, overlap in symptoms with sexually transmitted infections (STI) made triage for mpox testing challenging. More information was needed on whom to screen and the main route of transmission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We aimed to identify characteristics of mpox cases to further strengthen case definitions. We also compared Cycle threshold (Ct) values of the DNA positive mpox samples as a proxy for viral load by body location.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From 20 May 2022 to 15 September 2022, we tested all MSM who presented with malaise, and\/or ulcerative lesions, and\/or proctitis and\/or a papular\u2010vesicular\u2010pustular eruption attending the Centre of Sexual Health in Amsterdam, the Netherlands, for mpox, with a PCR test. In the same period, 6932 MSM mpox unsuspected clients were not tested. We compared those tested positive for mpox with those tested negative and those unsuspected for mpox.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 374 MSM tested, 135 (36%) were positive for mpox. The mpox\u2010positive MSM were older (median age, respectively, 36, 34 and 34\u2009years, <jats:italic>p<\/jats:italic>\u2009=\u20090.019) and more often lived with HIV (30% vs. 16% and 7%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Furthermore, mpox\u2010positive patients more often reported receptive anal sex without a condom, sexualized drug use, more sex partners, and were more often diagnosed with bacterial STI (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Systemic symptoms and anogenital lesions were associated with mpox infection. For mpox\u2010positive patients, anal samples (<jats:italic>p<\/jats:italic>\u2009=\u20090.009) and lesional samples (<jats:italic>p<\/jats:italic>\u2009=\u20090.006) showed significantly lower median mpox Ct values compared to throat samples.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Mpox\u2010positive patients more often reported receptive anal sex without a condom, had more sex partners and more often lived with HIV. Our results suggest that in the current mpox outbreak among MSM, sexual transmission is the main route.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.19223","type":"journal-article","created":{"date-parts":[[2023,5,22]],"date-time":"2023-05-22T12:45:09Z","timestamp":1684759509000},"page":"1891-1896","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Characteristics of mpox positive, versus mpox negative, and mpox unsuspected clients from the Centre of Sexual Health, Public Health Service of Amsterdam, 20 May to 15 September 2022"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9062-4105","authenticated-orcid":false,"given":"M. L.","family":"Siegenbeek\u00a0van\u00a0Heukelom","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases Public Health Service Amsterdam  Amsterdam The Netherlands"},{"name":"Department of Dermatology Amsterdam UMC, Location University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V. W.","family":"Jongen","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Public Health Service Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Schouten","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Public Health Service Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Hoornenborg","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Public Health Service Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Bruisten","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Public Health Service Amsterdam  Amsterdam The Netherlands"},{"name":"Amsterdam Institute for Infection and Immunity (AII), and Amsterdam Public Health Research Institute (APH)  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Westerhuis","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Public Health Service Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. R.","family":"Welkers","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Public Health Service Amsterdam  Amsterdam The Netherlands"},{"name":"Division of Infectious Diseases, Department of Internal Medicine Amsterdam UMC, Location University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. E.","family":"Vergunst","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Public Health Service Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Prins","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Public Health Service Amsterdam  Amsterdam The Netherlands"},{"name":"Amsterdam Institute for Infection and Immunity (AII), and Amsterdam Public Health Research Institute (APH)  Amsterdam The Netherlands"},{"name":"Division of Infectious Diseases, Department of Internal Medicine Amsterdam UMC, Location University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. F.","family":"Schim\u00a0van\u00a0der\u00a0Loeff","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Public Health Service Amsterdam  Amsterdam The Netherlands"},{"name":"Amsterdam Institute for Infection and Immunity (AII), and Amsterdam Public Health Research Institute (APH)  Amsterdam The Netherlands"},{"name":"Division of Infectious Diseases, Department of Internal Medicine Amsterdam UMC, Location University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9784-547X","authenticated-orcid":false,"given":"H. J. C.","family":"de Vries","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Public Health Service Amsterdam  Amsterdam The Netherlands"},{"name":"Department of Dermatology Amsterdam UMC, Location University of Amsterdam  Amsterdam The Netherlands"},{"name":"Amsterdam Institute for Infection and Immunity (AII), and Amsterdam Public Health Research Institute (APH)  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,5,27]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.o1874"},{"key":"e_1_2_11_3_1","unstructured":"ECDC highlights measures to mitigate possible increase in mpox cases during spring and summer. [last accessed 2023 Apr 21]. Available from:https:\/\/www.ecdc.europa.eu\/en\/news\u2010events\/ecdc\u2010highlights\u2010measures\u2010mitigate\u2010possible\u2010increase\u2010mpox\u2010cases\u2010during\u2010spring\u2010and\u2010summer"},{"key":"e_1_2_11_4_1","unstructured":"Multi\u2010country outbreak of mpox. External Situation Report 20 published 2023 Apr 13 [last accessed 2023 Apr 21]. Available from:https:\/\/www.who.int\/publications\/m\/item\/multi\u2010country\u2010outbreak\u2010of\u2010mpox\u2010\u2010external\u2010situation\u2010report\u2010\u201020\u2010\u201013\u2010april\u20102023"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0010141"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/v12020138"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/bioinformatics\/bty407"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)02075-X"},{"key":"#cr-split#-e_1_2_11_9_1.1","unstructured":"UK Health Security Agency.Mpox (monkeypox): case definitions London 2022. [updated 2022 Aug 9"},{"key":"#cr-split#-e_1_2_11_9_1.2","unstructured":"last accessed 2023 Jan 26]. Available from:https:\/\/www.gov.uk\/guidance\/monkeypox\u2010case\u2010definitions"},{"key":"e_1_2_11_10_1","unstructured":"Multi\u2010country outbreak of monkeypox. Geneva: WHO; 2022 [last accessed 2023 Jan 26]. Available from:https:\/\/www.who.int\/publications\/m\/item\/multi\u2010country\u2010outbreak\u2010of\u2010monkeypox\u2010\u2010external\u2010situation\u2010report\u2010\u20105\u2010\u2010\u20107\u2010september\u20102022"},{"key":"e_1_2_11_11_1","unstructured":"Monkeypox multi\u2010country outbreak \u2013 second update. Stockholm: European Centre for Disease Prevention and Control; 2022 [updated 2022 Oct 18; last accessed 2023 Jan 26]. Available from:https:\/\/www.ecdc.europa.eu\/sites\/default\/files\/documents\/Monkeypox\u2010multi\u2010country\u2010outbreak\u2010second\u2010update.pdf"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jviromet.2010.07.012"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jviromet.2016.07.024"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)01436-2"},{"key":"e_1_2_11_15_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmj-2022-072410","article-title":"Clinical features and novel presentations of human monkeypox in a central London centre during the 2022 outbreak: descriptive case series","volume":"378","author":"Patel A","year":"2022","journal-title":"BMJ"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-022-02004-w"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2022.27.27.2200471"},{"key":"e_1_2_11_18_1","unstructured":"World Health Organization.Mpox (Monkeypox) outbreak: global trends. Geneva Switzerland: World Health Organization; 2022 [last accessed 2023 Jan 26]. Available from:https:\/\/worldhealthorg.shinyapps.io\/mpx_global\/#31_Reporting_coverage"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.2807\/1560\u20107917.ES.2023.28.17.2200869"}],"container-title":["Journal of the European Academy of Dermatology and Venereology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jdv.19223","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T08:04:54Z","timestamp":1692950694000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jdv.19223"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,27]]},"references-count":19,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["10.1111\/jdv.19223"],"URL":"https:\/\/doi.org\/10.1111\/jdv.19223","archive":["Portico"],"relation":{},"ISSN":["0926-9959","1468-3083"],"issn-type":[{"value":"0926-9959","type":"print"},{"value":"1468-3083","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,27]]},"assertion":[{"value":"2023-02-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}