TEMPO.CO, Jakarta – Swelling around the penis and pain in the rectum have been reported by some infected people monkey pox in the current epidemic. The two symptoms had never been reported in previous outbreaks of the same viral infection.
Julia Bilinska of the Guy’s and St Thomas’ NHS Foundation Trust in London, England, and colleagues identified the symptoms of 197 people, all men, who tested positive for monkeypox at an infectious disease center in the city, last May-July. Except for one person, all of the men were known to be gay, bisexual or have had sex with other men.
As the results published on July 28, 2022, of the 197, 71 of them complained of rectal pain and 31 experienced swelling around the penis. In all, 20 people had to be hospitalized, eight of them for anal pain and five for swelling around the penis.
All the men had some form of lesions on their skin or mucous membranes, such as those of the mouth or genitals. Monkeypox is usually associated with a diffuse itching like chickenpox, which develops into lesions and then dries up. In 22 of the 197 participants, however, only a single lesion was present.
A total of nine participants also had tonsillitis. This is a symptom monkeypox others that are foreign.
As of July 28, neither the UK’s National Health Service (NHS) nor the US Centers for Disease Control and Prevention (CDC) nor the World Health Organization (WHO) have recognized anal pain, swelling around the penis or tonsillitis as symptoms of monkeypox.
However, on July 25, the NHS added single lesions or lesions limited to the genitals or anus and surroundings to the list of symptoms of monkeypox, as did proctitis–pain or bleeding in the rectum.
Most (86 percent) of the participants reported other symptoms common to monkeypox in previous outbreaks. Symptoms include fever (62 percent), swollen lymph nodes (58 percent) and muscle aches and pains (32 percent).
According to Bilinska, it is not yet clear why the current monkeypox outbreak can cause new symptoms in some people. “This may be a natural change from the disease, or this is due to the transmission that occurs. Further research is needed to answer it,” he said.
While it can take time for a new symptom to be added to the official list, Bilinska said the signs of infection should not be ignored. “If you know the signs or symptoms, you can screen everyone and get them checked out early,” he said.
Of the 197 participants, 70 were known to be HIV positive and 56 had sexually transmitted infections. “It’s also very possible that having two infections of the disease together makes the symptoms worse,” Bilinska said. “That’s why it’s so important if a doctor thinks ‘this might be monkeypox’, they should also think ‘what screening can I do for sexually transmitted infections?’
People wait to be vaccinated at a monkeypox vaccination site in New York, United States (US), July 14, 2022. The US is increasing testing capacity and vaccine supply to tackle the monkeypox outbreak as more than 1,000 confirmed cases have been reported nationwide. Xinhua/Michael Nagle
The researchers also found that only 26.5 percent of participants reported having close contact with someone who was confirmed positive for monkeypox or known to have had symptoms of the disease before. “This clearly raises the possibility that someone may have no symptoms but can transmit it,” Bilinska said, pointing out that asymptomatic people may have mild symptoms or may have unrecognized symptoms.
In a study published on 21 July 2022, Chloe Orkin of Queen Mary’s University of London and colleagues found the same number of 528 diagnoses of monkeypox infection in 16 countries between April and June. A total of 54 people are said to have only one lesion on their skin. Precisely around the genitals.
“These can be lesions around the penis, anal and mouth appearing at the site of first contact with the virus. Or, otherwise, transmitted sexually or through close contact,” Orkin said at the time.
NEW SCIENTIST, BMJ
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