Other monkeypox studies of interest
Simon Collins, HIV i-Base
US CDC Science brief: updated research on MPX transmission
A comprehensive health briefing from the US CDC updates latest research about detection and transmission of MPX.
US CDC. Science brief: Detection and transmission of monkeypox virus. (18 October 2022).
Intradermal vaccination for monkeypox — benefits for individual and public health
This perspective article in the NEJM outlines the importance of using intradermal vaccine delivery for the MPX vaccine.
Ref: Brooks JT. Intradermal vaccination for monkeypox — benefits for individual and public health. N Engl J Med 2022; 387:1151-1153. DOI: 10.1056/NEJMp2211311. (29 September 2022).
Review of 546 MPX cases in German outbreak
Results from a retrospective study of all confirmed cases from May to 30 June 2022 from 42 centres.
The paper included clinical characteristics, comorbidities, and coinfections, including HIV, viral hepatitis, and sexually transmitted infections (STIs).
All cases were in gay men: 47% were living with HIV and 42% were taking PrEP. Median age was 39 (range: 20 to 67).
Ref: Hoffmann C et al. Clinical characteristics of monkeypox virus infections among men with and without HIV: A large outbreak cohort in Germany. (4 September 2022).
Positive anorectal swabs in men with and without proctitis
This paper in CID on 18 gay men (10/18 were HIV positive) with MPX reported positive MPX DNA swabs in 9/9 with and 7/9 without proctitis. Testing was taken after a mean 4.6 days (range 1-8) after first symptoms. Both the negative cases had received the MPX vaccines before symptoms.
All 9/9 participants with follow up had negative swabs taken a mean of 26 days from initial symptom onset (range 21 to 32), including six men who presented with proctitis.
Monkeypox cases in children and infants including neonatal transmission
Details of the complications and management of an infant <2 months old are detailed in a separate report. 
A UK case of perinatally acquired MPX and adenovirus coinfection in a 10-day-old infant was reported in a letter to the NEJM.
The baby developed a rash nine days after birth. The likely route of inadvertent transmission was identified as the father having a disseminated rash nine days before the birth and the mother developing a rash four days after the birth. The baby was transferred to neonatal intensive care on day 15 and discharged four weeks after recovery. 
- CDC. Monkeypox. Monkeypox cases by age and gender, race/ethnicity, and symptoms. Atlanta, GA: US Department of Health and Human Services, CDC; 2022.
- Saunders KE et al. Monkeypox in a Young Infant — Florida, 2022. MMWR Morb Mortal Wkly Rep 2022;71:1220–1221.
- Ramnarayan P et al. Neonatal Monkeypox Virus Infection. NEJM correspondaece. DOI: 10.1056/NEJMc2210828. (12 October 2022).
Monkeypox in pregnancy
A review in Lancet Infections Diseases that includes ten cases of MPX in pregnancy during the current outbreak. Luckily none have been severe but the article highlights the importance of an international registry of cases.
Ref: Khalil A et a. Monkeypox in pregnancy: update on current outbreak Lancet Inf Dis. DOI: 10.1016/S1473-3099(22)00612-0. (14 September 2022).
Monkeypox: challenging clinical questions
A free webinar from the Annals of Internal Medicine that includes three MPX case studies and a useful panel discussion.
Occupational needlestick MPX infection: single lesion despite vaccine
A case report published in the US MMWR included a health worker who developed MPX after recapping a needle (even though it recommended to not do this). The worker received a single shot of the MPX injection 16 hours after the exposure. However, 10 days later, a single PCR-confirmed MPX lesion occurred at the injury site.
Ref: Mendoza R et al. Monkeypox virus infection resulting from an occupational needlestick — Florida, 2022. MMWR Morb Mortal Wkly Rep. ePub: 17 October 2022.