Title : Mpox in patients seen at the research institute for tropical medicine: A case series
Abstract:
Background: WHO declared the Mpox outbreak as a public health emergency of international concern twice in 3 years, in July 2022 and August 2024. To date, the Philippines has reported 15 confirmed cases. We described the demographics, clinical presentations, transmission risks, outcome and viral genetic clades of confirmed mpox cases seen in our institution.
Methods: Data were obtained from cases seen and RT-PCR-confirmed at the Research Institute for Tropical Medicine Special Pathogens Laboratory. Analyses were descriptive.
Findings: Six cases described in this report consisted of five cisgender men who have sex with men – three of which were known to be living with HIV with good virologic response to ART – and one cisgender female. Median age is 31 years old. Two cases had history of international travel prior to symptoms.
The cases commonly presented with any rash (100%), fever 100%), malaise (100%), genital rash (67%), localized lymphadenopathy (16.67%), and headache (16.67%). All skin lesions were umbilicated, presenting as vesicles (100%), papules (83%), or pustules (50%).
Secondary bacterial skin infections were reported in two cases. Post-mpox sequelae included post-inflammatory hyperpigmentation and scarring of previous lesions. There were no severe complications or deaths. Genetic analysis identified MPXV clade II in five cases and MPXV clade III in one case.
Conclusion: The current mpox outbreak emphasized the threat of emerging and re-emerging infectious diseases to global and local communities. Our case series provides insights into the clinical manifestations, transmission, and outcomes of mpox, in patients with MSM and PLHIV. The data aligns with the current global outbreak, highlighting the disproportionate impact on young males who engage in high-risk sexual behaviors. The mild disease presentations in HIV patients emphasize the importance of ART adherence in preventing severe complications. Although limited by its small sample size, this study underscores the need for ongoing surveillance and targeted public health interventions. Public health efforts should focus on raising awareness, promoting safe sexual practices, and ensuring early diagnosis and treatment to control the spread of mpox within high-risk populations.