The number of monkeypox cases in the US was underestimated

Most Hospitalized Monkeypox Patients in the U.S. Were H.I.V.-Positive and Infected with Monkeypox

New study from the Emerging Infectious Diseases (EID) research project at the University of Texas Medical Branch, Baltimore, finds that during the peak of monkeypox outbreaks in 2008, a large percentage (39.6%) of hospitalized patients in the US were H.I.V.-positive, and had monkeypox skin lesions. The findings indicate that during these periods, the medical community was less likely to have suspected Monkeypox patients or to have isolated the disease.

“There have been several monkeypox outbreaks in the United States in the past five years,” the authors wrote. “Most physicians were unaware of the disease during these outbreaks, and there were few public health actions to control them.”

During the peak of the 2008 monkeypox outbreak in the greater Washington, DC, area, the number of H.I.V. positive patients increased from one to four. One patient died, and the authors believe that the illness was not recognized as monkeypox by medical personnel. This, plus the fact that physicians were not aware of the disease’s presence, may have led to an underestimation of the actual number of patients.

The researchers then tracked the number of monkeypox cases in the US through January 18, 2009, noting the number of H.I.V. positive patients and the number of patients with monkeypox skin lesions. These findings are summarized in the graph below:

A total of 14 H.I.V. positive patients were identified, seven of whom were admitted to the hospital and admitted for fever and skin rash. Two were discharged (before H.I.V. was tested), one was hospitalized, and seven were sent home with a monkeypox skin rash.

“The majority of hospitalized patients had H.I.V. positivity, and it is likely that these patients had skin lesions of monkeypox,” the authors wrote. “

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