Monkeypox Outbreak: Biweekly Update (October 31, 2022)

The CDC report reveals that most patients hospitalized with severe monkeypox complications are HIV-positive. In rare cases, monkeypox can affect the eyes and cause vision impairment.

As the monkeypox outbreak slows down, Healthnews is moving to biweekly updates.

The Centers for Disease Control and Prevention (CDC) data shows that as of October 28, there are 28,302 confirmed cases of monkeypox in the US.

Most hospitalized patients have HIV

A report from the CDC shows that most people hospitalized with severe monkeypox tested positive for HIV.

From August 10 to October 10, 2022, the CDC provided consultation for 57 adult patients hospitalized with severe complications of monkeypox. Among the patients, 54 (95%) were male, with an average age of 34 years, and 47 (82%) were HIV-positive. Among those HIV-positive, 72% had a very low CD4 count (<50 CD4 cells per mm³).

Of those hospitalized with severe monkeypox, 12 (21%) patients died. Monkeypox was a cause of death or contributing factor in five of these deaths, while six deaths remain under investigation to determine what role monkeypox played in them. In one death, monkeypox was not a cause or contributing factor.

According to the report, most patients eventually received tecovirimat (TPOXX), the FDA-approved drug against smallpox, which is also used to treat monkeypox.

However, some underwent monkeypox-directed therapy with a delay of up to 4 weeks. Therefore, the CDC recommends health care providers consider starting treatment early in patients with AIDS and other types of severe immunocompromise.

Most hospitalized patients were Black (68%), and 13 (23%) were experiencing homelessness.

“These findings likely reflect inequities in access to resources for the prevention, early diagnosis, and treatment of HIV infection, as well as missed opportunities to engage groups that have been socially or economically marginalized,” the report says.

Five cases of ocular monkeypox

The CDC report from October 21 describes five cases of ocular monkeypox, which can occur when the monkeypox virus is introduced into the eye from another part of the body. The condition can cause conjunctivitis, blepharitis, keratitis, and loss of vision.

All five patients received treatment with tecovirimat (TPOXX), and four of them were hospitalized. One patient experienced marked vision impairment.

To decrease the risk of transferring the virus from other parts of the body to the eyes, the CDC recommends people with monkeypox practice hand hygiene and avoid touching their eyes, which includes refraining from using contact lenses.

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