Two Cases of Monkeypox-Associated Encephalomyelitis - Colorado and the District of Columbia, July-August 2022

Monkeypox virus (MPXV) is an orthopoxvirus in the Poxviridae family. The current multinational monkeypox outbreak has now spread to 96 countries that have not historically reported monkeypox, with most cases occurring among gay, bisexual, and other men who have sex with men (1,2). The first monkeypo...

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Bibliographic Details
Published in:	MMWR. Morbidity and mortality weekly report 2022-09, Vol.71 (38), p.1212-1215
Main Authors:	Pastula, Daniel M, Copeland, Matthew J, Hannan, Markus C, Rapaka, Samuel, Kitani, Takashi, Kleiner, Elizabeth, Showler, Adrienne, Yuen, Cindy, Ferriman, Elizabeth M, House, Jennifer, O'Brien, Shannon, Burakoff, Alexis, Gupta, Bhavik, Money, Kelli M, Matthews, Elizabeth, Beckham, J David, Chauhan, Lakshmi, Piquet, Amanda L, Kumar, Rebecca N, Tornatore, Carlo S, Padgett, Kia, O'Laughlin, Kevin, Mangla, Anil T, Kumar, Princy N, Tyler, Kenneth L, O'Connor, Siobhán M
Format:	Article
Language:	eng
Subjects:	Antibodies Aquaporins Blood Colorado - epidemiology Complications District of Columbia Edema Encephalomyelitis Epidemiology Exanthema Full Report Health care Homosexuality, Male Human monkeypox Humans Illnesses Immunocompetence Immunoglobulins Infections Invasiveness Lymphadenopathy Magnetic resonance imaging Male Medical colleges Medical laboratories Men Monkeypox Monkeypox virus Mpox (monkeypox) - epidemiology Neurological complications Outbreaks Patients Public health Severe acute respiratory syndrome coronavirus 2 Sexual and Gender Minorities Smallpox Spinal cord Syphilis United States Viral infections Viruses
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Summary:	Monkeypox virus (MPXV) is an orthopoxvirus in the Poxviridae family. The current multinational monkeypox outbreak has now spread to 96 countries that have not historically reported monkeypox, with most cases occurring among gay, bisexual, and other men who have sex with men (1,2). The first monkeypox case in the United States associated with this outbreak was identified in May 2022 in Massachusetts (1); monkeypox has now been reported in all 50 states, the District of Columbia (DC), and one U.S. territory. MPXV is transmitted by close contact with infected persons or animals; infection results in a febrile illness followed by a diffuse vesiculopustular rash and lymphadenopathy. However, illness in the MPXV current Clade II outbreak has differed: the febrile prodrome is frequently absent or mild, and the rash often involves genital, anal, or oral regions (3,4). Although neuroinvasive disease has been previously reported with MPXV infection (5,6), it appears to be rare. This report describes two cases of encephalomyelitis in patients with monkeypox disease that occurred during the current U.S. outbreak. Although neurologic complications of acute MPXV infections are rare, suspected cases should be reported to state, tribal, local, or territorial health departments to improve understanding of the range of clinical manifestations of and treatment options for MPXV infections during the current outbreak.
ISSN:	0149-2195 1545-861X