Monkey pox | New symptoms that may be mistaken for tonsillitis or syphilis

The rapidly rising trend in monkeypox is scaring some experts. Vaccines, health alerts, news in the media are some of the outlets offered by countries to raise awareness and mitigate the proliferation of cases. Spain is one of the countries most affected by monkeypox in the world. The Ministry of Health has already notified a total of 4,500 infections, of which 1,766 are recorded in Madrid, followed by Catalonia with 1,463 and Andalusia with 545, according to the latest data.

Symptoms go beyond the rash so characteristic of the disease: muscle aches, fever, chills, exhaustion, headache, back pain or swollen lymph nodes.

However, a new study published in the medical journal The BMJ indicated that symptoms have changed since the first case (outside Africa) was reported on May 7 in London.

Symptoms have changed since the first case (outside Africa) was reported on May 7 in London

Patients where the disease is endemic (Cameroon, Republic of Congo or Sierra Leone) do not show the same symptoms as those who are currently infected.

The findings are based on the study of 197 patients from the UK and diagnosed between May 13 and July 1 this year. Eight of them had more than 100 skin lesions and 29 did not have a single blistering rash.

“Twenty-two had a lesion: 12 concerned the genitals and seven the perianal region. Twenty-seven participants described the mucocutaneous manifestations as pruritic and 27 reported a concomitant generalized maculopapular rash.

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The majority (86.3%) reported systemic symptoms, that is, they affect the whole body, as happens, for example, with diabetes or fibromyalgia.

The most common symptoms were fever, lymphadenopathy and myalgia (muscle pain). 38% of patients developed these symptoms after the appearance of mucocutaneous lesions. 71 of the participants also had rectal pain or pain during bowel movements, 33 had a sore throat and 31 had penile swelling.

In this sense, the specialists assure that “people with confirmed monkeypox infection with extensive lesions on the penis or severe rectal pain should be considered for ongoing examination or hospital treatment”.

Tonsil inflammation was not known as a common symptom of monkeypox

Solitary lesions and swollen tonsils were not known to be typical symptoms of monkeypox infection.

“The single lesions can be mistaken for other conditions, such as syphilis, lymphogranuloma venereum (a sexually transmitted disease caused by a specific strain of chlamydia), or ingrown hair follicles,” the authors explain.

Inflammation of the tonsils, meanwhile, “could be mistaken for bacterial tonsillitis.” The researchers note that “only a quarter of this group had known contact with someone with confirmed monkeypox infection, raising the possibility of asymptomatic or paucisymptomatic transmission.”


In Spain there are more than 4,000 confirmed cases of monkeypox


Regarding the new symptoms identified in this study, this represents a step forward “for contact tracing, public health advice and ongoing isolation and infection control measures”.

The NHS said at the time that the infection could spread from infected wild animals in parts of West and Central Africa.

And contrary to what can be deduced from its name, those who spread this disease are mainly wild mice. And to a lesser extent, some monkeys and squirrels. It is even thought that it can be spread through contaminated objects such as clothing or bedding.

As for human-to-human transmission, the virus enters the body through skin wounds, the respiratory tract, the eyes, the nose and the mouth.

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