Piercing or tattooing appears to be the vehicle that left 21 people infected with mpox virus (MPXV) after visiting the same tattoo parlor in Cadiz, Spain, during 2 weeks in July, according to a report yesterday in the New England Journal of Medicine.
From July 6 to July 19, the parlor served 58 customers, and 21 of them (36%) became infected with the virus. Of the mpox patients, 14 (67%) were female, and 9 (43%) were children. The median patient age was 26.
The first case was confirmed by polymerase chain reaction testing on July 19. The parlor was closed the next day after health authorities were notified. An outbreak probe revealed that 15 or 16 piercing- or tattoo-related items harbored MPXV. Contact tracing revealed a secondary case in one patient's mother. None of the tattoo parlor staff contracted the disease.
Clinical features were swollen lymph nodes a median of 7 days after piercing or tattooing. And around day 9, the patients started experiencing skin inflammation and rash. Fourteen patients had lesions spread to the trunk, head, and arms and legs.
Noting that much of mpox in the current outbreak has spread via male-to-male sexual contact, the authors conclude, "MPXV may develop new networks of transmission, with epidemiologic changes of the disease."