Study highlights complications of mpox, chickenpox co-infections

mpox virus

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Almost 30% of mpox patients described in a retrospective study from Nigeria were co-infected with chickenpox. The study was published yesterday in The Journal of Infectious Diseases.

Previous mpox outbreaks in endemic countries in Africa have involved co-infections with chickenpox, resulting in more severe symptoms and presentation. The authors of the study say the burden of chickenpox is not well-known in Nigeris, as it is not a notifiable disease and the vaccine is not included in the national immunization program.

The study analyzed suspected mpox cases reported in six states in southern Nigeria from January 2022 to March 2023. Mpox and chickenpox were confirmed by polymerase chain reaction tests at hospitals where patients were diagnosed.

Of 94 suspected case-patients, 56 (59.6%) had confirmed mpox. Of those with mpox, 28.6% (16 patients) also were co-infected with chickenpox.

More muscle pain, sore throats with co-infections

Compared to those who had mpox only, mpox/chickenpox co-infected patients were significantly more likely to report muscle pain (87.5% vs 57.5%), sore throat (68.8% vs 30.0%), fatigue (75.0% vs 45.0%), and complications (56.3% vs 22.5%).

The average age of patients was 29 years, 60.7% were men, and 12.5% of patients identified as bisexual or other men who have sex with men. A total of 92.9% of patients had fever. All patients presented with an itchy rash, with 60.7% reporting that the rash began on their face.

We observed that persons co-infected with chickenpox had a higher risk, with 4.4 times the odds to develop complications than those with mpox mono-infection.

"Although our study did not reveal any statistically significant association of death with co-infection, we observed that persons co-infected with chickenpox had a higher risk, with 4.4 times the odds to develop complications than those with mpox mono-infection," the authors said .

Upticks in some US cities

In US mpox news, some cities are starting to report an increase in cases. The Rhode Island Department of Health urged at-risk residents to get the Jynneos vaccine to protect against the virus, after cases there increased.

In Nashville, the city is hosting a pop-up vaccination event today after an uptick in cases.

The United States has recorded more than 30,000 mpox cases in the past 18 months as part of a global outbreak of the virus primarily seen in men who have sex with men.

CDC issues alert on clade 1 spread

Finally today, the US Centers for Disease Control and Prevention (CDC) issued a health advisory on the ongoing outbreak of clade 1 mpox virus (MPXV) in the Democratic Republic of the Congo (DRC).

"MPXV has two distinct genetic clades (subtypes), and cases of Clade I MPXV have not been reported in the United States at this time," the CDC said. "However, clinicians should be aware of the possibility of Clade I MPXV in travelers who have been in DRC."

Clade 1 historically has higher case-fatality rates than clade 2, the strain that caused the global mpox outbreak in 2022. The ongoing ou

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