The changing face of monkeypox

More than 50 years ago in 1970 the then US Surgeon General allegedly stated that we could “close the book on infectious diseases, declare the war against pestilence won and shift national resources to such chronic problems as cancer and heart disease.”Luckily for William Stewart’s reputation the statement’s attribution remains unverified,1 since we continue to reel from the emergence of viral threats, including HIV and AIDS, Ebola virus disease, covid-19, and now an international outbreak of monkeypox. But not monkeypox as we know it, as Patel and colleagues (doi:10.1136/bmj-2022-072410) report in a series of 197 patients from the UK.2The striking new distribution of clinical features and presentations reported in their linked paper differs from previously characterised outbreaks in the Democratic Republic of Congo3 and Nigeria.4 These changes may well lead to delayed diagnoses and avoidable onward transmission. Four out of five patients in the series sought care within the national…
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