Epidemiology, Clinical Presentation, and Outcome of Mpox: a Study of 381 Cases in Saudi Arabia

Background There are limited data on clinical and epidemiological aspects of Mpox in Saudi Arabia. Objective This study investigates these characteristics of recent cases from May to September 2023. Methods This study included a total of 381 Mpox cases with Mpox based on clinical symptoms and laboratory testing. Results The majority of Mpox cases were males (91.1%) with a mean age of 32.4 years and 356 (93.4%) did not report travel, 277 (72.7%) denied engaging in extra-marital sex, and 379 (99.5%) were not linked to secondary cases. Fever was reported in 371 (97.4%), while headache was present in 314 (82.4%). Cough (1.3%) and conjunctivitis (0.5%) were rare. The most frequent location of lesions were palms and soles 297 (78%), genital 206 (54%), face 198 (52%) and oral lesions (160, 42%). Of the 1325 identified contacts, 1134 (85.5%) were hospital, 191 (14.5%) were community contacts, and 393 (29.6%) were high risk contact. Of the high-risk, 284 (72.3%) accepted post-exposure vaccination. The genotyped samples were all subclade IIb (subclade of formerly the West Africa clade). Conclusion This study provides valuable insights into Mpox characteristics in Saudi Arabia. Genome of monkeypox virus belonged to subclade IIb of the West Africa clade. Further analysis of the global tree sublineage is needed.