No deaths occurred during the study period.Īlthough life-threatening mpox appears rare in hospitalised populations during the current outbreak, severe mpox and associated complications can occur in immunocompetent individuals. 38 (24%) of the 156 individuals received tecovirimat with early cessation in four cases (two owing to hepatic transaminitis, one to rapid treatment response, and one to patient choice). Ten individuals required surgery and two cases of encephalitis were reported. Median admission duration was 5 days (IQR 2-9). Severe pain was reported in 89 (57%) of 156, and secondary bacterial infection in 82 (58%) of 142 individuals with available data. Rectal or perianal pain (including proctitis) was the most common indication for hospital admission (44 of 156). 105 (71%) of 148 participants with available ethnicity data were of White ethnicity and 47 (30%) of 155 were living with HIV with a median CD4 count of 510 cells per mm 3 (IQR 349-828). The prespecified options for data collection for gender were male, female, trans, non-binary, or unknown. Gender data were collected from electronic patient records, which encompassed full formal review of clincian notes. 153 (98%) were male and three (2%) were female, with a median age of 35 years (IQR 30-44). Outcomes were assessed in all patients with available data.ġ56 individuals were admitted to hospital with complicated mpox during the study period. Routine biochemistry, haematology, microbiology, and virology data were also collected. Key outcomes included admission indication, complications (including pain, secondary infection, and mortality) and use of antibiotic and anti-viral treatments. Patients admitted solely for isolation purposes were excluded from the study. Inclusion criteria were clinical signs consistent with mpox and MPXV DNA detected from at least one clinical sample by PCR testing. The hospitals were located in ten cities in England and Northern Ireland. In this cohort study, we undertook retrospective review of electronic clinical records and pathology data for all individuals admitted between May 6, and Aug 3, 2022, to 16 hospitals from the Specialist and High Consequence Infectious Diseases Network for Monkeypox. We aimed to describe the clinical and laboratory characteristics and outcomes of individuals admitted to hospital with mpox and associated complications, including tecovirimat recipients. Mortality has been reported as rare but hospital admission has been relatively common. In less than 6 months, non-endemic countries have reported more than 67 000 cases of a disease that had previously been rare outside of Africa. She has also been recognized with an article published in the NC Bar Association Family Law Section Newsletter entitled, “Q&A with Digital Forensic Experts.The scale of the 2022 global mpox (formerly known as monkeypox) outbreak has been unprecedented. Fink has various speaking engagements including speaking at the NBI:CLE on the issues of prenuptial/postnuptial agreements and when a spouse is hiding assets and as well as speaking at a CLE for the Paralegal division dealing with retirement assets. She is a member of the North Carolina Bar Association-Family Law Section, and a graduate of NITA/ABA Family Law Advocacy Institute an intensive seven day training program. Fink practiced several years in an international family law firm in their Charlotte, NC office, focusing primarily on men’s domestic issues and most recently practiced in a boutique family law firm in Charlotte, NC. Prior to her recent transition back home to Boone, NC, Mrs. She was awarded her Juris Doctorate from the UNC-Chapel Hill School of Law in 2009 and was selected as a National Member of the Order of the Barristers during her tenure. Fink is a 2006 graduate of UNC-Chapel Hill where she received her Bachelor of Arts in History. Fink joined as partner on Septemand will practice primarily family law as well as Real Estate Law. A native of Boone, Andrea Miller Fink is married to Michael Fink and they are the parents to one daughter Ava.
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