Mpox: symptoms of disease

At the latest three weeks after infection, the first symptoms of the disease appear. These include:

  • Acute onset of fever (>38.5°C)
  • Acute rash or single lesion (vesicles, then pustules, and finally crusts, similar to smallpox)
  • Headache
  • Swollen lymph nodes
  • Muscle and body aches
  • back pain
  • expressed weakness
  • Inflammation of the mucosa of the rectum
  • Inflammation of the glans penis

The expression of symptoms is individual. In the current outbreak, some cases have only isolated or mild symptoms. Often the rash is discrete, with only a few individual vesicles or pustules. In some cases, the rash is limited to the genital region only. In some sufferers, there is no rash at all.

The following differential diagnoses (list is not exhaustive) can also explain the clinical picture of acute exanthema:

  • allergic reaction (for example, to plants)
  • bacterial skin infections,
  • Chancroid (ulcus molle),
  • Chikungunya,
  • Dengue,
  • disseminated gonococcal infection,
  • Granuloma inguinale,
  • Herpes simplex,
  • Herpes zoster,
  • Lymphogranuloma venereum,
  • Measles,
  • Molluscum contagiosum,
  • primary or secondary syphilis,
  • Varizella zoster,
  • Zika
  • and any other locally relevant common causes of maculopapular or vesicular efflorescence