MPXV Transmission at a Tattoo Parlor - The New England Journal of Medicine

[sharon sanders]

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[Mary Wilson]

December 14, 2022
DOI: 10.1056/NEJMc2210823


TO THE EDITOR:

From July 6 to 19, 2022, a total of 21 persons were infected by monkeypox (recently renamed mpox) virus (MPXV) that was likely to have been transmitted by means of piercing or tattooing at the same parlor in Cadiz, Spain (Table S1 in the Supplementary Appendix, available with the full text of this letter at NEJM.org). During this period, 21 of 58 customers (36%) at the tattoo parlor became infected (Fig. S1).

Of the 21 infected patients, 14 (67%) were female and 9 (43%) were younger than 18 years of age. The median age of the patients was 26 years (interquartile range, 16 to 38). The patients had no history of recent high-risk sexual activity (e.g., sex without a barrier method of contraception or with multiple partners), travel to areas where mpox is endemic, or close contact with MPXV-infected persons.

Clinical features started with painful regional inflammatory lymphadenopathy, with onset a median of 7 days (interquartile range, 6 to 9) after the piercing or tattooing. All the patients subsequently had local cutaneous inflammation on approximately day 9 (interquartile range, 7 to 11). Physical examination showed cutaneous necrosis in the area of the piercing or tattoo and surrounding umbilicated pustules with an underlying edematous and erythematous plaque (Figure 1). ...

https://www.nejm.org/doi/full/10.1056/NEJMc2210823