Patients report physical effects more than a year following the 2022 mpox outbreak

More than half of adults diagnosed with mpox during the 2022 outbreak continued to experience physical effects up to 18 months later, with persistent appearance-related changes and ongoing anorectal or urinary symptoms among a minority of participants

A cohort study of more than 300 adults has found that a substantial proportion of people diagnosed with mpox during the 2022 outbreak continued to report physical symptoms 11 to 18 months after infection. The analysis compared individuals who had received a diagnosis of mpox between May 2022 and January 2023 with people considered at risk during the outbreak period who had not become infected.

More than half of those in the post-mpox group reported at least one persistent symptom at follow-up, most commonly appearance-related changes such as scarring or skin discolouration, alongside ongoing anorectal or urinary problems in a smaller subset.

The study examined both physical and psychosocial outcomes to assess the longer-term burden associated with mpox. Researchers from the Centers for Disease Control and Prevention, in Atlanta, USA, alongside colleagues from Columbia University Division of Infectious Diseases, in New York, USA, and the University of Texas Health Science Center Houston, USA, aimed to characterise differences in health status, behaviour and wellbeing between people who had experienced mpox and those who had not across the same period.

Participants were recruited from health centres in New York City and Houston and were grouped as post-mpox or no-mpox. All participants completed psychosocial and behavioural self-assessments, while those in the post-mpox group also underwent a clinical evaluation to document ongoing physical findings. This approach allowed the investigators to link self-reported outcomes with objective clinical assessments in those who had been infected.

Among the post-mpox participants, 58 per cent reported at least one persistent symptom more than a year after acute infection. Appearance-related sequelae were the most frequently described effects, although the extent was generally limited. Most individuals with visible changes had fewer than 10 scars or areas of discolouration and involvement of two or fewer body sites. Despite this relatively low burden, the presence of visible marks was considered important given the potential psychosocial implications associated with a condition that had attracted considerable public attention during the outbreak.

The study also found that 13 per cent of post-mpox participants experienced ongoing changes in physical function. A smaller proportion, 2 per cent, reported effects on activities of daily living, indicating that while severe functional impairment was uncommon, a measurable minority continued to experience disruptions to normal life well beyond the acute phase of illness.

By comparing outcomes between infected and non-infected individuals who shared similar risk profiles, the researchers were able to place these findings in a broader behavioural and psychosocial context. The results suggest that mpox can lead to enduring physical effects in a significant proportion of cases, even when visible sequelae appear limited in scope.

The authors concluded that these findings provided important insight into the longer-term consequences of mpox infection and underlined the need for clinicians to recognise and address persistent symptoms during follow-up care. They also highlighted the value of integrating physical and psychosocial assessment when evaluating recovery after emerging infectious disease outbreaks, particularly those associated with visible or stigmatising symptoms.

For further reading please visit: 10.7326/ANNALS-25-00036