Table 1.

Main differences reported in the clinical presentations of monkeypox in patients from the present outbreak and from previous outbreaks. Symptoms in one column do not mean that they cannot be present in the other. However, the frequency of presentation is lower.

2022 Outbreak	Previous (African) Outbreaks
Lesions in genital (penis, testicles, labia and vagina) or perineal/perianal area (anus), which may not spread further	Extensive characteristic centrifugal rash, starting from the site of primary infection, which rapidly spreads to other locations, characteristically palms and soles
Low number of lesions (a few, a single, absence)	Fever
Anal pain and bleeding	Swollen lymph nodes
Asynchronous development of lesions, which may be in different stages
Possible absence of prodromal period, with no fever, malaise or other constitutional symptoms

Adapted from [18].