Table 1. Demographic, clinical characteristics and disease-severity of confirmed and probable monkeypox cases, 36 WHO European Region countries, 7 March–23 August 2022, (n = 20,690 cases).
| Variables | Overall cases | Hospitalised | Not hospitalised | Unknown | Hospitalisation ratio (per 1,000 cases) |
p value | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| n | % | n | % | n | % | n | % | ||||
| Total cases | 20,690 | 100 | 197 | 100 | 10,601 | 100 | 9,892 | 100 | 10 | ||
| Age group (years) | 0–17 | 41 | 0.2 | 2 | 1.0 | 25 | 0.2 | 14 | 0.1 | 49 | 0.015 |
| 18–30 | 5,078 | 24.5 | 57 | 28.9 | 2,504 | 23.6 | 2,517 | 25.4 | 11 | ||
| 31–40 | 8,231 | 39.8 | 87 | 44.2 | 4,202 | 39.6 | 3,942 | 39.9 | 11 | ||
| 41–50 | 4,970 | 24.0 | 40 | 20.3 | 2,695 | 25.4 | 2,235 | 22.6 | 8 | ||
| 51–60 | 1,882 | 9.1 | 9 | 4.6 | 947 | 8.9 | 926 | 9.4 | 5 | ||
| > 60 | 442 | 2.1 | 2 | 1.0 | 209 | 2.0 | 231 | 2.3 | 5 | ||
| Unknown | 46 | 0.2 | 0 | 0.0 | 19 | 0.2 | 27 | 0.3 | 0 | ||
| Gendera | Female | 212 | 1 | 4 | 2 | 137 | 1.3 | 71 | 0.7 | 19 | 0.404 |
| Male | 17,685 | 85.5 | 193 | 98 | 10,457 | 98.6 | 7,035 | 71.1 | 11 | ||
| Other | 16 | 0.1 | 0 | 0 | 6 | 0.1 | 10 | 0.1 | 0 | ||
| Unknown | 2,777 | 13.4 | 0 | 0 | 1 | 0.0 | 2,776 | 28.1 | 0 | ||
| Prior smallpox vaccination | Vaccinated | 528 | 2.6 | 12 | 6.1 | 495 | 4.7 | 21 | 0.2 | 23 | 0.334 |
| Not vaccinated | 2,974 | 14.4 | 94 | 47.7 | 2,758 | 26.0 | 122 | 1.2 | 32 | ||
| Unknown | 17,188 | 83.1 | 91 | 46.2 | 7,348 | 69.3 | 9,749 | 98.6 | 5 | ||
| Smallpox vaccination for current event | PEPV | 42 | 0.2 | 0 | 0 | 40 | 0.4 | 2 | 0 | 0 | 0.461 |
| PPV | 1 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 0 | ||
| PEPV/PPV | 4 | 0 | 0 | 0 | 2 | 0 | 2 | 0 | 0 | ||
| Not vaccinated | 3,017 | 14.6 | 101 | 51.3 | 2,798 | 26.4 | 118 | 1.2 | 33 | ||
| Unknown | 17,626 | 85.2 | 96 | 48.7 | 7,760 | 73.2 | 9,770 | 98.8 | 5 | ||
| HIV status | Positive | 3,070 | 14.8 | 37 | 18.8 | 2,697 | 25.4 | 336 | 3.4 | 12 | 0.441 |
| Negative | 5,187 | 25.1 | 52 | 26.4 | 4,536 | 42.8 | 599 | 6.1 | 10 | ||
| Unknown | 12,433 | 60.1 | 108 | 54.8 | 3,368 | 31.8 | 8,957 | 90.5 | 9 | ||
| STI | Yes | 93 | 0.4 | 8 | 4.1 | 81 | 0.8 | 4 | 0 | 86 | 0.67 |
| No | 625 | 3 | 44 | 22.3 | 537 | 5.1 | 44 | 0.4 | 70 | ||
| Unknown | 19,972 | 96.5 | 145 | 73.6 | 9,983 | 94.2 | 9,844 | 99.5 | 7 | ||
| Sexual orientation | MSM | 8,777 | 42.4 | 84 | 42.6 | 6,677 | 63 | 2,016 | 20.4 | 10 | Not calculated |
| Bisexual | 93 | 0.4 | 4 | 2 | 80 | 0.8 | 9 | 0.1 | 43 | ||
| Heterosexual | 276 | 1.3 | 9 | 4.6 | 242 | 2.3 | 25 | 0.3 | 33 | ||
| Unknown | 11,544 | 55.8 | 100 | 50.7 | 3,602 | 34.0 | 7,842 | 79.2 | 13 | ||
| Health worker | Yes | 64 | 0.3 | 0 | 0 | 56 | 0.5 | 8 | 0.1 | 0 | 0.64 |
| No | 3,645 | 17.6 | 80 | 40.6 | 3,334 | 31.4 | 231 | 2.3 | 22 | ||
| Unknown | 16,981 | 82.1 | 117 | 59.4 | 7,211 | 68 | 9,653 | 97.6 | 7 | ||
| Rash | Not reported | 657 | 3.2 | 4 | 2.0 | 424 | 4.6 | 229 | 2.0 | 6 | 0.085 |
| Reported | 12,415 | 60.0 | 187 | 94.9 | 8,367 | 90.1 | 3,861 | 34.4 | 15 | ||
| Unknown/no data on symptoms | 7,618 | 36.8 | 6 | 3.0 | 494 | 5.3 | 7,118 | 63.5 | 1 | ||
| Lymphadenopathy | Not reported | 7,837 | 37.9 | 91 | 46.2 | 5,118 | 55.1 | 2,628 | 23.4 | 12 | 0.005 |
| Reported | 5,235 | 25.3 | 100 | 50.8 | 3,673 | 39.6 | 1,462 | 13.0 | 19 | ||
| Unknown/no data on symptoms | 7,618 | 36.8 | 6 | 3.0 | 494 | 5.3 | 7,118 | 63.5 | 1 | ||
| Systemic symptomsb | Not reported | 4,596 | 22.2 | 91 | 46.2 | 2,917 | 31.4 | 1,588 | 14.2 | 20 | < 0.001 |
| Reported | 8,476 | 41.0 | 100 | 50.8 | 5,874 | 63.3 | 2,502 | 22.3 | 12 | ||
| Unknown/no data on symptoms | 7,618 | 36.8 | 6 | 3.0 | 494 | 5.3 | 7,118 | 63.5 | 1 | ||
MSM: men who have sex with men; PEPV: Post-exposure preventive vaccination; PPV: Primary preventive (pre-exposure) vaccination; STI: sexually transmitted infection.
a Gender collected in TESSy as female, male, other (e.g. transgender) or unknown.
b Fever, fatigue, muscle pain, chills and/or headache.
Based on case-based data reported in TESSy, hospitalisation ratios and p values were calculated for cases for whom hospitalisation status (i.e. not hospitalised, hospitalised for isolation purposes (n = 129 cases) or hospitalised for clinical management purposes (n = 197 cases)) was known. Cases whose hospitalisation status was reported as unknown or who were known to have been hospitalised, but purpose (isolation/clinical management) was unknown (n = 254) were not included in the analyses. ‘Hospitalisation’ is defined as hospitalisation for clinical care (n = 197 cases). Hospitalisation for known isolation (n = 129 cases) is included as ‘Not hospitalised’. P values were calculated by Fisher’s exact test. For each tabulation of hospitalisation (yes/no) by another variable, when one of the cells was equal to 0, 0.5 was added to all cells of the table in order to be able to conduct the statistical test.
All variables excluding vaccination are up to 23 August 2022. Smallpox vaccination variables combine data from 10 August 2022 and 23 August 2022 for completeness.