St George’s researchers call for international monkeypox registry

Published: 20 September 2022

A group of researchers including two professors at St George’s, University of London, have urged the international community to establish a reporting system for monkeypox.

In a letter to The Lancet Infectious Diseases, Professor Asma Khalil, Professor at St George's, University of London, and consultant obstetrician at St George's Hospital; and Dr Shamez Ladhani of the St George’s Institute of Infection and Immunity, along with colleagues in Brazil and Sweden, called for such a system to improve the care of people infected with monkeypox, including pregnant women.

Pregnant women and newborn babies may be more at risk of severe monkeypox disease due to their suppressed or naïve immune systems, but this hasn’t been confirmed because there is so little information available.

There have been more than 52,000 cases of monkeypox during the current global outbreak, which began in May this year. The WHO declared the outbreak a Public Health Emergency of International Concern in July. Symptoms include a fever, swollen lymph nodes and skin lesions.

The virus circulates continuously in Western and Central African countries but in the most recent outbreak has spread to countries where it is isn’t usually present.

“With more than 50,000 people having been infected in this outbreak that we know of, we urgently need an international registry of cases, symptoms, disease progression, severity, treatments and patient outcomes,” said Professor Khalil.

Professor Khalil and her colleagues have resorted to news reports to find information about monkeypox cases in pregnant women.

By 2 September, 10 cases of monkeypox had been reported in pregnant women worldwide. One case was in the United States, with the other nine in four different Brazilian states.

“It is reassuring that there is currently no evidence of mothers infected with monkeypox passing the virus to their newborn babies, or of pregnant women suffering from more severe monkeypox disease, but we are having to use media reports from affected regions to draw these conclusions rather than formal publications,” said Dr Khalil.

“News reports contain little detail and haven’t been verified. Despite this, more monkeypox infections in pregnancy have already been reported since this outbreak began than in the past few decades from countries where monkeypox normally circulates. This just highlights the extent to which the international community has neglected diseases such as monkeypox in endemic countries.”

Professor Khalil and colleagues say that a registry of cases would help medical professionals to better understand the course of the disease and how it should be managed and treated. It would also allow them to assess the safety and effectiveness of monkeypox vaccines in high-risk populations, including pregnant women and their fetuses. This would lead to patients everywhere being given evidence-based care and accurate advice.

“Such a registry would be beneficial for all communities, as well as the medical professionals trying to care for them”, added Professor Khalil.