# National Emergency Department Registry for Mpox: Coordinating Multisite Surveillance Networks to Inform Current and Future Outbreaks

## TL;DR

This study created a national registry of mpox cases in emergency departments to better understand the outbreak and improve future responses.

## Contribution

The paper introduces a coordinated multisite surveillance network for mpox in EDs, enabling detailed epidemiological insights.

## Key findings

- Most patients were young men, with common symptoms including skin lesions and fever.
- Over half of patients had HIV, and high rates of STI coinfections were observed.
- Multisite data collection revealed the importance of EDs in outbreak surveillance and response.

## Abstract

Despite many emergency departments (EDs) managing patients with possible mpox, individual institution reports have been limited, making it challenging to understand demographic trends and service needs. We established a data repository of ED patients with mpox to inform epidemiologic trends and future practice.

This national multicenter retrospective chart review included patients aged ≥ 18 years presenting to 8 EDs across the United States during the mpox outbreak (June 2022 to January 2023) with laboratory-confirmed mpox. Data were collected on demographic variables and clinical characteristics from each participating site, representing the northeast, midwest, south, and west regions.

A total of 270 patients were included in the cohort; most were men (264, 98%) and relatively young (median age: 34 years; IQR: 28-41). Patients commonly presented with skin lesions (253, 94%), fever or flu-like symptoms (152, 56%), and rectal pain (70, 26%). More than half (141/270, 52%) of individuals had a known diagnosis of HIV. Among those tested for sexually transmitted infection (STI) coinfection, 36% (51/143) had positive syphilis serology (not all diagnoses could be confirmed by clinical history), followed by gonorrhea 7% (9/128) and chlamydia 7% (8/122).

Similar to the COVID-19 pandemic, EDs played a critical role in the mpox response. High coinfection rates with STIs highlight the need for routine coinfection testing. Multisite data collection identified key trends, emphasizing the value of surveillance networks for outbreak response.