O11 Surveillance of Mpox cases attending sexual health services in England (SOMASS): design, implementation and initial findings from the SOMASS data collection tool, 2022

Introduction

To understand the clinical presentation, severity and epidemiology of individuals with Mpox attending sexual health services (SHSs) in England, we developed a tool for Surveillance of Mpox Cases Attending Sexual Health Services (SOMASS).

Methods

Experts from the UK Health Security Agency (UKHSA), British Association of Sexual Health and HIV and the British Association of Dermatologists formed a multi-disciplinary working group in May 2022 and co-developed a web-based data collection tool. The UKHSA hosted the tool, which was accessible from July 2022. SHS clinicians abstracted information from clinical records into SOMASS following consultations with patients suspected to have Mpox.

Results

As of 17th November 2022, 276 SOMASS responses were submitted from 31 SHSs in England, representing 8% of all confirmed Mpox cases in England as of 14th November 2022. Of these, 274 were subsequently laboratory-confirmed Mpox positive; in two cases the laboratory result was unknown but assumed to be positive, and therefore these individuals were retained for analysis. Where recorded, most (245/261; 94%) people identified as gay, bisexual or men who have sex with men (GBMSM). For 46% (127/276), dermatological lesions were the initial symptom. Lesions were mostly asymmetrical and polymorphic, predominately affecting genital area and perianal areas. Among GBMSM, we found an association between receptive anal intercourse and proctitis (27/115; 24% vs. 7/130; 5%; p<0.0001), and perianal lesions as the primary lesion site (46/115; 40% vs. 25/130; 19%; p=0.0003).

Discussion

SOMASS demonstrates multi-disciplinary, responsive, and agile working between front-line sexual health practitioners, clinical professional bodies and the national health protection agency. The data collection tool improved surveillance, strengthened the knowledge base and supported clinical care during the Mpox outbreak. This tool will be ready to capture resurgences of Mpox in England and the development process could be adapted to future outbreaks.