Mpox Cases Among Cisgender Women and Pregnant Persons — United States, May 11–November 7, 2022

United States, May 11-November 7, 2022

Lisa P. Oakley, PhD; Kaitlin Hufstetler, MD; Jesse O'Shea, MD; J. Danielle Sharpe, PhD; Cristin McArdle, PhD; Varsha Neelam, MPH; Nicole M. Roth, MPH; Emily O. Olsen, PhD; Maren Wolf, MPH; Leah Zilversmit Pao, PhD; Jeremy A. W. Gold, MD; K. Meryl Davis, MD; Dana Perella, MPH; Shara Epstein, MD; Maura K. Lash, MPH; Olivia Samson, MPH; Jessica Pavlick, DrPH; Amanda Feldpausch, DVM; Jennifer Wallace, MD; Atmaram Nambiar, MD; Van Ngo, MPH; Umme-Aiman Halai, MD; Claudia W. Richardson, MD; Traci Fowler, DNP; Burnestine P. Taylor, MD; Joyce Chou, MSPH; Lindsey Brandon, MSN; Rose Devasia, MD; Erin K. Ricketts, MD; Catherine Stockdale; Mellisa Roskosky, PhD; Rachel Ostadkar; Yeng Vang; Romeo R. Galang, MD; Kiran Perkins, MD; Melanie Taylor, MD; Mary Joung Choi, MD; Paul J. Weidle, PharmD; Patrick Dawson, PhD; Sascha Ellington, PhD


Morbidity and Mortality Weekly Report. 2023;72(1):9-14. 

In This Article

Cases Among Cisgender Women

During May 11–November 7, 2022, a total of 769 cases of mpox among cisgender women, including 23 (3%) who were pregnant, were reported by 42 public health jurisdictions (Table 1). The median age was 32 years (IQR = 25–40 years). Among the 717 (93%) cisgender women with information on race and ethnicity, 313 (44%) were Black, 182 (25%) were White, and 167 (23%) were Hispanic. Among 463 (60%) cisgender women with information on recent sexual behaviors, 329 (71%) reported recent sexual activity or close intimate contact,*** including 296 (90%) who had recent sexual contact with a cisgender man and 18 (6%) who had recent sexual contact with a cisgender woman. Among the 18 patients who had recent sexual contact with a woman, 12 also had a recent male sex partner. Of the 73 cisgender women who had complete exposure data, 53 (73%) reported recent sexual or intimate contact as the likely route of exposure. Among the 16 who reported household contact or caregiving as the likely route of exposure, five reported recent sexual or intimate contact. Among the 378 cisgender women with available data on immunocompromising conditions, 35 (9%) reported any known immunocompromising condition other than HIV infection. Information on HIV status was available for 173 cisgender women, 13 (8%) of whom had HIV infection; no cisgender women with HIV infection were pregnant.

Among all cisgender women with mpox and available data, the most frequently reported signs and symptoms were rash (93%), headache (54%), pruritis (57%), malaise (54%), fever (49%), and chills (49%) (Table 2). Among 376 (49%) cisgender women with data on rash location, rash was most frequently reported on the legs (48%), arms (47%), genitals (36%), and trunk (33%); 50 (16%) reported rash in one region, 63 (20%) in two regions, 57 (18%) in three regions, and 140 (45%) in four or more regions. Rash location was similar when comparing cisgender women who reported recent sexual exposure with those who did not.

***Defined as any sex or close intimate contact during the 3 weeks before symptom onset.