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Surveillance of Mpox Cases Attending Sexual Health Services in England (SOMASS): design, implementation and initial findings from the SOMASS data collection tool, 2022
  1. Hannah Charles1,
  2. Mateo Prochazka1,
  3. Judith Murray2,
  4. UKHSA Sexual Health Liaison Group1,
  5. Suneeta Soni3,
  6. Lewis Haddow2,
  7. Katie Beets4,
  8. Victoria Pilkington5,
  9. Nicola Low6,
  10. Sophie Candfield7,8,
  11. Rachael Jones9,
  12. Tanya Bleiker10,
  13. Claire Dewsnap11,
  14. Matt Phillips12,
  15. David Phillips13
  1. 1 UK Health Security Agency, London, UK
  2. 2 Kingston Hospital NHS Foundation Trust, Kingston upon Thames, UK
  3. 3 Claude Nicol Centre, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
  4. 4 University of Liverpool, Liverpool, UK
  5. 5 King’s College Hospital NHS Trust, London, UK
  6. 6 Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
  7. 7 Warwick Medical School, University of Warwick, Coventry, UK
  8. 8 West Midlands health protection team, UK Health Security Agency, Birmingham, UK
  9. 9 Genitourinary and HIV Medicine, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
  10. 10 Burton NHS Foundation Trust, Derby, UK
  11. 11 Genitourinary Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
  12. 12 North Cumbria Integrated Care NHS Foundation Trust, Penrith, UK
  13. 13 Croydon University Hospital, Croydon, UK
  1. Correspondence to Ms Hannah Charles, UK Health Security Agency, London, UK, NW9 5EQ, UK; hannah.charles{at}


Objectives We aimed to design and implement a data collection tool to support the 2022 mpox (monkeypox) outbreak, and to describe clinical and epidemiological data from individuals with mpox attending sexual health services (SHSs) in England.

Methods The UK Health Security Agency and the British Association for Sexual Health and HIV established the Surveillance of Mpox Cases Attending Sexual Health Services in England (SOMASS) system.

Descriptive data were collected via a secure web-based data collection tool, completed by SHS clinicians following consultation with individuals with suspected mpox. Data were collected on patient demographics, clinical presentation and severity, exposures and behavioural characteristics.

Results As of 17 November 2022, 276 SOMASS responses were submitted from 31 SHSs in England.

Where recorded, most (245 of 261; 94%) individuals identified as gay, bisexual or men who have sex with men (GBMSM), of whom two-thirds were HIV negative (170 of 257; 66%) and taking HIV pre-exposure prophylaxis (87 of 140; 62%), with a median age of 37 years (IQR: 30–43). Where known, thirty-nine per cent (63 of 161) had a concurrent sexually transmitted infection (STI) at the time of their mpox diagnosis.

For 46% of individuals (127 of 276), dermatological lesions were the initial symptom. Lesions were mostly asymmetrical and polymorphic, predominately affecting the genital area and perianal areas.

Nine per cent (24 of 276) of individuals were hospitalised. We report an association between receptive anal intercourse among GBMSM and proctitis (27 of 115; 24% vs 7 of 130; 5%; p<0.0001), and the presence of perianal lesions as the primary lesion site (46 of 115; 40% vs 25 of 130; 19%; p=0.0003).

Conclusions We demonstrate multidisciplinary and responsive working to develop a robust data collection tool, which improved surveillance and strengthened the knowledge base. The SOMASS tool will allow data collection if mpox resurges in England. The model for developing the tool can be adapted to facilitate the preparedness and response to future STI outbreaks.

  • Epidemiology

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  • Handling editor Stefano Rusconi

  • Twitter @suneeta_soni_, @nicolamlow, @DewsnapClaire

  • Correction notice This article has been corrected since it was first published online. The corresponding author's email address has been updated to:

  • Collaborators UKHSA Sexual Health Liaison Group: Katy Sinka1, Helen Fifer1, Kate Folkard1, Hamish Mohammed1, John Saunders1, Norah O'Brien1, Helen Corkin1, Katie Thorley1, Matt Hibbert1, Suzy Sun1

  • Contributors JM, SSo, LH, KB, VP, NL, SC, RJ, TB, CD, MP and DP contributed to design of the data collection tool and subsequent data collection. HC, MP, KT, MH and SSu were involved in operationalising the data collection tool and data validation. The UKHSA Sexual Health Liaison Group provided subject matter expertise and feedback on the data collection tool. HC led the data management and analysis and drafted the manuscript. All coauthors contributed to interpretation of the findings and to revision of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests NL is the Deputy Editor at BMJ Sexually Transmitted Infections.

  • Provenance and peer review Not commissioned; externally peer reviewed.