Urgent Updates | June 3, 2022

A NOVEL INTERNATIONAL MONKEYPOX OUTBREAK
A new, unusual, multinational outbreak of monkeypox that is unfolding rapidly makes it important to know what a case might look like. Clinicians seeing patients with new onset of febrile illness and rash should consider monkeypox, especially if lymphadenopathy is also present. The rash typically starts in the mouth, then moves to the face, followed by the extremities (including the palms and soles) in a centrifugal pattern.  Clinicians who suspect they may have a patient with monkeypox should contact their state or local health department immediately.
Full Access: Annals of Internal Medicine

ADMISSIONS OF CHILDREN AND ADOLESCENTS WITH DELIBERATE SELF-HARM TO INTENSIVE CARE DURING THE SARS-COV-2 OUTBREAK IN AUSTRALIA
Cohort study identified 813 patients aged 12 to 17 years admitted to pediatric ICUs with deliberate self-harm (DHS) over 6.5 years Australian subset of the registry during the study period. Monthly admissions per million children and adolescents increased significantly at the onset of the pandemic, from 7.2 admissions in March 2020 to 11.4 admissions by August 2020. This cohort study found that the coronavirus pandemic in Australia was associated with a significant increase in admissions of children and adolescents to intensive care with DSH.

CDC IDENTIFIES MORE PEDIATRIC HEPATITIS CASES, INCLUDING ONE MORE DEATH
The CDC has identified more cases of acute hepatitis with an unknown cause among children in the United States, including one more death. Adenovirus infection has been implicated — but not proven — as the cause of the unexplained illnesses, which have also been reported in Europe. The CDC said this week that it has received reports of 180 cases in 36 states and territories over the last 7 months — up from 109 cases reported as of 2 weeks ago.
Full Access: Helio

THROMBOEMBOLIC RISK IN PATIENTS WITH PNEUMONIA AND NEW-ONSET ATRIAL FIBRILLATION NOT RECEIVING ANTICOAGULATION THERAPY
In this cohort study including 274 196 patients with pneumonia, of whom 6553 developed atrial fibrillation, the 1-year risk of thromboembolism was 0.8% in patients without atrial fibrillation vs 2.1% in patients with atrial fibrillation. This cohort study found that new-onset AF after community-acquired pneumonia was associated with an increased risk of thromboembolism, which may warrant anticoagulation therapy. Approximately one-third of patients had a new hospital or outpatient clinic contact for AF during the 3-year follow-up, suggesting that AF triggered by acute infections is not a transient, self-terminating condition that reverses with resolution of the infection.
Full Access: JAMA