临床表现
clinical manifestation
潜伏期5-21天，多为6-13天。发病早期出现寒战、发热，体温多在38.5℃以上，可伴头痛、嗜睡、乏力、背部疼痛和肌痛等症状。多数患者出现颈部、腋窝、腹股沟等部位淋巴结肿大。发病后1-3天出现皮疹。皮疹首先出现在面部，逐渐蔓延至四肢及其他部位，皮疹多呈离心性分布，面部和四肢皮疹较躯干更为多见，手心和脚掌均可出现皮疹，皮疹数量从数个到数千个不等；也可累及口腔黏膜、消化道、生殖器、结膜和角膜等。皮疹经历从斑疹、丘疹、疱疹、脓疱疹到结痂几个阶段的变化，疱疹和脓疱疹多为球形，直径约0.5-1厘米，质地较硬，可伴明显痒感和疼痛。从发病至结痂脱落约2-4周。结痂脱落后可遗留红斑或色素沉着，甚至瘢痕，瘢痕持续时间可长达数年。部分患者可出现并发症，包括皮损部位继发细菌感染、支气管肺炎、脑炎、角膜感染、脓毒症等。
The incubation period is 5-21 days, mostly 6-13 days. Shiveringand fever occur in the early stage of the disease, and the bodytemperature is mostly above 38.5 ℃, which can be accompanied byheadache, lethargy, fatigue, back pain, myalgia and other symptoms.Most patients have swollen lymph nodes in the neck, armpit, groinand other parts. Rash occurs 1-3 days after onset. The rash firstappeared on the face and gradually spread to the limbs and otherparts. The rash was mostly distributed centrifugally. The rash onthe face and limbs was more common than that on the trunk. The rashcould appear on the palm and sole of the foot, and the number ofrashes ranged from several to thousands; It can also involve oralmucosa, digestive tract, genitals, conjunctiva and cornea. The rashgoes through several stages from macula, papule, herpes, purulentherpes to scab. Herpes and purulent herpes are mostly spherical,about 0.5-1 cm in diameter, hard in texture, and can be accompaniedby obvious itching and pain. It takes about 2-4 weeks from theonset to scabbing and falling off. After scabs fall off, erythemaor pigmentation can be left, and even scars, which can last forseveral years. Some patients may have complications, includingbacterial infection secondary to skin lesions, bronchopneumonia,encephalitis, corneal infection, sepsis, etc.
猴痘为自限性疾病，大部分预后良好。严重病例常见于年幼儿童、免疫功能低下人群，预后与感染的病毒分支、病毒暴露程度、既往健康状况和并发症严重程度等有关。西非分支病死率约3%，刚果盆地分支病死率约10%。
Monkeypox is a self limiting disease, and most of them have agood prognosis. Severe cases are common in young children andpeople with low immune function. The prognosis is related to theinfected virus branch, the degree of virus exposure, previoushealth status and the severity of complications. The mortality ofWest African branch is about 3%, and that of Congo Basin branch isabout 10%.
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