Most hospitalized monkey patients in the US were HIV positive.

Nearly all Americans hospitalized for syphilis have weakened immune systems, often from HIV infection, the Centers for Disease Control and Prevention reported Wednesday.

Of the 57 hospitalized patients identified in the report, 82 percent had HIV, more than two-thirds of the patients were black, and nearly a quarter were homeless, reflecting the overall racial and economic inequity of the epidemic.

The findings suggest that while most cases of monkeypox are mild, doctors should also test patients with suspected HIV and be prepared to provide prompt treatment for both infections.

“Monkey disease and HIV have collided with tragic consequences,” Dr. Jonathan Mermin, the CDC’s chief monkey disease scientist, said in a statement.

Most of the patients in the study were given Tecovirmat or Tpoxx, but for some patients, treatment was delayed for four weeks after first seeking care.

As of Tuesday, more than 28,000 cases of monkeypox have been reported in the United States, and nearly 76,000 cases have been reported worldwide. The vast majority are still among men who have sex with men, according to the CDC

The number of new cases of monkeypox has gradually decreased since September. But the number of high-risk people opting for vaccination has also declined. So far, only 7 percent of vaccine doses have gone to black recipients.

People who have weakened immune systems or live with other diseases have been vulnerable to monkey disease in the past in African countries.

In the new report, CDC scientists analyzed case reports from 57 patients over the age of 18 who were hospitalized for monkeypox between August 10 and October 10.

All had skin rashes, and most had severe lesions of the mouth, urethra, anus, or vulva. One in five people experienced symptoms in their lungs and eyes, and in four patients the brain and spinal cord were affected.

Four of the 47 HIV-infected patients were taking drugs to suppress the virus before developing monkeypox. One in three had a CD4 count – a proxy for the strength of the immune system – below 50, indicating severe immunosuppression.

Two of the patients were HIV-positive and were being treated for cancer; There were three solid organ transplant recipients; All three were pregnant. All these conditions are related to a weakened immune system.

A third of the patients were admitted to intensive care units. Of the 12 deaths recorded, five are due to complications from the monkeypox, six are under investigation and one has been determined to be unrelated.

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