The multinational Mpox outbreak that began in 2022 still represents a global public health emergency of international concern and requires continuous surveillance and a rapid response. The state of São Paulo is one of the epicenters of the disease and concentrates the largest number of suspected and confirmed cases in Brazil. This study aims to describe the profile of confirmed cases, focusing on temporal distribution as well as socio-demographic and clinical characteristics. A descriptive analysis was carried out using consolidated data from Mpox notification and laboratory surveillance in the state of São Paulo between May 2022 and May 2025. Cases with a positive RT-PCR result for Mpox were included. The variables analyzed included year of notification, sex, sexual orientation, HIV serological status, type and location of lesions, and associated clinical symptoms. The data were organized in an Excel spreadsheet for analysis of absolute and relative frequencies. Among the 25,735 cases reported as suspected Mpox during the study period, 5,521 were confirmed by RT-PCR. Most cases occurred in 2022 (74.9%), with a significant reduction in 2023 (2.8%) and a new increase in 2024 (19.0%), while the first five months of 2025 accounted for 3.3% of total cases. There was a predominance of cases in males (93%), particularly cisgender men (74.5%), with the highest concentration among individuals aged 25 to 39 years, and 46.2% of cases occurred among Black and mixed-race individuals. Regarding sexual orientation, 69.6% identified as men who have sex with men/bisexual (MSM), and 82 cases occurred among transgender, travesti, and non-binary individuals. A total of 32.7% of cases occurred among people living with HIV/AIDS, and 82.9% reported being on antiretroviral therapy. More than half (56.7%) presented with genital lesions. Fever (56.8%), lymphadenopathy (42.3%), and myalgia (41.8%) were the symptoms most frequently associated with skin lesions. The Mpox outbreak in São Paulo reached its greatest magnitude in 2022; however, the persistence of viral circulation in subsequent years, even with fewer reported and confirmed cases, demonstrates a transition toward an endemic pattern. The high concentration of MSM and the large proportion of people living with HIV among confirmed cases highlight the need for sustained disease surveillance and control strategies that prioritize these groups, aiming to reduce transmission chains and provide individual protection against severe forms of the disease.
Costa et al. (Sun,) studied this question.