Abstract: Objective: To analyze the clinical and epidemiological characteristics of cases with monkeypox in Suzhou City, and provide scientific basis for the prevention and control of monkeypox epidemic. Methods: Forty four confirmed cases of monkeypox with current residence in Suzhou City , reported through the online direct reporting system of the China Information System for Disease Control and Prevention from July 1, 2023 to January 31, 2025, were selected. Professionals collected epidemiological investigations and descriptive epidemiological methods were used for analysis. Throat swabs, anal swabs and pustular fluid samples from the cases were collected for nucleic acid detection and high-throughput sequencing of the monkeypox virus. Results: Forty four cases of monkeypox were among men who have sex with men, with a median age of 33.5 (27, 38) years old, 40.91% were co-infected with HIV, 90.91% were detected through active medical visits, among them, 40% were diagnosed for the first time. 95.45% of the cases reported having had male-to-male sexual activity within 21 days before the onset. The initial symptoms of the cases were mainly rash (75.00%) and fever (15.91%). The proportion of cases with perianal rashes among HIV-infected individuals was higher than that among non-HIV-infected individuals (P＜0.05). The nucleic acid positive detection rate of vesicle swabs (100%) was higher than that of throat swabs (50%). All positive specimens were subjected to whole genome sequencing, and all belonged to the West African type IIb branch, C.1 lineage. Conclusion: The monkeypox epidemic in Suzhou City is mainly sporadic, with the main infected group being men who have sex with men. The main symptoms of monkeypox cases are rash and fever. The positive detection rate of nucleic acid in vesicle swabs was significantly higher than that in throat swabs.

Key words: monkeypox, men who have sex with men, HIV, epidemiology