With monkeypox cases emerging across 12 countries in the world, the World Health Organization (WHO) has now declared it an outbreak.
As of 21st May, the world has reported 92 laboratory-confirmed and 28 suspected monkeypox cases. The cases have come forward from across 12 countries; the majority occurred in the UK, Spain, and Portugal. According to WHO’s latest press release, as countries expand surveillance, more cases will appear globally.
What makes this outbreak unusual is that all cases have occurred in countries that are not endemic to monkeypox. Moreover, many of the cases emerged among people with no history of travel to Central or West Africa.
Monkeypox cases first appeared this year in early May, in England. The UK Health Security Agency (UKHSA) had reported a single case with a history of travel to Nigeria. The patient had remained under isolation at St. Thomas’ Hospital in London. However, since then, several more cases have been identified in the UK.
Available information suggests that human-to-human transmission is occurring among people in close physical contact with cases who are symptomatic.
World Health Organization
The rare, but serious illness is endemic to African countries: Nigeria, Cameroon, Liberia, and the Democratic Republic of Congo. It typically appears as a flu-like illness accompanied by a rash, swollen lymph nodes, muscle ache, and exhaustion. The rash begins as a macule that turns into a papule, a vesicle, a puss-filled blister that bursts and then finally scabs over. It typically appears on the face first before spreading all over the body, including to the palms of the hands and soles of the feet. Approximately a third of the people can have lesions on the genitals as well.
Spain, Canada, Australia Record Cases
Recently, Spanish health authorities reported a possible monkeypox outbreak after 23 people began showing symptoms of the illness. Although the suspected cases occurred in the Madrid region, authorities have issued a nationwide alert. All cases are under isolation at home and doctors are monitoring their condition to look for any signs of hospitalization.
In Canada, more than a dozen cases have appeared in Quebec, five of which have been confirmed as monkeypox. Moreover, Portugal, Australia, Belgium, Germany, Italy, France, the Netherlands, and the US have also reported cases.
The UKHSA’s latest update confirmed 36 additional monkeypox cases; thus, bringing the total to 56. According to the press release, a great proportion of these cases occurred in gay and bisexual men. Therefore, experts are particularly urging these men to stay alert for any rash or other monkeypox symptoms. Despite the increasing numbers worldwide, health officials have maintained that the risk to public remains low. However, as a precaution, UKHSA has purchased supplies of the smallpox vaccine, Imvanex.
There is currently a monkeypox vaccine under development, but smallpox vaccine and treatments could be deployed to control any monkeypox outbreak, but we don’t know how successful that might be because it’s never been tried.
Dr. Simon Clarke, University of Reading
There is currently no specific treatment for monkeypox infection. Since the monkeypox virus belongs to the same family responsible for causing smallpox, researchers believe that the smallpox vaccine can also protect against the current outbreak. According to the US Centers for Disease Control and Prevention (CDC), the vaccine is at least 85% effective at preventing monkeypox. Currently, the smallpox vaccines are not available to the public
The UK has already begun administering Imvanex to high-risk healthcare workers and close contacts of infected individuals.
Why the Sudden Spike in Monkeypox Cases?
Close contact with an infected animal, or eating inadequately cooked meat or meat products from an infected animal is a cause of virus transmission to humans. The monkeypox virus is present in squirrels, rodents, and some species of monkeys. According to WHO, human-to-human transmission occurs from close contact with respiratory droplets, exposure to skin lesions, or contaminated objects. However, since respiratory droplets are large and cannot travel more than a few feet, it requires prolonged face-to-face contact with an infected individual.
Although the disease typically appears as a mild, self-limiting infection, in young children and immunodeficient people, it can lead to complications or even death. However, since the virus is not easily transmitted, health experts believe the risk to the public remains low.
What’s concerning about the current outbreak is that a majority of cases have occurred among gay or bisexual men, mostly at sexual health clinics. Moreover, none of these men had a travel history to any of the endemic African regions. Thus, suggesting that physical contact with lesions or infected surfaces during sexual activity is likely spreading the disease among the public.
What seems to be happening now is that it has got into the population as a sexual form, as a genital form, and is being spread as are sexually transmitted infections, which has amplified its transmission around the world.
David Heymann, World Health Organization
However, it is important to specify that the risk of infection is not exclusively for gay or bisexual men. The WHO has advised everyone, irrespective of their sexual identity, to avoid closer personal contact with anyone with a rash or illness. Moreover, in case of suspicion or contact, they should self-isolate and stay alert for symptoms of monkeypox.
