Monkeypox outbreak: List of countries with reported cases

The monkeypox virus, which causes smallpox-like infection, is spreading around the world. It can be fatal in certain cases. Yet it is described as "under-recognised" and "underreported emerging disease", according to the World Health Organisation (WHO).

So far, 21 countries — those that don’t normally report monkeypox (including in Europe, Americas, Morocco, Isreal and the UAE) — have confirmed cases of infections as of Tuesday (May 24, 2022). It's nearly double the previous number (12 countries with confirmed or suspected cases on Saturday, May 21).

There are 270 people (from the the previous 111) who had been infected or suspected to be infected with monkeypox virus (MPXV), according to latest reports by health authorities and www.global.health/.

More cases are likely to be reported as surveillance expands. The World Health Organisation (WHO) is working with the affected countries and others to expand disease surveillance to find and support people who may be affected, and to provide guidance on how to manage the disease.

UPDATES:

> At least 21 countries have reported monkeypox cases.

> In the last two days, Argentina, The Netherlands, Slovenia, Switzerland, Morocco and the UAE have confirmed cases or announced they are investigating suspected cases of the smallpox-like viral infection.

> Most monkeypox cases are mild.

> A senior WHO official said monkeypox can be “contained” in countries outside of Africa where the virus is not usually detected.

> “This is a containable situation,” the WHO's emerging disease lead Maria Van Kerkhove said at a news conference on Monday.

> “We want to stop human-to-human transmission. We can do this in the non-endemic countries,” she said.

> At least 175 cases of the virus have been confirmed in Europe, the Americas and Australia.

> That number is expected to rise still, but experts say the overall risk to the broader population is “very low”.

> The virus is most common in remote parts of Central and West Africa.

> The virus has now been detected in 20 countries outside Africa.

> It is the largest outbreak outside of Africa in 50 years.

> Experts say the threat is not comparable to the coronavirus pandemic, and that close contacts facilitate transmission.

> Monkeypox does not spread easily between people.

> Incubation is long (5-21 days), suspicion was low thus allowing for "stealth transmissions”.

> “Transmission is really happening from skin-to-skin contact, most of the people who have been identified have more of a mild disease,” Van Kerkhove said.

> Other experts, however, say the monkeypox virus is “airborne”, citing previous studies.

> Virus has likely been circulating in Europe since April, say experts.

> French Health Authority recommends to vaccinate people who have been in contact with monkeypox patients

> Health officials worldwide are rushing to assess reserves of vaccines and treatments that may be needed to contain its spread.

> Meanwhile, the US emergency stockpile holds 100 million units of two vaccines approved by the Food and Drug Administration (FDA) that could be used to contain monkeypox, officials at the Centers for Disease Control and Prevention told reporters on Monday.

> Since incubation is long (5 to 21 days), suspicion was low, thus allowing for “stealth transmissions”.

> It appears scientists warned in 2019 about the recent rise in monkeypox cases? In 2019, experts attended a seminar in London and discussed the need to develop "new generation vaccines and treatments".

> In the seminar, the experts apparently discussed that a large part of the world population (said to be 70%) is not protected against smallpox as, after the eradication of the disease, smallpox vaccinations have been stopped (or paused).

> It eventually means that the particular population is no longer protected against other viruses in the same family.

> The United States is in the process of releasing monkeypox vaccine. The two-dose Jynneos vaccine is licensed to prevent smallpox and specifically to prevent monkeypox, according to US media.

> Germany has also placed orders for the first batch of smallpox vaccines (which also work against monkeypox) as a preventive measure.

What we know so far (from an earlier report):

What is monkeypox?

Monkeypox is a rare disease caused by infection with monkeypox virus, which originates in wild animals like rodents and primates, and then spreads to people.

It’s usually a mild viral infection. The virus belongs to the same family as the smallpox (Orthopoxvirus genus in the family Poxviridae). This genus also includes variola virus (which causes smallpox), vaccinia virus (used in the smallpox vaccine), and cowpox virus.

How many strains of the virus are known?

The WHO has said there are two main strains:

How fatal is monkeypox?

In Africa, —the Congro strain is more severe "with up to 10% mortality” (even up to 15%), Death is more likely among kids.

The West African strain, on the other hand, is less severe, has a case fatality rate in about 1% of cases.

It’s not immediately known what strain is found in the countries with reported cases, though the UK cases have been reported as the West African strain.

While epidemiology experts say monkeypox usually is “extremely rare”, the US CDC has expressed concern over the surge in transmission and warned that the UK outbreak could spread — alongside the Portugal and Spain outbreaks.

“It is so unusual. Yet I see people saying it’s nothing, just like the flu. Do we never learn to follow new data?” said Harvard epidemiologist Dr Eric Feign-Ding.

How can you get infected with monkeypox?

The virus enters the body through:

It is thought to be spread by rodents, such as rats, mice and squirrels. Key point: Human-to-human transmission is possible.

Is monkeypox virus airborne?

Previous studies state monkeypox is airborne — and stable for up to 90 hours, which could mean it’s infectious during that period (3.75 days).

“Monkeypox is likely aerosol airborne,” said Harvard epidemiologist Dr Eric Feigl-Ding, citing a 2012 study published in the Journal of Virological Methods.

“I pray we’ve learned our lesson with #COVIDisAirborne and don’t repeat the droplet vs airborne 2-year nonsense.”

Are there drugs or vaccines specifically against monkeypox?

Currently, there’s no monkeypox-specific drugs or vaccines. In the past, smallpox vaccines had been used to curb monkeypox viral transmission.

Was there a previous outbreak of monkeypox?

In 2003, a monkeypox outbreak was recorded in the US. It was traced back to imported exotic animals. In that outbreak, 71 people in 6 US states contracted monkeypox.

Is there a common pattern of transmission?

It's not clear yet as to how people in those clusters in four continents were exposed to monkeypox.  CDC is urging healthcare providers to be alert for patients who have rash illnesses consistent with monkeypox, regardless of whether they have travel or specific risk factors for monkeypox and regardless of gender or sexual orientation.

COUNTRY UPDATES:

> Australia: 1 probably case (a traveller from Europe) reported on Friday by Australian authorities. Confirmatory testing underway.

> Belgium: 2 cases confirmed in two different places — one each in Antwerp and the Flemish Brabant region, according to AFP report.

> Canada: 2 confirmed cases as of Friday. Quebec authorities investigating 17 suspected cases.

> France: 1 case of monkeypox infection confirmed in a 29-year-old person with no history of travel, found in Ile-de-France region, which includes Paris.

> Germany: 1 case reported by Reuters quoting “Focus”, a German-language news magazine that, in turn, cited German military.

> Italy: 1 case confirmed.

> Sweden: 1 case confirmed.

> Portugal: 14 cases so far, with 20 others being monitored. The Portuguese health authority “is worried”, according to Reuters, and stressed the need to break transmission chains.

> Spain: 14 confirmed cases on Friday (total 21), with 20 more suspected cases.

> UK: 9 cases since May 6. The UK Health Security Agency has warned gay and bisexual men, urging them to 'be aware of any unusual rashes or lesions'. The World Health Organisation this week said: "We are seeing transmission among men having sex with men.”

> US: 1 person tested positive for monkeypox on May 18 after returning to the US from Canada; tracking 6 more possible monkeypox cases. All were in close contact with a fellow traveller — on a flight from Nigeria to the UK earlier this month — who has shown symptoms.

>Netherlands: The Netherlands reported its first case on Friday and the government's health agency has warned of more infections. Dutch health authorities are bracing for several more cases to be reported.

(With input from Agencies)