Monkeypox hands
Monkeypox virus cases have sparked concerns in many European countries — Belgium, France, Germany, Italy, the Netherlands, Portugal, Spain, Sweden and the United Kingdom — even as cases have been reported from the United States, Canada and Australia too. Image Credit: Reuters

Belgium became the first country in the world to mandate a 21-day quarantine for patients affected by monkeypox even as Israel confirmed its first case of the smallpox-like viral infection, it was reported on Monday.

Brussels' 21-day monkeypox quarantine comes as 15 countries now confirmed outbreaks of the viral disease.

Belgium has confirmed four cases of monkeypox so far. Those who contract the virus will now have to self-isolate for three weeks, Belgian health authorities said, after four cases were recorded in the country. The infections, the first of which was recorded on Friday, are all linked to a festival in the port city of Antwerp.

Microbiologist Emmanuel Andre, the official in charge of the National Reference lab for COVID-19 in Belgium, said on Sunday (May 22) that their laboratories "work 7/7 to offer rapid diagnosis (PCR and sequencing) for patients with suspected monkeypox infection." He also confirmed the fourth monkeypox infection in the country Sunday.


On Sunday, Israeli authorities announced they detected the country's first case of monkeypox in a man who returned from abroad, even as they were looking into other suspected cases. Israel's Health Ministry said the man was in a Tel Aviv hospital in good condition.

It called on anyone returning from abroad with fever and lesions to see a doctor. Sharon Alroy-Preis, the head of public health services at the ministry, told Israeli Army Radio Sunday that medical teams were investigating other suspected monkeypox cases, AP reported. Israel's case appeared to be the first identified in the Middle East.

Mainland Europe

Doctors warn of a "significant rise" in monkeypox virus cases, sparking concerns in many European countries — Belgium, France, Germany, Italy, the Netherlands, Portugal, Spain, Sweden and the United Kingdom — even as cases have been reported from the United States, Canada and Australia too.

The Belgian health authorities took the decision Friday, according to reports citing Belgian media.

As the WHO held an emergency meeting on Friday, a top health official has raised the possibility that cases could “accelerate”.

“As we enter the summer season... with mass gatherings, festivals and parties, I am concerned that transmission could accelerate,” WHO regional director for Europe Hans Kluge has been quoted as saying by news agency AFP.


In the UK, high-risk contacts of monkeypox cases were told to self-isolate and avoid children for three weeks. The UK is set to announce more cases as high-risk close contacts told to isolate for three weeks.

So far, a total of 20 monkeypox cases have been confirmed by the UK Health Security Agency (HSA), according to British media. The patients include a child reportedly in intensive care with monkeypox as new cases are being detected daily in Britain. A fresh HSA update due on Monday.


In the US, President Joe Biden said "everybody should be concerned" about spread of monkeypox, but said quarantine for monkeypox are not need in America, adding that the US has “enough” vaccines.

monkeypox WHO map
Geographical distribution of confirmed and suspected cases of monkeypox in non-endemic between 13 to 21 May 2022 (1pm) Image Credit: WHO

What is Monkeypox?

STOCK Monkeypox_07235
This 2003 electron microscope image made available by the Centers for Disease Control and Prevention shows mature, oval-shaped monkeypox virions, left, and spherical immature virions, right, obtained from a sample of human skin associated with the 2003 prairie dog outbreak. Monkeypox, a disease that rarely appears outside Africa, has been identified by European and American health authorities in recent days. Image Credit: AP

Monkeypox is a smallpox-like disease with symptoms include a distinct bumpy rash, a fever, sore muscles and a headache.

Monkeypox is labelled as "less deadly than smallpox". Experts, however, cited what has been described as the "unusual spread" of the disease beyond Africa where it usually circulates.

The rare viral infection can be transmitted by very close contact with an infected person. It is usually mild, with most patients recovering within a few weeks — without treatment. The disease, however, can prove fatal with the strain causing the current outbreak killing one in 100 infected.

A study published in February in PLoS Neglected Tropical Diseases conducted a systematic review of 48 peer-reviewed studies, looking primarily at the number of cases of monkeypox, age at presentation, mortality and geographical spread.

The review found that the number of human monkeypox cases has been on the rise since the 1970s, most dramatically in the Democratic Republic of the Congo (DRC). The median age at of patients with monkeypox increased from 4 years in the 1970s to 21 years between 2010 and 2019, the review stated.

In the report, the authors found that 8.7% of patients with monkeypox died — 10.6% of those infected with the Central African strain, or "clade", of the virus and 3.6% infected with the West African strain, "which has been implicated in the recent cases".

Researchers stated that "waning population immunity" against smallpox — a result of discontinued vaccination campaigns for the now-eradicated disease — “has established the landscape for the resurgence of monkeypox.”