Monkeypox spread to more than 20 countries, but outbreaks containable, WHO says

The World Health Organization on Thursday said the monkeypox virus has spread to more than 20 countries, urging nations to increase surveillance of the infectious disease as outbreaks grow. 

About 200 confirmed cases and more than 100 suspected cases of monkeypox have been detected outside of countries where it usually circulates, according to Maria Van Kerkhove, the WHO’s Covid-19 technical lead. She said more cases of the rare viral illness will likely be reported as surveillance expands, but added that the recent spread is containable.

“We expect more cases to be detected. We are asking countries to increase surveillance,” Van Kerkhove said during a Q&A on the global health agency’s social media platforms. “This is a containable situation. It will be difficult, but it’s a containable situation in the non-endemic countries,” she said.

Monkeypox has spread to North America and Europe in recent weeks, generating outbreaks in countries outside of Central and West Africa where the virus has circulated at low levels over the past four decades. A milder West African strain of the virus is driving the outbreaks and most patients recover in a few weeks. No deaths have been reported so far.

The European Union has confirmed 118 cases of monkeypox, according to the European Centre for Disease Prevention and Control. Spain and Portugal have reported the largest outbreaks in the EU with 51 and 37 cases respectively. The United Kingdom has confirmed 90 cases of the virus, according to the U.K. Health Security Agency.

In North America, the U.S. has identified nine cases of monkeypox across seven states, according to the Centers for Disease Control and Prevention. Canadian health officials confirmed 16 cases of monkeypox, all detected in the province of Quebec.

CDC Director Dr. Rochelle Walensky said on Thursday some patients in the U.S. haven’t traveled to countries with active outbreaks, suggesting that the virus is spreading domestically. Walensky said the CDC is conducting contact tracing and trying to break chains of transmission in the U.S.

Health officials in Europe, the U.K. and the U.S. have said a majority the patients are gay or bisexual men, with the virus spreading in many cases through sex. However, the officials emphasized that monkeypox can spread to anyone through close physical contact regardless of sexual orientation. Van Kerkhove said it is important to raise awareness about who faces an elevated risk right now without stigmatizing anyone.

Monkeypox is not a sexually transmitted disease. The virus can spread through any kind of sustained skin-to-skin contact with an infected person who has a lesion. It can also spread through body fluids, contaminated bedsheets and clothing, or respiratory droplets if a person has a lesion in their mouth.

The virus usually begins with symptoms similar to the flu such as fever, muscle aches, chills, headaches, exhaustion and swollen lymph nodes. It then progresses to body rashes characterized by raised bumps that turn into puss-filled blisters which eventually dry out and fall off.

Van Kerhkove urged health-care professionals to consider monkeypox a diagnosis for patients with rash illnesses that present at sexual health clinics, emergency departments, infectious disease clinics, primary-care physicians and dermatologists. 

“It doesn’t mean that anyone with a rash will have monkeypox but we need to raise awareness about what monkeypox is and isn’t, and we need to ensure that countries have the capacity to test and provide the right information,” she said.