Monkeypox spreads to more nations, more US states

Monkeypox lesions on the back of the hands
Monkeypox lesions on the back of the hands

CDC / Brian W. J. Mahy

Clusters of monkeypox cases continue to be confirmed in countries once unfamiliar with the virus. Today the United Arab Emirates confirmed its first case, in a woman who was visiting the country from West Africa.

Initial detections were also reported in Slovenia and the Czech Republic. In Slovenia, the case occurred in a person returning from the Canary Islands, Spain.

According to the World Health Organization, many of these cases are being transmitted during the close, personal contact that arises from sexual relations. The disease is not known to be transmitted via vaginal secretions or seminal fluid, but can be spread through shared clothes and linens, respiratory droplets, and contact with skin rashes.

France, UK offer vaccination

Since monkeypox is a relative of the smallpox virus, smallpox vaccines are about 85% effective in preventing monkeypox. In the United Kingdom, health officials are offering smallpox vaccine to close contacts of cases and at-risk health workers.

"UKHSA health protection teams are contacting people considered to be high-risk contacts of confirmed cases and are advising those who have been risk assessed and remain well to isolate at home for up to 21 days," the agency said, adding that it had purchased vaccine supplies

The UK Health Security Agency (UKHSA) said today there were 14 additional monkeypox cases confirmed in that country, bringing the total to 71.

In France, high risk close contacts are also being offered vaccines as post-exposure prophylaxis. Germany also ordered 40,000 doses of a Bavarian Nordic smallpox vaccine called Imvanex—the same vaccine being used in the United States under the brand name Jynneos.

Yesterday President Joe Biden said the United States had enough stockpile of smallpox vaccine to deal with the current cluster of cases.

First cases in California, Washington state

A person in Sacramento County who had recently traveled internationally is California's first person with monkeypox.

In Seattle, King County officials say a man who also recently traveled internationally has contracted that state's first presumptive case of monkeypox.

"The public and healthcare providers should be aware of the growing international monkeypox outbreak," said Jeff Duchin, MD, health officer for public health in Seattle and King County. "At this time, we have no evidence that monkeypox is spreading locally, but if there are unrecognized cases, that is a possibility."

Today during a clinical outreach call by Centers for Disease Control and Prevention researchers, doctors emphasized the need to take a close history of any patient presenting with new rash symptoms—especially on the genitals.

Though herpes and syphilis are much more common and likely genital infections than monkeypox, it is critical that the monkeypox rash is properly identified.

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