More nations report monkeypox; possible case in New York

Just weeks after the detection of monkeypox in two separate case clusters in the United Kingdom, at least eight European countries, as well as Canada, the United States, and Australia, now have confirmed cases of the virus.

Worldwide, 70 cases of the virus typically seen in West African countries have been detected this month. Almost all cases have occurred in men under age 40.

Belgium, France, and Germany joined Portugal, Spain, the United Kingdom, Italy, and Sweden in reporting initial cases of the disease, which is transmitted through close contact with an infected person. Many of the cases have been described in men who have sex with men who have no travel history to countries where monkeypox is endemic, such as Nigeria.

The case in Germany occurred in a 26 year-old Brazilian man who was traveling the country after also visiting Portugal and Spain.

Michael Osterholm, PhD, MPH, director of the University of Minnesota's Center for Infectious Disease Research and Policy (CIDRAP), told CIDRAP News he expects the outbreak to grow further.

"We have to expect there will be many more cases described in the coming days," he said.

Suspected case at Bellevue Hospital, NYC

Late yesterday evening, New York City health officials announced they were investigating a possible monkeypox case in a patient being treated at Bellevue Hospital and that they were sending samples to the Centers for Disease Control and Prevention (CDC) to confirm.

So far, the United States has one confirmed case, in Massachusetts. Canada has two confirmed cases, with several more suspected cases under investigation.

According to the CDC, the incubation period for monkeypox can last 5 to 21 days, before causing fever, fatigue, and swollen lymph nodes. A telltale rash appears on the face and hands and typically resolves within 1 month.

In Australia, both Victoria and New South Wales confirmed their first cases today.

"It is important to note that significant close contact with an infected person who is displaying symptoms is usually required for transmission. This means that, with good community awareness, transmission is likely to be localised, readily identified and able to be contained," the Australian Department of Health said in a press release.

UK confirms 11 more cases

The UK Health Security Agency (UKHSA) reported an additional 11 confirmed cases, bringing the country's total to 20 since May 6.

"We expect this increase to continue in the coming days and for more cases to be identified in the wider community. Alongside this we are receiving reports of further cases being identified in other countries globally," said Susan Hopkins, MD, chief medical advisor of UKHSA. "Clinicians should be alert to any individual presenting with unusual rashes without a clear alternative diagnosis and should contact specialist services for advice.”

Today, the World Health Organization (WHO) called a meeting of the Strategic and Technical Advisory Group on Infectious Hazards with Pandemic and Epidemic Potential (STAG-IH) to discuss the case clusters.

"Monkeypox has so far been reported from 11 countries that normally don't have the disease. WHO is working with these countries & others to expand surveillance, and provide guidance. There are about 80 confirmed cases, and 50 pending investigations. More likely to be reported," WHO tweeted today.

Before the current outbreak, the largest monkeypox outbreaks outside of West and Central Africa occurred in six US states: Illinois, Indiana, Kansas, Missouri, Ohio, and Wisconsin, in 2003, when 47 cases were recorded with a link to infected pet prairie dogs.

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