June 6, 2022 – The global number of monkeypox cases has passed 800 and is still rising daily in more than two dozen countries where the virus is not normally present, according to the latest report from the World Health Organization.
To date, no deaths have been linked to the current spread of monkeypox in non-endemic countries, although deaths have been reported in Central and West Africa, where the virus is considered endemic.
“Epidemiological investigations are underway,” the World Health Organization said. “Most of the cases reported to date have been provided by sexual health services or other health services in primary or secondary health care facilities and have involved mainly, but not exclusively, men who have sex with men.”
Most cases have been reported in the WHO’s European region, which covers 20 countries. The UK has reported 302 cases, according to an update from Britain’s Health Security Agency on Monday, which added 77 new cases since Friday.
Spain has reported 186 cases, according to a global map of the Centers for Disease Control and Prevention, followed by 143 in Portugal, 80 in Canada, 65 in Germany, and 51 in France.
The World Health Organization reported that eight cases were reported outside Europe and North America in the United Arab Emirates, and one in Morocco. In the Western Pacific region, Australia has reported six cases.
Although the West African version of the virus has been identified in nearly all case samples to date, most confirmed cases with a travel history have reported travel to countries in Europe and North America, rather than Africa.
“Confirmation of monkeypox in people who have not traveled to an endemic area is unusual, and even a single case of monkeypox in a non-epidemic country is considered an outbreak,” the WHO said.
Since January, seven endemic countries in Africa have reported 44 confirmed cases, more than 1,400 suspected cases and 66 deaths. The Democratic Republic of the Congo reported the highest numbers, with 1,284 suspected cases and 58 deaths, followed by Nigeria with 66 suspected cases, 21 confirmed cases, and one death.
The World Health Organization reported that symptoms observed in people with confirmed cases varied, and many of the cases in this outbreak do not show the ‘traditional clinical picture’. Symptoms most commonly seen in cases to date include genital and anal lesions, fever, swollen lymph nodes, and pain when swallowing. Some people have also reported that rashes or bumps on the genitals appear before other symptoms, such as a fever, and that the lesions appear at different stages of development, which they do not usually appear in the past.
“Apart from patients admitted to hospital for the purpose of isolation, few cases of hospitalization have been reported,” the WHO said. “Complications that led to hospitalization included the need to provide adequate pain management and the need to treat secondary infection.”
The World Health Organization said many countries are using monkeypox and smallpox vaccines for close contact. The United States and the European Union have also approved an antiviral drug to treat orthopoxviruses, the family of viruses that includes monkeypox.
The United States has so far provided 1,200 vaccine doses to people who have been at high risk for the virus. As of Sunday, 25 cases were reported in 12 states, according to the latest CDC data, including five in California and five in New York. US public health officials have conducted 120 tests so far for orthopoxviruses.
The United States has millions of doses of the vaccine in its strategic national stockpile, according to CNBC. Two vaccines are available. Jynneos, the preferred option, is a two-dose vaccine approved by the Food and Drug Administration in 2019 to prevent monkeypox in adults. The ACAM2000 vaccine, an older smallpox vaccine, can have serious side effects.
Last week, a CDC official reported that the United States has 1,000 doses of the Jynneos vaccine available, according to CNBC. But Bavarian Nordic, the Danish biotech company that makes the shots, said the US has more than 1 million frozen doses stockpiled in the US and Denmark under an order filed in 2020. The shots have a 3-year shelf life.
CNBC reports that Nordic Bavarian plans to ramp up production this summer and could produce 30 million rounds per year.
Possible case in Washington, DC
On Sunday, District of Columbia public health officials announced the first case of orthopoxvirus, which may be the first case of monkeypox. The samples were sent to the CDC to see if they tested positive for monkeypox virus, according to a DC Health announcement.
A resident of the capital reported that he had recently traveled to Europe. Local health officials are identifying and monitoring contacts, although no other cases have been identified so far. DC Health said the patient is isolating and does not pose a risk to the public.
Will testing in endemic countries ramp up now that the virus has emerged elsewhere?