#16,764
Five days ago we first learned of community acquired cases of Monkeypox in the UK (see UKHSA Reports 2 Monkeypox Cases In London - Route Of Exposure Under Investigation), and just over 24 hours ago we learned of multiple cases in Spain and Portugal, a geographic expansion that suggests this outbreak has been ongoing, and flying under the radar, for some time.
So it is not terribly surprising that overnight the United States reported their first case, involving an adult male with recent travel to Canada - a nation which has not officially reported cases - but is reportedly investigating a dozen suspected cases in Quebec.
Although the risk to the general public is believed to be low, the size - and geographical extent - of this outbreak is still unknown. The good news is that this appears to be the milder West African clade of the Monkeypox virus, which is far less deadly than its Congo basin cousin.
The press release from the Massachusetts Department of Public Health follows:
PRESS RELEASE
Massachusetts public health officials confirm case of monkeypox
The confirmed case poses no risk to the general public
FOR IMMEDIATE RELEASE:
5/18/2022 Department of Public Health
BOSTON — The Massachusetts Department of Public Health (DPH) today confirmed a single case of monkeypox virus infection in an adult male with recent travel to Canada. Initial testing was completed late Tuesday at the State Public Health Laboratory in Jamaica Plain and confirmatory testing was completed today at the US Centers for Disease Control and Prevention (CDC). DPH is working closely with the CDC, relevant local boards of health, and the patient’s health care providers to identify individuals who may have been in contact with the patient while he was infectious. This contact tracing approach is the most appropriate given the nature and transmission of the virus. The case poses no risk to the public, and the individual is hospitalized and in good condition.
Monkeypox is a rare but potentially serious viral illness that typically begins with flu-like illness and swelling of the lymph nodes and progresses to a rash on the face and body. Most infections last 2-to-4 weeks. In parts of central and west Africa where monkeypox occurs, people can be exposed through bites or scratches from rodents and small mammals, preparing wild game, or having contact with an infected animal or possibly animal products. The virus does not spread easily between people; transmission can occur through contact with body fluids, monkeypox sores, items that have been contaminated with fluids or sores (clothing, bedding, etc.), or through respiratory droplets following prolonged face-to-face contact.
No monkeypox cases have previously been identified in the United States in 2022; Texas and Maryland each reported a case in 2021 in people with recent travel to Nigeria. Since early May 2022, the United Kingdom has identified 9 cases of monkeypox; the first case had recently traveled to Nigeria. None of the other cases have reported recent travel. UK health officials report that the most recent cases in the UK are in men who have sex with men.
Based on findings of the Massachusetts case and the recent cases in the UK, clinicians should consider a diagnosis of monkeypox in people who present with an otherwise unexplained rash and 1) traveled, in the last 30 days, to a country that has recently had confirmed or suspected cases of monkeypox 2) report contact with a person or people with confirmed or suspected monkeypox, or 3) is a man who reports sexual contact with other men. This clinical guidance is consistent with recommendations from UK health officials and US federal health officials, based on identified cases.
Suspected cases may present with early flu-like symptoms and progress to lesions that may begin on one site on the body and spread to other parts. Illness could be clinically confused with a sexually transmitted infection like syphilis or herpes, or with varicella zoster virus. The CDC plans to issue public information soon on poxvirus infections which, when available, will be found here.
For more about this virus, visit https://www.cdc.gov/poxvirus/monkeypox/.###
While the ultimate impact of this outbreak of Monkeypox probably won't be fully appreciated for weeks or even months, it should remind us of how easily a novel virus or exotic pathogen can spread via our modern transportation system.
