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There’s a monkeypox outbreak in England, Portugal and Spain. The outbreak is quite small – just 36 suspected cases spread across the three countries, including 8 in England and 20 in Portugal. A case in the U.S. has also been reported.
But health officials have little clue where people caught the virus. And there’s concern the virus may be spreading through the community – undetected – and possibly through a new route of transmission.
“This [outbreak] is rare and unusual,” epidemiologist Susan Hopkins, who’s the chief medical adviser of the U.K. Health Security Agency [UKHSA], said in a statement on Monday.
“Exactly where and how they [people] acquired their infections remains under urgent investigation,” the agency said in a statement.
Monkeypox can be a nasty illness, which causes a fever, body aches, enlarged lymph nodes and eventually “pox” or painful, fluid-filled blisters on the face, hands and feet. One version of monkeypox is quite deadly and kills up to 10% of people infected. The version currently in England is more mild. Its fatality rate is less than 1%. A case generally resolves in 2 to 4 weeks.
Typically, people catch monkeypox from animals in West or Central Africa and import the virus to other countries. Person-to-person transmission isn’t common, as it requires close contact with bodily fluids, such as saliva or pus from the lesions. So the risk to the general population is low, the U.K. health agency notes.
But in England, 7 of the 8 cases haven’t traveled recently to Africa, suggesting they caught the virus in England. On top of that, these cases haven’t had contact with the one case known to have traveled to Nigeria, the UKHSA reported Tuesday. Together this data suggests the virus is spreading in the community undetected.
“Presumably this is cryptic spread from an imported case(s),” virologist Angie Rasmussen of the Vaccine and Infectious Disease Organization wrote on Twitter on Tuesday.
In the U.S., the case in Massachusetts had not recently traveled to countries where the disease occurs but had visited Canada.
In addition, there’s evidence the virus could be transmitting through a new route: sexual contact. “What is even more bizarre is finding cases that appear to have acquired the infection via sexual contact,” epidemiologist Mateo Prochazka at the UKHSA wrote on Twitter. “This is a novel route of transmission that will have implications for outbreak response and control.”
“We are particularly urging men who are gay and bisexual to be aware of any unusual rashes or lesions and to contact a sexual health service without delay,” epidemiologist Susan Hopkins wrote.
So far, there are no cases in the U.S. But scientists at the Centers for Disease Control and Prevention are watching the outbreak in Europe closely. “We do have a level of concern that this is very different than what we typically think of from monkeypox,” Jennifer McQuiston, a senior CDC official, told STAT Tuesday.
In 2019, the U.S. Food and Drug Administration approved the first vaccine for monkeypox, which also protects against smallpox. “This vaccine is also part of the Strategic National Stockpile (SNS), the nation’s largest supply of potentially life-saving pharmaceuticals and medical supplies for use in a public health emergency that is severe enough to cause local supplies to be depleted,” the agency said.
A primer on monkeypox
So just what is known about monkeypox? And how threatening is it compared to other emerging viruses?
Back in 2017, Goats and Soda interviewed two monkeypox experts – Anne Rimoin at the University of California, Los Angeles, and Jay Hooper at the…
Read More: Goats and Soda : NPR