June 6, 2022 – The global tally of monkeypox cases has passed 800 and continues to increase daily across more than two dozen countries where the virus isn’t typically found, according to the latest report from the World Health Organization.
So far, no deaths have been linked to the current monkeypox outbreak in non-endemic countries, although deaths have been reported in Central and West Africa, where the virus is considered endemic.
“Epidemiological investigations are ongoing,” the WHO said. “Most reported cases so far have been presented through sexual health 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, spanning 20 countries. The U.K. has reported 302 cases, according to an update from the U.K. Health Security Agency on Monday, which added 77 new cases since Friday.
Spain has reported 186 cases, according to a global map by the CDC, followed by 143 cases in Portugal, 80 cases in Canada, 65 cases in Germany, and 51 cases in France.
Outside of Europe and North America, eight cases have been reported in the United Arab Emirates, and one case has been reported in Morocco, the WHO reported. In the Western Pacific region, Australia has reported six cases.
Although the West African version of the virus was identified in nearly all samples of the cases so far, most confirmed cases with a travel history have reported travel to countries in Europe and North America, rather than Africa.
“The confirmation of monkeypox in persons who have not traveled to an endemic area is atypical, and even one case of monkeypox in a non-endemic 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 has 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 symptoms seen in people with confirmed cases have varied, the WHO reported, and many cases in this outbreak don’t show the “classical clinical picture.” In the cases so far, the most common symptoms include genital and anal lesions, fever, swollen lymph nodes, and pain when swallowing. Some people also reported that the genital rash or bumps appear before other symptoms, such as fever, and that lesions appear at different stages of development, which isn’t usually how monkeypox has shown up in the past.
“Apart from patients hospitalized for the purpose of isolation, few hospitalizations have been reported,” the WHO said. “Complications leading to hospitalization have included the need to provide adequate pain management and the need to treat secondary infections.”
Using Vaccines
Several countries are using monkeypox and smallpox vaccines for close contacts, the WHO said. The U.S. and the European Union have also approved an antiviral medication to treat orthopoxviruses, the virus family that includes monkeypox.
So far, the U.S. has provided 1,200 vaccines doses to people who have had high-risk exposures to the virus. As of Sunday, 25 cases had been reported across 12 states, according to the latest CDC data, including five cases in California and five cases in New York. U.S. Public health officials have done 120 tests so far for orthopoxviruses.
The U.S. has millions of vaccine doses in its strategic national stockpile, according to CNBC. Two vaccines are available. Jynneos, the preferred option, is a two-dose vaccine approved by the FDA in 2019 to prevent monkeypox in adults. ACAM2000, which is an older smallpox vaccine, can have serious side effects.
Last week, a CDC official reported that the U.S. has 1,000 doses of the Jynneos vaccine available, according to CNBC. But Bavarian Nordic, which is the Danish biotech company that makes the shots, said the U.S. has more than 1 million frozen doses stored in the U.S. and Denmark under an order placed in 2020. The shots have a 3-year shelf life.
Bavarian Nordic plans to increase production this summer and can produce 30 million shots per year, CNBC reported.
Potential Case in Washington, DC
On Sunday, public health officials in the District of Columbia announced its first positive orthopoxvirus case, which could be its first monkeypox case. Samples have been sent to the CDC to see if the case tests positive for monkeypox, according to the DC Health announcement.
The DC resident reported recent travel to Europe. Local health officials are identifying and monitoring close contacts, though no other cases have been identified so far. The patient is isolating and doesn’t pose a risk to the public, DC Health said.
Will testing ramp up in the endemic countries now that the virus is showing up elsewhere?
World Health Organization: “Multi-country monkeypox outbreak: situation update, June 4, 2022.”
U.K. Health Security Agency: “Monkeypox cases confirmed in England – latest updates, June 6, 2022.”
CDC: “2022 Monkeypox and Orthopoxvirus Outbreak Global Map,” “U.S. Monkeypox 2022: Situation Summary.”
CNBC: “The CDC is sending monkeypox vaccines to people at high risk in a race to prevent the spread.”
DC Health: “DC Health Confirms First Orthopoxvirus and Potential Monkeypox Case in the District.”
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