Symptoms of the monkeypox virus are shown on a patient's hand, from a 2003 case in the United States. In most instances, the disease causes fever and painful, pus-filled blisters. New cases in the United Kingdom, Spain and Portugal are spreading possibly through sexual contact, which had not previously been linked to monkeypox transmission.
There's a monkeypox outbreak in the United Kingdom, Portugal, Spain and other European countries. The outbreak is small — so far 68 suspected cases, including eight in England and 20 in Portugal. Cases in Canada and a case in the U.S. have also been reported.
But health officials have little clue where people caught the monkeypox 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 [the people] acquired their infections remains under urgent investigation," the agency said in the statement.
Monkeypox can be a nasty illness; it causes 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 milder. Its fatality rate is less than 1%. A case generally resolves in two to four weeks.
Suspected or confirmed cases of monkeypox, a rare viral infection related to smallpox, have now been reported in the United States, Canada and several European countries, marking an unusual international outbreak of a disease typically limited to Africa.
Canada is reportedly investigating a dozen suspected cases around Montreal, after Spain and Portugal spotted more than 40 possible and confirmed cases and the UK confirmed a total of nine.
In the US, the eastern state of Massachusetts confirmed on Wednesday a rare case of monkeypox in a man who recently travelled to Canada, and health officials are looking into whether it is connected to the cases in Europe.
The WHO says many cases reported have been in people identifying as gay, bisexual or men who have sex with men.
Typically, people catch monkeypox from animals in West Africa 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 from coughing 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 don't involve recent travel to Africa, suggesting the patients involved in those cases caught the virus in England. On top of that, those individuals haven't had contact with the one patient known to have traveled to Nigeria, the UKHSA reported Tuesday. Together, this data suggests the virus is spreading in the community undetected.
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