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New virus monkeypox | Multi-country monkeypox outbreak in non-endemic countries

A sudden outburst

As of 13 May 2022, monopoly cases have been reported to WHO from 12 member states that are not diagnosed with monopoly virus, in three WHO regions. Epidemiological investigations are ongoing, however, the reported cases so far do not have fixed travel links to the epicenter. Based on the available information, cases in particular have not been identified only between men who have sex with men (MSM) seeking care in health care facilities and sex clinics.

The purpose of these epidemics is to raise awareness, to inform preparedness and response efforts, and to provide technical guidance on rapid action.

The situation is improving and the WHO expects that there will be more monopoly cases identified as surveillance increases in non-stop countries. Immediate action focuses on informing those who may be at high risk of infection with mypocyncy with accurate information, in order to prevent further spread. Current evidence suggests that those most at risk are those who once had a close relationship with a monkey, while they themselves have symptoms. The WHO is also working to provide guidance to protect key health care providers and other potential health workers such as cleaners. The WHO will be providing additional technical recommendations in the coming days.

Definition of breakdown

As of May 21, at 13:00, 92 confirmed laboratory cases, as well as 28 suspected cases of monkey with ongoing investigations, were reported to WHO from 12 Member States that were not diagnosed with monopoly virus, in three WHO regions (Table) 1, Figure 1). No deaths related to this have been reported so far.

Incidents reported so far do not have fixed travel links to the epidemic. Based on the available information, cases in particular have not been identified only between men who have sex with men (MSM) seeking care in health care facilities and sex clinics.

To date, all cases of PCR-certified samples have been identified as West African clade virus. The genome sequence from a swab sample in a certified case in Portugal, showed similarities to the monopoly virus that causes current outbreaks, exported cases from Nigeria to the United Kingdom, Israel and Singapore in 2018 and 2019.

The identification of verified and suspected monmypox cases without direct travel links to the epicenter represents a very unusual event. Surveillance so far in unusual areas is limited, but it is now growing. The WHO expects more cases to be reported in non-playing areas. Available information suggests that human-to-human transmission occurs between people who are physically close and symptomatic cases.

In addition to these new developments, WHO continues to receive updates on the status of ongoing reports of cases of monocytes through established monitoring mechanisms (Integrated Disease Surveillance and Response) of cases in infected countries [1], as summarized in Table 2.

[1] The countries found in monotheypox are: Benin, Cameroon, Central African Republic, Democratic Republic of the Congo, Gabon, Ghana (animal-only), Ivory Coast, Liberia, Nigeria, Republic of the Congo, Sierra Leone, and South Sudan.
Epidemiology of the disease

Monkeypox is a viral zoonosis (a virus transmitted from humans to animals) with symptoms very similar to those seen earlier in smallpox patients, although less severe in the clinic. It is caused by the mantleypox virus that is part of the orthopoxvirus of the Poxviridae family. There are two phases of the monopoly virus: the West African clade and the Congo Basin (Central African) clade. The term monkeypox comes from the first discovery of the virus in monkeys in a Danish laboratory in 1958. The first human case was discovered in a child in the Democratic Republic of the Congo in 1970.

Monsexox virus is spread from one to another through close contact with sores, body fluids, respiratory droplets and contaminants such as sleep. The incubation period for monmoypox usually lasts from 6 to 13 days but can range from 5 to 21 days.

Various species of animals have been identified as susceptible to the monopoly virus. Uncertainty remains in the natural history of the monometer virus and further research is needed to identify the lake (s) directly and how the circulation of the virus is maintained naturally. Eating insufficient meat and other animal products of infected animals is a potential risk factor.

Monkeypox is often self-limiting but can be difficult for some people, such as children, pregnant women or people with a weakened immune system due to other health conditions. Infection in the West African region appears to be causing the worst disease compared to the Congo Basin clade, with a mortality rate of 3.6% compared to 10.6% of the Congo Basin clade.

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