December 8, 2022

CDC – At least two distinct monkeypox outbreaks underway outside Africa

Multiple cases of monkeypox in Europe, the UK, Canada and the United States have health authorities worried that the dangerous, though usually not life-threatening, disease could be spreading – Copyright AFP Olga MALTSEVA

U.S. health officials on Friday urged doctors to test for monkeypox if they suspect cases, saying there may be community-level spread but that it was too soon to say if the disease will become endemic and that the overall public health risk remained low.

To date the number of cases of the virus have increased to 21 confirmed cases in 11 states as public health authorities increase testing in an effort isolate patients and prevent the virus from spreading in communities, according to the Centers for Disease Control and Prevention (CDC).

According to CNBC News, Dr. Jennifer McQuiston, a CDC official, said the overall health risk to the public remains low right now. Most of the U.S. patients had a history of international travel and it’s likely that they caught the virus while abroad, but the virus could be spreading domestically, McQuiston said.

“There could be community level transmission that is happening, and that’s why we want to really increase our surveillance efforts,” McQuiston told reporters during a call on Friday. “We want to really encourage physicians that if they see a rash and they’re concerned it might be monkeypox to go ahead and test for that,” she said.

It is currently believed that there is a higher risk for gay and bisexual men in contracting the disease. Of 17 patients that have provided detailed information to the CDC, 16 self-identified as men who have had sex with men, McQuiston said.

And while anyone can catch monkeypox through close physical contact, the CDC is closely monitoring all groups in the U.S. However, public health authorities are working to raise awareness in the LGBTQ community, McQuiston said.

“Our priority is to help everyone make informed decisions to protect their health and the health of their community guided by science,” she said.

At least two separate monkeypox outbreaks underway

The West African strain of monkeypox is behind the current outbreak, which is less severe than the other strain known as Congo Basin, according to the CDC.

Three of 10 viruses the CDC has sequenced from recent U.S. monkeypox cases — two from 2021 and eight from 2022 — are different from the viruses that have been sequenced by several countries involved in the large outbreak that is spreading in and from Europe, according to Stat News.

The large outbreak that has spread from Europe is currently being driven by infections in gay and bisexual men, as well as other men who have sex with men.

While the three divergent viruses are clearly linked to one another and have a common ancestor, they also differ more from one another than do the other viruses, Inger Damon, director of CDC’s division of high-consequence pathogens and pathology, told STAT in an interview.

Of the people infected with the three virus strains, they contracted the disease over a very wide geographic range of places. One was in Nigeria, one elsewhere in West Africa, and the third in either the Middle East or East Africa.

This apparent wide dissemation of related viruses – one that differs from the European outbreak strain  – strongly suggests that outbreaks outside of countries where monkeypox is considered endemic may have been smoldering for longer than has been appreciated, Damon acknowledged.