What is monkeypox and where does it spread?

LONDON – European and American health authorities have identified a number of cases of monkeypox in recent days, mainly among young men. It’s a surprise outbreak of a disease rare outside of Africa.

Health officials around the world are on the lookout for more cases as the disease appears to be spreading for the first time among people who have not traveled to Africa. However, they emphasize that the risk to the general population is low.


Monkeypox is a virus that originates from wild animals such as rodents and primates and occasionally spreads to humans. Most human cases have occurred in central and western Africa, where the disease is endemic.

The disease was first identified by scientists in 1958 when there were two outbreaks of a “smallpox-like” disease in research monkeys – hence the name monkeypox. The first known human infection occurred in 1970 in a 9-year-old boy in a remote part of Congo.



Monkeypox belongs to the same virus family as smallpox but causes milder symptoms.

Most patients suffer only from fever, body aches, chills and fatigue. People with more severe illnesses can develop a rash and lesions on the face and hands, which can spread to other parts of the body.

The incubation period is about five days to three weeks. Most people recover in about two to four weeks without requiring hospitalization.

Monkeypox can kill up to 1 in 10 people and is thought to be more serious in children.

Individuals exposed to the virus are often given one of several smallpox vaccines that have been shown to be effective against monkeypox. Antiviral drugs are also being developed.

On Thursday, the European Center for Disease Prevention and Control recommended that all suspected cases be isolated and that high-risk contacts be offered the smallpox vaccine.



The World Health Organization estimates that there are thousands of monkeypox infections in about a dozen African countries each year. Most are in Congo, which reports about 6,000 cases annually, and Nigeria, with about 3,000 cases annually.

Incomplete health surveillance systems mean many infected people are likely to be missed, experts say.

Isolated cases of monkeypox are seen outside of Africa, including in the US and UK. Cases are typically related to travel to Africa or contact with animals from areas where the disease is more prevalent.

In 2003, 47 people in six US states had confirmed or probable cases. They caught the virus from prairie dogs kept near small mammals imported from Ghana.


It’s the first time monkeypox seems to be spreading among people who haven’t traveled to Africa. In most cases, these are men who have had sex with men.


In Europe, infections have been reported in the UK, Italy, Portugal, Spain and Sweden.

Britain’s Health Security Agency said its cases were not all linked, suggesting multiple chains of transmission are taking place. The infections in Portugal were discovered at a sexual health clinic where the men were seeking help for lesions on their genitals.

On Wednesday, US officials reported a case of monkeypox in a man who recently traveled to Canada. Health Canada also confirmed two cases linked to this positive test. Quebec health officials previously said they had suspected 17 cases in the Montreal area.


It’s possible, but it’s unclear at the moment.

Monkeypox has not been documented as being spread through sex, but it can be spread through close contact with infected people, their bodily fluids, and their clothing or bedding.


Michael Skinner, a virologist at Imperial College London, said it was too early to determine how the UK’s men became infected.

“Sexual activity inherently involves intimate contact, which would be expected to increase the likelihood of transmission, regardless of a person’s sexual orientation and regardless of the mode of transmission,” Skinner said.

Francois Balloux, of University College London, said monkeypox qualifies sex as the type of close contact needed to transmit the disease.

The UK cases “do not necessarily imply a recent change in the transmission route of the virus,” Balloux said.


Barry Hatton in Lisbon, Portugal contributed to this report.

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Joel McCord

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