The US Centers for Disease Control and Prevention (CDC) has revealed that half a dozen Americans are being monitored for potential signs of monkeypox infection and that the virus’ latest outbreak in the United Kingdom has raised a few eyebrows across the pond.
The six people are not believed to have had direct contact with an infected man who traveled from Nigeria to the UK on May 4, but they sat within three rows of him on the same flight, Jennifer McQuiston, a senior CDC specialist in outbreak investigations and research involving diseases that spread from animals to people, told Stat News on Wednesday. They will be monitored for 21 days.
McQuiston told the Boston Globe-owned outlet that the US public health agency does “have a level of concern that this is very different than what we typically think of from monkeypox. And I think we have some concern that there could be spread outside the UK associated with this.”
Monkeypox outbreaks are not unheard of: the US tracked a 71-person outbreak in 2003 and in Nigeria, where small outbreaks are more common, health authorities tracked 183 cases between 2017 and late 2019. Human-to-human transmission is rare, with most cases coming from contact with infected animals, such as monkeys or pouched rats, but the virus can be spread either through the air or by exchanging infected fluids.
This image from 1971, depicts a view of the right hand and leg, of a 4 year-old female in Bondua, Grand Gedeh County, Liberia, which reveals numerous maculopapular monkeypox lesions, enabling you to see the similarity of these lesions to those of smallpox.
However, since early May, the UK Health Security Agency (UKHSA) has tracked what it called a “rare and unusual” outbreak of at least seven cases in two seemingly unrelated clusters, four of whom were gay and bisexual men who may have gotten it via contact with infectious skin lesions.
“You have two clusters that have no link to travel or to other people who are known to be associated with a recognized outbreak. It suggests that there are unknown chains of transmission happening,” McQuiston told Stat news. “If there appears to be unknown chains of transmission, it just puts us on alert to be thinking: Could this be spreading outside the UK?”
Indeed, on Wednesday Portugal's General Directorate for Health confirmed finding five cases of monkeypox in young men and were investigating 15 suspected cases, all of them near the capital of Lisbon, according to Lusa News Agency. The report did not say how they got infected.
Spain’s Health Ministry also said Wednesday it was investigating 23 suspected cases, up from eight a day prior.
Dr. Ibrahim Soce Fall, the World Health Organization's assistant director-general for emergency response, told the Associated Press that the new outbreak needs to be investigated to understand how the disease was being transmitted, noting that despite thousands of cases in West Africa in recent years, there are “so many unknowns in terms of the dynamics of transmission.''
The virus can take between 5 and 21 days to develop symptoms, after which infected people develop skin lesions with an identical appearance to those caused by the related smallpox virus, as well as other similar symptoms like tiredness, fever, and muscle aches. However, unlike smallpox, monkeypox also causes swollen lymph nodes, and it is not nearly as deadly as smallpox, with a death rate of about 10%. The illness can last for two weeks.
There is no vaccine against monkeypox, but researchers believe the smallpox vaccine could work well against it, because the diseases are so closely related. Indeed, the smallpox vaccine is derived from vaccinia, or cowpox virus, another member of the poxvirus family alongside monkeypox. Jynneos, a vaccine made by Bavarian Nordic, is licensed in the United States to be administered to adults for either smallpox or monkeypox.