The United States Centers for Disease Control and Prevention today provided an update on the monkeypox situation in the United States, which is linked to a growing multinational epidemic. He also used the time to answer open-ended questions and calm some unfounded fears.
To date, there are five confirmed and probable cases in the United States. The only confirmed case of monkeypox in the United States was identified last week in a man from Massachusetts who had recently traveled to Canada. The four probable cases include one in New York, one in Florida and two in Utah.
These four cases are probable because they all tested positive for orthopoxvirus, the family of viruses that includes monkeypox and smallpox. They are considered suspected cases of monkeypox and are treated as such while the CDC conducts secondary testing to confirm monkeypox.
All five confirmed and probable cases in the United States are in males and all have international travel histories consistent with the multinational outbreak.
The CDC also used today’s briefing to point out that it had sequenced the monkeypox virus genome from the original Massachusetts case. The genetic sequence closely matches that of a case in Portugal.
Globally, there are nearly 250 confirmed and suspected cases in 17 countries, most of which are in Europe. Around 165 cases are confirmed and 83 are suspected (you can follow the growing tally here and here). Cases are predominantly in men and, in particular, in men who identify as gay, bisexual, or men who have sex with men (MSM).
This is an unusual outbreak that health officials around the world say needs prompt attention and action. However, the risk to the general population is still considered low.
“It’s not a virus that’s easily transmitted through respiratory droplets and things like that,” Capt. Jennifer McQuiston, deputy director of the CDC’s High Consequences Division, said in today’s briefing.
“It’s not COVID,” she added. “We know a lot about monkeypox from many decades of study, and respiratory spread is not the overriding concern. It’s contact – and intimate contact – in the current context and population of the epidemic. And that’s really what we wanted to emphasize.”
Below is a brief overview of key questions and answers:
What is monkeypox virus?
Monkeypox is a DNA virus related to smallpox that infects animals and is endemic to forest areas of Central and West Africa. It is not known which animal or animals act as a reservoir for monkeypox, but rodents are prime suspects. The virus can also infect rats, squirrels, prairie dogs, different species of monkeys and other animals.
It got its name when researchers discovered the virus in monkeys in a Danish laboratory in 1958, according to the World Health Organization. The first human case was identified in a child in the Democratic Republic of Congo in 1970.
People are largely thought to become infected through hunting and handling wild animals and bushmeat.
There are two clades of monkeypox: the West African clade and the Congo Basin clade. The West African clade is the milder of the two, with an estimated case fatality rate in humans of around 1%. The Congo Basin clade has an estimated mortality rate of 10%.
Which clade is causing the current outbreak?
The West African clade, the sweetest.
What are the symptoms?
Once infected, a person typically develops symptoms five to 13 days after exposure, but the incubation period can range from five to 21 days.
Monkeypox typically begins with fever and flu-like symptoms, including headache, fatigue, muscle aches, and swollen lymph nodes. One to three days later skin lesions develop all over the body (a telltale rash) but tend to be concentrated on the face and extremities, especially the palms of the hands and soles of the feet. The lesions start out flat at the base, then lift and fill with fluid. A crusty crust then forms on each lesion and falls off later. The number of lesions an infected person develops can range from a few thousand to several thousand, according to the WHO.
The disease usually lasts two to four weeks and disappears without any specific treatment.