What you need to know about monkeypox and how it spreads

LONDON (AP) — Health authorities in Europe and the United States have identified several cases of monkeypox in recent days, most in young men. It is a surprising outbreak of a disease that rarely appears outside of Africa.

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Health officials around the world are watching for more cases because, for the first time, the disease appears to be spreading among people who did not travel to Africa. They emphasize, however, that the risk for the general population is low.

What is monkeypox?

Monkeypox is a virus that originates in wild animals such as rodents and primates, and occasionally jumps to people. 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 was in 1970, in a 9-year-old boy in a remote part of the Congo.

What are the symptoms and how is it treated?

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

Most patients experience only fever, body aches, chills, and fatigue. People with more severe illnesses may develop rashes and lesions on the face and hands that can spread to other parts of the body.

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

Monkeypox can be fatal to one in 10 people and is thought to be more serious in children.

People exposed to the virus often receive one of several smallpox vaccines, which 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 isolating all suspected cases and offering the smallpox vaccine to high-risk contacts.

How many cases of monkeypox are there normally?

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

Patchy health monitoring systems mean many infected people are likely to be missed, experts say.

Isolated cases of monkeypox are occasionally found outside of Africa, including in the US and Great Britain. Cases are often associated with travel to Africa or contact with animals from areas where the disease is more common.

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

What is different about these cases?

It is the first time that monkeypox appears to be spreading among people who did not travel to Africa. Most cases involve men who have had sex with men.

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In Europe, infections have been reported in Great Britain, Italy, Portugal, Spain, and Sweden.

Britain’s Health Security Agency said not all of its cases are connected, suggesting multiple chains of transmission are occurring. The infections in Portugal were detected at a sexual health clinic, where the men sought help for injuries to their genitals.

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

Is monkeypox transmitted through sex?

It is possible, but it is not clear at the moment.

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

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

“By nature, sexual activity involves intimate contact, which one would expect to increase the likelihood of transmission, regardless of a person’s sexual orientation and mode of transmission,” Skinner said.

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

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

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Barry Hatton in Lisbon, Portugal, contributed to this report.