Prioritise response to monkeypox outbreak as the case count grows

According to the Centers for Disease Control (CDC), monkeypox is a rare disease caused by infection with the monkeypox virus which is part of the same family of viruses that cause smallpox.

It was discovered in 1958 and the first human case recorded in 1970. Prior to this 2022 outbreak, almost all monkeypox cases in people outside of central and western Africa were linked to international travel.

The World Health Organization’s (WHO) International Health Regulations Emergency Committee says that as of end of June, 3,413 laboratory-confirmed cases and one death (occurring in Nigeria) had been reported from 50 countries under surveillance.

African countries that have reported cases include Benin, Cameroon, Central African Republic, Congo, Ghana, Nigeria and South Africa. This case count is expected to change as more information becomes available.

Routes of monkeypox virus transmission include human-to-human via direct contact with infectious skin lesions, respiratory droplets or indirect contact from contaminated objects or materials, also called fomite transmission.

Vertical transmission (mother-to-child) has also been documented. While it is known that close physical contact can lead to transmission, it is unclear whether sexual transmission via semen/vaginal fluids occurs and research is currently underway to understand this.

The clinical presentation of monkeypox cases associated with this outbreak has been unusual as compared to previously documented reports. Many cases are not presenting with the classical clinical picture of fever, swollen lymph nodes and rashes.

WHO continues to encourage countries to be on a high alert through surveillance for possible cases which may present to various community and health care settings including, but not limited to, primary and secondary care, fever clinics, sexual health services, infectious disease units, obstetrics and gynaecology centres, emergency departments, surgical and dermatology clinics.

In caring for suspected or confirmed cases, strict infection prevention and control measures should be applied, laboratory testing offered as well as risk communication and community engagement to inform at risk populations and the broader public on how to keep safe.