Monkeypox Outbreak

Authored by
Staff
Last reviewed
September 23, 2022

Monkeypox Outbreak

The World Health Organization (WHO) Director-General declared a Public Health Emergency of International Concern (PHEIC) regarding monkeypox virus (MPXV) outbreaks on July 23, 2022. Additionally, the WHO published: Multi-country outbreak of monkeypox, External situation report #6, on September 21, 2022. The WHO agreed that Clade II consists of 2 subclades, Clade IIa and Clade IIb. Each of the clades and subclades subdivides into multiple lineages. 

As of September 23, 2022, about (102) countries have reported 69,000 MPXV cases and (23) related fatalities.

Monkeypox Cases and Fatalities in the USA

As of September 22, 2022, the U.S. CDC reported 24,572 monkeypox cases and two related fatalities.

The U.S. government announced its Monkeypox Vaccine Strategy on June 28, 2022. In response to the ongoing outbreak, the U.S. administration declared a Public Health Emergency regarding the ongoing monkeypox virus (MPXV) outbreak. The CDC updated an Alert - Level 2, Practice Enhanced Precautions, on August 8, 2022, to alert international travelers regarding monkeypox outbreaks. And the CDC issued Technical Report #2 guidance on September 1, 2022. The U.S. CDC updated the 2022 Monkeypox Outbreak Global Map on September 6, 2022. 

Monkeypox Cases International

The European Centre for Disease Prevention and Control (ECDC) recently reported the likelihood of MPX spreading further in networks of people with multiple sexual partners in the EU/EEA is considered high, and the likelihood of MPX spreading among the broader population is assessed as very low. 

The monkeypox situation in the UK has changed as of September 21, 2022. It is clear that community transmission is occurring with multiple generations of spread. The illness appears to be generally mild, though some individuals will require hospital admissions to manage secondary infections or complications from the illness. The monkeypox clade of monkeypox predominantly circulating in the UK (Clade IIb, B.1 lineage) is no longer classified as a High Consequence Infectious Disease (HCID). However, importations of monkeypox from West or Central Africa and/or monkeypox not caused by Clade IIb, B.1 lineage should remain classified as an HCID, as the severity of the original clades remains unknown.

Non-African countries reporting monkeypox cases include the USAUnited Kingdom (Scotland), VenezuelaUruguayUAE, TurkeySpainSwitzerlandSwedenSudanSlovenia, SingaporeSerbia, RussiaRomania, PeruPortugalPolandParaguayPakistanNetherlandsMoroccoMexicoMaltaLuxembourgLatviaKosovaIranItalyIsrael, IndiaIcelandHungaryHaitiFrance, GuyanaFinlandGreeceGermanyGibraltarGeorgiaFranceEcuadorDenmarkCzech Republic, CroatiaCosta Rica, ColumbiaCayman IslandsCanadaBrazilBoliviaBelgiumBahamasAustriaArgentina, and Australia.

The U.K. Health Services Agency (UKHSA) began reporting MPXV cases in early May 2022. As of September 6, 2022, the UKHSA confirmed 3,484 total cases. In addition, the UKHSA recently published Technical Briefing #6. Previously the UKHSA stated in June 2022, 'the current outbreak clade of monkeypox virus has no longer been classified as a high consequence infectious disease (HCID) in the U.K. As of September 20, 2022, the UKHSA published the status of monkeypox as an HCID.

The ECDC and the WHO Regional Office for Europe published an updated Monkeypox Surveillance Report on August 29, 2022, indicating 18,072 cases had been reported from 29 EU/EEA countries. Previously, the Government of the Canary Islands investigated an event on May 5, 2022, attended by about 80,000 people on Gran Canaria as a potential source of the various MPXV outbreaks.

Monkeypox in Africa

Africa's CDC confirmed since the beginning of 2022, a total of 2,031 cases (250 confirmed; 1,781 suspected) and 75 deaths (CFR: 3.7%) of monkeypox had been reported by nine endemic and two non-endemic AU MS as of July 25, 2022. The first human case of Monkeypox was identified in the Democratic Republic of Congo in 1970.

Monkeypox Vaccines

As of September 20, 2022, 684,980 doses of the Jynneos vaccine had been Administered in the 48 U.S. Jurisdictions Reporting Data. Various monkeypox vaccine news is posted at PrecisionVaccinations.com/Monkeypox.

Monkeypox Treatments

The U.S. CDC, UKHSA, and the EMA have authorized various monkeypox treatments, such as TPOXX, which are listed on this PrecisionVaccinations.com webpage.

Monkeypox Testing

The Monkeypox virus is part of the same family of viruses as smallpox and can be detected by diagnostic testing. Visit Monkeypox Testing for more information.

Monkeypox Isolation

In August 2022, the CDC recommends that people with monkeypox remain isolated at home or at another location for the duration of their illness. 

Monkeypox Clinical Research

The first full genome was posted on May 19, 2022. There are different strains of monkeypox virus genetically divided into three main groups (Clades I, IIa, and IIb). The current monkeypox outbreak is being clinically reviewed by numerous researchers listed on this webpage

Monkeypox Blood Supply Test

The U.S. FDA confirmed on August 12, 2022, that it is issuing this communication to provide information regarding the monkeypox virus and blood donations. The levels of virus in the blood of an infected or exposed individual have not been well characterized.

Monkeypox in Children, Adolescents, and College

As of September 2022, the U.S. CDC says the risk of monkeypox to children and adolescents in the USA is low. However, this page answers FAQs about monkeypox for school administrators and staff. Institutions of higher education can prepare by understanding the guidance on congregate settings and by being sure their student health center is aware of the guidelines for healthcare professionals.

Monkeypox Outbreak News

September 21, 2022 - The WHO issued Situation Report #6.

September 21, 2022 - The UK published: Principles for monkeypox control in the UK: 4 nations consensus statement.

September 15, 2022 - Science.org published a Featured Article: The global monkeypox outbreak is giving the virus an unprecedented opportunity to adapt to humans. Will it change for the worse?

September 12, 2022 - The Los Angeles Department of Public Health confirmed the first death due to monkeypox in a LA County resident who was severely immunocompromised and had been hospitalized.

September 8, 2022 - More than 16,000 new first and second appointments will go online in NYC on September 9, 2022. Second-dose appointments are now available to anyone who received their first dose on or before July 23, 2022.

September 4, 2022 - India's capital city of New Delhi, reported its sixth case of Monkeypox in 2022.

September 2, 2022 - The latest UK Health Security Agency technical briefing shows a further decline in the number of new monkeypox cases being identified in the UK.

August 30, 2022 - The Texas Department of State Health Services has confirmed the first death of a person diagnosed with monkeypox in Texas. “Monkeypox is a serious disease, particularly for those with weakened immune systems,” said Dr. John Hellerstedt, DSHS Commissioner. “We continue to urge people to seek treatment if they have been exposed to monkeypox or have symptoms consistent with the disease.”

August 29, 2022 - CBS46 reported an elementary school in Gwinnett County, Georgia, reported a case of monkeypox in an adult.

August 25, 2022 - “At least 27 women are positive in the state, and we are seeing the spread within more people who weren’t sexually involved with another positive case and was spread through direct skin-to-skin contact or face-to-face spread through infected respiratory secretions,” said Dr. Desmar Walkes, Austin-Travis County Health Authority.

August 24, 2022 - This is the fourth WHO situation report for the multi-country outbreak of monkeypox, which provides details on the latest epidemiology, a short summary of infections among health workers, updates on guidance documents, and advice.

August 22, 2022 - The U.S. FDA is informing health care providers, and patients of the potential risk of transmission of monkeypox virus through fecal microbiota for transplantation products and that FDA has determined that additional safety protections are needed.

August 22, 2022 - Brazil's Ministry of Health has recorded 3,788 confirmed cases of the disease and 77 confirmed cases of monkeypox in children and adolescents, an incidence of 3.5% of infections. Of these, 20 cases (0.6%) were identified among children aged 0 to 4 years.

August 22, 2022 - A letter from UKHSA chief executive Professor Dame Jenny Harries to UK's Directors of Public Health presented the fractional dosing plan.

August 18, 2022 - The California Department of Public Health published 'Monkeypox Home Isolation Guidance for the General Public.'

August 17, 2022 - The WHO Virtual Press Conference on Monkeypox, COVID-19, and other global health issues posted the audio link. 

August 15, 2022 - “This isn’t like COVID – the virus is not highly transmissible through casual contact,” said Rebecca Fischer, assistant professor at the Texas A&M University School of Public Health. “I do not expect we’re going to see classroom spread, workplace spread – that would be a very rare circumstance.”

August 12, 2022 - The WHO agreed on new names for monkeypox virus variants.

August 10, 2022 - Updated Jynneos vaccination 'Interim Considerations' were published by the U.S. CDC.

August 10, 2022 - The WHO confirmed efforts are underway to rename the MPXV outbreak.

August 10, 2022 - The North Carolina Department of Health and Human Services released a report of the state's monkeypox data that shows that while 70% of cases are in Black men, Black North Carolinians have received less than 25% of the Jynneos vaccinations. North Carolina today is reporting 122 monkeypox cases — all in males and nearly all in men who have sex with men, consistent with findings from other states and countries.

August 9, 2022 - StatNews reported Georgetown, George Washington, West Chester, Bucknell, and the University of Texas at Austin had confirmed MPXV cases.

August 9, 2022 - The U.S. FDA announced an alternative vaccine dosing approach enabling healthcare providers to use one vial of the JYNNEOS vaccine to protect five people when administered intradermally to adults.

August 2, 2022 - The U.S. government announced Robert Fenton as the National Monkeypox Response Coordinator and Dr. Demetre Daskalakis as the National Monkeypox Response Deputy Coordinator.

August 1, 2022 - The U.S. CDC published 'Isolation and Prevention Practices for People with Monkeypox.'

July 30, 2022 - Spain's health ministry reported its second monkeypox-related fatality.

July 28, 2022 - The San Francisco Department of Public Health and the New York State Commissioner of Health announced local emergencies to strengthen responses to local monkeypox outbreaks. 

July 27, 2022 - WHO Director-General's opening remarks at the COVID-19 media briefing regarding the monkeypox outbreak.

July 26, 2022 - U.S. CDC's Clinician Outreach and Communication Activity Call and presentation.

July 26, 2022 - Singapore's Ministry of Health does not recommend mass monkeypox vaccination - four imported and four local cases of monkeypox have been detected in Singapore.

July 25, 2022 - The National Health Institute Director Victor Suarez confirmed that Peru is experiencing "community transmission" of the monkeypox virus, with 203 cases detected so far.

July 25, 2022 - The Lok Nayak Jai Prakash Hospital in Delhi is screening passengers arriving in India for monkeypox symptoms.

July 22, 2022 - VOA reported: The spread of monkeypox could represent the dawn of a new sexually transmitted disease.

July 19, 2022 - The media reported India's Union Health Ministry confirmed the screening of international travelers arriving in India at airports and ports for the monkeypox virus would begin.

July 17, 2022 - The University of Texas at Austin community reported its initial monkeypox case. And local media reporting indicates the greater Austin area has multiple cases.

July 17, 2022 - For the past twenty-five weeks, the Democratic Republic of the Congo province of Sankuru has been affected by an outbreak of monkeypox virus disease.

July 14, 2022 - The Union Health Ministry in India deployed a multi-disciplinary Central team to support the Kerala government after a case of Monkeypox was confirmed.

July 14, 2022 - Eurosurveillance published a Rapid Communication regarding the detection of monkeypox virus DNA in saliva, semen, and other clinical samples from 12 patients, in Spain, between May to June 2022.

July 12, 2022 - AFP News posted on Twitter that Russia confirmed its initial monkeypox case.

July 9, 2022 - Vancouver Coastal Health is offering MPXV vaccines at HIV clinics and bathhouses and is planning to set up a walk-in vaccination clinic in the West End, reported Canada news.

July 8, 2022 - The European Centre for Disease Prevention and Control (ECDC) published its first update to its rapid risk assessment of monkeypox. The overall risk is assessed as moderate for people having multiple sexual partners and low for the broader population. In addition, the risk of establishing an enzootic cycle and spill-over events to humans is considered low.

July 7, 2022 - The U.S. government confirmed that 56,000 Jynneos doses were made available to states and jurisdictions on June 28. Since then, 41,000 doses have been distributed.

July 6, 2022 - The Lancet published: Latin America: Situation and preparedness facing the multi-country human monkeypox outbreak.

July 6, 2022 - A North Carolina-based company, LabCorp, announced its monkeypox testing services would become available throughout the USA.

July 5, 2022 - The outbreak clade of monkeypox virus disease is no longer classified as a high consequence infectious disease by the United Kingdom because it does not meet the criteria, which is defined as having a high mortality rate and a lack of available interventions. 

July 1, 2022 - The UKHSA announced public health principles to be considered when planning events, such as festivals, during the current monkeypox outbreak.

July 1, 2022 - NPR reported - New monkeypox cases have tripled in Europe.

June 30, 2022 - The Texas Department of State Health Services and local health departments have identified (12) cases of monkeypox in Texas. While the first cases involved international travel, three patients reported that they did not travel in the three weeks before becoming sick, meaning they were exposed in Texas.

June 30, 2022 - The ECDC-WHO published an updated surveillance report that disclosed a total of 4,178 cases of monkeypox from 31 countries and areas throughout the European region. No patients were reported to have died.

June 29, 2022 - The Public Health Agency of Canada confirmed 276 monkeypox cases in Canada. The MPX breakdown by province is Quebec (202), Ontario (67), British Columbia (5), and Alberta (2).

June 28, 2022 - The U.S. CDC confirmed (306) monkeypox patients in about twenty-six states and the District of Columbia since early May 2022, with California reporting (66) and New York (61) cases.

June 27, 2022 - Toronto Public Health is offering the Imvamune® vaccine to protect residents during the monkeypox virus outbreak. There are 67 confirmed cases of monkeypox in Ontario.

June 22, 2022 - A British Airways crew is in isolation in Singapore for three weeks after one tested positive for the monkeypox virus.

June 18, 2022 - The Houston Health Department announced monkeypox infections related to international travel.

June 16, 2022 - The Oregon Health Authority reported the state's first probable case of the human monkeypox virus (hMPXV).

June 11, 2022 - Toronto Public Health is holding vaccination clinics to immunize high-risk individuals against the monkeypox virus.

June 8, 2022 - The Lancet published a Correspondence: Tracking the 2022 monkeypox outbreak with epidemiological data in real-time.

June 7, 2022 - The Texas Department of State Health Services is investigating a single case of MPX infection in a Dallas County resident with recent international travel. 

June 7, 2022 - SkyNews reported new legislation in the UK means all doctors in England must notify Health Protection Team if they suspect a patient has monkeypox. Notifiable Disease weekly reports are published for 2022.

June 5, 2022 - The WHO issued a 'Multi-country monkeypox outbreak - situation update as of June 4, 2022. As it is standard practice for large gatherings, and even more so during the COVID-19 pandemic, authorities and event organizers are invited to apply the WHO-recommended risk-based approach to decision-making for mass gatherings.

June 3, 2022 - The U.S. CDC published a Morbidity and Mortality Weekly Report that urges health departments, clinicians, and the public to focus on monkeypox cases.

June 2, 2022 - EuroSurveliance published a Rapid Communication: This study serves as a first step in understanding human MPX spread in a naive population in a non-endemic country and provides information to tailor preventive measures.

June 2, 2022 - The WHO Africa workgroup reveals mutations across the new sequences. The genomes from the current monkeypox outbreak share 40-some mutations that distinguish them from 2018. 

May 27, 2022 - The U.S. CDC issued an Alert - Level 2, Practice Enhanced Precautions, regarding monkeypox outbreaks. 

May 24, 2022 - The U.S. CDC conducted a COCA call and presentation: What Clinicians Need to Know About Monkeypox in the United States and Other Countries.

May 22, 2022 - Belgium has become the first to announce compulsory monkeypox quarantine. Anyone testing positive must isolate for three weeks.

May 20, 2022 - The U.S. CDC issued CDCHAN-00466, confirming the initial monkeypox case in Massachusetts after traveling to Canada.

May 18, 2022 - The media reported Portugal's Health Ministry confirmed five monkeypox cases, and it is studying more than 20 suspicious cases in the Lisbon region.

May 18, 2022 - Health authorities in Spain issued a media alert regarding a possible outbreak of monkeypox after (23) men showed symptoms. A spokesperson for Madrid's regional health department said that the National Microbiology Centre is working to determine a final diagnosis.

May 7, 2022 - The U.K. Health Security Agency confirmed individuals had been diagnosed with monkeypox in England.

May 30, 2022 - China-based Zelixir Biotech announced it has predicted more than 600 structures and added functional annotations of proteins from monkeypox virus proteomes, which are expected to help develop structure-based drug design and monkeypox vaccines.

May 30, 2022 - A new study was published by Virological, concluding the multi-country outbreak most likely has a single origin. 

May 23, 2022 - Study: Multi-country outbreak of Monkeypox virus: genetic divergence and first signs of microevolution. The researchers released nine additional genome sequences of the Monkeypox virus, causing a multi-country outbreak. These sequences were obtained from clinical specimens collected from nine patients on May 15 and 17, 2022. The multi-country outbreak has a single origin, with all sequenced viruses released so far* tightly clustering together.

July 14, 2020 - ScienceDirect published a Conference Report: Human monkeypox – After 40 years, an unintended consequence of smallpox eradication.

December 12, 2017 - Improving the Care and Treatment of Monkeypox Patients in Low-Resource Settings: Applying Evidence from Contemporary Biomedical and Smallpox Biodefense Research; these data—and data from biomedical research involving burns, superficial wounds, herpes, eczema vaccinatum, and so forth—suggest that MPX patients could benefit from clinical support to mitigate the consequences of compromised skin and mucosa. This should include preventing and treating secondary bacterial infections (and other complications), ensuring adequate hydration and nutrition, and protecting vulnerable anatomical locations such as the eyes and genitals. 

August 5, 2015 - Study: Evasion of the Innate Immune Type I Interferon System by Monkeypox Virus.

Monkeypox Virus Disease

Monkeypox is caused by the monkeypox virus, a member of the Orthopoxvirus genus in the family Poxviridae. The monkeypox virus has identified two distinct genetic clades of the Congo Basin and the West African clades. Monkeypox virus is transmitted from one person to another by contact with lesions, body fluids, respiratory droplets, and contaminated materials, says the WHO.