Monkeypox Outbreak

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Last reviewed
June 29, 2022

Monkeypox Outbreak

The U.S. CDC announced on June 28, 2022, that the Emergency Operations Center (EOC) has been activated for monitoring and coordinating the monkeypox outbreaks in the USA, and mobilizing about 300 CDC personnel and various resources. 

The World Health Organization (WHO) published an updated monkeypox virus outbreak on June 27, 2022, providing an update on the epidemiological situation and further information on the use of therapeutics and vaccines. Genomic sequencing of viral deoxyribonucleic acid of the monkeypox virus (MPXV) found in the current outbreak is ongoing, and preliminary data from polymerase chain reaction assays indicate that the MPXV genes detected belong to the West African clade.  

Previously, the WHO Director-General, Dr. Tedros Adhanom Ghebreyesus, stated on June 25, 2022, he concurred with the advice offered by the IHR Emergency Committee that the monkeypox virus outbreak does not 'constitutes a Public Health Emergency of International Concern' at present. On June 23, 2022, the WHO determined the multi-country monkeypox outbreak's overall public health risk at the global level is assessed as moderate, considering this is the first time MPXV infected patients were reported concurrently in non-endemic countries in disparate geographical areas.

Researchers from Portugal's National Institute of Health in Lisbon published a study in the peer-review journal Nature on June 24, 2022, showing that this MPXV belongs to clade 3 and that the outbreak most likely has a single origin. MPXV outbreaks from clade 3 have been reported from Cameroon to Sierra Leone and usually carry a less than 1% case-fatality rate. On June 23, 2022, The Lancet published a modeling study: Projected burden and duration of the 2022 Monkeypox outbreaks in non-endemic countries. 'In conclusion, our findings align with WHO's assessment that the overall public health risk at a global level is currently moderate. Observed outbreaks in non-endemic countries should be contained quite quickly, particularly when adequate mitigation measures are implemented.'

The U.S. CDC's National Center for Emerging and Zoonotic Infectious Diseases presented to the Advisory Committee on Immunization Practices committee on June 23, 2022 - Situational Awareness: Monkeypox Outbreak, by Agam Rao, MD CAPT, USPHS. Previously, the CDC updated an Alert - Level 2, Practice Enhanced Precautions, on June 6, 2022, regarding various monkeypox outbreaks. In addition, health Canada and the U.K. have issued similar advice for travelers.

Monkeypox USA

As of June 29, 2022, about (26) states - ArizonaCaliforniaColoradoFloridaGeorgiaHawaiiIllinoisIndianaMarylandMassachusetts, MinnesotaMissouriNew JerseyNew YorkNevada, North CarolinaOregonOhioOklahomaPennsylvaniaRhode IslandTexasUtahVirginiaWashington, and Washington DC recently confirmed about (351) monkeypox patients since early May 2022.

Texas and Maryland reported monkeypox cases in 2021 in people with recent travel history to Nigeria. Previously, forty-seven confirmed and probable monkeypox cases were reported from six U.S. states, Illinois, Indiana, Kansas, Missouri, Ohio, and Wisconsin, in 2003.

Monkeypox International

As of June 29, 2022, about (70) countries, including the USAUnited Kingdom (Scotland), VenezuelaUruguayUAESpainSwitzerlandSwedenSudanSlovenia, SerbiaRomaniaPortugalPolandParaguayPakistanNetherlandsMoroccoMexicoMaltaLuxembourgLatviaKosovaIranItalyIsraelIcelandHungaryHaitiFrench GuyanaFinlandGreeceGermanyGibraltarGeorgiaFranceEcuadorDenmarkCzech Republic, CroatiaCosta Rica, ColumbiaCayman IslandsCanadaBrazilBoliviaBelgiumBahamasAustriaArgentina, and Australia have reported West African cade monkeypox virus cases.

Worldwide, the total number of potential MPX cases has reached about 4,966. Click here for a visual global presentation.

Monkeypox Virus Wastewater Detection

The Oceanside Water Pollution Control Plant (CA 94132) wastewater samples taken between June 20 and June 23, 2022, "showed small concentrations of viral DNA for the monkeypox disease," mentioned Sewer Coronavirus Alert Network (SCAN) researcher Alexandria Boehm, professor of civil and environmental engineering at Stanford University.

Monkeypox Outbreak Genetic Analysis

A genetic analysis published in the peer-review journal Nature Medicine on June 24, 2022, revealed that the viruses responsible for the current monkeypox outbreak may be related to viruses responsible for human cases in the UK, Israel, and Singapore in 2018 and 2019. Previously, the Government of the Canary Islands investigated an event attended by about 80,000 people on the island of Gran Canaria, held on May 5, 2022, as one source of the various MPXV outbreaks.

Monkeypox Variants

Genomic sequencing of viral deoxyribonucleic acid of the monkeypox West African clade virus is being undertaken says the WHO. In addition, the Nextstrain team updated the genomic epidemiology of the MPX on June 4, 2022, indicating at least two distinct monkeypox outbreaks are underway outside of Africa.

Monkeypox Isolation

The WHO says anyone infected with hMPXV should be isolated for 21-days. Precautions (isolation and IPC measures) should remain in place until lesions have crusted, scabs have fallen off, and a fresh layer of skin has formed underneath. In addition, any suspected monkeypox case should be separated during the presumed and known infectious periods, that is, during the illness's prodromal and rash stages, which last up to two weeks. In addition, the U.K. suggest protecting hMPXV patients' households, and close connections, by keeping a 1-meter distance separation. As of June 29, 2022, Austria, Belgium, Canada, Germany, UAE, and the U.K. require/advise a 21-day, multi-step quarantine plan for monkeypox patients and close contacts.

Monkeypox Outbreak News

June 29, 2022 - The WHO/ECDC published an updated surveillance report that disclosed a total of 4,178 cases of monkeypox from 31 countries and areas throughout the European region.

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.K. Health Security Agency confirmed the total number of MPXV patients in the U.K. was 1,076. The median age of confirmed cases in the UK was 37 years old, the majority (96%) of cases were GBMSM, with five confirmed female cases.

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 8, 2022, The U.S. CDC published a guide for people concerned about or infected with the MPX.

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 that appear across the new sequences. The genomes from the current monkeypox outbreak share 40-some mutations that distinguish them from 2018. 

May 31, 2022 - Montreal's public health department reported (that 15) people with links to monkeypox patients had been given the Imvamune vaccine, and around ten others were scheduled. In addition, officials have said several Montreal cases were linked to a visitor from Boston.

May 29, 2022 - Germany's Health Minister Karl Lauterbach confirmed they would receive 240,000 vaccine doses against monkeypox.

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.

May 18, 2022 - The Massachusetts Department of Public Health confirmed a man was hospitalized with the monkeypox 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 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 most likely has a single origin, with all sequenced viruses released so far* tightly clustering together.

May 23, 2022 - A new study was published by Virological, concluding the multi-country outbreak most likely has a single origin. 

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.