Rare Monkeypox Has Made Its Way To The United States

The first U.S. case this year of a rare and potentially fatal virus known as monkeypox has been diagnosed in a man in Massachusetts who recently traveled to Canada, the U.S. Centers for Disease Control and Prevention announced Wednesday.

The illness does occasionally arise in the United States, but the Massachusetts case comes on the heels of unusual outbreaks over the past few weeks of monkeypox in Britain, Canada, Portugal and Spain — countries that typically don’t see such cases because monkeypox is largely endemic to Africa.

“It’s not clear how people in those clusters were exposed to monkeypox but cases include individuals who self-identify as men who have sex with men,” the agency said in a statement. “CDC is urging health care providers in the U.S. to be alert for patients who have rash illnesses consistent with monkeypox, regardless of whether they have travel or specific risk factors for monkeypox.”

Monkeypox is related to the more dangerous — and now eradicated — smallpox virus. It can be fatal, although most people who contract the illness do recover after treatment with an antiviral drug originally developed to fight smallpox. Monkeypox is not as infectious as viruses such as COVID-19, measles or the flu, and is usually confined to small outbreaks.

Infection “typically begins with flu-like illness and swelling of the lymph nodes and progresses to a widespread rash on the face and body,” the CDC said.

“Monkeypox reemerged in Nigeria in 2017 after more than 40 years with no reported cases,” the agency said. “Since then, there have been more than 450 reported cases in Nigeria and at least eight known exported cases internationally.”

According to the Massachusetts Department of Public Health, the man who contracted monkeypox did so after traveling to Canada. After testing confirmed monkeypox infection on Tuesday, health officials said they are “working closely with the CDC, relevant local boards of health, and the patient’s health care providers to identify individuals who may have been in contact with the patient while he was infectious.”

Currently, “the case poses no risk to the public, and the individual is hospitalized and in good condition,” the Massachusetts health officials said.

They added that “no monkeypox cases have previously been identified in the United States in 2022; Texas and Maryland each reported a case in 2021 in people with recent travel to Nigeria.”

According to The New York Times, Britain has so far reported nine such cases, with only one of the cases being linked to recent travel to Nigeria. The remaining eight cases did not seem to involve travel, so British health authorities are citing community transmission in Britain as a possible means of spread.

At the same time, Spain is reporting 23 suspected cases; Portugal has five confirmed cases and 15 more suspected; and Canada is reporting an outbreak of 15 possible monkeypox cases centered on Montreal, the Times said.

“The fact that it’s in the U.K. in multiple unrelated clusters, plus Spain, plus Portugal, is a surprise,” Dr. Tom Inglesby, director of the Johns Hopkins Center for Health Security at the Bloomberg School of Public Health, in Baltimore, told the Times.

People typically get monkeypox after contact with wild animals, either via bites or scratches or from eating bushmeat. According to the Times, there was a U.S. outbreak involving dozens of cases in 2003, tied to infected prairie dogs.

The illness doesn’t travel easily between people, although body fluids, touching contaminated objects or breathing in respiratory droplet under close conditions (for example, shared habitation) can cause infections, the CDC said.

The cases noted so far in the United Kingdom and Canada mostly involve gay or bisexual men.

“Many of these global reports of monkeypox cases are occurring within sexual networks,” poxvirus expert Dr. Inger Damon said in the CDC statement. “However, health care providers should be alert to any rash that has features typical of monkeypox. We’re asking the public to contact their health care provider if they have a new rash and are concerned about monkeypox.” Damon directs the CDC’s Division of High-Consequence Pathogens and Pathology, where the agency’s poxvirus research is based.

The CDC is advising that anyone with symptoms suggesting monkeypox (for example unusual rashes or lesions), and gay and bisexual men in particular, reach out to health care providers for an assessment.

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More information

Find out more about monkeypox at the World Health Organization.

SOURCES: U.S. Centers for Disease Control and Prevention, statement, May 18, 2022; Massachusetts Department of Public Health, statement, May 18, 2022; The New York Times