Cases of monkeypox are growing in the West among people who haven’t traveled to Africa — a phenomenon not seen before.
Most important points:
African researchers say the spread in Europe is unlike anything they’ve seen before. Early hypotheses from scientists in the West suggest the virus can be transmitted sexually. Other theories question whether there’s a new vulnerability, as communities no longer immunize against smallpox
The United Kingdom registered 11 cases on Friday, bringing the total to 20.
Portugal registered nine new points, bringing the total to 23.
France, Germany, Canada, and Belgium confirmed their first monkeypox cases on Friday.
Australia has recorded two cases, one in Melbourne and one in Sydney, of travelers who have recently returned from the UK.
“I am amazed at this. Every day I wake up, and more countries are infected,” said Oyewale Tomori, a virologist who previously headed the Nigerian Academy of Science and sat on several World Health Organization advisory boards.
“This isn’t the kind of spread we’ve seen in West Africa, so something new could be happening in the West.”
One of the theories that UK health officials are investigating is whether the disease is sexually transmitted. Health officials have asked doctors and nurses to be alert to possible cases, but the general population’s risk is low.
Outbreaks in Nigeria, which report about 3,000 cases of monkeypox each year, mostly occur in rural areas, where people have close contact with infected rats and squirrels, Dr. Tomori said.
He said the disease is not easily spread, and many cases will likely be missed.
“Unless the person ends up in an advanced health center, they don’t attract the attention of the surveillance system,” he said.
Dr. Tomori hoped that the appearance of monkeypox cases in Europe and other Western countries would increase scientific understanding of the disease.
Dr. Ibrahima Soce Fall, the World Health Organization’s emergency response leader, acknowledged this week that there were still “many unknowns in transmission dynamics, clinical features (and) epidemiology.”
Scientists hope the sudden spike in cases leads to a better understanding of the virus. (Reuters: Cynthia S Goldsmith, Russell Regnery/CDC/Handout)
British officials have noted that the most recent cases have occurred in young men who had no history of traveling to Africa and were gay, bisexual, or had sex with men.
Authorities in Spain and Portugal also said their cases involved young men who usually had sex with other men and said those cases were picked up when the men with lesions showed up at sexual health clinics.
Experts have emphasized that they do not know whether the disease is spread through sex or other close contact related to sex.
“This is not something we have seen in Nigeria,” said Dr. Tomori. He said viruses that were initially unknown to be transmitted through sex, such as Ebola, later did after larger epidemics showed different distribution patterns.
The same could be true for monkeypox, said Dr. Tomori. “We should search our records to see if this happened, such as between a man and a woman,” he said.
Health Minister Karl Lauterbach said the government is confident the outbreak can be contained in Germany. He said the virus was being sequenced to see if genetic changes would have made it more contagious.
Scientists said that while it’s possible the outbreak’s first patient contracted the disease in Africa, what’s happening now is exceptional.
“We’ve never seen anything like what’s happening in Europe,” said Christian Happi, director of the African Center of Excellence for Genomics of Infectious Diseases.
“We haven’t seen anything to say that monkeypox transmission patterns in Africa have changed, so if there’s something else going on in Europe, Europe needs to look into it.”
Dr. Happi also pointed out that suspending smallpox vaccination campaigns after the disease was eradicated in 1980 could inadvertently contribute to the spread of monkeypox.
Smallpox vaccinations also protect against monkeypox, but mass immunization was discontinued decades ago.
“Apart from people in West and Central Africa who have some immunity to monkeypox from past exposure, not having any smallpox vaccination means that no one has any kind of immunity to monkey pox,” said Dr. happy.
Shabir Mahdi, a professor of vaccinology at the University of Witwatersrand in Johannesburg, said a detailed investigation into the outbreak in Europe, including determining who the first patients were, was now critical.
“We need to understand how this started and why the virus is gaining traction,” he said.
“In Africa, there have been very controlled and rare monkeypox outbreaks. If that changes now, we need to understand why.”