Monkeypox Has Been Silently Spreading For Years, First Mistaken as STIs

Since the monkeypox outbreak began on May 13 this year (and as of June 2), 780 confirmed cases of monkeypox have been reported from at least 27 World Health Organization (WHO) member states. This count includes the United States and Canada.

Monkeypox is endemic to African countries such as the Democratic Republic of the Congo, the Central African Republic, and Cameroon, where thousands of cases are reported each year. Experts say that investigations are currently being done to learn more about why the disease is spreading to countries where it does not normally occur.

From the Experts

However, the WHO pointed out in a recent outbreak update that the sudden and unexpected spread of monkeypox in several non-endemic countries suggested that undetected transmission for an unknown period predated recent amplifier events.

Rosamund Lewis, WHO technical lead for monkeypox, suggested during a briefing the past week that undetected transmission may have been going on for weeks, months, or possibly a couple of years.

According to Amesh A. Adalja, a senior scholar at the Johns Hopkins Center for Health Security, a possible scenario is that the endemic infectious disease from Africa infiltrated a social and sexual network, and was then greatly aided by major amplification events, such as raves in Belgium, to make its way across the globe.

Adalja explained further that the skin marks attributed to monkeypox are being misinterpreted as those of other sexually transmitted infections, potentially affecting diagnosis.

Meanwhile, scientists are aiming to find out if the virus has undergone any genetic changes that have allowed it to spread more effectively outside of Africa than before.

Monkeypox Virus

Monkeypox is a disease caused by the same-named virus, which was first discovered in monkeys and used in animal testing in 1958. In 1970, the first human case of the virus was confirmed, Newsweek reports.

The disease has symptoms that are similar to smallpox but are less severe, with an incubation period, or time between infection and onset of symptoms, usually between six and 13 days.

According to the WHO, fever, headaches, other body aches, swelling of the lymph nodes, and a lack of energy are the most common symptoms. A skin rash appears a day or two after the fever, which can affect various parts of the body of the confirmed patient.

The symptoms will last two to four weeks on average. In the general population, the case fatality ratio of monkeypox has ranged from zero to 11% in the past. The recent rate is around 3 to 6%.

Monkeypox is transmitted from person to person through direct contact with infectious sores, scabs, or bodily fluids. According to the Centers for Disease Control and Prevention (CDC), it can also be spread through prolonged face-to-face contact and sexual intercourse.

It is still unconfirmed if the disease can be transmitted through sperm or vaginal fluids. It can also be transmitted from animals to humans through bites, scratches, or handling wild game. The CDC's website has more information about transmission.

The current outbreak is the first time that a large number of monkeypox cases have been reported simultaneously in non-endemic countries around the world. Men who have sex with men have been receiving much of the focus of the cases thus far, but not exclusively. Other demographic are being studied as well.