Monkeypox outbreak in 2022

Article

July 6, 2022

An ongoing outbreak of monkeypox disease was confirmed in May 2022, starting with a cluster of cases found in the UK. The first case was confirmed on 6 May 2022 in an individual with travel links to Nigeria (where the disease is endemic), but it was suggested that cases had already been spreading in Europe in previous months. As of May 18, cases have been reported in an increasing number of countries and regions, predominantly in Europe, but also in North and South America, Asia, Africa and Australia. 4,126 cases were confirmed as of June 24. The outbreak marked the first time that the disease had spread widely outside Central and West Africa. Cases have been identified mainly, but not exclusively, among men who have sex with men (MSM), but health officials have emphasized that anyone can catch the disease, particularly if they have close contact with a symptomatic person. Initial WHO assessments expressed the expectation that the outbreak would be contained and of low impact to the general population in affected countries. A more recent statement acknowledged that undetected transmission had occurred for some time and called for urgent action to reduce transmission.Monkeypox is a viral infection that manifests itself one or two weeks after exposure with fever and other nonspecific symptoms and then produces a blistering rash that can last for a few weeks before usually disappearing. In infections before the current outbreak, 1-3% of people with known infections died (without treatment). Cases in children are more likely to be severe.

Background

Emergency preparedness

In March 2021, the Nuclear Threat Initiative led a tabletop exercise at the Munich Security Conference, simulating a hypothetical public health response to the release of a genetically engineered smallpox strain.

Cases in endemic areas

The African Centers for Disease Control and Prevention alerted several African Union members in May 2022 about smallpox cases. Africa CDC Director Ahmed Ogwell said that four African countries reported 1405 endemic cases with 62 deaths between early 2022 and May 2022. The case fatality rate in these four African countries combined is 4.4%. in The Conversation, Oyewale Tomori pointed out that the number of monkeypox infections in Nigeria by 2021 is likely to be underreported because much of the Nigerian population has been avoiding healthcare facilities due to fear of contracting COVID-19. Nigeria's surveillance of various diseases, including monkeypox, had to focus on the global COVID-19 pandemic in 2020 and 2021, losing many cases and resulting in a drop in official statistics. As British health authorities reported the first case of smallpox in the UK in May 2022, the Nigerian government has released information and statistics on reported cases and deaths in the country to the public. In the May 9, 2022 report, the NCDC stated that 230 cases were confirmed in 20 states and the Federal Capital Territory between 2017 and 2022. Rivers state was the most affected, followed by Bayelsa and Lagos. In the period 2017 to 2022, the NCDC reported six deaths in six different states, representing a fatality rate of 3.3%. according to WHO:

Characteristics of the outbreak

Simian smallpox is endemic to West and Central Africa. Prior to the 2022 outbreak, the UK had only recorded seven previous cases of smallpox, all of which were cases imported from Africa or healthcare workers involved in their treatment. The first three of these cases were in 2018, if