LOS ANGELES, Aug. 10: New data published in the Morbidity and Mortality Weekly Report and gathered by the Centers for Disease Control and Prevention (CDC) showed that 99 percent of monkeypox cases in the United States are in males.
The report released on Aug. 5 also showed that 94 percent of those male infected patients reported male-to-male sexual or close intimate contact during the three weeks before symptom onset, and racial and ethnic minority groups appear to be disproportionately affected.
Moreover, the data from the report, which was gathered from reported cases of the virus in the United States from May 17 to July 22, showed that clinical presentations of some patients differed from typical monkeypox, with fewer persons experiencing prodrome and more experiencing genital rashes.
These epidemiologic details should guide treatment and vaccine protocols, the authors of the study said, adding "current findings indicate that community transmission of monkeypox is widespread and is disproportionately affecting gay, bisexual, and other men who have sex with men; this is consistent with data reported from other countries."
It noted that although the largest proportion of cases have occurred in white persons, Black and Hispanic persons, who represent 34 percent of the general population, accounted for more than one half (54 percent) of confirmed monkeypox cases.
As of Monday, the United States had the world's most number of confirmed cases of monkeypox, which stood at 8,934. It is likely that the figure is a severe undercount because of the lack of testing.
The Biden administration has started shipping monkeypox tests to commercial laboratories, in a bid to speed diagnoses for suspected infections of the virus
JUNE 3: In the UK there have been 190 confirmed cases in recent weeks.
Infections are usually mild and the risk to the general population is low, but the UK government has bought stocks of smallpox vaccine to guard against monkeypox.
How common is monkeypox?
Monkeypox is caused by the monkeypox virus, a member of the same family of viruses as smallpox, although it is much less severe and experts say chances of infection are low.
It occurs mostly in remote parts of central and west African countries, near tropical rainforests.
There are two main strains of virus - west African and central African - and it's the milder one from west Africa which is now circulating in other regions of the world.
The unusually high numbers of people infected with monkeypox outside of Africa with no travel links to the region, means the virus is now spreading in the community.
The UK Health Security Agency says anyone concerned they could be infected should phone NHS 111 or contact their local sexual health clinic, but call or email ahead of a visit.
It is also advising those infected not to have sex while they have symptoms and use condoms for eight weeks after an infection, as a precaution.
What are the symptoms?
Initial symptoms include fever, headaches, swellings, back pain, aching muscles.
Once the fever breaks a rash can develop, often beginning on the face, then spreading to other parts of the body, most commonly the palms of the hands and soles of the feet.
The rash, which can be extremely itchy or painful, changes and goes through different stages before finally forming a scab, which later falls off. The lesions can cause scarring.
The infection usually clears up on its own and lasts between 14 and 21 days.
How do you catch it?
Monkeypox can be spread when someone is in close contact with an infected person. The virus can enter the body through broken skin, the respiratory tract or through the eyes, nose or mouth.
It has not previously been described as a sexually transmitted infection, but it can be passed on by close contact.
New guidance is advising anyone with the virus to abstain from sex while they have symptoms.
While there is currently no available evidence that monkeypox can be spread in sexual fluids, people confirmed to have the virus are advised to use condoms for eight weeks after infection as a precaution.
It can also be spread by contact with infected animals such as monkeys, rats and squirrels, or by virus-contaminated objects, such as bedding and clothing.
How dangerous is it?
Most cases of the virus are mild, sometimes resembling chickenpox, and clear up on their own within a few weeks.
Monkeypox can sometimes be more severe, however, and has been reported to have caused deaths in west Africa.
Are gay men at greater risk?
Although some of the cases have been seen in gay and bisexual men, anyone who comes into close contact with someone who has monkeypox could potentially get the virus.
The UK Health Security Agency has said "a notable proportion" of the recent cases in the UK and Europe have been found in gay and bisexual men "so we are particularly encouraging them to be alert to the symptoms and seek help if concerned".
How common are outbreaks?
The virus was first identified in a captive monkey and since 1970 there have been sporadic outbreaks reported across 10 African countries.
In 2003 there was an outbreak in the US, the first time it had been seen outside Africa. Patients caught the disease from close contact with prairie dogs that had been infected by small mammals imported into the country. A total of 81 cases were reported, but none resulted in deaths.
In 2017, Nigeria experienced the largest known outbreak. There were 172 suspected cases and 75% of victims were men between 21 and 40 years old.
What is the treatment?
Outbreaks can be controlled by infection prevention.
Vaccination against smallpox has been proven to be 85% effective in preventing monkeypox.
The UK has bought doses of the smallpox vaccine, but it is not clear how many jabs might be given.
Antiviral drugs may also help.
Should the public be concerned?
Experts say we are not on the brink of a national outbreak and, according to the UK Health Security Agency (UKHSA), the risk is low.
Prof Jonathan Ball, professor of molecular virology, University of Nottingham, said: "The fact that only one of the 50 contacts of the initial monkeypox-infected patient has been infected shows how poorly infectious the virus is.
"It is wrong to think that we are on the brink of a nationwide outbreak."
UKHSA is following up those who have had close contact with patients to offer advice and to monitor them.
With inputs from BBC
Monkeypox can be contained in countries outside of Africa where the virus is not usually detected, the World Health Organization (WHO) says.
MAY 24: More than 100 cases of the virus - which causes a rash and a fever - have been confirmed in Europe, the Americas and Australia.
That number is expected to rise still, but experts say the overall risk to the broader population is very low.
The virus is most common in remote parts of Central and West Africa.
"This is a containable situation," the WHO's emerging disease lead Maria Van Kerkhove said at a news conference on Monday.
"We want to stop human-to-human transmission. We can do this in the non-endemic countries," she added - referring to recent cases in Europe and North America.
The virus has now been detected in 16 countries outside Africa.
Despite being the largest outbreak outside of Africa in 50 years, monkeypox does not spread easily between people and experts say the threat is not comparable to the coronavirus pandemic.
"Transmission is really happening from skin-to-skin contact, most of the people who have been identified have more of a mild disease," Ms Van Kerkhove said.
Another WHO official added that there was no evidence the monkeypox virus had mutated, following earlier speculation over the cause of the current outbreak.
Viruses in this group "tend not to mutate and they tend to be fairly stable", said Rosamund Lewis, who heads the WHO's smallpox secretariat.
Meanwhile, a top EU health official has warned that some groups of people may be more at risk than others.
"For the broader population, the likelihood of spread is very low," said Dr Andrea Ammon of the European Centre for Disease Prevention and Control.
"However the likelihood of further spread of the virus through close contact for example during sexual activities amongst persons with multiple sexual partners is considered to be high".
Monkeypox has not previously been described as a sexually transmitted infection, but it can be passed on by direct contact during sex.
Dr Ammon suggested that countries should review the availability of the smallpox vaccine which is also effective against monkeypox.
In the UK, which has now recorded 57 cases, authorities are advising anyone who has had close contact with a confirmed case to isolate for 21 days.
A person is considered at high risk of having caught the infection if they have had household or sexual contact with someone with monkeypox, or have changed the bedding of an infected person without wearing personal protective equipment (PPE).
Symptoms, which include a high temperature, aches, and a rash of raised spots that later turn into blisters, are typically mild and for most people clear up within two to four weeks.
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