United Nations/Geneva: As of May 13 and as of June 2, a total of 780 laboratory-confirmed cases of monkeypox have been reported or identified in 27 countries in four WHO regions not endemic to monkeypox virus, the World Health Organization said.
The UN health agency said that while epidemiological investigations are ongoing, most of the reported cases to date have been submitted through sexual health or other health services in primary or secondary health care facilities and primarily, but not exclusively, involve men who have sex with men (MSM).
Although the West African clade of the virus has so far been identified from case samples, most confirmed cases with travel history reported travel to countries in Europe and North America, rather than to West or Central Africa where the monkeypox virus is endemic.
The confirmation of monkeypox in individuals who have not traveled to an endemic area is atypical, and even one case of monkeypox in a non-endemic country is considered an outbreak. While most cases are not associated with travel from endemic areas, member states are also reporting small numbers of cases from travelers from Nigeria, as previously observed, it said on Sunday.
Endemic countries with monkeypox include Cameroon, the Central African Republic, the Democratic Republic of the Congo, Gabon, Ghana (identified in animals only), Ivory Coast, Liberia, Nigeria, the Republic of the Congo, and Sierra Leone. Benin and South Sudan have documented imports in the past. Countries currently reporting cases of the West African clade include Cameroon and Nigeria, the WHO said.
The sudden and unexpected appearance of monkeypox in several non-endemic countries at the same time suggests that there may have been an undetected transmission for an unknown length of time, followed by recent enhancer events.
The WHO rates the risk at a global level as moderate, as this is the first time many cases and clusters of monkeypox have been reported simultaneously in non-endemic and endemic countries in widely divergent WHO geographic areas.
The WHO said it continues to receive updates on the situation in endemic countries. As of June 2, 780 laboratory-confirmed cases were reported to WHO under International Health Regulations (IHR) or identified by WHO from official public sources in 27 non-endemic countries in four WHO regions. This represents an increase of 523 laboratory-confirmed cases (+203%) since the Disease Outbreak News of May 29, when a total of 257 cases were reported.
As of June 2, there have been no deaths related to the current monkeypox outbreak in non-endemic countries, but cases and deaths are still being reported from endemic countries.
While the studies are ongoing, preliminary data from polymerase chain reaction (PCR) assays indicate that the monkeypox virus strains detected in Europe and other non-endemic areas belong to the West African clade.
Most cases were reported by the WHO European Region (20 countries). Confirmed cases have also been reported from the Americas, Eastern Mediterranean and Western Pacific region.
In addition to cases reported from or identified in non-endemic countries, WHO continues to receive updates on the status of ongoing monkeypox outbreaks in endemic countries in the African region through well-established Integrated Disease Surveillance and Response (monitoring) mechanisms. From January to June 1, 2022, 1,408 suspected and 44 confirmed cases, including 66 deaths, were reported from seven endemic countries.
The WHO said it continues to support the sharing of information about this monkeypox outbreak. At WHO and in many Member States, the response to clinical and public health incidents has been activated to coordinate comprehensive case findings, contact tracing, laboratory investigations, clinical management, isolation and implementation of infection and prevention and control measures.
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